Naidoo B, Thorogood M, McPherson K, Gunning-Schepers L J
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine.
J Epidemiol Community Health. 1997 Apr;51(2):144-50. doi: 10.1136/jech.51.2.144.
To investigate the use of computer models as tools for policy makers in evaluating physical activity interventions aimed at reducing deaths from coronary heart disease (CHD).
The cell-based computer model Prevent, adapted to simulate risk factor interventions for an English and Welsh population, was used to simulate the effect of two strategies for increasing physical activity levels in respect of CHD mortality over 25 years. The first strategy involved a 25% increase in the proportion of 15-64 year olds who were moderately active, while the second strategy involved a similar increase in the proportion who were vigorously active. The effects of focusing on narrower age ranges and on people at different initial activity levels were also explored.
The simulations showed a small reduction in the CHD death rates--less than 0.15% and 0.06% for men and women respectively. The strategies would postpone up to 12,100 deaths over 25 years, comparable to the effect of a 2% reduction in smoking prevalence. The strategies seemed as if they would be more effective if they concentrated on men rather than women, on those over 45 years of age as opposed to all or younger age groups, and on the least active members of the population rather than those already taking some exercise.
The use of computer modelling for stimulating physical activity strategies has shown that concentrating these interventions on older sedentary men will produce the greatest health gain, but efforts to encourage smoking cessation may be more effective in terms of years of life saved.
研究将计算机模型作为工具，供政策制定者评估旨在降低冠心病（CHD）死亡人数的身体活动干预措施。
基于细胞的计算机模型Prevent，适用于模拟针对英格兰和威尔士人群的风险因素干预措施，用于模拟两种提高身体活动水平的策略在25年内对冠心病死亡率的影响。第一种策略是使15 - 64岁中度活跃人群的比例增加25%，而第二种策略是使剧烈活跃人群的比例有类似增加。还探讨了关注更窄年龄范围以及不同初始活动水平人群的影响。
模拟结果显示冠心病死亡率有小幅下降——男性和女性分别下降不到0.15%和0.06%。这些策略在25年内可推迟多达12100例死亡，与吸烟率降低2%的效果相当。如果这些策略集中在男性而非女性、45岁以上人群而非所有或更年轻年龄组、以及人群中最不活跃的成员而非已经进行一些锻炼的人身上，似乎会更有效。
使用计算机建模来模拟身体活动策略表明，将这些干预措施集中在久坐不动的老年男性身上将产生最大的健康收益，但就挽救生命年数而言，鼓励戒烟的努力可能更有效。
