title: A community-based multilevel intervention for smoking, physical activity and diet: short-term findings from the Community Interventions for Health programme in Hangzhou, China.
abstract: BACKGROUND
  To assess the short-term impact of a comprehensive, community-based multilevel intervention on knowledge, beliefs and practices with respect to smoking, physical activity and diet in Hangzhou, China.
  
  
  METHODS
  A non-randomised, controlled, before-after quasi-experimental trial was conducted in two intervention areas and one comparison area. The intervention built on a socioecological framework and took place across four settings: neighbourhoods, schools, workplaces and community health centres. Two independent cross-sectional surveys of adults aged 18-64 years at baseline and a subsequent follow-up were conducted in 2008/2009 and 2011 in the intervention and comparison areas. A 2-year intervention programme was begun in mid-2009 and continued until mid-2011.
  
  
  RESULTS
  A total of 2016 adults at baseline and 2016 adults at follow-up completed the survey. Over the 2-year intervention period, the intervention areas showed a statistically significant decline (25.2% vs 18.7%, p<0.001) in the prevalence of smoking compared with the comparison area (18.0% vs 16.4%, p=0.343). The proportion of individuals who had noticed anyone smoking in any of nine locations in the previous 30 days demonstrated a statistically significant decline in the intervention (78.9% vs 66.5%, p<0.001) and comparison (76.3% vs 66.5%, p<0.001) areas. The fruit and vegetable consumption score increased in a statistically significant manner in the intervention (24.84 vs 25.97, p=0.036) and comparison (24.25 vs 26.67, p<0.001) areas. The metabolic equivalent of physical activity increased from 1204 to 1386 (p=0.023) in the intervention areas compared with 918 to 924 in the comparison area (p=0.201).
  
  
  CONCLUSIONS
  After a 2-year intervention, beneficial changes were noted in the intervention areas with respect to smoking and physical activity but not diet. A community-based multilevel intervention programme is feasible in urban China.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, , Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lv
authors.forename: Qing-Min
authors.initials: QM
authors.lastname: Liu
authors.forename: Yan-Jun
authors.initials: YJ
authors.lastname: Ren
authors.forename: Ping-Ping
authors.initials: PP
authors.lastname: He
authors.forename: Sheng-Feng
authors.initials: SF
authors.lastname: Wang
authors.forename: Fang
authors.initials: F
authors.lastname: Gao
authors.forename: Li-Ming
authors.initials: LM
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D055361:Multilevel Analysis; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D000074606:Smoking Prevention; D055815:Young Adult
keywords: Developing Countr; Health Behaviour; Health Promotion