| BackgroundNon-communicable diseases (NCDs), also known as chronic diseases, consists of a range of diseases, which is characterized by a long incubation period, long duration, generally slow progression, and resulting in weakness or loss of function in patients. Cardiovascular diseases (CVDs), cancer, chronic respiratory diseases and diabetes are the four main types of NCDs. NCDs are by far the leading cause of mortality in China, representing82.5%of all deaths. NCDs had serious impact on the health of China’s labor force, with great harm to individuals, families, society and national economies.In reference to the international NCDs prevention and control practices and experiences, our country carried out a series of NCDs prevention and control programs, of which the most representative was the national demonstration project for NCDs prevention and control. In1997, the Ministry of Health of the People’s Republic of China launched the demonstration project in Jinan. Three cross-sectional surveys were conducted in1999,2002and2010.ObjectiveTo explore the impact of11years’community intervention on prevalence of NCDs, behavioral risk factors and knowledge, attitude and practice (KAP) related to NCDs; to evaluate the effect of community intervention and analyze the influencing factors; and to provide reference for improvement of community intervention on NCDs.MethodsThe population-based surveys used a multi-stage stratified cluster random sampling method, and the number of valid questionnaires obtained was1995,1974and2042, respectively. Subjects were all resident aged15years or older living in the current address in Muaiyin District for at least6months. A face-to-face interview was carried out using a self-designed questionnaire. The questionnaire mainly consisted of eight parts: socio-demographic information, tobacco use, alcohol use, physical activity, dietary habits, hypertension, raised cholesterol, diabetes, etc.All the collected data were entered in duplicate into a database using the Epi Data3.1. And statistical analysis was performed using SPSS16.0and Stata8.0. Descriptive statistical analysis was used to describe demographic characteristics, KAP scores and the prevalence of high blood pressure, diabetes, and high cholesterol. Measurement data were expressed as mean and standard deviation, and count data used proportion and ratio. Chi-square test, t test and one-way ANOVA were used to explore the statistical differences. Weighted linear regression to test time trends was performed using mean values, and changes in the prevalence were tested using linear trend chi-square test. Logistic regression was used to select the influencing or risk factors. A comprehensive quantitative analysis was performed to calculate the value of the combined effect of three surveys.Results1.Effects on KAP related to NCDsKAP scores related to NCDs increased bv1.86from1999to2010. Those of35～44and55years old. male and female, high school or higher education, married and widowed, employed. unemployed and retired residents were increased by2.13.1.41～4.64.1.711.97，1.64.1.992.62.0.751.77(P<0.05)2. Effects on behavioral risk factorsProportions of residents smoking, drinking, cycling or walking30minutes and salt intake <6g daily decreased to27.1%.24.1%.69.6%and17.5%. respectively (P<0.05). Rate of residents participating in physical activity daily increased to45.2%(P<0.05). No significant change was observed in the number of resident intake of vegetables and fruits≥400g daily. 3. Changes in prevalence of NCDsAge adjusted prevalence of hypertension, diabetes and high cholesterol increased to11.5%,3.9%and8.5%(P<0.05)4. Influencing factors of KAP related to NCDsNCDs-related KAP scores of45～64years old and female residents were higher, and the pooled RR values were0.497～0.567and0.655～0.658, respectively. Those of junior high school or lower education level, widowed, unemployed residents and families with per capita monthly income of0to499were lower, and the pooled RR values were1.763～3.410,1.367～1.370,1.739～1.761,1.617～1.749, respectively.5. Influencing factors of NCDsResults showed that low education level, high cholesterol, drinking were risk factors for hypertension, and the pooled OR were1.345～1.346,4.288～4.382,1.238～1.239, respectively.25～64years old and high behavior scores were protective factors with the pooled OR were0.044～0.566and0.711～0.729.Primary and lower education level, high blood pressure and high cholesterol were risk factors for diabetes, and the pooled OR were1.678～1.770,2.034～2.087,3.391～3.579, respectively.35～44years old, high knowledge scores and cycling or walking30minutes daily were protective factors with the pooled OR were0.164～1.203,0.401-0.411and0.680～0.714.Primary and lower education level, smoking, drinking, consumption of salted or smoked foods were risk factors for high cholesterol, and the pooled OR were1.300～1.340,1.515～1.564,1.540～1.561and1.407～1.456. respectively.25～44years old, low income levels, high KAP scores, high behavior scores, physical exercise and cycling or walking30minutes daily were protective factors, and the pooled OR were0.052～0.337,0.587～0.729,0.492～0.493,0.308～0.313,0.740～0.745,0.643～0.647, respectively.Conclusions1. Mean KAP score increased by2.32from2002to2010, but it’s still not ideal. KAP score associated with age, gender, education level, marital status, employment status, and family income level.45～64years old and female residents had a higher KAP score, junior high school or lower education level, widowed, unemployed residents and families with per capita monthly income of0to499had a lower KAP score.2.Rates of smoking and drinking were both reduced by9.4%. Proportion of residents participating in physical exercise increased by5.3%, but those of residents cycling or walking30minutes and salt intake <6g daily decreased by20.0%and10.8%.3.The age-standardized prevalence of hypertension, diabetes and high cholesterol were14.6%,3.9%and8.5%. Low educational level, high cholesterol, drinking were risk factors for hypertension, and25～54years old, high behavior scores were protective factors. Primary and lower education level, high blood pressure and high cholesterol were risk factors for diabetes, and35～44years old, high knowledge scores and cycling or walking30minutes daily were protective factors. Primary and lower education level, smoking, drinking, consumption of salted or smoked foods were risk factors for high cholesterol, and25～44years old, low income levels, high KAP scores, high behavior scores, physical exercise and cycling or walking30minutes daily were protective factors.4.Alter11years of community interventions, integrated intervention model of behavioral risk factors was established. The next step should be to continue to maintain the operating mode and convert it to regular work. Building behavioral risk factors and community environment monitoring network is necessary to get comprehensive and dynamic understanding of the prevalence of different risk factors... |
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