Isfahan healthy heart program: Evaluation of comprehensive, community-based interventions for non-communicable disease prevention

Summary Background: Isfahan healthy heart program (IHHP), a six year, action-oriented, comprehensive and integrated community-based demonstration study, was launched late in 1999 to address the ongoing epidemic of non-communicable diseases (NCDs) and their major risk factors in Iran. It is a quasi-experimental trial that includes a reference area and several levels of evaluation including process, impact and outcome evaluations. IHHP involves individual, community and environmental changes to support health behavior modification. Objectives: To describe the IHHP evaluation design and to assess the extent to which the program has attained its short-term impacts. Methods: The IHHP evaluation includes four annual independent sample surveys in four specific sub-groups (adults, adolescents, health professionals and individuals at high risk for NCD) in both intervention and reference areas. In addition a sixyear cohort study of persons aged P35 years in both areas measures impact on behaviors at the individual level and assesses the risk of myocardial infarction and stroke. The WHO STEPwise risk factor surveillance questionnaires were used to conduct the cross sectional surveys, which evaluate the impacts and outcomes