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Community Interventions for Health can support clinicians in advising patients to reduce tobacco use, improve dietary intake and increase physical activity.Anthony, Denis; Dyson, Pamela A; Lv, Jun; Thankappan, Kavumpurathu Raman; Champgane, Beatriz; Matthews, David R; University of Leeds; University of Oxford; Sree Chitra Tirunal Institute for Medical Sciences and Technology; International American Heart Organisation; et al. (Wiley, 2016-07-25)AIMS AND OBJECTIVES: 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. DESIGN: 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. RELEVANCE TO CLINICAL PRACTICE: 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.
Reducing health risk factors in workplaces of low and middle-income countries.Anthony, Denis; Dyson, Pamela A.; Lv, Jun; Thankappan, Kavumpurathu R.; Matthews, David R.; University of Leeds; Healthcare; University of Leeds; Leeds UK; Oxford Centre for Diabetes, Endocrinology & Metabolism; University of Oxford; Oxford UK; School of Public Health; Peking University Health Science Center; Beijing China; Achutha Menon Centre for Health Science Studies; Sree Chitra Tirunal Institute for Medical Sciences and Technology; Trivandrum India; et al. (Wiley., 2015-03-19)Objective: To reduce risk factors in workplace settings in low- and middle-income countries. Design and Sample: Workplace interventions were utilized as part of the Community Interventions for Health program, a nonrandomized, controlled study undertaken in three communities in China, India, and Mexico. Exactly, 45 industrial, 82 health and 101 school workplace settings with a target population of 15,726. Two independent cross-sectional surveys of workers were conducted at baseline and follow-up, after 18–24 months of intervention activities. Measures: Culturally appropriate interventions to reduce tobacco use, increase physical activity, and improve dietary intake were delivered in the intervention areas. Results: Exactly, 12,136 adults completed surveys at baseline, and 9,786 at follow-up. In the intervention group, the prevalence of tobacco use reduced significantly in men (-6.0%, p < .001) and the proportion eating five portions of fruit and vegetables daily increased (+6.9%, p < .001) compared with the control group. There were no significant differences between the groups for changes in physical activity or prevalence of overweight. Conclusions: Workplace interventions improved risk factors in China, India, and Mexico.