Nishtar Sania, Badar Asma, Kamal Mohammad Umer, Iqbal Azhar, Bajwa Rashid, Shah Tauqeer, Larik Zahid, Karim Fazle, Mehmood Mahmood ul Hassan, Jehangir Haroon, Azam Syed Iqbal, Mirza Yasir Abbas, Khan Shahzad Ali, Qayyum Aamra, Aqeel Fauzia, Bakir Abdul, Rahim Ejaz
Heartfile, Pakistan.
Promot Educ. 2007;14(1):17-27.
Mainstream preventive interventions often fail to reach poor populations with a high risk of cardiovascular diseases (CVDs) in Pakistan. A community-based CVD primary prevention project aimed at developing approaches to reduce risk factors in such populations was established by Heartfile in collaboration with the National Rural Support Program in the district of Lodhran. The project implemented a range of activities integrated with existing social and health service mechanisms during a three year intervention period 2000/01-03/04. These were targeted in 4 key settings: community health education, mass media interventions, training of health professionals and health education through Lady Health Workers. The project received support from the Department for International Development, U.K. At the community level, a pre-test-post-test quasi-experimental design was used for examining project outcomes related to the community component of the intervention. Pre and post-intervention (training) evaluations were conducted involving all health care providers in randomly selected workshops in order to determine baseline levels of knowledge and the impact of training on knowledge level. In order to assess practices of physician and non-physician health care providers patient interviews, with control comparisons were conducted at each health care facility. Significant positive changes were observed in knowledge levels at a community level in the district of intervention compared with baseline knowledge levels particularly in relation to a heart healthy diet, beneficial level of physical activity, the causes of high blood pressure and heart attack and the effects of high blood pressure and active and passive smoking on health. Significant changes in behaviors at a practice level were not shown in the district of intervention. However the project played a critical role in spurring national action for the prevention and control of non-communicable diseases and introducing sustainable public health interventions for poor communities in Pakistan.
在巴基斯坦，主流的预防性干预措施往往无法惠及心血管疾病（CVD）高风险的贫困人口。心脏档案组织（Heartfile）与洛德兰地区的国家农村支持计划合作，设立了一个以社区为基础的心血管疾病一级预防项目，旨在开发降低此类人群风险因素的方法。该项目在2000/01至03/04年的三年干预期内实施了一系列与现有社会和卫生服务机制相结合的活动。这些活动针对4个关键领域：社区健康教育、大众媒体干预、卫生专业人员培训以及通过女性卫生工作者进行健康教育。该项目得到了英国国际发展部的支持。在社区层面，采用了前后测准实验设计来检验与干预社区部分相关的项目成果。在随机挑选的研讨会上对所有医疗服务提供者进行干预前和干预后（培训）评估，以确定知识的基线水平以及培训对知识水平的影响。为了评估医生和非医生医疗服务提供者的实践情况，在每个医疗机构进行了患者访谈并进行对照比较。与基线知识水平相比，在干预地区的社区层面观察到知识水平有显著的积极变化，特别是在心脏健康饮食、有益的身体活动水平、高血压和心脏病发作的原因以及高血压和主动及被动吸烟对健康的影响方面。在干预地区的实践层面未显示行为有显著变化。然而，该项目在推动巴基斯坦预防和控制非传染性疾病的国家行动以及为贫困社区引入可持续的公共卫生干预措施方面发挥了关键作用。
