title: Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience.
abstract: The Isfahan Healthy Heart Programme (IHHP) is a five to six year comprehensive integrated community-based programme for cardiovascular diseases (CVD) prevention and control via reducing CVD risk factors and improvement of cardiovascular healthy behaviour in a target population. IHHP started late in 1999 and will be finished in 2005-2006. A primary survey was done to collect baseline data from interventional (Isfahan and Najaf-Abad) and reference (Arak) communities. In a two-stage sampling method, we randomly selected 5 to 10 percent of households from randomly selected clusters. Then individuals aged > or = 19 years were selected for the survey. This way, data from 12,600 individuals (6300 in interventional counties and 6300 in the reference county) was collected and stratified according to living area (urban vs. rural) and different age and sex groups. The samples underwent a 30-minute interview to complete validated questionnaires containing questions on demography, socioeconomic status, smoking behaviour, physical activity, nutritional habits and other behaviour regarding CVD. Blood pressure and body mass index (BMI) measurements were done and fasting blood samples were taken for two hours post load plasma glucose (2 hpp), serum (total, HDL and LDL) cholesterol and triglyceride levels. A twelve-lead electrocardiogram was recorded in all persons above 35 years of age. Community-wide surveillance of deaths, hospital discharges, myocardial infarction and stroke registry was carried out in the intervention and control areas. Four to five years of interventions based on different categories such as mass media, community partnerships, health system involvement and policy and legislation have started in the intervention area while Arak will be followed without intervention. Considering the results of the baseline surveys, (assessments needed, the objectives, existing resources and the possibility of national implementation) the interventions were planned. They were set based on specific target groups like school children, women, work-site, health personnel, high-risk persons, and community leaders were actively engaged as decision makers. A series of teams was arranged for planning and implementation of the intervention strategies. Monitoring will be done on small samples to assess the effect of different interventions in the intervention area. While four periodic surveys will be conducted on independent samples to assess health behaviours related to CVD risk factors in the intervention and reference areas, the original pre-intervention subjects aged more than 35 years will be followed in both areas to assess the individual effect of interventions and outcomes like sudden death, fatal and nonfatal MI and stroke. The whole baseline survey will be repeated on the original and an independent sample in both communities at the end of the study.
authors.affiliation: Isfahan Cardiovascular Center, Isfahan University of Medical Sciences, Isfahan, Iran. isfcarvasrc@hotmail.com
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarraf-Zadegan
authors.forename: Gholamhosein
authors.initials: G
authors.lastname: Sadri
authors.forename: Hosein
authors.initials: H
authors.lastname: Malek Afzali
authors.forename: Mehdi
authors.initials: M
authors.lastname: Baghaei
authors.forename: Nooshin
authors.initials: N
authors.lastname: Mohammadi Fard
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Shahrokhi
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Tolooie
authors.forename: Masoud
authors.initials: M
authors.lastname: Poormoghaddas
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Sadeghi
authors.forename: Aliakbar
authors.initials: A
authors.lastname: Tavassoli
authors.forename: Morteza
authors.initials: M
authors.lastname: Rafiei
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Katayoun
authors.initials: K
authors.lastname: Rabiei
authors.forename: Nasrollah
authors.initials: N
authors.lastname: Bashardoost
authors.forename: Maryam
authors.initials: M
authors.lastname: Boshtam
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Asgary
authors.forename: Gholamali
authors.initials: G
authors.lastname: Naderi
authors.forename: Tahereh
authors.initials: T
authors.lastname: Changiz
authors.forename: Alireza
authors.initials: A
authors.lastname: Yousefie
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004032:Diet; D015444:Exercise; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016730:Program Development; D018570:Risk Assessment; D012307:Risk Factors