title: Rationale and design of the Rural Andhra Pradesh Cardiovascular Prevention Study (RAPCAPS): a factorial, cluster-randomized trial of 2 practical cardiovascular disease prevention strategies developed for rural Andhra Pradesh, India.
abstract: BACKGROUND
  Developing countries are experiencing increasing levels of cardiovascular disease (CVD). Although there is a good understanding of how to deliver CVD prevention programs in developed countries, there are few data regarding strategies for CVD prevention in resource-poor settings. This study aimed to implement and evaluate a CVD prevention program in a rural area of India.
  
  
  METHODS
  The 2 strategies of CVD prevention to be investigated are an algorithm-based care approach and a health-promotion campaign. A factorial, cluster-randomized trial design will be used to evaluate these, in which villages will be exposed to one, both, or neither of the interventions for a period of about 12 months. Surveys of households in every village will be used to assess outcomes in all high-risk individuals and a sample of the general adult population.
  
  
  RESULTS
  The primary outcome of the algorithm-based component of this study will be the percentage of high-risk individuals that have been "identified"-defined as having received a cardiovascular-risk assessment in the last 12 months. The primary outcome for the health-promotion component will be the percentage of the adult population with correct knowledge about the effects of 6 behavioral determinants of cardiovascular risk (green-leafy vegetables, fruits, oily foods, salt, smoking, physical activity). Secondary outcomes include a range of measures defining uptake of different preventive strategies.
  
  
  CONCLUSIONS
  This study will provide evidence about the effectiveness of a simple practical mechanism of CVD preventive care specifically designed for delivery in a resource-poor area in India.
authors.affiliation: The George Institute for International Health, University of Sydney, Sydney, Australia.
authors.forename: Clara K
authors.initials: CK
authors.lastname: Chow
authors.forename: Rohina
authors.initials: R
authors.lastname: Joshi
authors.forename: Arun K
authors.initials: AK
authors.lastname: Gottumukkala
authors.forename: Krishnam
authors.initials: K
authors.lastname: Raju
authors.forename: Rama
authors.initials: R
authors.lastname: Raju
authors.forename: Srinath
authors.initials: S
authors.lastname: Reddy
authors.forename: Stephen
authors.initials: S
authors.lastname: Macmahon
authors.forename: Bruce
authors.initials: B
authors.lastname: Neal
mesh_terms: D000328:Adult; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002985:Clinical Protocols; D003906:Developing Countries; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D007194:India; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012424:Rural Population