Chow Clara K, Joshi Rohina, Gottumukkala Arun K, Raju Krishnam, Raju Rama, Reddy Srinath, Macmahon Stephen, Neal Bruce
The George Institute for International Health, University of Sydney, Sydney, Australia.
Am Heart J. 2009 Sep;158(3):349-55. doi: 10.1016/j.ahj.2009.05.034. Epub 2009 Jul 15.
Developing countries are experiencing increasing levels of cardiovascular disease (CVD). Although there is a good understanding of how to deliver CVD prevention programs in developed countries, there are few data regarding strategies for CVD prevention in resource-poor settings. This study aimed to implement and evaluate a CVD prevention program in a rural area of India.
The 2 strategies of CVD prevention to be investigated are an algorithm-based care approach and a health-promotion campaign. A factorial, cluster-randomized trial design will be used to evaluate these, in which villages will be exposed to one, both, or neither of the interventions for a period of about 12 months. Surveys of households in every village will be used to assess outcomes in all high-risk individuals and a sample of the general adult population.
The primary outcome of the algorithm-based component of this study will be the percentage of high-risk individuals that have been "identified"-defined as having received a cardiovascular-risk assessment in the last 12 months. The primary outcome for the health-promotion component will be the percentage of the adult population with correct knowledge about the effects of 6 behavioral determinants of cardiovascular risk (green-leafy vegetables, fruits, oily foods, salt, smoking, physical activity). Secondary outcomes include a range of measures defining uptake of different preventive strategies.
This study will provide evidence about the effectiveness of a simple practical mechanism of CVD preventive care specifically designed for delivery in a resource-poor area in India.
发展中国家的心血管疾病（CVD）发病率正在上升。尽管人们对如何在发达国家开展心血管疾病预防项目有很好的了解，但关于资源匮乏地区心血管疾病预防策略的数据却很少。本研究旨在在印度农村地区实施并评估一项心血管疾病预防项目。
拟研究的两种心血管疾病预防策略是基于算法的护理方法和健康促进运动。将采用析因整群随机试验设计对这些策略进行评估，其中村庄将接受一种干预、两种干预或不接受任何干预，为期约12个月。将对每个村庄的家庭进行调查，以评估所有高危个体和普通成年人群样本的结果。
本研究基于算法部分的主要结果将是“被识别”的高危个体的百分比，“被识别”定义为在过去12个月内接受过心血管风险评估。健康促进部分的主要结果将是对心血管风险的6种行为决定因素（绿叶蔬菜、水果、油性食物、盐、吸烟、体育活动）的影响有正确认识的成年人口的百分比。次要结果包括一系列定义不同预防策略采用情况的指标。
本研究将为一种专门为印度资源匮乏地区设计的简单实用的心血管疾病预防护理机制的有效性提供证据。
