What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?
What are the Evidence Based Public Health Interventions for Prevention and Control of NCDs in Relation to India?
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DOI：
10.4103/0970-0218.94705
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发表时间：
2011-12
期刊：
影响因子：
--
通讯作者：
Prabhakaran D
中科院分区：
文献类型：
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作者：
Singh K;Reddy KS;Prabhakaran D
印度非传染性疾病(NCDs)疫情的加速蔓延要求采取全面的公共卫生应对措施，在它们达到峰值并造成无法负担的卫生、经济和社会代价之前，有效地抗击和控制它们。综合和提出关于几种类型的公共卫生干预措施对减轻非传染性疾病负担的有效性的最新证据。通过政策、公共教育或两者结合影响行为风险因素(如不健康饮食、缺乏运动、吸烟和饮酒)的干预措施已被证明在降低人群和个人的非传染性疾病风险方面有效。政策干预也有效地降低了与非传染性疾病有关的几个主要生物风险因素(高血压、超重和肥胖、糖尿病和血胆固醇异常)的水平。按照联合用药和确保循证临床护理的路线进行二级预防也是至关重要的。尽管促进健康和一级预防的证据较弱，但政策干预和二级预防与这些相结合，很可能对减轻国家非传染性疾病负担产生更大影响。对非传染性疾病控制和预防的全面和综合应对需要一种“生命过程方法”。需要将经证明具有成本效益的干预措施纳入非传染性疾病预防和控制政策框架，并通过监管、环境改善、教育和卫生保健应对等协调机制加以实施。
The accelerating epidemics of noncommunicable diseases (NCDs) in India call for a comprehensive public health response which can effectively combat and control them before they peak and inflict severe damage in terms of unaffordable health, economic, and social costs. To synthesize and present recent evidences regarding the effectiveness of several types of public health interventions to reduce NCD burden. Interventions influencing behavioral risk factors (like unhealthy diet, physical inactivity, tobacco and alcohol consumption) through policy, public education, or a combination of both have been demonstrated to be effective in reducing the NCD risk in populations as well as in individuals. Policy interventions are also effective in reducing the levels of several major biological risk factors linked to NCDs (high blood pressure; overweight and obesity; diabetes and abnormal blood cholesterol). Secondary prevention along the lines of combination pills and ensuring evidenced based clinical care are also critical. Though the evidence for health promotion and primary prevention are weaker, policy interventions and secondary prevention when combined with these are likely to have a greater impact on reducing national NCD burden. A comprehensive and integrated response to NCDs control and prevention needs a “life course approach.” Proven cost-effective interventions need to be integrated in a NCD prevention and control policy framework and implemented through coordinated mechanisms of regulation, environment modification, education, and health care responses.