RESUMO
ABSTRACT Objective: To identify the strategies and effects of interventions carried out by community health workers (CHW) on physical activity (PA) levels in children and adolescents. Data source: In August 2020, a systematic review, designed according to the PRISMA checklist items, was conducted by searches in seven electronic databases and in reference lists. Original studies were searched without restriction with regard to year of publication; they were written in Spanish, English or Portuguese and examined interventions implemented by CHW, involving theoretical and/or practical contents of PA, with a focus on children and/or adolescents between three and 19 years of age. Data synthesis: Of the 2,321 studies initially retrieved, eight were included, targeting samples with more specific characteristics (e.g., clinical, ethnic and/or socioeconomic). In all studies, CHW were trained to lead educational activities. In three non-controlled trials, positive results were observed, involving indicators such as moderate and vigorous PA and physical inactivity reduction. Also, two positive results were found in reducing sedentary behavior. Conclusions: Even though most of the interventions included did not have a significant effect on increasing PA levels, the available findings reinforce the role of CHW as an important strategy for dialogue between health services and the most vulnerable communities, and they suggest a greater articulation of these professionals in the actions developed in the school context.
RESUMO Objetivo: Identificar as estratégias e os efeitos de intervenções conduzidas por agentes comunitários de saúde (ACS) nos níveis de atividade física (AF) em crianças e adolescentes. Fontes de dados: Em agosto de 2020, uma revisão sistemática, delineada de acordo com os itens da lista de verificação PRISMA, foi desenvolvida por meio de buscas em sete bases de dados eletrônicas e em listas de referências. Foram procurados estudos originais, sem restrição quanto ao ano de sua publicação, escritos em espanhol, inglês e português, que desenvolveram intervenções implementadas por ACS envolvendo conteúdos teóricos e/ou práticas de AF com foco em crianças e/ou adolescentes na faixa entre os 3 e os 19 anos de idade. Síntese dos dados: Dos 2.321 estudos inicialmente avaliados, foram incluídos oito, direcionados a amostras com características mais específicas (clínicas, étnicas e/ou socioeconômicas). Em todos os estudos, ACS receberam treinamento prévio para a condução de atividades educativas. Em três ensaios não controlados foram observados resultados positivos envolvendo indicadores de AF moderadas, vigorosas e redução da inatividade física. Complementarmente, dois resultados positivos foram encontrados na redução do comportamento sedentário. Conclusões: Mesmo que a maior parte das intervenções incluídas não tenha apresentado efeitos significativos no aumento dos níveis de AF, a evidência disponível reforça o papel dos ACS como uma importante estratégia de diálogo entre os serviços de saúde e as comunidades mais vulneráveis e sugere maior articulação desses profissionais nas ações desenvolvidas no contexto escolar.
RESUMO
OBJECTIVE: To identify the strategies and effects of interventions carried out by community health workers (CHW) on physical activity (PA) levels in children and adolescents. DATA SOURCE: In August 2020, a systematic review, designed according to the PRISMA checklist items, was conducted by searches in seven electronic databases and in reference lists. Original studies were searched without restriction with regard to year of publication; they were written in Spanish, English or Portuguese and examined interventions implemented by CHW, involving theoretical and/or practical contents of PA, with a focus on children and/or adolescents between three and 19 years of age. DATA SYNTHESIS: Of the 2,321 studies initially retrieved, eight were included, targeting samples with more specific characteristics (e.g., clinical, ethnic and/or socioeconomic). In all studies, CHW were trained to lead educational activities. In three non-controlled trials, positive results were observed, involving indicators such as moderate and vigorous PA and physical inactivity reduction. Also, two positive results were found in reducing sedentary behavior. CONCLUSIONS: Even though most of the interventions included did not have a significant effect on increasing PA levels, the available findings reinforce the role of CHW as an important strategy for dialogue between health services and the most vulnerable communities, and they suggest a greater articulation of these professionals in the actions developed in the school context.
