Lv Jun, Liu Qing-Min, Ren Yan-Jun, He Ping-Ping, Wang Sheng-Feng, Gao Fang, Li Li-Ming
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, , Beijing, China.
J Epidemiol Community Health. 2014 Apr;68(4):333-9. doi: 10.1136/jech-2013-203356. Epub 2013 Dec 2.
To assess the short-term impact of a comprehensive, community-based multilevel intervention on knowledge, beliefs and practices with respect to smoking, physical activity and diet in Hangzhou, China.
A non-randomised, controlled, before-after quasi-experimental trial was conducted in two intervention areas and one comparison area. The intervention built on a socioecological framework and took place across four settings: neighbourhoods, schools, workplaces and community health centres. Two independent cross-sectional surveys of adults aged 18-64 years at baseline and a subsequent follow-up were conducted in 2008/2009 and 2011 in the intervention and comparison areas. A 2-year intervention programme was begun in mid-2009 and continued until mid-2011.
A total of 2016 adults at baseline and 2016 adults at follow-up completed the survey. Over the 2-year intervention period, the intervention areas showed a statistically significant decline (25.2% vs 18.7%, p<0.001) in the prevalence of smoking compared with the comparison area (18.0% vs 16.4%, p=0.343). The proportion of individuals who had noticed anyone smoking in any of nine locations in the previous 30 days demonstrated a statistically significant decline in the intervention (78.9% vs 66.5%, p<0.001) and comparison (76.3% vs 66.5%, p<0.001) areas. The fruit and vegetable consumption score increased in a statistically significant manner in the intervention (24.84 vs 25.97, p=0.036) and comparison (24.25 vs 26.67, p<0.001) areas. The metabolic equivalent of physical activity increased from 1204 to 1386 (p=0.023) in the intervention areas compared with 918 to 924 in the comparison area (p=0.201).
After a 2-year intervention, beneficial changes were noted in the intervention areas with respect to smoking and physical activity but not diet. A community-based multilevel intervention programme is feasible in urban China.
评估在中国杭州开展的一项基于社区的综合性多层次干预措施对吸烟、体育活动和饮食方面的知识、信念及行为的短期影响。
在两个干预地区和一个对照地区进行了一项非随机、对照、前后对照的准实验性试验。该干预基于社会生态框架，在四个场所开展：社区、学校、工作场所和社区卫生中心。2008/2009年和2011年在干预地区和对照地区对18 - 64岁成年人进行了两次独立的横断面基线调查及后续随访。2009年年中开始了为期2年的干预项目，并持续至2011年年中。
共有2016名基线成年人和2016名随访成年人完成了调查。在为期2年的干预期内，与对照地区相比，干预地区吸烟率出现了具有统计学意义的下降（25.2%对18.7%，p<0.001），而对照地区吸烟率变化不显著（18.0%对16.4%，p = 0.343）。在过去30天内注意到在九个场所中任何一处有人吸烟的个体比例在干预地区（78.9%对66.5%，p<0.001）和对照地区（76.3%对66.5%，p<0.001）均出现了具有统计学意义的下降。干预地区（24.84对25.97，p = 0.036）和对照地区（24.25对26.67，p<0.001）的果蔬消费得分均出现了具有统计学意义的增加。干预地区的体育活动代谢当量从1204增加到1386（p = 0.023），而对照地区从918增加到924（p = 0.201）。
经过2年干预，干预地区在吸烟和体育活动方面出现了有益变化，但在饮食方面未出现变化。基于社区的多层次干预项目在中国城市是可行的。
