Powell Tara M, Li Shang-Ju, Hsiao Yuan, Thompson Michelle, Farraj Aseel, Abdoh Mariam, Farraj Rami
University of Illinois, School of Social Work 1010 West Nevada Street, University of Illinois Urbana-Champaign, 61801, United States.
Americares, 88 Hamilton Avenue, Stamford, CT 06902, United States.
Prev Med Rep. 2021 Jan 7;21:101310. doi: 10.1016/j.pmedr.2021.101310. eCollection 2021 Mar.
The Syrian crisis has had a devastating impact on displaced populations and among host communities in neighboring countries such as Jordan. Many of these individuals are at risk for non-communicable diseases (NCD) and mental health disorders, yet do not have access to services designed to manage or prevent these conditions. The purpose of this study was to examine the efficacy of a non-communicable disease (NCD) awareness educational intervention and an integrated NCD and mental health education intervention on reducing cardiovascular disease (CVD) risk among Jordanians and displaced Syrians. This natural experiment study was conducted in three health centers in Irbid, Jordan with 213 Syrian participants and 382 Jordanians. Participants were assigned to one of three study conditions: the Healthy Community Clinic (HCC), a non-communicable disease educational intervention; the HCC with added mental health awareness sessions; standard healthcare. CVD risk factors were assessed at baseline, 12 and 18 months. The HCC education group yielded significant improvements in three CVD risk factors including: body mass index (BMI) -1.91 (95% CI: -2.09, -1.73); systolic blood pressure (SBP) -12.80 mmHg (95% CI: -16.35, -9.25); and diastolic blood pressure (DBP) -5.78 mmHg (95% CI: -7.96, -3.60) compared to standard care. The HCC-mental health treatment arm also demonstrated significant improvements in BMI, SBP, and DBP compared to standard care. Significant improvements in fasting blood glucose -20.32 (CI: -28.87, -11.77) and HbA1c -0.43 (-0.62, -0.24) were also illustrated in the HCC-mental health treatment arm. The HCC-mental health group sustained greater reductions in CVD risk than the HCC education group at 18-months. This study is among the first to our knowledge illustrating an integrated health and mental health educational intervention can reduce CVD risk among Syrian refugees and Jordanians. Continued investment and research in CVD prevention interventions is needed to enhance health, reduce costs, and have lasting benefits for conflict-affected individuals and communities.
叙利亚危机对约旦等邻国的流离失所人口以及收容社区产生了毁灭性影响。这些人中许多面临非传染性疾病（NCD）和精神健康障碍的风险，但却无法获得旨在管理或预防这些疾病的服务。本研究的目的是检验非传染性疾病（NCD）意识教育干预以及NCD与精神健康教育综合干预在降低约旦人和流离失所的叙利亚人心血管疾病（CVD）风险方面的效果。这项自然实验研究在约旦伊尔比德的三个健康中心开展，有213名叙利亚参与者和382名约旦人。参与者被分配到三种研究条件之一：健康社区诊所（HCC），一种非传染性疾病教育干预；增加了心理健康意识课程的HCC；标准医疗保健。在基线、12个月和18个月时评估CVD风险因素。与标准护理相比，HCC教育组在三个CVD风险因素方面取得了显著改善，包括：体重指数（BMI）-1.91（95%置信区间：-2.09，-1.73）；收缩压（SBP）-12.80 mmHg（95%置信区间：-16.35，-9.25）；舒张压（DBP）-5.78 mmHg（95%置信区间：-7.96，-3.60）。与标准护理相比，HCC-心理健康治疗组在BMI、SBP和DBP方面也显示出显著改善。HCC-心理健康治疗组在空腹血糖-20.32（置信区间：-28.87，-11.77）和糖化血红蛋白A1c -0.43（-0.62，-0.24）方面也有显著改善。在18个月时，HCC-心理健康组在降低CVD风险方面比HCC教育组持续有更大幅度的降低。据我们所知，本研究是首批表明健康与心理健康综合教育干预可降低叙利亚难民和约旦人心血管疾病风险的研究之一。需要继续投资并开展心血管疾病预防干预研究，以增进健康、降低成本，并为受冲突影响的个人和社区带来持久益处。
