Resumen
Objetivo: Buscar en la literatura métodos y estrategias eficaces para combatir la obesidad infantil en el contexto de la atención primaria. Métodos: Revisión integrativa de la literatura con un enfoque sistemático, realizada mediante búsquedas en las bases de datos Scielo, PubMed y BVS. Se aplicaron los descriptores (Primary Health Care) AND (Pediatric obesity). Se incluyeron estudios controlados aleatorios (ECA), ensayos clínicos aleatorizados por conglomerados y ensayos híbridos, entre 2019 y 2024, en inglés y disponibles en texto completo. Se excluyeron estudios que no cumplían con los criterios de inclusión. Resultados: Se identificaron 2.988 estudios, de los cuales, se seleccionaron 21 artículos para componer esta revisión. Se identificó que el uso de la tecnología es una estrategia para combatir la obesidad infantil, mediante aplicaciones educativas con orientaciones sobre dieta y ejercicio físico. Además, los programas educativos centrados en la familia resultaron en una mayor eficacia, con mejoras duraderas en la salud de los niños y en la dinámica familiar. Otro aspecto analizado fue la influencia del agente comunitario, cuyo desarrollo de proyectos de educación en salud promovió un mayor compromiso de la población. Consideraciones finales: La atención primaria de salud es un pilar fundamental en la lucha contra la obesidad infantil.
Referencias
ALEXANDROU C, et al. Effectiveness of a Smartphone App (MINISTOP 2.0) integrated in primary child health care to promote healthy diet and physical activity behaviors and prevent obesity in preschool-aged children: randomized controlled trial. The international journal of behavioral nutrition and physical activity, 2023; 20(1): 22.
EK A, et al. A Parent Treatment Program for Preschoolers With Obesity: A Randomized Controlled Trial. Pediatrics, 2019; 144: 2.
EPSTEIN LH, et al. Family-based behavioral treatment for childhood obesity implemented in pediatric primary care: A randomized clinical trial. JAMA: the journal of the American Medical Association, 2023; 329(22): 1947-1956.
FOSTER BA, et al. Growing healthy together: A randomized clinical trial using parent mentors for early childhood obesity in low-income, Latino families. Childhood obesity, 2021; 18(3): 168-177.
HAMPL SE, et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics, 2023; 151(2).
HEERMAN WJ, et al. Competency-Based Approaches to Community Health: A Randomized Controlled Trial to Reduce Childhood Obesity among Latino Preschool-Aged Children. Child Obesity, 2019; 15(8): 519-531.
LIU Z, et al. Effectiveness of a multifaceted intervention for prevention of obesity in primary school children in China: A cluster randomized clinical trial. JAMA pediatrics, 2022; 176(1).
LUQUE V, et al. Impact of the motivational interviewing for childhood obesity treatment: The Obemat2.0 randomized clinical trial. Pediatric obesity, 2024; 19(7).
MESSITO MJ, et al. Prenatal and Pediatric Primary Care-Based Child Obesity Prevention Program: A Randomized Trial. Pediatrics, 2020; 146(4).
NATALE R, et al. Cluster-randomised trial of the impact of an obesity prevention intervention on childcare centre nutrition and physical activity environment over 2 years. Public health nutrition, 2021; 25(11): 3172–3181.
OMS. ORGANIZAÇÃO MUNDIAL DA SAÚDE. Obesity and overweight. [S.l.]: WHO, 2023. Disponível em: https ://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Acessado em: 11 de novembro de 2024.
OMS. ORGANIZAÇÃO MUNDIAL DA SAÚDE. Diretrizes sobre manejo da obesidade infantil na atenção primária. Genebra: OMS, 2022. Disponível em: https ://www.who.int/publications. Acessado em: 11 de novembro de 2024.
PARRA-SOLANO A, et al. Reducing the number of times eating out helps to decrease adiposity (overweight/obesity) in children. Nutrients, 2024; 16(17).
RAYNOR HA, et al. Reach of a low-intensity, multicomponent childhood overweight and obesity intervention delivered in an integrated primary care setting. Translational Behavioral Medicine, 2020; 10(3): 760-769.
RESNICOW K, et al. Outcome of BMI2+: Motivational interviewing to Reduce BMI through primary care AAP PROS practices. Pediatrics, 2024; 153(2).
SACHER PM, et al. Addressing childhood obesity in low-income, ethnically diverse families: outcomes and peer effects of MEND 7-13 when delivered at scale in US communities. International Journal of Obesity, 2019; 43(1): 91-102.
SIMIONE M, et al. Family-centeredness of childhood obesity interventions: psychometrics & outcomes of the family-centered care assessment tool. Health and Quality of Life Outcomes, 2020; 18(1): 179.
SMITH JD, et al. Health behaviour outcomes of a family based intervention for paediatric obesity in primary care: A randomized type II hybrid effectiveness-implementation trial. Pediatric Obesity, 2021; 16(9).
STARK LJ, et al. Maintenance Following a Randomized Trial of a Clinic and Home-based Behavioral Intervention of Obesity in Preschoolers. Journal of Pediatrics, 2019; 213: 128-136.
TUCKER JM, et al. Evaluation of a Primary Care Weight Management Program in Children Aged 2⁻5 years: Changes in Feeding Practices, Health Behaviors, and Body Mass Index. Nutrients, 2019; 11(3): 498.
TUCKER K, et al. Results from La Vida Buena (The Good Life): A quasi-experimental intervention of a community health worker-led family-based childhood obesity program for Latino children 5-8 years of age on the U.s.-Mexico border. Health promotion practice, 2022; 24(6):1196–1205.
WARD DS, et al. Keys to healthy family child care homes: Results from a cluster randomized trial. Preventive Medicine, 2020; 132.
YUN YJ, et al. Association of dietary habits with general and abdominal obesity in Korean children and adolescents: cluster analysis of nationwide population survey data. Frontiers in endocrinology, 2024; 15.
ZHANG E, et al. Validation of remote anthropometric measurements in a rural randomized pediatric clinical trial in primary care settings. Scientific reports, 2024; 14(1): 411.
