Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience
Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience
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DOI：
10.2143/ac.58.4.2005288
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发表时间：
2003-08-01
影响因子：
1.6
通讯作者：
Yousefie, A
中科院分区：
文献类型：
--
作者：
Sarraf-Zadegan, N;Sadri, G;Yousefie, A
伊斯法罕健康心脏方案是一项为期五至六年的综合性社区方案，通过减少心血管疾病风险因素和改善目标人群的心血管健康行为来预防和控制心血管疾病。IHHP于1999年底开始，将于2005 - 2006年完成。进行了初步调查，以收集干预社区（伊斯法罕和纳杰夫-阿巴德）和参考社区（阿拉克）的基线数据。在两阶段抽样方法中，我们从随机选择的集群中随机选择了5%到10%的家庭。然后选择年龄大于或等于19岁的个体进行调查。通过这种方式，收集了12，600人（干预县6300人，参考县6300人）的数据，并根据生活区域（城市与农村）以及不同的年龄和性别群体进行分层。样本进行了30分钟的访谈，以完成有效的问卷调查，其中包括人口统计学，社会经济地位，吸烟行为，体育活动，营养习惯和其他有关CVD的行为。进行血压和体重指数（BMI）测量，并在负荷后两小时采集空腹血液样品，血浆葡萄糖（2 hpp）、血清（总、HDL和LDL）胆固醇和甘油三酯水平。所有35岁以上的人都记录了12导联心电图。在干预区和对照区开展了全社区范围的死亡、出院、心肌梗死和中风登记监测，在干预区开始了为期4至5年的基于不同类别的干预，如大众媒体、社区伙伴关系、卫生系统参与以及政策和立法，而阿拉克将在不干预的情况下进行随访。考虑到基线调查的结果。（需要进行的评估、目标、现有资源和国家执行的可能性）对干预措施进行了规划。这些方案是根据具体目标群体制定的，如学童、妇女、工作场所、保健人员、高风险人员，社区领导人积极参与决策。一系列的团队被安排来规划和实施干预策略。将对小样本进行监测，以评估干预地区不同干预措施的效果。虽然将对独立样本进行四次定期调查，以评估与干预和参考领域的心血管疾病风险因素相关的健康行为，但将在这两个领域对年龄超过35岁的原始干预前受试者进行随访，以评估干预措施的个体效果和结果，如猝死，致命和非致命性MI和中风。在研究结束时，将对两个社区的原始样本和独立样本重复进行整个基线调查。
The Isfahan Healthy Heart Programme (IHHP) is a five to six year comprehensive integrated community-based programme for cardiovascular diseases (CVD) prevention and control via reducing CVD risk factors and improvement of cardiovascular healthy behaviour in a target population. IHHP started late in 1999 and will be finished in 2005-2006.A primary survey was done to collect baseline data from interventional (Isfahan and Najaf-Abad) and reference (Arak) communities. In a two-stage sampling method, we randomly selected 5 to 10 percent of households from randomly selected clusters. Then individuals aged greater than or equal to19 years were selected for the survey. This way, data from 12,600 individuals (6300 in interventional counties and 6300 in the reference county) was collected and stratified according to living area (urban vs. rural) and different age and sex groups. The samples underwent a 30-minute interview to complete validated questionnaires containing questions on demography, socioeconomic status, smoking behaviour, physical activity, nutritional habits and other behaviour regarding CVD. Blood pressure and body mass index (BMI) measurements were done and fasting blood samples were taken for two hours post load plasma glucose (2 hpp), serum (total, HDL and LDL) cholesterol and triglyceride levels. A twelve-lead electrocardiogram was recorded in all persons above 35 years of age. Community-wide surveillance of deaths, hospital discharges, myocardial infarction and stroke registry was carried out in the intervention and control areas.Four to five years of interventions based on different categories such as mass media, community partnerships, health system involvement and policy and legislation have started in the intervention area while Arak will be followed without intervention. Considering the results of the baseline surveys. (assessments needed, the objectives, existing resources and the possibility of national implementation) the interventions were planned. They were set based on specific target groups like school children, women, work-site, health personnel, high-risk persons, and community leaders were actively engaged as decision makers. A series of teams was arranged for planning and implementation of the intervention strategies. Monitoring will be done on small samples to assess the effect of different interventions in the intervention area. While four periodic surveys will be conducted on independent samples to assess health behaviours related to CVD risk factors in the intervention and reference areas, the original pre-intervention subjects aged more than 35 years will be followed in both areas to assess the individual effect of interventions and outcomes like sudden death, fatal and nonfatal MI and stroke. The whole baseline survey will be repeated on the original and an independent sample in both communities at the end of the study.