title: Community Interventions for Health can support clinicians in advising patients to reduce tobacco use, improve dietary intake and increase physical activity.
abstract: OBJECTIVE
  To increase clinical interventions to reduce modifiable risk factors for noncommunicable disease in low- and middle-income countries.
  
  
  BACKGROUND
  Noncommunicable disease is the leading cause of death in the world and is common in low- and middle-income countries. Risk factors for noncommunicable disease are modifiable and health professionals are in an unique position to intervene and influence them.
  
  
  METHODS
  Clinical interventions were used as part of the Community Interventions for Health programme, a nonrandomised, controlled study undertaken in three communities - one each in China, India and Mexico.
  
  
  METHODS
  All clinicians in intervention and control areas of the study were invited to complete surveys. A total of 2280 completed surveys at baseline and 2501 at follow-up. Culturally appropriate interventions to reduce tobacco use, improve dietary intake and increase physical activity were delivered in the intervention areas.
  
  
  RESULTS
  Clinicians in the intervention group felt more prepared to advise smoking cessation and improvement of diet. They were more likely to test serum cholesterol and blood pressure, but less likely to take measurements of height, hip, waist and skin-fold thickness. There were more resources available to clinicians in the intervention group and they used counselling more and complementary medicine less than those in the control group.
  
  
  CONCLUSIONS
  Community interventions which have been shown to have a positive effect in the community and workplace also change clinical practice.
  
  
  CONCLUSIONS
  Community interventions make clinicians, including nurses, more likely to feel prepared to offer advice and more likely to use counselling. This would be expected to reduce risk factors in patients.
authors.affiliation: University of Leeds, Leeds, UK. d.anthony@leeds.ac.uk.|Harris Manchester College, University of Oxford, Oxford, UK. d.anthony@leeds.ac.uk.
authors.forename: Denis
authors.initials: D
authors.lastname: Anthony
authors.affiliation: Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Dyson
authors.affiliation: School of Public Health, Peking University Health Science Center, Beijing, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lv
authors.affiliation: Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
authors.forename: Kavumpurathu R
authors.initials: KR
authors.lastname: Thankappan
authors.affiliation: International American Heart Organisation, Dallas, TX, USA.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Champgane
authors.affiliation: Harris Manchester College, University of Oxford, Oxford, UK.|Oxford NIHR Biomedical Research Centre, Oxford, UK.
authors.forename: David R
authors.initials: DR
authors.lastname: Matthews
mesh_terms: D000328:Adult; D002681:China; D003153:Community Health Services; D004032:Diet; D015444:Exercise; D005260:Female; D006293:Health Promotion; D006801:Humans; D007194:India; D008297:Male; D008800:Mexico; D012307:Risk Factors; D020340:Tobacco Use Cessation
keywords: nursing; nutrition; obesity; physical activity; smoking; tobacco