Effectiveness of Educational Interventions on Adolescent Knowledge and Practices for Preventing Noncommunicable Diseases in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Abstract

Noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, and cancers are major global health concerns, disproportionately impacting low- and middle-income countries (LMICs). Adolescents in LMICs are particularly vulnerable due to urbanization, lifestyle changes, and limited preventive care access. This study evaluates the effectiveness of educational interventions in improving adolescents' knowledge, and behaviors, for NCD prevention in LMICs. The systematic review and meta-analysis followed patient, intervention, comparison, outcome and preferred reporting items for systematic reviews and meta-analyses guidelines, targeting studies involving adolescents aged 10-19 who received educational interventions for NCD prevention. A comprehensive search across 5 databases identified 22 eligible studies. Study quality was assessed using the Cochrane risk-of-bias tool, and statistical analyses were conducted in R, with effect sizes expressed as risk ratios and mean differences, calculated with 95% confidence intervals (CIs). Educational interventions significantly improved knowledge about the health benefits of fruit consumption (mean difference: 0.52; 95% CI: 0.31-0.74; p < .001) and awareness of the harms of deep-fried foods (mean difference: 0.60; 95% CI: 0.43-0.76; p < .001). Interventions also reduced screen time (mean difference: 534.09 minutes; 95% CI: 345.39-722.80). However, changes in body mass index (mean difference: 0.04; 95% CI: -0.02 to 0.11; p = .193) and waist circumference (mean difference: 0.06; 95% CI: -0.33 to 0.45; p = .778) were not statistically significant. Multisession interventions involving parents and teachers showed greater improvements in physical fitness, dietary habits, and quality of life. Single-session interventions were effective mainly when involving parents. Educational interventions improve knowledge and reduce screen time among adolescents, laying a foundation for healthier behaviors. However, achieving sustained behavior change requires targeted strategies beyond education alone. Future programs should incorporate skill-building, follow-up, family or community involvement to support adolescents in adopting and maintaining healthy habits. Comprehensive, multicomponent interventions are essential for fostering long-term lifestyle changes and reducing NCD risk among adolescents in LMICs.