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

我们提议在6个地点进行可行性研究和调查--2个在印度，2个在斯里兰卡，2个在孟加拉国。可行性研究将在操作、研究和政策层面上了解同伴指导干预措施的可行性。在操作层面上，我们将在孟加拉国(2个)、印度(2个)和斯里兰卡(2个)确定6个工作地点，获得管理层的认可，确定适当的人员进行干预，并在工作地点确定实施干预措施的领域(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干预风险个人，测量风险因素水平，确定和培训同伴导师，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有关州政府部门(卫生和劳工部)讨论，确定干预的必要性、方法和结果。这一战略确保我们对干预措施以及关键利益相关者在相关部门的协议和投资有有用的见解。将进行一项定性研究，以了解政策层面改变的优先事项，以改善每个国家工作场所的心血管环境，在中央和地区层面；了解工作场所最佳心血管环境的共同障碍；以及了解最可接受的基于同伴导师的干预措施，以改善员工的心血管疾病健康。我们将调查每个地点至少三个级别的管理人员对工作场所的心血管环境。具体地说，这将包括烟草政策、工作场所的食品、身体活动机会、工作场所提供的医疗服务(如果有的话)、员工慢性护理政策、最佳护理的障碍以及改善简历健康的可能干预措施。我们将对每个级别的5名管理人员或每个工作地点15名管理人员进行调查，总共在8个地点进行120人的调查。我们将进行有针对性的小组讨论，并在管理人员和员工之间进行深入访谈，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。如果同伴导师中介的干预措施被证明在减少心血管风险因素方面有效，这种干预措施可以在全球范围内推广。由于成年人可以将多达60%的时间花在工作场所，这样的干预措施可能被证明在降低心血管风险方面有效，并通过减少心血管死亡而获得丰厚的红利，从而帮助实现世界炉灶联合会的目标，即25到25岁。

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.