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.

The objective of the study is to investigate the effect of a comprehensive community trial on behavioral modification after 2 years of intervention. The interventions of this 6-year, comprehensive community-based study target the whole population, of nearly 2 180 000, living in 2 cities in Iran and are compared with another Iranian city considered as reference. Educational, environmental, and legislative interventions are being conducted at the population level. From the baseline to the second year of evaluation of this study, the consumption of hydrogenated fat decreased significantly in the intervention community, but it remained nearly constant in the reference area. Meanwhile, the consumption of liquid oil increased in the intervention community, whereas it decreased in the reference area. The prevalence of current smoking and attempt to smoke decreased, respectively, in men and youths living in the intervention area but increased or remained constant in the reference area; however, no favorable change was seen for smoking among women. Leisure time physical activity increased in women and declined in men of both communities; the slopes of these changes were greater in the intervention area. Although the consumption of salty/fat snacks slightly decreased in the school students of the intervention area, it had a sharp increase in the reference area. This program succeeded in improving some aspects of lifestyle in its different target groups. The authors suggest that the synergy of activities intensified the dose of interventions and led to this improvement.

How effective are strategies for non-communicable disease prevention and control in a high risk population in a developing country? Isfahan Healthy Heart Programme.

INTRODUCTION: The Isfahan Healthy Heart Programme (IHHP) is a community-based programme for non-communicable diseases prevention and control using both a population and high risk approach in Iran. This study demonstrated the efficacy of IHHP interventional strategies to improve lifestyle behaviours in a population at risk for developing cardiovascular diseases. MATERIAL AND METHODS: Healthy Lifestyle for NCDs High Risk Population is one of ten projects of IHHP. High risk individuals were defined as those who have at least one risk factor for developing coronary artery disease (CAD). Changes of behavioural indicators have been compared between two areas with a survey after 5 years of intervention. RESULTS: Among high risk individuals in the intervention and reference areas, 77.8% and 82.5% had at least one major risk factor for CAD. The prevalence of major risk factors for CAD (except cigarette smoking) was decreased in both intervention and reference areas during 5 years of intervention and the pattern of diet and physical activity was improved. CONCLUSIONS: Interventional activities in IHHP targeting the high risk population seem to be effective in improving lifestyle behaviour, increasing awareness and control of risk factors of the high risk population.

Determinants of tobacco use among youths in Isfahan, Iran.

OBJECTIVE: To determine potential factors that may result in motivating the youths to adopt smoking behaviour. METHOD: This cross-sectional study was conducted on 210 smoking and 217 non-smoking youths, aged 12-20 years. RESULTS: The average age of starting cigarette and water pipe smoking was 14.5 +/- 2.4 and 11.2 +/- 1.5 years, respectively. The first experience with water pipe occurred mostly in the traditional teahouses for girls (54.8%), and in family parties (48.2%) for boys. In both genders, the first place of cigarette smoking was at friends' parties (56.8% for boys, and 52.1% for girls) and then followed by traditional teahouses (43.2% for boys, and 47.9% for girls). The most common reasons youths have picked up cigarette smoking were mainly to attract attention from friends, family inattention and poverty. Meanwhile, nearly all water pipe smokers reported using it for fun. The strongest predictors of smoking among boys were respectively father's occupation, having a smoking mother, and the number of smoking peers, whereas among girls, these factors were respectively having a smoking mother, frequenting traditional teahouses, and the number of smoking peers. Lower education of fathers and divorce among parents increased the probability of smoking in both genders, especially girls. School/work failure, as well as troubled relationship with parents and siblings were the other significant predictors of smoking in both genders, notably in girls. CONCLUSION: Public health control measures should be adopted not only to curtail cigarette use, but also to address water-pipe use. Preventive measures should be regarded as a high priority for socio-economically disadvantaged families.

Cumulative prevalence of risk factors for atherosclerotic cardiovascular diseases in Iranian adolescents: IHHP-HHPC.

OBJECTIVE: To evaluate the cumulative prevalence of atherosclerotic cardiovascular disease risk factors in a representative sample of Iranian adolescents. METHODS: The subjects of this cross-sectional study were 1,000 girls and 1,000 boys, ages 11-18 years, selected by multi stage-random cluster sampling from urban and rural areas of three cities in Iran. RESULTS: The prevalence of physical inactivity, dyslipidemia, smoking, high blood pressure and obesity (body mass index >95th percentile) were 66.6, 23.7, 8.7, 5.7 and 2.2%, respectively. Of subjects studied, 79.1% had at least one and 24.6% had two cardiovascular disease risk factors. The prevalence of physical inactivity was significantly lower in boys than girls [53.9 vs. 79.3%, respectively, OR 95%CI, 0.44 (0.39-0.51)]. The prevalence of smoking was higher in boys than girls [13.1 vs. 4.2%, respectively, OR 95%CI, 3.4 (2.4-4.9)]. CONCLUSION: Considering the high prevalence of cardiovascular disease risk factors in adolescents, age-appropriate and culturally sensitive interventions for lifestyle change are warranted, so that preventive measures can be taken in a timely manner.

Cumulative prevalence of risk factors for atherosclerotic cardiovascular diseases in Iranian adolescents: IHHP-HHPC / A prevalência cumulativa de fatores de risco para doença cardiovascular em adolescentes iranianos: IHHP-HHPC

OBJETIVO: Avaliar a prevalência cumulativa dos fatores de risco para a doença cardiovascular aterosclerótica numa amostra de adolescentes iranianos. MÉTODOS: Foi realizado um estudo transversal com 1000 meninas e 1000 meninos, com idade entre 11 e 18 anos, selecionados através de uma amostragem aleatória multietapas à base de conglomerados das áreas urbana e rural de três cidades iranianas. RESULTADOS: As taxas de prevalência de inatividade física, dislipidemia, tabagismo, pressão arterial alta e obesidade (índice de massa corporal >P95) foram 66,6, 23,7, 8,7, 5,7 e 2,2 por cento, respectivamente. Dentre os indivíduos estudados, 79,1 por cento apresentaram pelo menos um e 24,6 por cento tiveram dois fatores de risco para doença cardiovascular. A prevalência de inatividade física foi significativamente menor entre os meninos que entre as meninas [53,9 contra 79,3 por cento, respectivamente, OR IC95 por cento, 0,44 (0,39-0,51)]. A prevalência de tabagismo foi maior nos meninos que nas meninas [13,1 contra 4,2 por cento, respectivamente, OR IC95 por cento, 3,4 (2,4-4,9)]. CONCLUSÃO: Considerando a alta prevalência de fatores de risco para doença cardiovascular em adolescentes, deve-se garantir intervenções que sejam adequadas à idade e sensíveis a aspectos culturais para que medidas preventivas possam ser tomadas em tempo hábil.