برنامه‌ی قلب سالم اصفهان: حجم نمونه و ساختارهای نمونه‌گیری

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 کارشناس ارشد، مرکز تحقیقات قلب و عروق اصفهان، پژوهشکده‌ی قلب و عروق، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشیار، گروه آمار زیستی و اپیدمیولوژی، دانشکده‌ی بهداشت و مرکز تحقیقات بازتوانی قلب، پژوهشکده‌ی قلب و عروق، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استاد، مرکز تحقیقات قلب و عروق اصفهان، پژوهشکده‌ی قلب و عروق، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: از راه‌کارهای مهم در پیش‌گیری و کنترل بیماری‌های قلبی- عروقی (CVD یا Cardiovascular diseases)، آموزش از طریق مداخلات در سطح جامعه است. هدف مطالعه‌ی حاضر، تبیین حجم نمونه و ساختار نمونه‌گیری برنامه‌ی قلب سالم اصفهان (IHHP یا Isfahan Healthy Heart Program) به عنوان یک مطالعه‌ی مداخلاتی وسیع جامعه‌نگر، جهت اصلاح شیوه‌ی زندگی و پیش‌گیری و کنترل بیماری‌های قلبی- عروقی و عوامل خطر آن بود.روش‌ها: IHHP شامل چهار گروه هدف بالغین، کارکنان بهداشتی، بیماران قلبی و دانش‌آموزان در شهرستان‌های اصفهان و نجف‌آباد (مورد) و اراک (شاهد) و مشتمل بر سه مرحله‌ی بررسی وضعیت موجود در سال‌های 80-1379، اجرای مداخلات در سال‌های 85-1381 و بررسی وضعیت بعد از مداخله در سال‌های 87-1386 بود. هم‌زمان با اجرای مداخلات، چهار بررسی به منظور ارزیابی تغییرات آگاهی و عملکرد افراد نیز انجام گردید.یافته‌ها: حجم نمونه‌ی مراحل اول و سوم، در بالغین 12514 و 9572 نفر و با روش نمونه‌گیری سهمیه‌ای، طبقه‌ای، خوشه‌ای، تصادفی، متناسب با حجم، سیستماتیک و تصادفی ساده؛ در دانش‌آموزان 1946 و 1992 نفر و با روش نمونه‌گیری سهمیه‌ای، طبقه‌ای، خوشه‌ای، تصادفی، متناسب با حجم، تصادفی ساده؛ در کارکنان بهداشتی 923 و 2015 نفر و در بیماران قلبی 814 و 502 نفر و با روش نمونه‌گیری تصادفی ساده بود. افراد بالای 35 سال، مرحله‌ی اول بالغین برای شرکت در یک مطالعه‌ی طولی 10 ساله به نام مطالعه‌ی Cohort اصفهان جهت بررسی بروز و محاسبه‌ی ارزیابی خطر حوادث بیماری‌های قلبی- عروقی انتخاب و پی‌گیری شدند.نتیجه‌گیری: برنامه‌ی قلب سالم اصفهان از مطالعات مداخلاتی وسیع جامعه‌نگر در ایران به شمار می‌آید و شامل مشترکات زیادی با مطالعات مطرح در سطح دنیا می‌باشد.

کلیدواژه‌ها

عنوان مقاله [English]

Isfahan Healthy Heart Program, Sample Size and Sampling Structure: A Comprehensive Report

نویسندگان [English]

  • Fatemeh Nouri 1
  • Awat Feizi 2
  • Noushin Mohammadifard 1
  • Nizal Sarrafzadegan 3
1 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associate Professor, Department of Biostatistics and Epidemiology, School of Health AND Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: One of the important strategies for preventing and controlling cardiovascular diseases (CVD) is providing training through interventions at the population. This study aimed to explain the sample size and sampling structure of the Isfahan Healthy Heart Program (IHHP). This program was considered as a comprehensive community-based interventional trial to modify population lifestyle in relation to cardiovascular disease (CVD) and its risk factors prevention and control.Methods: Isfahan Healthy Heart Program (IHHP) addressed four target groups including adults, health professionals, patients with cardiac diseases, and children and adolescents in three districts in Iran including Isfahan and Najaf Abad (intervention) and Arak (reference). It was consisted of three phases: baseline survey in 2000-2001, intervention in 2002-2005 and post-intervention survey in 2006-2007. Four evaluation studies were done during 2002 to 2005 to evaluate knowledge and behaviors improvements.Findings: The sample sizes and sampling methods in the pre- and the post-intervention phases were as followed: 12514 and 9572 and quota, stratified, cluster, random, probability proportionate to size, systemic and simple random in adults; 1946 and 1992 and quotas, stratified, cluster, random, probability proportionate to size, simple random, simple random in adolescents; 923 and 2015 and simple random in health professionals; and also 814 and 502 and simple random in patients with cardiac diseases. We carried out a 10-year longitudinal cohort study entitled the Isfahan Cohort Study on population aged ≥ 35 years starting from the baseline to examine the incidence of cardiovascular disease events and to calculate the risk assessment chart for cardiovascular disease occurrence.Conclusion: Isfahan Healthy Heart Program, as comprehensive community-based interventional trial in Iran, was so similar to the same worldwide.

کلیدواژه‌ها [English]

  • Isfahan Healthy Heart Program
  • Cardiovascular Disease
  • Prevention and Control
  • Sample Size
  • Sampling structure

مراجع

  1. Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control. Geneva, Switzerland: World Health Organization; 2011.
  2. Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol 2010; 141(2): 122-31.
  3. World Health Organization. The global burden of disease: 2004 update. Geneva, Switzerland: WHO; 2004.
  4. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380(9859): 2197-223.
  5. Reddy KS. Cardiovascular disease in non-Western countries. N Engl J Med 2004; 350(24): 2438-40.
  6. Yusuf S, Reddy S, Ounpuu S, Anand S. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Circulation 2001; 104(22): 2746-53.
  7. Sarraf-Zadegan N, Sayed-Tabatabaei FA, Bashardoost N, Maleki A, Totonchi M, Habibi HR, et al. The prevalence of coronary artery disease in an urban population in Isfahan, Iran. Acta Cardiol 1999; 54(5): 257-63.
  8. Shahraz S, Forouzanfar MH, Sepanlou SG, Dicker D, Naghavi P, Pourmalek F, et al. Population health and burden of disease profile of Iran among 20 countries in the region: from Afghanistan to Qatar and Lebanon. Arch Iran Med 2014; 17(5): 336-42.
  9. Farzadfar F, Danaei G, Namdaritabar H, Rajaratnam JK, Marcus JR, Khosravi A, et al. National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment. Popul Health Metr 2011; 9(1): 55.
  10. Kabagambe EK, Baylin A, Campos H. Nonfatal acute myocardial infarction in Costa Rica: modifiable risk factors, population-attributable risks, and adherence to dietary guidelines. Circulation 2007; 115(9): 1075-81.
  11. Ebrahimi-Mameghani M, Toupchian O, Farsad Naimi A, Nurmohammadi M. Women's knowledge and attitude toward cardiovascular diseases risk factors and its relation with obesity and biochemical factors. Med J Tabriz Univ Med Sci 2011; 33(2): 1-7. [In Persian].
  12. Sarrafzadegan N, Kelishadi R, Esmaillzadeh A, Mohammadifard N, Rabiei K, Roohafza H, et al. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran. Bull World Health Organ 2009; 87(1): 39-50.
  13. Kelishadi R, Pashmi R, Sadri Gh, Sarraf-Zadegan N, Ahmadi M, Mohammadzadeh M, et al. Healthy Heart Program: heart health promotion from childhood. J Qazvin Univ Med Sci 2003; 7(2): 15-26. [In Persian].
  14. Noto D, Cefalu AB, Barbagallo CM, Sapienza M, Cavera G, Nardi I, et al. Hypertension and diabetes mellitus are associated with cardiovascular events in the elderly without cardiovascular disease. Results of a 15-year follow-up in a Mediterranean population. Nutr Metab Cardiovasc Dis 2009; 19(5): 321-6.
  15. Dawber TR, Meadors GF, Moore FE. Epidemiological approaches to heart disease: the Framingham Study. Am J Public Health Nations Health 1951; 41(3): 279-81.
  16. Ovcarov VK, Bystrova VA. Present trends in mortality in the age group 35--64 in selected developed countries between 1950--1973. World Health Stat Q 1978; 31(3): 208-346.
  17. Sarraf-Zadegan N, Sadri G, Malek AH, Baghaei M, Mohammadi FN, Shahrokhi S, et al. Isfahan Healthy Heart Programme: a comprehensive integrated community-based programme for cardiovascular disease prevention and control. Design, methods and initial experience. Acta Cardiol 2003; 58(4): 309-20.
  18. Sarrafzadegan N, Baghaei A, Sadri G, Kelishadi R, Malekafzali H, Boshtam M, et al. Isfahan healthy heart program: Evaluation of comprehensive, community-based interventions for non-communicable disease prevention. Prevention and Control 2006; 2(2): 73-84.
  19. Kelishadi R, Sadry G, Zadegan NS, Hashemipour M, Sabet B, Bashardoust N, et al. Smoking, adolescents and health: Isfahan healthy heart programme-heart health promotion from childhood. Asia Pac J Public Health 2004; 16(1): 15-22.
  20. Sadeghi M, Roohafza H, Shirani S, Poormoghadas M, Kelishadi R, Baghaii A, et al. Diabetes and associated cardiovascular risk factors in Iran: the Isfahan Healthy Heart Programme. Ann Acad Med Singapore 2007; 36(3): 175-80.
  21. Gharipour M, Kelishadi R, Sarrafzadegan N, Baghaei A, Yazdani M, Anaraki J, et al. The association of smoking with components of the metabolic syndrome in non-diabetic patients. Ann Acad Med Singapore 2008; 37(11): 919-23.
  22. Sarrafzadegan N, Kelishadi R, Baghaei A, Hussein SG, Malekafzali H, Mohammadifard N, et al. Metabolic syndrome: an emerging public health problem in Iranian women: Isfahan Healthy Heart Program. Int J Cardiol 2008; 131(1): 90-6.
  23. Bahonar A, Khosravi A, Esmaeelian H, Babak A, Rahmati M, Jamshidi A, et al. Methods of implementing the operational phases of the Health Professionals Education Project-Isfahan Healthy Heart Program (IHHP-HPEP). ARYA Atheroscler 2009; 5(3): 102-5.
  24. Roohafza H, Sadeghi M, Shirani S, Bahonar A, Mackie M, Sarafzadegan N. Association of socioeconomic status and life-style factors with coping strategies in Isfahan Healthy Heart Program, Iran. Croat Med J 2009; 50(4): 380-6.
  25. Sarrafzadegan N, Sadeghi M, Tavassoli A, Mohseni M, Alikhasi H, Rabiei K, et al. Sex differences in the impact of a community-based program for non-communicable disease prevention: The Isfahan Healthy Heart Program (IHHP). Journal of Public Health 2009; 17(4): 257-63.
  26. Shirani S, Kelishadi R, Sarrafzadegan N, Khosravi A, Sadri G, Amani A, et al. Awareness, treatment and control of hypertension, dyslipidaemia and diabetes mellitus in an Iranian population: the IHHP study. East Mediterr Health J 2009; 15(6): 1455-63.
  27. Baghaei A, Sarrafzadegan N, Rabiei K, Gharipour M, Tavasoli AA, Shirani S, et al. How effective are strategies for non-communicable disease prevention and control in a high risk population in a developing country? Isfahan Healthy Heart Programme. Arch Med Sci 2010; 6(1): 24-31.
  28. Boshtam M, Sarafzadegan N, Zare K, Sadeghi S, Sajjadi F, Rabiei K, et al. Effects of 5-year interventions on cardiovascular risk factors of factories and offies employees of isfahan and najafabad: worksite intervention project-isfahan healthy heart program. ARYA Atheroscler 2010; 6(3): 94-101.
  29. Heidari R, Sadeghi M, Talaei M, Rabiei K, Mohammadifard N, Sarrafzadegan N. Metabolic syndrome in menopausal transition: Isfahan Healthy Heart Program, a population based study. Diabetol Metab Syndr 2010; 2: 59.
  30. Khosravi A, Mehr GK, Kelishadi R, Shirani S, Gharipour M, Tavassoli A, et al. The impact of a 6-year comprehensive community trial on the awareness, treatment and control rates of hypertension in Iran: experiences from the Isfahan healthy heart program. BMC Cardiovasc Disord 2010; 10: 61.
  31. Rabiei K, Kelishadi R, Sarrafzadegan N, Sadri G, Amani A. Short-term results of community-based interventions for improving physical activity: Isfahan Healthy Heart Programme. Arch Med Sci 2010; 6(1): 32-9.
  32. Sadeghi A, Ramezani J, Sanei H, Rabeiee K, Gharipoor M, Toghianifar N. Adherence to evidence-based therapies and modifiable risk factors in patients with coronary artery disease - the HLCP Project. ARYA Atheroscler 2006; 2(3): 147-51.
  33. Bahonar A, Sarrafzadegan N, Kelishadi R, Shirani S, Ramezani MA, Taghdisi MH, et al. Association of socioeconomic profiles with cardiovascular risk factors in Iran: the Isfahan Healthy Heart Program. Int J Public Health 2011; 56(1): 37-44.
  34. Gharipour M, Kelishadi R, Toghianifar N, Mackie M, Yazdani M, Noori F, et al. Sex based pharmacological treatment in patients with metabolic syndrome: Findings from the Isfahan healthy heart program. Afr J Pharm Pharmacol 2011; 5(3): 311-6.
  35. Najafian J, Toghianifar N, Mohammadifard N, Nouri F. Association between sleep duration and metabolic syndrome in a population-based study: Isfahan Healthy Heart Program. J Res Med Sci 2011; 16(6): 801-6.
  36. Roohafza H, Ramezani M, Sadeghi M, Shahnam M, Zolfagari B, Sarafzadegan N. Development and validation of the stressful life event questionnaire. Int J Public Health 2011; 56(4): 441-8.
  37. Sarrafzadegan N, Rabiei K, Alavi M, Abedi H, Zarfeshani S. How can the results of a qualitative process evaluation be applied in management, improvement and modification of a preventive community trial? The IHHP Study. Arch Public Health 2011; 69(1): 9.
  38. Feizi A, Aliyari R, Roohafza H. Association of perceived stress with stressful life events, lifestyle and sociodemographic factors: a large-scale community-based study using logistic quantile regression. Comput Math Methods Med 2012; 2012: 151865.
  39. Kelishadi R, Mohammadifard N, Sarrazadegan N, Nouri F, Pashmi R, Bahonar A, et al. The effects of a comprehensive community trial on cardiometabolic risk factors in adolescents: Isfahan Healthy Heart Program. ARYA Atheroscler 2012; 7(4): 184-90.
  40. Mohammadifard N, Sarrafzadegan N, Nouri F, Sajjadi F, Alikhasi H, Maghroun M, et al. Using factor analysis to identify dietary patterns in Iranian adults: Isfahan Healthy Heart Program. Int J Public Health 2012; 57(1): 235-41.
  41. Toghianifar N, Najafian J, Pooya A, Rabiei K, Eshrati B, Anaraki J, et al. Association of smoking status with quality of life in a cross-sectional population-based sample of Iranian adults: Isfahan Healthy Heart Program. Asia Pac J Public Health 2012; 24(5): 786-94.
  42. Ahmadi A, Gharipour M, Nouri F, Sarrafzadegan N. Metabolic syndrome in Iranian youths: a population-based study on junior and high schools students in rural and urban areas. J Diabetes Res 2013; 2013: 738485.
  43. Roohafza H, Sarrafzadegan N, Sadeghi M, Rafieian-Kopaei M, Sajjadi F, Khosravi-Boroujeni H. The association between stress levels and food consumption among Iranian population. Arch Iran Med 2013; 16(3): 145-8.
  44. Sarrafzadegan N, Gharipour M, Sadeghi M, Nouri F, Asgary S, Zarfeshani S. Differences in the prevalence of metabolic syndrome in boys and girls based on various definitions. ARYA Atheroscler 2013; 9(1): 70-6.
  45. Sarrafzadegan N, Kelishadi R, Sadri G, Malekafzali H, Pourmoghaddas M, Heidari K, et al. Outcomes of a comprehensive healthy lifestyle program on cardiometabolic risk factors in a developing country: the Isfahan Healthy Heart Program. Arch Iran Med 2013; 16(1): 4-11.
  46. Talaei M, Rabiei K, Talaei Z, Amiri N, Zolfaghari B, Kabiri P, et al. Physical activity, sex, and socioeconomic status: A population based study. ARYA Atheroscler 2013; 9(1): 51-60.
  47. Ahmadi A, Gharipour M, Nouri F, Kelishadi R, Sadeghi M, Sarrafzadegan N. Association between adolescence obesity and metabolic syndrome: Evidence from Isfahan Healthy Heart Program. Indian J Endocrinol Metab 2014; 18(4): 569-73.
  48. Najafian J, Mohammadifard N, Naeini FF, Nouri F. Relation between usual daily walking time and metabolic syndrome. Niger Med J 2014; 55(1): 29-33.
  49. Roohafza H, Khani A, Sadeghi M, Bahonar A, Sarrafzadegan N. Health volunteers' knowledge of cardiovascular disease prevention and healthy lifestyle following a community trial: Isfahan healthy heart program. J Educ Health Promot 2014; 3: 59.
  50. Sajjadi F, Gharipour M, Mohammadifard N, Nouri F, Maghroun M, Alikhasi H. Relationship between legumes consumption and metabolic syndrome: Findings of the Isfahan Healthy Heart Program. ARYA Atheroscler 2014; 10(1): 18-24.
  51. Mohammadifard N, Sajjadi F, Maghroun M, Alikhasi H, Nilforoushzadeh F, Sarrafzadegan N. Validation of a simplified food frequency questionnaire for the assessment of dietary habits in Iranian adults: Isfahan Healthy Heart Program, Iran. ARYA Atheroscler 2015; 11(2): 139-46.
  52. Sarrafzadegan N, Talaei M, Sadeghi M, Kelishadi R, Oveisgharan S, Mohammadifard N, et al. The Isfahan cohort study: rationale, methods and main findings. J Hum Hypertens 2011; 25(9): 545-53.
  53. Kafeshani O, Sarrafzadegan N, Nouri F, Mohammadifard N. Major dietary patterns in Iranian adolescents: Isfahan Healthy Heart Program, Iran. ARYA Atheroscler 2015; 11(Suppl 1): 61-8.
  54. Nouri F, Sarrafzadegan N, Mohammadifard N, Sadeghi M, Mansourian M. Intake of legumes and the risk of cardiovascular disease: frailty modeling of a prospective cohort study in the Iranian middle-aged and older population. Eur J Clin Nutr 2016; 70(2): 217-21.
  55. Azizi F, Ghanbarian A, Momenan AA, Hadaegh F, Mirmiran P, Hedayati M, et al. Prevention of non-communicable disease in a population in nutrition transition: Tehran Lipid and Glucose Study phase II. Trials 2009; 10: 5.
  56. The Swedish Council on Technology Assessment in Health Care (SBU). Att forebygga sjukdom i hjarta och karl genom befolknings inriktade program en systematisk litteraturoversikt. [The community control prevention programme for cardiovascular diseases critical literature review.] (SBU Report No. 134). Stockholm, Sweden: SBU; 1997. [In Swedish].
  57. Farquhar JW, Fortmann SP, Maccoby N, Haskell WL, Williams PT, Flora JA, et al. The Stanford Five-City Project: design and methods. Am J Epidemiol 1985; 122(2): 323-34.
  58. Fortmann SP, Varady AN. Effects of a community-wide health education program on cardiovascular disease morbidity and mortality: the Stanford Five-City Project. Am J Epidemiol 2000; 152(4): 316-23.
  59. Luepker RV, Murray DM, Jacobs DR, Jr., Mittelmark MB, Bracht N, Carlaw R, et al. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. Am J Public Health 1994; 84(9): 1383-93.
  60. Luepker RV, Rastam L, Hannan PJ, Murray DM, Gray C, Baker WL, et al. Community education for cardiovascular disease prevention. Morbidity and mortality results from the Minnesota Heart Health Program. Am J Epidemiol 1996; 144(4): 351-62.
  61. Vartiainen E, Puska P, Pekkanen J, Tuomilehto J, Jousilahti P. Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland. BMJ 1994; 309(6946): 23-7.
  62. Nissinen A, Berrios X, Puska P. Community-based noncommunicable disease interventions: lessons from developed countries for developing ones. Bull World Health Organ 2001; 79(10): 963-70.
مجله دانشکده پزشکی اصفهان
دوره 33، شماره 362 - شماره پیاپی 362
بهمن و اسفند 1394
صفحه 2152-2166

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  • تاریخ دریافت: 21 مرداد 1394
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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