Division of Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy., MS-K45, Atlanta, GA 30341, USA.
J Community Health. 2012 Oct;37(5):1081-90. doi: 10.1007/s10900-012-9542-3.
The burden of preventable chronic diseases is straining our nation's health and economy. Diseases caused by obesity and tobacco use account for the largest portions of this preventable burden. CDC funded 50 communities in 2010 to implement policy, systems, and environmental (PSE) interventions in a 2-year initiative. Funded communities developed PSE plans to reduce obesity, tobacco use, and second-hand smoke exposure for their combined 55 million residents. Community outcome objectives and milestones were categorized by PSE interventions as they related to media, access, promotion, pricing, and social support. Communities estimated population reach based on their jurisdiction's census data and target populations. The average proportion of each community's population that was reached was calculated for each intervention category. Outcome objectives that were achieved within 12 months of program initiation were identified from routine program records. The average proportion of a community's jurisdictional population reached by a specific intervention varied across interventions. Mean population reach for obesity-prevention interventions was estimated at 35%, with 14 (26%) interventions covering over 50% of the jurisdictional populations. For tobacco prevention, mean population reach was estimated at 67%, with 16 (84%) interventions covering more than 50% of the jurisdictional populations. Within 12 months, communities advanced over one-third of their obesity and tobacco-use prevention strategies. Tobacco interventions appeared to have higher potential population reach than obesity interventions within this initiative. Findings on the progress and potential reach of this major initiative may help inform future chronic disease prevention efforts.
可预防的慢性病负担正在给我们国家的健康和经济带来压力。肥胖和烟草使用导致的疾病在可预防的负担中占比最大。疾病预防控制中心在 2010 年资助了 50 个社区，开展为期两年的倡议，实施政策、系统和环境 (PSE) 干预措施。受资助的社区制定了 PSE 计划，以减少肥胖、烟草使用和二手烟暴露，涉及他们的 5500 万居民。社区的结果目标和里程碑根据与媒体、获取、推广、定价和社会支持相关的 PSE 干预措施进行了分类。社区根据其管辖范围内的人口普查数据和目标人群来估计人口覆盖范围。对于每个干预类别，计算了社区人口中达到目标的平均比例。从常规项目记录中确定了在项目启动后 12 个月内实现的结果目标。特定干预措施对社区人口的平均覆盖比例因干预措施而异。肥胖预防干预措施的估计人口覆盖率为 35%，其中 14 项（26%）干预措施覆盖了管辖范围内人群的 50%以上。对于烟草预防，估计人口覆盖率为 67%，其中 16 项（84%）干预措施覆盖了管辖范围内人群的 50%以上。在 12 个月内，社区推进了三分之一以上的肥胖和烟草使用预防策略。在这项倡议中，烟草干预措施似乎比肥胖干预措施具有更高的潜在人口覆盖范围。这项重大倡议的进展和潜在覆盖范围的发现可能有助于为未来的慢性病预防工作提供信息。
