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Effectiveness of community-based comprehensive healthy lifestyle promotion on cardiovascular disease risk factors in a rural Vietnamese population: a quasi-experimental study
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
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2012 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 12, no article nr 56Article in journal (Refereed) Published
Abstract [en]

Background: Health promotion is a key component for primary prevention of cardiovascular disease (CVD). This study evaluated the impact of healthy lifestyle promotion campaigns on CVD risk factors (CVDRF) in the general population in the context of a community-based programme on hypertension management. Methods: A quasi-experimental intervention study was carried out in two rural communes of Vietnam from 2006 to 2009. In the intervention commune, a hypertensive-targeted management programme integrated with a community-targeted health promotion was initiated, while no new programme, apart from conventional healthcare services, was provided in the reference commune. Health promotion campaigns focused on smoking cessation, reducing alcohol consumption, encouraging physical activity and reducing salty diets. Repeated cross-sectional surveys in local adult population aged 25 years and over were undertaken to assess changes in blood pressure (BP) and behavioural CVDRFs (smoking, alcohol consumption, physical inactivity and salty diet) in both communes before and after the 3-year intervention. Results: Overall 4,650 adults above 25 years old were surveyed, in four randomly independent samples covering both communes at baseline and after the 3-year intervention. Although physical inactivity and obesity increased over time in the intervention commune, there was a significant reduction in systolic and diastolic BP (3.3 and 4.7 mmHg in women versus 3.0 and 4.6 mmHg in men respectively) in the general population at the intervention commune. Health promotion reduced levels of salty diets but had insignificant impact on the prevalence of daily smoking or heavy alcohol consumption. Conclusion: Community-targeted healthy lifestyle promotion can significantly improve some CVDRFs in the general population in a rural area over a relatively short time span. Limited effects on a context-bound CVDRF like smoking suggested that higher intensity of intervention, a supportive environment or a gender approach are required to maximize the effectiveness and maintain the sustainability of the health intervention.

Place, publisher, year, edition, pages
2012. Vol. 12, no article nr 56
Keyword [en]
cardiovascular disease risk factors, healthy lifestyle promotion, community-based intervention, hypertension management, quasi-experimental study, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-55189DOI: 10.1186/1471-2261-12-56ISI: 000310645800001OAI: oai:DiVA.org:umu-55189DiVA: diva2:526192
Available from: 2012-05-10 Created: 2012-05-10 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Understanding and managing cardiovascular disease risk factors in Vietnam: integrating clinical and public health perspectives
Open this publication in new window or tab >>Understanding and managing cardiovascular disease risk factors in Vietnam: integrating clinical and public health perspectives
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Vietnam, like other low-income countries, is facing an epidemic burden of cardiovascular disease risk factors (CVDRFs). The magnitude and directions of CVDRF progression are matters of uncertainty.

Objectives: To describe the epidemiological progression of CVDRFs and the preventive effects of community lifestyle interventions, with reference to the differences in progression of CVDRF patterns between men and women.

Methods: The study was conducted during 2001-2009 in nationally representative samples and in a local setting of rural areas of Ba-Vi district, Ha-Tay province. Both epidemiological and interventional approaches were applied: (i) a population-based cross-sectional survey of 2,130 people aged ≥25 years in Thai-Binh and Hanoi; (ii) an individual participant-level meta analysis of 23,563 people aged 24-74 years from multiple similar surveys in 9 provinces around Vietnam; (iii) a 17-month cohort study of 497 patients in a hypertension management programme; (iv) a quasi-experimental trial on community lifestyle promotion integrated with a hypertension management programme, evaluated by surveys of 4,645 people in both intervention and reference communes before and after a 3-year intervention.

Main findings: (i) in the general adult population ≥25 years, CVDRFs were common, often clustered within individuals, and increased with age; (ii) the Vietnamese population is facing a growing epidemic of CVDRFs, which are generally not well managed; (iii) it is possible to launch a community intervention in low-resource settings within the scope of a commune-based patient-targeted programme on hypertension management; (iv) community health intervention with comprehensive healthy lifestyle promotion improves blood pressure and some behavioural CVDRFs.

Conclusion: Alarming increases in CVDRFs in the general population need comprehensive multi-level prevention strategies, which combine both individual high-risk and population health approaches. The commune-based hypertension-centred management programmes integrated with community health promotion are the initial but essential steps towards comprehensive and effective management of CVDRFs and should be part of an integrated and co-ordinated national program on the prevention and control of chronic diseases in low-resource settings like Vietnam.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2012. 62 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1498
Keyword
cardiovascular disease risk factors, epidemiology, prevention, hypertension, Vietnam, yếu tố nguy cơ bệnh tim mạch, dịch tễ học, dự phòng, tăng huyết áp, Việt Nam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Cardiology
Identifiers
urn:nbn:se:umu:diva-55132 (URN)978-91-7459-420-1 (ISBN)
Public defence
2012-06-01, Room 135, Family Medicine, Umeå University Hospital, Umeå, Sweden, 13:00 (English)
Opponent
Supervisors
Available from: 2012-05-11 Created: 2012-05-09 Last updated: 2015-04-29Bibliographically approved

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