A community intervention for behaviour modification: an experience to control cardiovascular diseases in Yogyakarta, Indonesia

BMC Public Health

Lars Weinehall⁴  Ann Öhman²  V Utari Marlinawati⁵  Hans Stenlund³  Fatwa Sari Tetra Dewi¹ 

[1] Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden;Umeå Centre for Gender Studies, Umeå University, Umeå, Sweden;Umeå Center for Global Health Research, Umeå University, Umeå, Sweden;Ageing and Living Conditions, CPS, Umeå University, Umeå, Sweden;Center for Health and Nutrition Research Laboratory, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia

关键词: Primary prevention;    Community-empowerment;    Community-based intervention;    CVD prevention;   

Others  :  1161583
DOI  :  10.1186/1471-2458-13-1043

 received in 2012-10-17, accepted in 2013-10-28,  发布年份 2013

【 摘 要 】

Background

Non-communicable Disease (NCD) is increasingly burdening developing countries including Indonesia. However only a few intervention studies on NCD control in developing countries are reported. This study aims to report experiences from the development of a community-based pilot intervention to prevent cardiovascular disease (CVD), as initial part of a future extended PRORIVA program (Program to Reduce Cardiovascular Disease Risk Factors in Yogyakarta, Indonesia) in an urban area within Jogjakarta, Indonesia.

Methods

The study is quasi-experimental and based on a mixed design involving both quantitative and qualitative methods. Four communities were selected as intervention areas and one community was selected as a referent area. A community-empowerment approach was utilized to motivate community to develop health promotion activities. Data on knowledge and attitudes with regard to CVD risk factors, smoking, physical inactivity, and fruit and vegetable were collected using the WHO STEPwise questionnaire. 980 people in the intervention areas and 151 people in the referent area participated in the pre-test. In the post-test 883 respondents were re-measured from the intervention areas and 144 respondents from the referent area. The qualitative data were collected using written meeting records (80), facilitator reports (5), free-listing (112) and in-depth interviews (4). Those data were analysed to contribute a deeper understanding of how the population perceived the intervention.

Results

Frequency and participation rates of activities were higher in the low socioeconomic status (SES) communities than in the high SES communities (40 and 13 activities respectively). The proportion of having high knowledge increased significantly from 56% to 70% among men in the intervention communities. The qualitative study shows that respondents thought PRORIVA improved their awareness of CVD and encouraged them to experiment healthier behaviours. PRORIVA was perceived as a useful program and was expected for the continuation. Citizens of low SES communities thought PRORIVA was a “cheerful” program.

Conclusion

A community-empowerment approach can encourage community participation which in turn may improve the citizen’s knowledge of the danger impact of CVD. Thus, a bottom-up approach may improve citizens’ acceptance of a program, and be a feasible way to prevent and control CVD in urban communities within a low income country.

【 授权许可】

   
2013 Tetra Dewi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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