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Step 4: Health Promotion University of San Francisco
M.A. public education. The replacement of regular yogurt with probiotic yogurt is an easy and inexpensive way to help control the cholesterol levels of its citizens. These interventions include health promotion.. Although the Isfahan Healthy Heart Program is long from finished. M. Kelishadi. 22-27.. Sarrafzadegan.. Kelishadi.. 9(57). H. & Tahbaz.. A. Zare. …. A. 54. Heidari. Rabiei.. Bahonar. B. (2009).. Majd. & Malekafzali. Annals of Nutritional Metabolism. Bulletin of the World Health . Larijani... Abedi. F. doi:10. S. Alavi. A. H. M. (2009). One group was given regular yogurt and the other received probiotic yogurt.. Esmaillzadeh. This article was chosen because Iran is just beginning to recognize that it has a public health crisis related to non communicable diseases. K.. • Conclusion: Probiotic yogurt consumption significantly lowered serum cholesterol level in the subjects. Ataie-Jafari. allocated to two groups. Iran. K. and healthcare treatments. BMC Public Health.. Sarrafzadegan. Rabiei. Examine three epidemiological research articles identifying health promotion interventions. N.. (2009). N. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran. with public health workers traveling to businesses. K. & Sadeghi. their cholesterol levels were measured against those same levels before the start of the trial. the process evaluation has concluded that workplace interventions are largely successful.. • Conclusion: Although exploring only one aspect of the extensive Isfahan Healthy Heart Program.A.. N. Cholesterol-lowering effect of probiotic yogurt in comparison with ordinary yogurt in mildly to moderately hypercholesterolemic subjects. At the end of two weeks. This article was chosen because it shows the current success of the largest community-based public health campaigns in the developing world.. R. Boshtam. K. Mohommadifard.1186/1471-2458-9-57 Article summary: • Objective: This process evaluation sought to identify the efficacy and cost effectiveness of the Isfahan Healthy Heart Program’s workplace health promotion. Process evaluation of a community based-program for the prevention and control of non-communicable disease in a developing country: The Isfahan Healthy Heart Program.. • Design: Randomized trial with 15 healthy subjects.1159/000203284 Article summary: • Objective: To determine if a change in diet will help control one of the main risk factors for cardiovascular disease.Health Promotion 2 Step 4: Health Promotion Implications/Interventions A. this process evaluation demonstrates that large-scale interventions to reduce non-communicable disease are possible in such countries. doi: 10. R. hypercholesterolemia.
For this part of the evaluation of the program. 39-50.Health Promotion Organization. physical activity levels. • Increase funding for sports and other high activity practices on a national level. • Within those populations most at risk. Two of these areas receive community based interventions to reduce cardiovascular disease while the third has been established as a control. • Methods: The Isfahan Healthy Heart Program is being conducted in the large area within Iran. The Isfahan Healthy Heart Program may become a working model for other developing countries to emulate as they suffer from their own problems with obesity and cardiovascular disease. smoking was decreasing. statistically significant findings were reported as follows: healthy diet was increasing. This article was chosen because it demonstrates many of the public health tactics employed in the United States can also be successful in combating non-communicable disease in developing countries. doi:10. B. • Begin nation-wide campaign against smoking. 87. as they will bear most of the burden of disease if trends in Iran continue. • Increase funding for farmers markets and other avenues for healthy food at a local level. and physical activity was decreasing at a slower pace. • Focus on youth in the community for education. • Findings: In the areas receiving public health interventions.07. and smoking behaviors were measured in the two intervention sites against the control. • Conclusion: Community-based lifestyle interventions can be successful in the developing world. . begin intensive public health education programs to increase awareness of risk factors at a province level.049841 3 Article summary: • Objective: The purpose of this study was to analyze the success in another aspect of the Isfahan Healthy Heart Program. food consumption. Potential community actions Improvement activities: • Begin surveillance of risk factors associated with heart disease at a national level within Iran to determine which populations are most at risk for developing chronic problems.2471/BLT.
Epidemiological triangle HOST: Iranian individual risk factors: Smoking. genetic predisposition. male sex Heart Disease in Iran ENVIRONMENT Knowledge deficit 2nd hand smoke Poor nutritional value in food Few avenues for physical activity Lack of access to healthcare AGENT: Trans-fats.Health Promotion 4 C. there is no evidence that this is occurring • Organizing community based exercise such as weekend runs and daily walks. increasing age. secondary. lack of exercise. poor diet. there is some evidence that this is occurring • Provide free smoking cessation courses to the community Secondary prevention • Provide free cardiovascular health screenings. smoking • Organizing healthy eating through locally grown farmers markets would be effective in providing a healthier diet. or workplace calisthenics would help reduce sedentary lifestyle. Primary. make testing a routine part of medical care • Teach families and healthcare workers early signs and symptoms of cardiovascular disease • Improved access to drugs that reduce risk factors for cardiovascular disease. and tertiary prevention Primary prevention and health promotion activities • Provide health education on heart disease risk factors such as sedentary lifestyle. saturated fats High-cholesterol food Arteriosclerosis Glucose D. poor diet. like antihypertensives .
should be implemented nation-wide The CASPIAN Program • Provides baseline health statistics in pediatric population o Surveillance of pediatric populations demonstrate which groups are at risk for the development of cardiovascular disease and allow more efficient allocation of resources • The CASPIAN program should be turned into annual surveillance Analogue to the Presidential Fitness Challenge • Healthy lifestyle should be taught to students at a nationwide level • By targeting pediatric populations.Health Promotion 5 Tertiary prevention • • • • • Improved treatment and care of those already affected by cardiovascular disease Better distribution of health services for rural populations Improved access to surgical interventions. Health policy The Isfahan Healthy Heart Program • Provides surveillance and intervention to help prevent spread of cardiovascular disease in three provinces within Iran o Interventions include workplace health education and free classes on smoking cessation • If successful. chronic disease is more effectively controlled Other health policy recommendations: • Provide health education on cardiovascular disease • Start nation-wide anti-smoking campaign • Implement exercise program for students • Create food labeling system with pertinent information . such as Coronary Artery Bypass Grafts Improved access to drugs that control heart disease. such as nitrates Provide patient education to those with cardiovascular disease to prevent exacerbation of symptoms E.
. Amirkhani. Ardalan. N. N. N.Health Promotion References Ataie-Jafari. Cholesterol-lowering effect of probiotic yogurt in comparison with ordinary yogurt in mildly to moderately hypercholesterolemic subjects. 38(1).049841 .1186/1471-2458-9-57 Sarrafzadegan. (2009). M. 87. Iranian Journal of Public Health... Majd. Bahonar. doi:10. Bulletin of the World Health Organization. Process evaluation of a community basedprogram for the prevention and control of non-communicable disease in a developing country: The Isfahan Healthy Heart Program. Rabiei. R. K.. B.. Abedi. A. (2009).A. A. M. 9(57). An overview of a national surveillance program in Iran for prevention of chronic non-communicable diseases from childhood: CASPIAN study. 39-50. Kelishadi. K. H. & Tahbaz. BMC Public Health. 22-27... G.2471/BLT. Esmaillzadeh. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran.. H. Annals of Nutritional Metabolism.. Majdzadeh... Zare.. 102106. K... & Malekafzali.. Iran. Alavi. doi:10. A.07. F. (2009). Ziaoddini. doi: 10. Larijani. Mohommadifard. Rabiei. R. Boshtam.. S. K.. Heidari. Kelishadi. …. R. Sarrafzadegan. H... & Sadeghi.1159/000203284 6 Kelishadi. 54.. R.A. M... (2009). A.
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