title: COPD: can prevention be improved? Proposal for an integrated intervention strategy.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is a worldwide public health problem with increasing morbidity and mortality. The aim of this proposal is to contribute to the improvement of COPD prevention by identifying groups at risk for COPD and targeting them for preventive interventions.
  
  
  METHODS
  Based on the existing organizational structures for COPD detection, detailed analysis of the determinants of COPD will allow to identify groups at high risk to develop COPD. The Stepwise Target Group-Oriented Prevention (STOP) model developed during this study proposes an integrated identification and intervention strategy for high-risk groups.
  
  
  RESULTS
  Apart from smoking, other environmental determinants and host factors contribute to further lung function's rapid decline. Combined with smoking, these factors increase the risk for COPD. Target groups for early disease detection and appropriate interventions can be identified by the presence of one or more known risk factors and by identification of high-risk groups.
  
  
  CONCLUSIONS
  The Stepwise Target Group-Oriented Prevention (STOP) strategy is a step toward improvement in COPD prevention, by shifting the focus from the group of a focus symptomatic smokers aged 45+ years to much earlier and preventable stages of the disease, that is, from disease treatment to risk management.
authors.affiliation: Department for Preventive Programs Development and Realisation, National Centre for Preventive Medicine of Ministry of Health, Russian Federation, Moscow 101990, Russia. mghambarian@hotmail.com
authors.forename: Marine H
authors.initials: MH
authors.lastname: Ghambarian
authors.forename: Talitha L
authors.initials: TL
authors.lastname: Feenstra
authors.forename: Prisca
authors.initials: P
authors.lastname: Zwanikken
authors.forename: Anna M
authors.initials: AM
authors.lastname: Kalinina
mesh_terms: D000397:Air Pollution / Q000517:prevention & control; D016902:Air Pollution, Indoor / Q000517:prevention & control; D004787:Environmental Pollution / Q000517:prevention & control; D006801:Humans; D011322:Primary Prevention / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control*; D012307:Risk Factors; D000074606:Smoking Prevention; D012959:Socioeconomic Factors