期刊论文详细信息
BMC Cardiovascular Disorders
Effectiveness of community-based comprehensive healthy lifestyle promotion on cardiovascular disease risk factors in a rural Vietnamese population: a quasi-experimental study
Peter Byass2  Ruth Bonita1  Stig Wall2  Lars Weinehall2  Viet Lan Nguyen3  Son Thai Pham2  Quang Ngoc Nguyen2 
[1] School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, 1142, New Zealand;Umeå Centre for Global Health Research, Umeå University, Umeå, 90187, Sweden;Vietnam National Heart Institute, Bach Mai Hospital, 78 Giai-Phong Avenue, Dong-Da District, Hanoi, 10000, Vietnam
关键词: Vietnam;    Quasi-experimental study;    Hypertension management;    Community-based intervention;    Healthy lifestyle promotion;    Cardiovascular disease risk factors;   
Others  :  1084707
DOI  :  10.1186/1471-2261-12-56
 received in 2012-03-20, accepted in 2012-07-12,  发布年份 2012
PDF
【 摘 要 】

Background

Health promotion is a key component for primary prevention of cardiovascular disease (CVD). This study evaluated the impact of healthy lifestyle promotion campaigns on CVD risk factors (CVDRF) in the general population in the context of a community-based programme on hypertension management.

Methods

A quasi-experimental intervention study was carried out in two rural communes of Vietnam from 2006 to 2009. In the intervention commune, a hypertensive-targeted management programme integrated with a community-targeted health promotion was initiated, while no new programme, apart from conventional healthcare services, was provided in the reference commune. Health promotion campaigns focused on smoking cessation, reducing alcohol consumption, encouraging physical activity and reducing salty diets. Repeated cross-sectional surveys in local adult population aged 25 years and over were undertaken to assess changes in blood pressure (BP) and behavioural CVDRFs (smoking, alcohol consumption, physical inactivity and salty diet) in both communes before and after the 3-year intervention.

Results

Overall 4,650 adults above 25 years old were surveyed, in four randomly independent samples covering both communes at baseline and after the 3-year intervention. Although physical inactivity and obesity increased over time in the intervention commune, there was a significant reduction in systolic and diastolic BP (3.3 and 4.7 mmHg in women versus 3.0 and 4.6 mmHg in men respectively) in the general population at the intervention commune. Health promotion reduced levels of salty diets but had insignificant impact on the prevalence of daily smoking or heavy alcohol consumption.

Conclusion

Community-targeted healthy lifestyle promotion can significantly improve some CVDRFs in the general population in a rural area over a relatively short time span. Limited effects on a context-bound CVDRF like smoking suggested that higher intensity of intervention, a supportive environment or a gender approach are required to maximize the effectiveness and maintain the sustainability of the health intervention.

【 授权许可】

   
2012 Nguyen et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150113163728948.pdf 357KB PDF download
Figure 3. 60KB Image download
Figure 2. 38KB Image download
Figure 1. 87KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】
  • [1]Nguyen TTN, Tran KL, Bui ML, Vos T, Ngo DA, Nguyen TH: Vietnam Burden of Disease and Injury Study 2008. Hanoi. Vietnam: Medical Publishing House; 2011.
  • [2]Martiniuk AL, Lee CM, Lawes CM, Ueshima H, Suh I, Lam TH, Gu D, Feigin V, Jamrozik K, Ohkubo T, et al.: Hypertension: its prevalence and population-attributable fraction for mortality from cardiovascular disease in the Asia-Pacific region. J Hypertens 2007, 25(1):73-79.
  • [3]Gu D, Gupta A, Muntner P, Hu S, Duan X, Chen J, Reynolds RF, Whelton PK, He J: Prevalence of cardiovascular disease risk factor clustering among the adult population of China: results from the International Collaborative Study of Cardiovascular Disease in Asia (InterAsia). Circulation 2005, 112(5):658-665.
  • [4]Nguyen NQ, Pham TS, Do DL, Nguyen LV, Wall S, Weinehall L, Bonita R, Byass P: Cardiovascular disease rik factor pattern and their implications for intervention strategies in Vietnam. Int J Hypertens 2012.
  • [5]Jackson R, Lawes CM, Bennett DA, Milne RJ, Rodgers A: Treatment with drugs to lower blood pressure and blood cholesterol based on an individual's absolute cardiovascular risk. Lancet 2005, 365(9457):434-441.
  • [6]Son PT, Quang NN, Viet NL, Khai PG, Wall S, Weinehall L, Bonita R, Byass P: Prevalence, awareness, treatment and control of hypertension in Vietnam-results from a national survey. J Hum Hypertens 2011.
  • [7]Nguyen QN, Pham ST, Nguyen VL, Wall S, Weinehall L, Bonita R, Byass P: Implementing a hypertension management programme in a rural area: local approaches and experiences from Ba-Vi district. Vietnam. BMC Public Health 2011, 11:325. BioMed Central Full Text
  • [8]Global Physical Activity Surveillance. http://www.who.int/chp/steps/GPAQ/en/index.html webcite
  • [9]Inoue SZP, Caterson I, Chen C, Ikeda Y, Khalid AK, Kim YS, Bassett J: TheAsia-Pacific Perspective: Redefining Obesity and Its Treatment: Health Communications Australia Pty Limited. 2000.
  • [10]Ng N, Hakimi M, Van Minh H, Juvekar S, Razzaque A, Ashraf A, Masud Ahmed S, Kanungsukkasem U, Soonthornthada K, Huu Bich T: Prevalence of physical inactivity in nine rural INDEPTH Health and Demographic Surveillance Systems in five Asian countries. Global Health Action 2009, 2:44-53.
  • [11]Nguyen NQ, Pham TS, Nguyen LV, Weinehall L, Bonita R, Byass P, Wall S: Time trends in blood pressure, body mass index and smoking in the Vietnamese population: a meta-analysis from multiple cross-sectional surveys. PLoS One 2012.
  • [12]Razzaque A, Nahar L, Van Minh H, Ng N, Juvekar S, Ashraf A, Ahmed SM, Soonthornthada K, Kanungsukkasem U, Huu Bich T: Social factors and overweight: evidence from nine Asian INDEPTH Network sites. Global Health Action 2009, 2:54-59.
  • [13]Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, et al.: National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet 2011, 377(9765):557-567.
  • [14]Ashraf A, Quaiyum MA, Ng N, Van Minh H, Razzaque A, Masud Ahmed S, Hadi A, Juvekar S, Kanungsukkasem U, Soonthornthada K, et al.: Self-reported use of tobacco products in nine rural INDEPTH Health and Demographic Surveillance Systems in Asia. Global Health Action 2009, 2:19-27.
  • [15]Ng N, Weinehall L, Ohman A: 'If I don't smoke, I'm not a real man'–Indonesian teenage boys' views about smoking. Health Educ Res 2007, 22(6):794-804.
  • [16]Donny EC, Caggiula AR, Weaver MT, Levin ME, Sved AF: The reinforcement-enhancing effects of nicotine: implications for the relationship between smoking, eating and weight. Physiol Behav 2011, 104(1):143-148.
  • [17]Secker-Walker RH, Gnich W, Platt S, Lancaster T: Community interventions for reducing smoking among adults. Cochrane Database System Review 2002, 3:CD001745.
  • [18]Moher M, Hey K, Lancaster T: Workplace interventions for smoking cessation. Cochrane Database System Review 2005, 2:CD003440.
  • [19]Lindholm L, Rosen M: What is the "golden standard" for assessing population-based interventions?–problems of dilution bias. J Epidemiol Community Health 2000, 54(8):617-622.
  • [20]Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM: Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension 2003, 42(5):878-884.
  • [21]Ebrahim S, Taylor F, Ward K, Beswick A, Burke M, Davey Smith G: Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database System Review 2011, 1:CD001561.
  • [22]Nissinen A, Berrios X, Puska P: Community-based noncommunicable disease interventions: lessons from developed countries for developing ones. Bull World Health Organ 2001, 79(10):963-970.
  • [23]Dowse GK, Gareeboo H, Alberti KG, Zimmet P, Tuomilehto J, Purran A, Fareed D, Chitson P, Collins VR: Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of the non-communicable disease intervention programme in Mauritius, Mauritius Non-communicable Disease Study Group. BMJ 1995, 311(7015):1255-1259.
  • [24]Tian HG, Guo ZY, Hu G, Yu SJ, Sun W, Pietinen P, Nissinen A: Changes in sodium intake and blood pressure in a community-based intervention project in China. J Hum Hypertens 1995, 9(12):959-968.
  • [25]Kelishadi R, Sarrafzadegan N, Sadri GH, Pashmi R, Mohammadifard N, Tavasoli AA, Amani A, Rabiei K, Khosravi A, Bahonar A: Short-term results of a community-based program on promoting healthy lifestyle for prevention and control of chronic diseases in a developing country setting: Isfahan Healthy Heart Program. Asia Pac J Public Health 2011, 23(4):518-533.
  • [26]Khosravi A, Mehr GK, Kelishadi R, Shirani S, Gharipour M, Tavassoli A, Noori F, Sarrafzadegan N: The impact of a 6-year comprehensive community trial on the awareness, treatment and control rates of hypertension in Iran: experiences from the Isfahan healthy heart program. BMC Cardiovasc Disord 2010, 10:61. BioMed Central Full Text
  • [27]Bovet P, Gervasoni JP, Ross AG, Mkamba M, Mtasiwa DM, Lengeler C, Burnier M, Paccaud F: Assessing the prevalence of hypertension in populations: are we doing it right? J Hypertens 2003, 21(3):509-517.
  • [28]Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D: Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. Lancet 2010, 376(9754):1775-1784.
  • [29]Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, Baugh V, Bekedam H, Billo N, Casswell S, et al.: Priority actions for the non-communicable disease crisis. Lancet 2011, 377(9775):1438-1447.
  • [30]Chiuve SE, Rexrode KM, Spiegelman D, Logroscino G, Manson JE, Rimm EB: Primary prevention of stroke by healthy lifestyle. Circulation 2008, 118(9):947-954.
  • [31]Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, Giles WH, Capewell S: Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Eng J Med 2007, 356(23):2388-2398.
  • [32]Ha DA, Chisholm D: Cost-effectiveness analysis of interventions to prevent cardiovascular disease in Vietnam. Health Policy Plan 2011, 26(3):210-222.
  • [33]Nishtar S: Prevention of coronary heart disease in south Asia. Lancet 2002, 360(9338):1015-1018.
  文献评价指标  
  下载次数:35次 浏览次数:13次