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

我们建议在6个地点进行可行性研究和调查-印度2个，斯里兰卡2个，孟加拉国2个。可行性研究将在操作、研究和政策层面上进行，以了解同行指导干预措施改善心血管疾病健康的可行性。在操作层面上，我们将在孟加拉国（2）、印度（2）和斯里兰卡（2）确定6个工作地点，获得管理层的认可，确定适当的人员作为同行来执行干预措施，并确定在工作场所执行干预措施的领域（咖啡馆，体育锻炼，减压，烟草环境）。在研究层面，我们将选择最佳方法来识别有干预风险的个人，测量风险因素水平，识别和培训同伴导师，设计最合适的干预措施，确定同伴导师的培训目标，选择培训方法，开发干预工具。在政策层面，我们将与工地管理层和相关州政府部门（卫生和劳动部门）讨论，确定干预措施的必要性、方法和结果。这一战略确保我们对相关部门的干预措施以及主要股东的协议和投资有有用的见解2。将进行一项定性研究，以了解在中央和区域各级为改善每个国家工作场所的CVD环境而进行的政策层面变革的优先事项;了解工作场所最佳CVD环境的共同障碍; and to understand理解the most最acceptable接受peer同行mentor导师-我们将对每个工厂至少三个级别的管理人员进行关于工作场所CVD环境的调查。具体而言，这将包括烟草政策、工作场所的食品、体育活动的机会、工作场所提供的医疗保健（如果有的话）、员工慢性病护理政策、最佳护理的障碍以及改善心血管健康的可能干预措施。我们将在8个研究中心对每一级别的5名管理人员或每个工作场所15名管理人员进行调查，共计120人。我们将对管理人员和员工进行重点小组讨论和深入访谈，以更好地了解政策问题、心血管疾病护理的障碍以及改善心血管健康的可接受干预措施。如果同伴指导介导的干预措施被证明有效降低心血管风险因素，这些干预措施可以在全球范围内推广。由于成年人有60%的时间在工作场所，这些干预措施可以有效降低心血管风险，并通过减少心血管死亡获得丰厚的红利，从而帮助实现世界壁炉联合会的25乘25的目标。

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.