Community-based health promotion interventions to reduce risk factors of non-communicable diseases among adolescent and young adults in low-and middle-income countries: A systematic review and meta-analysis

Objective: To systematically review the effectiveness of community-based health promotion interventions in reducing risk factors for non-communicable diseases (NCDs) among adolescents and young adults in low- and middle-income countries (LMICs). Study design: Systematic review and meta-analysis. Methods: A systematic review followed a registered protocol (PROSPERO 2022 CRD42022369054). A comprehensive search was performed across the databases, including Cochrane Library, PubMed, and ScienceDirect, resulting in 6,523 studies, of which 18 articles met the inclusion criteria. Studies were selected based on rigorous eligibility criteria, focusing on community-based interventions targeting modifiable risk factors for NCDs among individuals aged 10-30 years. Data extraction and quality assessment were independently performed by two reviewers, with results synthesised according to PRISMA guidelines. Results: The review included studies on a variety of interventions, with outcomes indicating no reduction in smoking prevalence and increased fruit intake in intervention groups compared to controls. Legislative measures and community engagement were particularly effective in reducing smoking rates in some studies, while other outcomes showed improvements in physical activity, dietary habits, and psychological well-being. The interventions demonstrated high feasibility, reach, and acceptance, suggesting potential for scalability. However, mixed results for risk factor reduction highlight the need for tailored approaches. Conclusion: The effectiveness of community-based interventions in reducing NCD risk factors among adolescents and young adults in low- and middle-income countries (LMICs) remains uncertain, as outcomes differ across various demographics and types of interventions. Future research should prioritise long-term impacts, sustainable intervention models, and context-specific strategies, as well as cost-effectiveness, to improve the effectiveness of health promotion efforts.