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IHHP projects

Healthy Food for Healthy Community (HFHC)

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In view of the importance of eating habits and their role in prevention and control of cardiovascular disease (CVD) risk factors, the following measures have been taken within HFHC:

- Setting up healthy food stalls to serve healthy food in restaurants, sandwich stands, pizzerias, etc.
- Providing training on healthy cooking to kitchen staff of factories and offices
- Improving non-industrial food production methods to make healthier products, such as high-fiber low-salt bread, high-fiber low-fat low-sugar sweets, and low-fat dairies
- Enforcing Healthy Food for Healthy Heart policies, including:
-Encouraging the food industries to produce food with healthy processing for CVD patients, diabetics and hypertensive individuals
-Encouraging hydrogenated oil factories to produce low-trans fatty acid products
-Making arrangements for the sale of healthy food products in cultural centers and entertainment resorts
-Enforcing mandatory labeling regulation for food products
- Increasing public awareness of the importance of making healthy food choices and paying attention to food labels
- Publication and distribution of the book entitled “Healthy Cooking for Healthy Heart”
- Arranging contests entitled “Opt for Healthy Food to Have a Healthy Heart”
- Airing on the local television network of a program entitled “Healthy Cooking for Healthy Heart”.

In view of the importance of food habits in the society and their role in prevention and control of cardiovascular disease risk factors, the following activities were performed within the Health Food for Health Community Project (HFHC) of Isfahan Healthy Heart Program (IHHP):

- Improving the preparation and distribution of food in restaurants, sandwich sellers, pizzerias, etc.
- Training the kitchen staffs of factories, offices and organizations which serve food to their own personnel. Offering suitable strategies for production of healthy food products, such as low-salt high-fiber bread, low-fat low-sugar candy and confections, and low-fat dairy product
- Formulating healthy food strategies for a healthy community, including:
1Encouraging the food industries to produce healthy food products in an effort to prevent cardiovascular diseases in the community, especially cardiovascular, diabetic, and hypertensive patients
2Encouraging hydrogenated oil factories to produce oil with lower saturated and trans fatty acids
3Establishing facilities for supply of health food products in the community
4Cooperating with the Commerce Organization to increase coupon-based distribution of liquid oil

- Improving the labeling of food products in a way that is informative to the public, and increasing public awareness of food labels
- Publication and distribution of educational materials, including a book entitled Healthy Cooking for a Healthy Heart, a multimedia CD entitled A Table for My Heart, and other educational brochures and leaflets
- Production and broadcast of television programs, including a series entitled Healthy Cooking for a Healthy Heart

Interventions performed through legislative strategies in business associations:
- Issuing of guidelines to the restaurant owners'' association, cafeterias and confectionaries to observe healthy cooking procedures
- Issuing of guidelines by the restaurant owners'' association to restaurants to observe healthy cooking procedures
- Developing a checklist to institutionalize the evaluation of business associations by the supervisory system of Isfahan Health Center

Issued guidelines
From: Head of Restaurant Owners'' Association
To: All restaurant owners
Subject: Improvement of cooking procedures in restaurants, increasing consumption of vegetables, reducing consumption of saturated fats and stopping the use of trans fatty acids if possible, adding the choice of yoghurt drink to existing beverages, adding the choice of half-servings to menus, and reducing the consumption of fatty dressings such as mayonnaise.

Guidelines issued by the director of the City Health Center
To: Head of Isfahan Restaurant Owners'' Association
Subject: Improvement of cooking procedures in restaurants, increasing consumption of vegetables, reducing consumption of saturated fats and stopping the use of trans fatty acids if possible, adding the choice of yoghurt drink to existing beverages, adding the choice of half-servings to menus, and reducing the consumption of fatty dressings such as mayonnaise.

To: Head of Isfahan Pizzerias Association
Subject: Improvement of pizza ingredients, increasing vegetables, reducing consumption of pizza cheese, salt, boloney and sausage, and adding the choice of yoghurt drink as a substitute to high-sugar drinks

To: Head of Food Suppliers and Cafeterias Association
Subject: Improving the ingredients used in preparing sandwiches, offering more vegetables, using frying oil and adding the choice of yoghurt drink

To: Head of Isfahan Confectioners and ''Gaz'' (pistachio-based Iranian candy) Producers Association
Subject: Improving baking procedures, using oils with lower trans and saturated fatty acids, reducing sugar content of products

Guidelines issued by the director of Isfahan Province Health Center
To: Heads of Health Centers 1 and 2 of Isfahan and Najafabad
Subject: a) Completing evaluation checklists by environmental health inspectors of the cities of Isfahan and Najafabad, for restaurants, pizzerias, confectionaries and cafeterias to monitor the implementation of the strategies of the Healthy Food for Healthy Community Project, b) Completing quarterly inspection forms to be presented to the Provincial Health Center based on the above checklist

Guidelines issued by the Vice-Chancellery for Treatment of Isfahan University of Medical Sciences
To: City hospital directors
Subject: Implementation of healthy nutrition guidelines concerned with reduction of saturated fatty acids and stopping the use of trans fatty acids if possible, improving cooking procedures in Isfahan hospitals

Food behaviors were determined using a 48-hour food frequency questionnaire. The results are indicative of implementation of strategies regarding the use of oils, fruit and vegetables.
Assessments performed before the study, and annually performed during the implementation of interventions, and comparison of results with those from the reference community showed that consumption (times per week) of liquid oil has increased from 3.5±2.5 to 7.4±4.7 in the intervention communities, and from 3.4±1.7 to 2.2±3.9 in the reference community, which demonstrates a significant increase in the intervention communities compared to reference (P<0.05).
Consumption of hydrogenated oil and hard margarine decreased from 6.8±3.4 to 5.3±4.1 in the intervention communities, and from 10.6±4.6 to 8.8±5.6 in the reference community, which demonstrates a significant decrease in the intervention communities compared to reference (P<0.05).
Consumption of fruit and vegetables (times per week) increased from 1.7±0.9 to 2±1.6 in the intervention communities and from 2.4±1.6 to 1.9±1.3 in the reference community, which demonstrates a significant increase in the intervention communities compared to reference (P<0.05).
Also, the trend of consumption of fish showed a significantly greater increase in the intervention community (P<0.05)

Integrating the interventions of the Healthy Food for Healthy Community Project (HFHCP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Improving cooking procedures towards healthy cooking methods at restaurants, cafeterias, and pizzerias
2. Leading the initiative for establishment of bakeries that make whole-wheat low-salt bread (the so-called Healthy Bread)
3. Advocating the production of the so-called Healthy Food Products by factories active in food processing industries
4. Modifying food labels and encouraging the public to use them
5. Educating the public on the concept of healthy nutrition

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
6. Improving the formulations and cooking procedures used in confectionaries to produce the so-called Healthy Candy and Confections
7. Leading the initiative for introduction and establishment of the so-called Healthy Brands in restaurants, cafeterias, pizzerias, etc.
8. Introduction of half-portions into restaurant menus

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:-

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Isfahan Exercise and Air Pollution Control Project (IEAPCP)

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Physical activity plays a major role in cardiovascular disease (CVD) prevention and control; the community should be provided with necessary training and encouraged to exercise at workplace. Stay-at-home women and low-income families must not be overlooked. Based on the results of our previous studies, 85% of the population of Isfahan has inadequate physical activity.

Activities
- Educating the society on the benefits of physical activity
- Proposing equivalent physical activities for stay-at-home women who cannot exercise outdoors
- Modifying the behavioral and social patterns to encourage physical activity
- Facilitating exercise in the community and creating appropriate exercise environments for different age groups
- Advocating the implementation of compulsory exercise hours at workplace and schools
- Encouraging bicycling and walking in place of motor vehicles in city trips
- Regularly organizing Automobile-Free days and IHHP exhibitions
- Organizing sports campaigns for women, men, children, adolescents and youth

Integrating the interventions of the Isfahan Exercise and Air Pollution Control Project (IEAPCP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Providing training on exercise and physical activity through the local television network
2. Authoring and distribution of a CD on home exercise for women, exercise at workplace, and on long trips
3. Organizing exercise rallies

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
4. Organizing no-automobile days and healthy heart exhibitions
5. Providing education on air pollution control methods through the local television network

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
6. Advocating the development of bicycle lanes in the city
7. Providing training on physical education and air pollution control methods by use of educational aids

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Heart Health Promotion from Childhood (HHPCP)

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Given the importance of preventing cardiovascular diseases (CVD) and their associated risk factors such as hyperlipidemia, obesity and physical inactivity from early life, this intervention was designed to improve the lifestyle of Iranian children and adolescents.

Target group: Children and adolescents (up to 18 years old), parents, school staff
Some of the interventions are as follows:
- Education with pamphlets, booklets and face-to-face meetings
- Designating role models among school children
- Organizing sports and painting competitions with health heart themes
- Serving healthy snacks
- Establishing healthy heart buffets
- Reinforcing healthy eating habits
- Increasing exercise hours in schools, etc.

Organizations cooperating with HHPC include the Provincial Education Administration, the Welfare Association, and Kindergartens.

Integrating the interventions of the Heart Health Promotion from Childhood Project (HHPCP) into the health system

Summary
The Heart Health Promotion from Childhood Project targets children and adolescents below the age of eighteen. The children and adolescents are categorized into two relatively separate groups, namely preschool and school-age groups, in terms of their receptiveness to education, and venues where target groups can be reached. Hence the interventions of this project, in spite of methodological similarity, are performed on two main target groups, resulting in multiplicity of interventions by using population and high-risk approaches.

a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:

Population approach
1. Training school staff, school health instructors, kindergarten staff and child health professionals about healthy lifestyle from early life
2. Training children of different age groups in schools and kindergartens
3. Training the parents of children in schools and kindergartens, as well as the parents presenting to Mother and Child Health Units and vaccination centers
4. Promotion of exercise and physical activity in schools and kindergartens
5. Introduction of healthy snacks into schools
6. Providing a uniform menu of healthy snacks for children in kindergartens
7. Providing practical training through special television programs about healthy lifestyle and primary prevention of chronic diseases

High-risk approach
1. Training the nurses working at the cardiology wards and coronary care units of hospitals about prevention of cardiovascular diseases in children of high-risk families
2. Training the families of patients who have suffered premature myocardial infarction about prevention of cardiovascular diseases in children
3. Establishment of risk clinics for: a) under-18 children of patients with premature myocardial infarction or stroke, b) children and adolescents with cardiovascular risk factors
4. Screening for cardiovascular disease risk factors in: a) under-18 children of patients with premature myocardial infarction or stroke, b) children and adolescents with cardiovascular risk factors

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:-

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:-

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Youth Intervention Project (YIP)

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The relatively large population of youth in the Iranian society, the escalating trend of cardiovascular disease (CVD) risk factors, especially smoking, and the lowering onset age of CVD warrants greater attention to this important segment of the Iranian population. The Youth Intervention Project has been designed to modify the Iranian youngsters'' lifestyle.

Target group: Youth aged 19-25.
The main objective of this intervention is to improve the knowledge, attitude and practice of young people about prevention and control of CVD risk factors. Some of the interventions are as follows:
- Face-to-face training, education by lectures, posters and pamphlets.
- Presenting an improved lifestyle that appeals to the younger age groups (healthy eating, effective exercise, non-smoking, and stress management techniques)
- Carrying out intervention in venues frequented by youth (universities, sports clubs and gyms, garrisons, etc.)

Integrating the interventions of the Youth Intervention Project (YIP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Training volunteers from the local Red Crescent Organization about prevention and control of non-communicable diseases and lifestyle modification
2. Training young male soldiers in their mandatory military service, as well as other garrison personnel about prevention and control of non-communicable diseases and lifestyle modification
3. Implementing the international antismoking Quit and Win Campaign to promote the non-smoking culture among youth

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
4. Training students of universities and Teacher Training Centers about prevention and control of non-communicable diseases and lifestyle modification
5. Enforcing no-smoking regulations in teahouses and coffee shops

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
6. Using educational aids to train youth about prevention and control of non-communicable diseases

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Women Healthy Heart Project (WHHP)

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Women make up almost half of the Iranian society and play major roles in the family. They have an undeniable influence on nutrition and family education. The Women Health Heart Project has been designed with special regard to the importance of preventing CVD risk factors in this group.

Some of the interventions are:
- Improving women’s knowledge, attitude and practice towards CVD and their risk factors, prevention and control
- Providing training on healthy cooking
- Presenting workable models for physical activity at home
- Training women on CVD symptoms and ways of approaching cardiac patients
- Explaining cardiopulmonary resuscitation (CPR) in simple words
- Educating women on healthy lifestyle for children and other family members

Integrating the interventions of the Women Healthy Heart Project (WHHP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Training young women attending pre-marriage educational sessions
2. Training instructors of the Literacy Campaign Movement and their students
3. Training the women who seek the services of health centers or health houses
4. Training female volunteer-instructors of the Red Crescent Society
5. Educating the public through television programs and cook books
6. Authoring and distributing a CD about methods of physical activity requiring no special facilities for women

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
7. Training the instructors of Imam Khomeini Relief Committee, a major Iranian charity
8. Training the instructors of women's Basij Movement
9. Training the instructors of different organizations, including theology students, members of the Women's Commission of Isfahan Province Governorate, and culture centers

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:-

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Worksite Intervention Project (WIP)

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Project colleagues
-Dr. Gholam-Hossin Sadri, Director, Isfahan Province Health Center
-Mohammad-Bagher Reza-Ali, B.S of Health education, Isfahan Health Center No.1
-Azadeh Moazami, B.S of Health education, Isfahan Health Center No.2
-Jalil Jalali, B.S of Professional Health, Isfahan Health Center No.1
-Shahla Taheri, B.S of Professional Health, Isfahan Health Center No.2
-Iraj Dorosti, B.S of Professional Health, Najaf-Abad Health Center
-Mansoureh Boshtam, Expert, Education and Monitoring Unit of Isfahan Cardiovascular Research Center
-Mohammad-Reza Chami, B.S of Health education, Najaf-Abad Health Center
-Dr. Katayoon Rabiei, M.D, Head of Rehabilitation Unit of Isfahan Cardiovascular Research Center
-Firouzeh Sajadi, B.S of Nutrition, Isfahan Cardiovascular Research Center
-Dr. Hamid-Reza Roohafza, MD, Head of Mental Health Unit of Isfahan Cardiovascular Research Center
-Shahryar Masood, M.S of Health Education, Isfahan Province Health Center
-Prof. Nizal Sarraf-Zadegan, Director, Isfahan Cardiovascular Research Center

Goal
Promoting the health status of workers, administrative staff, and other employees of business associations in the cities of Isfahan and Najaf-Abad

Objectives
- Improving the knowledge, attitude and practice of workers, administrative staff and other employees of business associations in the cities of Isfahan and Najaf-Abad about CVD risk factors
- Encouraging the consumption of healthy food in offices and factories
- Decreasing cigarette smoking in offices and factories
- Detection and management of hypertension and obesity in employees of offices and factories
- Decreasing other CVD risk factors in employees of offices and factories

Strategies
- Training employees of business associations about CVD risk factors
- Encouraging consumption of healthy food in the restaurants of offices and factories
- Advocating the enforcement of non-smoking regulations in buildings of offices and factories
- Offering smoking cessation assistance to willing employees
- Promoting physical activity among employees of offices and factories
- Designing a screening system for hypertension and obesity in the employees of offices and factories
- Designing a screening system for other CVD risk factors in the employees of offices and factories

Target Groups
- Workers and administrative personnel of factories
- Employees of business associations

Activities
- Preparing educational materials (booklets, etc.)
- Collective training of employees on CVD risk factors and healthy lifestyle by using a specifically-designed module (i.e. booklet)
- Individual training of employees using booklets, posters, pamphlets, and newsletters
- Collective training of kitchen staff on healthy cooking methods
- Collective training of employees on doing stretching exercises at workplace
- Modifying food menus of restaurants to improve the types and quantities of food ingredients
- Substituting unhealthy food ingredients with healthy ones (such as hydrogenated oil with liquid and frying oils, high-sugar fizzy drinks with yoghurt drink (yogurt diluted with water) and diet drinks
- Substituting usual bread with whole wheat bread
- Adding salad, vegetables and fruits to food menus
- Decreasing some food ingredients (such as salt and fat)
- Encouraging morning exercise at workplace
- Advocating the enforcement of no-smoking regulations in buildings
- Referring willing employees to the Smoking Cessation Unit of Isfahan Cardiovascular Research Center
- Annual measurement of height, weight, waist and hip circumference in all employees
- Annual measurement of blood lipids and sugar of employees

Cooperating Organizations
1.Yam Company
2.Smoking Company
3.Iran Spiral Company
4.Sepahan Profil Company
5.Mobarez Company
6.Dorj Company
7.Coffee Cola Company
8.Khoiei Cake Company
9.Ale Kood Company
10.Sarayesh Company
11.Ahan & Foolad Company
12.Isfahan Keleed
13.Aail-nam Company
14.Isfahan Maryam Company
15.Kasra Mooket
16.Chodan Sazan Company
17.Sepahan Shargh Lastik-Sazan Company
18.Water and Sewage Company
19.Negahban-Gaz Company
20.Behshidan Company
21.Naz Vegetable Oil Company
22.Isfahan Botoun Development & Housing Company
23.Saheb-Al-Zaman Engineering Group, Sepah Land Force
24.Steel Fadaran Company
25.Pars Pakook Company
26.Sepahan Rosoub Company
27.Isfahan Kelid Company
28.Zarif Ghateh Company
29.Farkhondeh Bisquite Productive Company
30.Dadras'' Atash Company
31.Isfahan Sugar Company
32.Kasra Spinning Company
33.Zayandeh-Rood Aalinam Company
34.Sepahan Company
35.Jazeh Ghaem-Baft Spinning Company
36.Pars Electricity Transformation Company
37.Deputy of Isfahan Electricity Exploitation
38.Abar Koohpayeh Company
39.Farman Khodroo Company
40.Isfahan Registration Organization
41.Isfahan Islamic Advertisement Organization
42.Isfahan Imam Khomeini Relief Committee
43.Isfahan Provincial Gas Company
44.Economic and Finance Org (Financial Affairs)
45.Eastern-Isfahan Area Electricity Distribution Company
46.Northern-Isfahan Area Electricity Distribution Company
47.Isfahan Post Office
48.Isfahan Area No.4 Municipality
49.Isfahan Area No.7 Municipality
50.Isfahan Area No.3 Municipality
51.Khorasgan Municipality.
52.Isfahan Area No.2 Education Office
53.Isfahan Area No.4 Education Office
54.Jey Area Education Office
55.Deputy of Culture, Isfahan Municipality
56.Isfahan Broadcasting Organization
57.Exclusive Bus Company
58.Isfahan Communication Organization
59.Isfahan Cultural Inheritance Organization
60.Isfahan Shahid-Beheshti International Airport
61.Isfahan Disciplinary Force Public Health
62.Isfahan Provincial Environmental Protection Org
63.Isfahan Provincial Office of Culture and Islamic Guidance
64.Isfahan Area No.10 Municipality
65.Isfahan Red Crescent Society
66.Islamic Advertisements
67.Jahade keshavarzi Organization
68.Veterinary
69.Association of Union-Distribution Affairs
70.Commercial Organization
71.Maskan Organization
72.Artillery Bank
73.Artillery Training Center
74.Custom House
75.Engineering Research Center

Future Strategies and Activities
- Individual training of employees of business associations using pamphlets
- Advocating the endorsement by provincial authorities of a directive requiring all offices to carry out the interventions
- Carrying out health promotion programs for drivers, passengers and employees of Isfahan bus terminals, employees of Mobarakeh Steel Industries Complex, Isfahan, and employees of Isfahan Steel Company

Evaluation
This project is being evaluated to assess the changes accomplished by the interventions, adjust strategies and activities, and to design an interventional model suited for offices and factories.

Stages of evaluation:
- Preparing questionnaires for evaluation of the structure and trend of strategies
- Completing questionnaires before starting the interventions
- Completing questionnaires every 6 months during the implementation of the project
- Completing questionnaires at the end of the project
- Data analysis
- Making the necessary modifications and adjustments

Integrating the interventions of the Worksite Intervention Project (WIP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Training industrial medicine physicians or assistants who would in turn train other factory workers
2. Introducing nutritional modifications at restaurants of factories and offices which serve at least one meal a day to their personnel
3. Enforcing no-smoking regulations in workplace in accordance with existing directives and rules
4. Training health volunteers of offices who would in turn train other workers of offices and organizations
5. Using the existing screening system for detecting cardiovascular disease risk factors to identify high-risk workers

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
6. Increasing physical activity and exercise at workplace

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
7. Training and screening of workers of banks and other offices where regular group education programs cannot be organized
8. Training members of various business associations and small industrial workshops

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Health Professionals Education Project (HPEP)

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This project has been planned to improve the knowledge, attitude and practice (KAP) of health professionals towards CVD and stroke risk factors. The target group is divided into three subgroups based on level of education and type of work:
- Physicians including cardiologists, internists and general physicians,
- Health professionals including health experts, health workers, primary health care providers, etc.
- Clinical staff including nurses, etc.

The following strategies were adopted to improve knowledge, attitude and practice (KAP) towards CVD control and prevention:
- Organizing continuing medical education sessions on CVD and stroke risk factors for each of the mentioned groups
- Providing training on how to use algorithms and guidelines for CVD risk factors, as well as control, diagnosis and treatment of CVD
- Organizing training seminars and workshops, especially for health workers on standard methods of blood pressure measurement, etc.
- Cooperating with physicians in health centers and supervising the activities of healthcare providers at these centers
- Developing local guidelines for management of hypertension, hypercholesterolemia and secondary prevention of coronary heart disease

Integrating the interventions of the Health Professionals Education Project (HPEP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Establishment of educational groups consisting of physicians and health and treatment personnel
2. Training general practitioners by holding continuing medical education courses (CME) oriented towards prevention and control of non-communicable diseases, in cooperation with the Center for Management of Studies and Medical Development of Isfahan University of Medical Sciences
3. Training internists, cardiologists and neurologists through periodical seminars of Isfahan Province of Internists Association
4. Publishing books aimed at promoting the knowledge, attitude and practice of primary healthcare providers (Behvarz) and health workers towards prevention and control of non-communicable diseases and their associated risk factors, as well as improving the lifestyle of healthy individuals and patients in the community
5. Publishing a book to increase the knowledge of nurses towards prevention and control of non-communicable diseases and their associated risk factors
6. Holding regular educational seminars for nurses
7. Organizing regular educational programs targeting primary healthcare providers and health workers
8. Publishing the newsletter: 'Nursing Today'
9. Compiling a CD-based software program containing educational and health messages to be played back by telephone switching units of hospitals, health centers and offices
10. Running information campaigns on various occasions, including the World Hypertension Day, World Heart Day, and the World Smoking Cessation Day

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
11. Authoring and distribution of the 'Healthy Heart Newsletter' to educate the community

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
12. Authoring and publishing a self-education book with CME points, targeting physicians

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Non-governmental organizations (NGOs) and volunteers (NGOV)

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The importance of forging community partnerships for promoting primary health care and involving the public in CVD prevention programs cannot be sufficiently emphasized. Among the most effective ways of promoting CVD prevention is to educate the public on CVD risk factors. Hence, the cooperation of health volunteers, non-government organizations (NGOs), and health volunteers working to promote health at the community level is essential to success of interventions.

The objectives of this project are as follows:

- Improving knowledge, attitude and practice of health volunteers and NGOs towards prevention of CVD risk factors and lifestyle improvement
- Establishing links between health volunteers and the NGOs and the community to promote risk factor prevention and lifestyle improvement

Integrating the interventions of the Non-governmental Organizations and Volunteers Project (NGOVP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Training health workers and volunteers in cities and villages who would in turn train the public
2. Forming and training an assembly of health volunteers who would train other health volunteers
3. Empowerment of health volunteers to increase the knowledge, attitude and practice of the public towards non-communicable diseases
4. Training the health volunteers on ways of performing exercise and maintaining physical activity in the absence of special facilities

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:-

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:-

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

Healthy Lifestyle for High-Risk groups (HLHR)

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Two-thirds of Iranians have at least one CVD risk factor. CVD risk factor prevention and control is essential to success of efforts aimed at reducing CVD-related morbidity and mortality. This project aims to decrease CVD events in high-risk patients such as smokers and diabetics, as well as hypertensive, hyperlipidemic and obese individuals. The designed interventional strategies are two-fold, namely training, and care and surveillance.
Target population: Families of CVD patients

Intervention venues:
- Hospitals
- Other centers for treatment
- Health centers
- Physicians'' offices
- Laboratories

Integrating the interventions of Healthy Lifestyle for High-Risk groups Project (HLHRP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Training the personnel of the health and treatment system, including physicians and pharmacists on non-communicable disease risk factors and prevention of disease in high-risk individuals
2. Training the individuals at risk of cardiovascular diseases, including hypertensive patients, diabetics, the elderly, and cigarette smokers, at general and specialist clinics
3. Providing public training about prevention and control of cardiovascular diseases and identification of high-risk individuals
4. Training retired employees through their respective business associations
5. Establishment and activation of clinics at different hospitals in Isfahan and Najafabad for high-risk individuals

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
6. Distributing educational brochures to individuals presenting to pharmacies and laboratories
7. Printing health messages about control and prevention of non-communicable diseases on laboratory report sheets
8. Follow-up and implementation of the system for registering the indicators for evaluation of high-risk individuals in the community at hospitals and health and treatment centers

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:-

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system: -

Healthy Lifestyle for Cardiovascular Patients (HLCP)

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The comprehensive program for secondary prevention of CVD includes lifestyle modification, control of risk factors such as hypercholesterolemia, hypertension and diabetes, as well as drug treatment to decrease the rate of morbidity and mortality and to improve the patients’ quality of life.

The main objectives are:
- To decrease CVD-related morbidity and mortality
- To promote the knowledge, attitude and practice of patients about CVD and their associated risk factors
- To promote the knowledge, attitude and practice of the patients'' families about CVD and their associated risk factors

Strategies and activities:
- Training patients during their stay at hospitals (hospital rehabilitation)
- Training patients and their families at the time of discharge from hospital
- Developing private and governmental rehabilitation services and facilities (simple and advanced) in hospitals and other centers for treatment
- Recording all patient information
- Training patients and their families after discharge from hospital
- Extending health insurance coverage to include secondary prevention services

Integrating the interventions of the Healthy Lifestyle for Cardiovascular Patients Project (HLCP) into the health system

Summary
a) Interventional activities that have been completely integrated into the health systems of the cities of Isfahan and Najafabad and can be integrated into the national health system:
1. Training of nurses by forming educational assemblies; the nurses in turn pass on the training to the patients
2. Training of patients and their families at the time of discharge by general practitioners and trained nurses
3. Printing cards for patients for recording all necessary information related to their disease condition

b) Interventional activities that were partially integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
4. Establishing rehabilitation units at all heart hospitals with cardiology departments to be used by patients
5. Improving nutrition-related and cooking procedures at hospital restaurants
6. Distributing the so-called educational folders containing educational materials on cardiovascular disease secondary prevention and rehabilitation, to increase the knowledge of patients, their families and the health personnel about simplified rehabilitation at centers for health and treatment services

c) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad but can be integrated into the national health system:
7. Performing simplified rehabilitation at health centers to improve patient health
8. Commissioning a system of recording and retrieving cardiovascular patients' data on electronic cards

d) Interventional activities that were not integrated into the health systems of the cities of Isfahan and Najafabad and cannot be integrated into the national health system:-

►Click HERE to view the list of IHHP project managers.