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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Immunization Essentials a practical Field Guide

USAID USAID (2004) CC

This guide provides a comprehensive overview of essential information related to immunization, including technical information about vaccines, a review of immunization program management best practices, guidance on the delivery of immunization services, monitoring and evaluation, disease surveillanc... more

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Sources And Prices Of Selected Medicines for Children
recommended

Unicef, WHO (2010) C_WHO

Including Therapeutic Food, Dietary Vitamin and Mineral Supplementation - 2nd edition

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Prevention and Control of Noncommunicable Diseases: Guidelines for Primary Health Care in Low-Resource Settings
recommended

S. Bahendeka, S.Colagiuri, S. Mendis, et al. WHO (2012) C_WHO

Cancer, diabetes, heart disease and stroke, chronic respiratory disease

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Essential Competencies for Basic Midwifery Practice

International Confederation of Midwives (2010)

Undernutrition: What works?

Manuel Sanchez-Montero and Núria Salse Ubach ACF International Network (2011)

A review of policy and practice; zero Hunger Phase 1

Recommendations for management of common childhood conditions
recommended

World Health Organization (2012)

Evidence for technical update of pocket book recommendations. Newborn conditions, dysentery, pneumonia, oxygen use and delivery, common causes of fever, severe acute malnutrition and supportive care

Guidelines for the Integrated Management of Severe Acute Malnutrition

ACF International (2011)

In-and Out-Patient Treatment

Born to Soon. Presentation

Joy Lawn Save the Children; WHO; et al. (2012)

The Global Action Report on Preterm Birth. Presentation

Operations Manual for Delivery of HIV Prevention, Care and Treatment at Primary Health Centres in High-Prevalence, Resource-Constrained Settings

World Health Organization (2008) C_WHO

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Trainee's guide for training of Medical Officers in Pregnancy Care and Management of Common Obstetric Complications

Maternal Health Division Ministry of Health & Family Welfare Government of India (2009) C1

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A Handbook for Auxiliary Nurse Midwives Lady Health Visitors & Staff Nurses

Maternal Health Division Ministry of Health and Family Welfare Government of India Maternal Health Division Ministry of Health and Family Welfare Government of India (2010) C1

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Guidelines for Management of Malaria in Zimbabwe

Ministry of Health and Child Welfare, Zimbabwe (2009) C1

DIAGNOSIS, MANAGEMENT OF UNCOMPLICATED AND SEVERE MALARIA

IMCI Chart Booklet

World Health Organization (2014)

The IMCI chart booklet is for use by doctors, nurses and other health professionals who see young infants and children less than five years old. It facilitates the use of the IMCI case management process in practice and describes a series of all the case management steps in a form of IMCI charts. ... more