Policy and peeR mentOr intervention proGrams on cardiovasculaR disEase at workSites in 3 South Asian countries.

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We propose a feasibility study and a survey conducted at 6 sites - 2 in India, 2 in Srilanka, and 2 in Bangladesh.1. The feasibility study will be conducted to understand the feasibility of peer-mentored interventions at the operational, research and policy levels to improve CVD health.At the operational level, we will identify 6 worksites in Bangladesh (2), India (2) and Sri Lanka (2), obtain acceptance from the management, identify the appropriate personnel as peers to carry out interventions and identify areas at worksites to implement interventions (café, physical exercise, stress reduction, tobacco environment).At research level, we will choose the best methods to identify individuals at risk for interventions, measure risk factor levels identify & train the peer mentors, design the most appropriate interventions, determine the training goals for the peer mentors, select the training methods, and develop the intervention tools. At policy level, we will, in discussion with the worksite management and the concerned State Government departments (health and labour departments) determine the need, methods and outcomes of the interventions. This strategy ensures that we have useful insights on the interventions as well as the agreement and investment of key stake-holders in relevant departments2. A qualitative study will be conducted to understand the priorities for policy level changes to improve the CVD environment at worksites in each country, at the Central and Regional levels; to understand the common barriers for an optimal CVD environment at worksites; and to understannd the most acceptable peer mentor-based interventions for employees to improve CVD health.We will survey at least three levels of management staff per site on the CVD environment at the workplace. Specifically this will include tobacco policy, food at workplace, opportunities for physical activity, medical care if any provided at worksites, policy on chronic care for employees, barriers for optimal care and possible interventions to improve CV health. We will survey 5 management staff at each level or 15 per worksite for a total of 120 at 8 sites.We will conduct focussed group discussions and in-depth interviews among management staff and employees to better understand policy issues, barriers for CVD care and acceptable interventions to improve CV health.If peer mentor mediated interventions prove to be effective in reducing cardiovascular risk factors, such interventions could be scaled up globally. As adults can spend upto 60% of their time at workplaces, interventions such as these could prove to be effective in reducing cardiovascular risks and reap rich dividends by reducing cardiovascular deaths, thus helping to achieve World Hearth Federation's goal of 25 by 25.