School-Based Interventions Targeting Double Burden of Malnutrition and Educational Outcomes of Adolescents in Low- and Middle-Income Countries: Protocol for a Systematic Review

2020 ◽  
Author(s):  
Sachin Shinde ◽  
Dongqing Wang ◽  
Wafaie W Fawzi
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Educational Outcomes ◽  
Controlled Trials ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
School Based ◽  
School Based Interventions

Abstract BackgroundAdolescence is a period of rapid physical growth and transition between childhood to adulthood. However, in many developing countries, nutritional and epidemiological transitions are contributing to surging overnutrition, which, together with prevalent undernutrition, is resulting in the double burden of malnutrition (DBM) among adolescents. Schools as social systems have tremendous but mostly underutilized capacity to facilitate change and address a range of nutritional and associated educational concerns of adolescents and young people. The main objective of this systematic review will be to synthesize the evidence on school-based nutrition interventions that aimed to address the DBM, and the associated educational outcomes among adolescents from low- and middle-income countries (LMICs).MethodsComprehensive literature searches will be conducted in multiple electronic databases, including the Medline (through PubMed), Embase, CENTRAL (through Cochrane Library), CINAHL, and Google Scholar. We will include randomized controlled trials (RCTs), controlled before-after studies, and non-randomized controlled trials examining the effects of nutrition interventions on DBM and educational outcomes among adolescents (10−19−years−old) in LMICs. Two reviewers will independently screen all citations and full-text articles and abstract data. The quality of the included studies will be assessed with the Cochrane Collaboration’s tool for assessing the risk of bias for RCTs and the Risk Of Bias In Non-randomized Studies of Interventions tool for controlled before-after studies and non-randomized controlled trials. DiscussionTo maximize the power of schools as a platform to reinforce the mutually beneficial relationship between adolescent nutrition and education, it is imperative to develop and implement integrated interventions connecting schools, adolescents, parents, communities, and the health care system. The results of this systematic review will provide a comprehensive state of current knowledge on the effectiveness of school-based interventions to enable future research that maximizes the impact and efficiency of integrated approaches to tackle multiple forms of malnutrition among school-going and out-of-school adolescents.Systematic review registrationPROSPERO ID: 211109 (under review)

scholarly journals School-based interventions targeting double burden of malnutrition and educational outcomes of adolescents in low- and middle-income countries: protocol for a systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Sachin Shinde ◽  
Dongqing Wang ◽  
Wafaie W Fawzi
Keyword(s):  
Systematic Review ◽  
Educational Outcomes ◽  
Multiple Forms ◽  
Double Burden ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
School Based ◽  
School Based Interventions ◽  
Double Burden Of Malnutrition

Abstract Background Adolescence is a period of rapid physical growth and transition between childhood to adulthood. However, in many developing countries, nutritional and epidemiological transitions are contributing to surging overnutrition, which, together with prevalent undernutrition, is resulting in the double burden of malnutrition (DBM) among adolescents. Schools as social systems have tremendous but mostly underutilized capacity to facilitate change and address a range of nutritional and associated educational concerns of adolescents and young people. The main objective of this systematic review will be to describe school-based interventions that address the multiple forms of malnutrition, and synthesize their effects on nutrition and educational outcomes among adolescents (10 − 19 − years − old) from low- and middle-income countries (LMICs). Methods Comprehensive literature searches will be conducted in multiple electronic databases, including Medline (through PubMed), Embase, CENTRAL (through Cochrane Library), CINAHL, and Google Scholar. We will include randomized controlled trials (RCTs), non-RCTs including controlled before-after studies, examining the effects of nutrition interventions on nutrition and educational outcomes among adolescents in LMICs. Two reviewers will independently screen all citations and full-text articles and abstract data. The quality of the included studies will be assessed with the Cochrane Collaboration’s revised tool for assessing the risk of bias for RCTs and the Risk Of Bias In Non-randomized Studies of Interventions tool for controlled before-after studies and non-randomized controlled trials. Discussion To maximize the power of schools as a platform to reinforce the mutually beneficial relationship between adolescent nutrition and education, it is imperative to develop and implement integrated interventions connecting schools, adolescents, parents, communities, and the health care system. The results of this systematic review may provide a comprehensive state of current knowledge on the effectiveness of school-based interventions to enable future research that maximizes the impact and efficiency of integrated approaches to tackle multiple forms of malnutrition among school-going and out-of-school adolescents. Systematic review registration PROSPERO ID: CRD42020211109

scholarly journals Informed consent rates for neonatal randomized controlled trials in low- and lower middle-income versus high-income countries: A systematic review

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248263
Author(s):  
Jacquelyn K. Patterson ◽  
Stuti Pant ◽  
Denise F. Jones ◽  
Syed Taha ◽  
Michael S. Jones ◽  
...  
Keyword(s):  
Systematic Review ◽  
Informed Consent ◽  
Randomized Controlled Trials ◽  
High Income ◽  
Income Country ◽  
High Income Country ◽  
Controlled Trials ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled

Objective Legal, ethical, and regulatory requirements of medical research uniformly call for informed consent. We aimed to characterize and compare consent rates for neonatal randomized controlled trials in low- and lower middle-income countries versus high-income countries, and to evaluate the influence of study characteristics on consent rates. Methods In this systematic review, we searched MEDLINE, EMBASE and Cochrane for randomized controlled trials of neonatal interventions in low- and lower middle-income countries or high-income countries published 01/01/2013 to 01/04/2018. Our primary outcome was consent rate, the proportion of eligible participants who consented amongst those approached, extracted from the article or email with the author. Using a generalised linear model for fractional dependent variables, we analysed the odds of consenting in low- and lower middle-income countries versus high-income countries across control types and interventions. Findings We screened 3523 articles, yielding 300 eligible randomized controlled trials with consent rates available for 135 low- and lower middle-income country trials and 65 high-income country trials. Median consent rates were higher for low- and lower middle-income countries (95.6%; interquartile range (IQR) 88.2–98.9) than high-income countries (82.7%; IQR 68.6–93.0; p<0.001). In adjusted regression analysis comparing low- and lower middle-income countries to high-income countries, the odds of consent for no placebo-drug/nutrition trials was 3.67 (95% Confidence Interval (CI) 1.87–7.19; p = 0.0002) and 6.40 (95%CI 3.32–12.34; p<0.0001) for placebo-drug/nutrition trials. Conclusion Neonatal randomized controlled trials in low- and lower middle-income countries report consistently higher consent rates compared to high-income country trials. Our study is limited by the overrepresentation of India among randomized controlled trials in low- and lower middle-income countries. This study raises serious concerns about the adequacy of protections for highly vulnerable populations recruited to clinical trials in low- and lower middle-income countries.

scholarly journals Effective school-based preventive interventions for alcohol use in Africa: a systematic review

2020 ◽  
Vol 20 (3) ◽  
pp. 1397-1406
Author(s):  
Sachi Tomokawa ◽  
Kimihiro Miyake ◽  
Takeshi Akiyama ◽  
Yuka Makino ◽  
Akihiro Nishio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alcohol Use ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Preventive Interventions ◽  
Effective School ◽  
Positive Effects ◽  
Randomized Controlled ◽  
School Based ◽  
School Based Interventions

Background: Despite recognition of the risks of alcohol use and importance of prevention from an early age, the effectiveness of school-based interventions in Africa has not been clarified. Objective: We aimed to identify effective school-based alcohol use prevention interventions in Africa. Methods: We searched eight databases for peer-reviewed articles published until February 3, 2019 that reported on randomized controlled trials, cluster randomized controlled trials, controlled clinical trials, pre-post quasi-experimental stud- ies, cohort studies, and case-control studies. The full-texts of relevant studies were searched. Results: Four of 2797 papers met our eligibility criteria. All reported interventions targeted secondary school students in South Africa and were incorporated in the school curriculum. The interventions comprised multi-component activities with participatory and peer educational methods, and applied modified programs originally developed in the US. However, inter- vention effects were inconsistent among studies, although the interventions tended to have a positive effect on non-drinkers at baseline, with stronger effects in girls. Conclusion: Interventions had positive effects on students that were non-drinkers at baseline, especially girls. Although we could not find robust evidence that school-based interventions changed attitudes, frequency/quantity of drinking, and intentions to use alcohol, one intervention showed an increase in students’ alcohol refusal self-efficacy. Keywords: School-based preventive interventions; alcohol use; Africa; systematic review.

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