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Table 1 Details of completed non-communicable disease intervention studies in the Indian context

From: Lifestyle change in Kerala, India: needs assessment and planning for a community-based diabetes prevention trial

Study (Author) Target population Study design Intervention Study outcomes
Target risk factor Components Response
1. Indian Diabetes Prevention Programme (IDPP) 1&2 (Ramachandran A et al. 2010): Risk for and incidence of T2DM - Follow-up of 845 out of 869 IGT subjects from IDPP 1and 2 studies,recruited from clinic setting followed up for 3 years - 3 yr RCT Individual: - IDPP 1: 502 out of 531 (94.5%) participants found to have IGT after standard Oral Glucose Tolerance Test (OGTT) - IDPP-1: Decrease in relative risk 29% (LSM), 26% (Metformin) & 28% (LSM+Metformin)
- IDPP 1: 4 groups - Personal sessions at 6-month intervals
1) Control with standard advice: - 0.15-0.75 h/year by dietician & social worker & monthly telephone contacts
2) LSM - LSM: diet & physical activity modification
3) Metformin (500 mg/day) - IDPP-2: Cumulative incidences at 36 months: 30% (LSM +Pioglitazone) & 32% (LSM+placebo)
- 2 groups of participants: Group 1 (n=667): Baseline isolated IGT; Group 2 (n=178): IGT+IFG 4) LSM + Metformin
- IDPP 2: 2 groups - IDPP 2: 367 out of 407 (90.2%) participants found to have IGT after standard OGTT
1) LSM + placebo - No additional benefit with drugs
2) LSM + Pioglitazone (30 mg/day)
2. Diabetes Prevention & Management (DPM) programme (Balagopal P et al. 2008): Proportion with high fasting blood glucose levels 850 village inhabitants, comprising adults and youth aged 10–92 years (included healthy, impaired fasting glucose and T2DM individuals) 7-month community-based non-pharmacological lifestyle intervention Individual: - Total eligible residents: 950 FBG levels decreased by 3% (healthy adults), 11% (adults with IFG), 17% (youth with IFG) & 25% (adults with T2DM)
- 10 face-to-face interviews
- Baseline survey: 850
Group:
- Post-intervention survey: 703 (Attrition rate due to migrations & refusals: 17%)
- Culturally sensitive sessions on physical activity & diet
Community: - Response rate at baseline: 89.5%
- Participatory analysis of village
- Involvement of village leaders, peer educators & residents
3. Chennai Urban Population Study-17 (Mohan V et al., 2006): Physical inactivity All individuals above age of 20 living in two residential colonies of urban Chennai Community-based intervention for increasing physical activity. Baseline cross-sectional survey and a 7-yr follow-up cross-sectional survey. Individual: - Baseline cross-sectional survey (1996): 479 out of 524 eligible participants (91.4%) - 7-yr follow-up cross-sectional survey (2004): 705 out of 712 eligible participants (99%) - Proportion of light-grade activity reduced in both men (55% to 36%) and women (74% to 57%) - Proportion of residents exercising increased from 14% to 59% - Community’s response: residents mobilised resources and constructed a park.
- Culturally tailored education campaign & materials, social worker visits - Diabetes and high risk intervention: information on diabetic status & individual counseling Population: - Awareness programme using public lectures, video clippings & short skits
4. Community-based intervention in Ballabgarh, India (Krishnan A et al. 2010): Non-communicable disease risk factors Residents in urban areas of Ballabgarh block, Faridabad district, Haryana (near New Delhi) - Community-based demonstration project using the Health Settings approach. - Cross-sectional surveys at pre-intervention and 3-year follow-up: pre-intervention survey in 2003-04 and post-intervention survey in 2006-07 Individual: - Advocacy and medication - Individual empowerment Community: - Social enhancement and community empowerment - Reorientation of health services Not mentioned - Programme reach (proportion of community who came in contact with the programme): 25% - Change from baseline proportion: consuming < 5 servings of fruits and vegetables decreased by 3% (men), 5% (women); Elevated BP decreased 9% (men), 2% (women)
5. Work site intervention programme on cardiovascular risk factors (Prabhakaran et al. 2009): Cardiovascular risk factors Employees and their family members (age 10–69 years) from 10 centres (Bangalore, Coimbatore, Delhi, Dibrugarh, Hyderabad, Lucknow, Ludhiana, Nagpur, Pune and Trivandrum) Work site demonstration project: - Intervention sites: Baseline cross-sectional survey, 4-year health intervention programme and a repeat cross-sectional survey. - Control sites: Baseline cross-sectional survey, 4-year minimal interventions and a repeat cross-sectional survey. Individual: - One-on-one interactions between the trained health project personnel and the participants Group: - Dynamic group interactions and healthy meals Population or community: - Use of posters, banners at strategic locations in the industry - Baseline cross-sectional survey: Intervention sites: 82.4% and control site: 90.0% - Repeat cross-sectional survey: Intervention sites: 98.3% and control site: 90.7% Change in proportion of risk factors in intervention vs. control sites: tobacco use: 39% to 29% vs. 17% to 20%, extra salt use: 28% to 13% vs. 22% to 25%, median physical activity score: 6 to 11 vs. 8 to 6, fruit consumption: 38% to 45% vs. 36% to 38%
- Handouts, booklets and video films shown on the internal cable network
6. Community-based intervention for tobacco cessation in rural Tamil Nadu, India: A cluster randomised trial (Kumar MS et al. 2012): Tobacco use (smoking and smokeless tobacco) Men aged 20–40 years using any form of tobacco who were residing in Tiruchirapalli district, Tamilnadu. A cluster randomised trial with two months follow up. Group: - Attendance in first intervention session: 88.5%; second intervention session: 60.5%. The follow-up rates for intervention and control arms were 90.5% and 92.5%, respectively. At 2 months:
Two sessions of health education was offered by a health professional, five weeks apart, along with self-help material on tobacco cessation to intervention group. The control group received only self-help material. - Self-reported point prevalence abstinence: 13% (intervention), 6% (control)
- Quit attempt: 27% (intervention), 20% (control)
- Harm reduction: 22% (intervention) 9% (control)
7. Government of India smokeless tobacco campaign (Murukutla N et al. 2011): Tobacco use Individuals aged 16–50 years in urban and rural areas who are current smokeless tobacco users and have access to mass media (television or radio) The six weeks campaign (November and December 2009) was evaluated with a nationally representative household survey of 2898 smokeless tobacco users during 20 December 2009 to 10 January 2010. Population: Screening interviews were completed in 92% of the respondents - Awareness of the campaign: 63% (smokeless-only users), 72% (dual users)
- An oral cancer surgeon from a tertiary care hospital in Mumbai described the serious illnesses and disfigurement of his patients, caused by cancers resulting from use of smokeless tobacco.
- Concern about their habit: 75% (smokeless-only users), 77% (dual users)
  1. Abbreviations: T2DM Type 2 Diabetes Mellitus; IGT Impaired Glucose Tolerance; IFG Impaired Fasting Glucose; RCT Randomised Controlled Trial; LSM Life Style Modification; FBG Fasting Blood Glucose; BP Blood Pressure.