|Isfahan Healthy Heart Program: A comprehensive integrated community-based program for cardiovascular disease prevention and control Click here to download full-text document|
Isfahan Healthy Heart Program (IHHP) is a 5-6 year comprehensive integrated community-based program for cardiovascular diseases (CVD) prevention and control via reducing CVD risk factors and improvement of cardiovascular healthy behavior in the target population. IHHP started late in 1999 and will be finished in 2005-2006.
A primary survey was conducted to collect baseline data from communities in the provinces of intervention (Isfahan and Najafabad) and reference (Arak). Using a two-stage sampling method, we randomly selected 5-10 percent of households from randomly selected clusters. Then individuals aged above 19 years were selected to enter the survey.
Data from 12,600 individuals (6300 in provinces of intervention and 6300 in the reference province) were collected and stratified according to the subjects' living area (urban vs. rural) and different age and sex groups. The samples underwent a 30-minute interview to complete validated questionnaires containing questions on demographic and socioeconomic status, smoking behavior, physical activity, nutritional habits and other healthy behaviors in the CVD context. Blood pressure and body mass index (BMI) measurements were conducted and fasting blood samples were taken to measure 2hpp, serum cholesterol (total, HDL and LDL) and triglyceride levels.
Twelve-lead electrocardiography was performed for all subjects aged above 35 years. Community-wide surveillance of deaths and hospital discharges, as well as myocardial infarction and stroke registry were conducted in intervention and control areas. Interventions are conducted in intervention areas for 4-5 years, through mass media, forging community partnerships, involving the health system, and influencing policies and legislation. Arak, however, is followed without intervention.
The interventions were planned in view of baseline surveys, required assessments, plan objectives, existing resources and feasibility of implementation at the national level. They were adjusted according to specific target groups and venues, such as school children, women, work sites, health personnel, and high-risk individuals. Community leaders were actively engaged in decision making. A number of teams were formed for planning and implementation of the intervention strategies. Monitoring will be conducted on small samples to assess the effect of different interventions in the intervention area. While four periodic surveys will be conducted on independent samples to assess health behaviors related to CVD risk factors in the intervention and reference areas, the original pre-intervention samples aged more than 35 years will be followed in both areas to assess the effect of individual interventions, and outcomes like sudden death, fatal and non-fatal MI and stroke. The entire baseline survey will be repeated on the original and independent samples in both communities at the end of the study.
Community based, Epidemiological studies, Methodology, Cardiovascular disease, Interventional studies, Tobacco control, Healthy diet, Physical activity