Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas

Yuan, Xi; Tao, Yadong; Zhao, Jianping; Liu, X.S.; Xiong, Weining; Xie, Jungang; Wang, Ni; Xu, Yongjian; Liu, Houguang

doi:10.1590/1414-431x20154385

Cited by 6 publications

(5 citation statements)

References 29 publications

(22 reference statements)

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“… 8 Despite the high death rate and the great disease burden of COPD, 1 , 2 cessation of smoking, regular exercising, and healthy eating, especially in the early stage of the disease, can postpone lung function decline and reduce considerable risk of hospital admission and mortality. 28 , 29 Given the low rates of healthy lifestyle behaviors in China, systematic efforts are required, 30 in particular for young men in rural areas with low education level and high family income.…”

Section: Discussionmentioning

confidence: 99%

Healthy lifestyle behaviors among individuals with chronic obstructive pulmonary disease in urban and rural communities in China: a large community-based epidemiological study

Yan

Wang

Jiang

et al. 2017

COPD

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BackgroundLifestyle modification is one of the most cost-effective strategies in self-management and secondary prevention of chronic obstructive pulmonary disease (COPD). However, the prevalence of healthy lifestyle behaviors in COPD patients in China remains unclear. The objective of this study was to examine the rates of healthy lifestyle behaviors including smoking cessation, regular exercise, and healthy diet in community population with COPD in China.MethodsWe recruited 46,285 individuals aged 35–70 years from 115 urban and rural communities in 12 provinces of China from 2005 to 2009. We recorded the smoking status, physical activity intensity, and quality of diet for all spirometry-diagnosed COPD patients by standardized questionnaires.ResultsAmong 3,690 individuals with COPD, 18.2% (95% confidence interval [CI], 13.0–24.9) quitted smoking, 27.1% (95% CI, 24.7–29.7) exercised often, and 34.8% (95% CI, 31.8–38.0) ate high-quality diet. More than half of the individuals followed one or less key healthy lifestyle, and only 8.4% (95% CI, 7.0–10.0) followed all of the three healthy behaviors. Urban residents had significant higher rates of smoking cessation (23.5% [95% CI, 17.3–31.1] vs 14.4% [95% CI, 9.9–20.5], p=0.0008), regular exercise (45.6% [95% CI, 42.4–48.8] vs 14.0% [95% CI, 12.1–16.2], p<0.0001), and healthy diet (38.5% [95% CI, 35.5–41.6] vs 32.2% [95% CI, 29.2–35.4], p=0.0013) than rural residents. Age, sex, education level, body mass index, respiratory symptoms, and family income were associated with healthy living, and the strength of associations varied between urban and rural areas.ConclusionThere is a large gap between the anticipated rate and the real participation in healthy lifestyle behaviors in Chinese adults with COPD, especially in rural communities. Simple and effective strategies are warranted to improve patients’ lifestyle in China.

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Section: Discussionmentioning

confidence: 99%

Healthy lifestyle behaviors among individuals with chronic obstructive pulmonary disease in urban and rural communities in China: a large community-based epidemiological study

Yan

Wang

Jiang

et al. 2017

COPD

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“…Across all included studies, the average age of participants was 62 years (mean age range 51–70 years), with a mean FEV 1 % predicted ranging from 38% to 68% (excluding the study by Yuan et al 29 where FEV 1 % predicted was 91% at entry to a 18-year follow-up of smoking cessation and COPD prevalence). The proportion of females within studies ranged from 4% to 55%.…”

Section: Resultsmentioning

confidence: 99%

“…For the meta-analyses that included studies with smoking cessation as the target behavior, results from individual interventions/comparisons within studies were excluded when counseling was part of both the intervention and the control, 31 , 40 results specific to COPD participants were not reported, 29 , 41 nonsmokers were included 37 and smoking cessation rates were not specifically reported. 42 Five studies totaling six intervention groups were included in the meta-analysis with effect sizes expressed as odds ratios ( Figure 3 ).…”

Section: Resultsmentioning

confidence: 99%

Counseling for health behavior change in people with COPD: systematic review

Williams¹,

Effing²,

Paquet³

et al. 2017

COPD

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Counseling has been suggested as a promising approach for facilitating changes in health behavior. The aim of this systematic review of counseling interventions for people with COPD was to describe: 1) counseling definitions, 2) targeted health behaviors, 3) counseling techniques and 4) whether commonalities in counseling techniques were associated with improved health behaviors. Ten databases were searched for original randomized controlled trials which included adults with COPD, used the term “counseling” as a sole or component of a multifaceted intervention and were published in the previous 10 years. Data extraction, study appraisal and coding for behavior change techniques (BCTs) were completed by two independent reviewers. Data were synthesized descriptively, with meta-analysis conducted where possible. Of the 182 studies reviewed as full-text, 22 were included. A single study provided a definition for counseling. Two key behaviors were the main foci of counseling: physical activity (n=9) and smoking cessation (n=8). Six studies (27%) reported underlying models and/or theoretical frameworks. Counseling was the sole intervention in 10 studies and part of a multicomponent intervention in 12. Interventions targeting physical activity included a mean of 6.3 (±3.1) BCTs, smoking cessation 4.9 (±2.9) BCTs and other behaviors 6.5 (±3.9) BCTs. The most frequent BCTs were social support unspecified (n=22; 100%), goal setting behavior (n=11), problem-solving (n=11) and instructions on how to perform the behavior (n=10). No studies shared identical BCT profiles. Counseling had a significant positive effect for smoking cessation and positive but not significant effect for physical activity. Counseling for health behavior change was rarely defined and effectiveness varied by target behavior. Provision of specific details when reporting studies of counseling interventions (definition, BCTs, dosage) would allow clarification of the effectiveness of counseling as an approach to health behavior change in people with COPD.

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“…Most community-based programs studied previously focused particularly on pulmonary rehabilitation, smoking cessation counseling, improving health-related quality of life, self-management counseling, reducing hospital admissions, delivered mainly by physicians, nurses, and physiotherapists [16][17][18][19][20][21][22]. The FRESH Air project study in Uganda involved midwives, but the intervention included the delivering of health education messages on the dangers of biomass smoke to pregnant women and post-natal mothers through the regular ante-and postnatal clinics [23].…”

Section: Introductionmentioning

confidence: 99%

Community-based intervention for prevention and management of chronic obstructive pulmonary disease in Nepal (COBIN-P trial): study protocol for a cluster-randomized controlled trial

Adhikari

Neupane

Karki

et al. 2021

Trials

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Background Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide and the commonest of non-communicable diseases (NCDs) in Nepal. Risk factors like indoor and outdoor air pollution, a high prevalence of smoking, and the lack of awareness of COPD make it a serious public health concern. However, no attempt has been made in Nepal to estimate its burden and address the disease at the community level. Method This study aims to evaluate the effect of a community-based health educational intervention administered by Female Community Health Volunteers (FCHVs) on the prevention and management of COPD. An open-label, two-group, community-based, cluster-randomized controlled trial will be implemented in the semi-urban area of Pokhara Metropolitan city (former Lekhnath Municipality) located in the Kaski district of Nepal. The estimated sample size of the intervention will be 1143. The unit of randomization is the ward (administrative unit) of the study area. The follow-up survey will be conducted immediately after 12 months of FCHVs-led interventions. The difference in the rate of decline of forced expiratory volume in 1 s (FEV1) and FEV1/FVC (forced vital capacity) ratio are the primary outcomes and the change in the proportion of modifiable risk factors of COPD, health-related quality of life scores, and change in knowledge of COPD will be secondary outcomes. Discussion This study will estimate the burden of COPD, the magnitude of risk factors and generate evidence to mobilize community health workers for COPD prevention and management at the community level in Nepal. Trial registration ClinicalTrials.gov NCT03797768. Registered on January 9, 2019.

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Long-term efficacy of a rural community-based integrated intervention for prevention and management of chronic obstructive pulmonary disease: a cluster randomized controlled trial in China's rural areas

Cited by 6 publications

References 29 publications

Healthy lifestyle behaviors among individuals with chronic obstructive pulmonary disease in urban and rural communities in China: a large community-based epidemiological study

Healthy lifestyle behaviors among individuals with chronic obstructive pulmonary disease in urban and rural communities in China: a large community-based epidemiological study

Counseling for health behavior change in people with COPD: systematic review

Community-based intervention for prevention and management of chronic obstructive pulmonary disease in Nepal (COBIN-P trial): study protocol for a cluster-randomized controlled trial

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