Background
Methods
Study design and settings
Site Name | District/Area | Participating Centre/Medical Institution | Setting | Details |
---|---|---|---|---|
Indorea | Sardarpur, Dhar | Sri Aurobindo Institute of Medical Sciences, Indore | Tribal | Predominantly tribal population, and agrarian society. Very poor connectivity by road. |
Junagadha | Junagadh, Gujrat | Aga Khan Health Services, Mumbai | Rural | Primarily rural with conservative social practices. |
Pondicherrya | Pondicherry, Puducherry | Pondicherry Institute of Medical Sciences, Puducherry | Urban | Urban and coastal site with fairly good public health infrastructure available. |
Shimlaa | Mashobra, Himachal Pradesh | Indira Gandhi Medical College, Shimla | Rural | A predominantly agrarian population in a hilly terrain; sparsely populated villages. |
Tandaa | Bharmour, Himachal Pradesh | Dr Rajendra Prasad Government Medical College, Tanda | Tribal | Predominantly tribal with agriculture as primary occupation. |
Bhubaneswar | Kalahandi, Bhawanipatna | Regional Medical Research Centres, Bhubaneswar | Tribal | Predominantly tribal population with major tribes of Kondhas and Souras. The primary occupation is agriculture |
Utnoor, Adilabad | National Institute of Nutrition, Hyderabad | Tribal | Predominantly tribal dominated population. The main occupation is agriculture | |
Jodhpur | Kotra | Desert Medicines Research Centre, Jodhpur | Tribal | Primarily tribal site, with hilly terrain. The main occupation is agriculture |
Ranchi & Patna | Ratu & Namkum | Rajendra Memorial Research Institute of Medical Sciences, Patna (in collaboration with Rajendra Institute of Medical Sciences , Ranchi) | Tribal | Primarily tribal population with agriculture as main occupation. |
Dibrugarh | Dibrugarh | Regional Medical Research Centre, North East Region | Tribal | Predominantly tribal population and mostly tea garden workers. |
Baseline risk factor survey
Survey Component | Measures | Source |
---|---|---|
Socio-demographic details of participant’s family | Age, Sex, Marital Status, Religion, Education, Income, Occupation | CARRS Surveillance Study (2012) [25] |
Tobacco Consumption | History, frequency and quantity of tobacco consumption, type of products used | |
Alcohol Consumption | History, frequency and quantity of tobacco consumption, type of products used | Adapted from WHO AUDIT [28] |
Physical Activity | Levels of sedentary, moderate and vigorous activity levels & time spent doing activity | |
Knowledge, Attitude & Practices about Blood Pressure | Currently knowledge & attitude toward high blood pressure | Specifically developed for study |
Diet and Nutrition | Food Habits and Consumption | Few items adapted from WHO Steps [29] Few items specifically developed for purpose of the study |
Medical History | Hypertension/Diabetes/Diabetes – related complications/Hyperlipidemia/Heart Disease | CARRS Surveillance Study (2012) [25] |
Family History | Mortality and/morbidity among participant’s family due to cardio-metabolic illness/risk factors | CARRS Surveillance Study (2012) [25] |
Treatment History & Expenditure | Expenses for inpatient & outpatient treatment in last 12 months and current | Specifically developed |
Medications | Name, dosage and disorder for which medication taken | Specifically developed |
Mental Health | General well-being & distress | Adapted in Indian settings [30] |
Anthropometric and blood pressure measurements
Measurement | Instrument |
---|---|
Height | Stadiometer (Seca) |
Weight | Digital weighing scales (Seca) |
Waist and hip circumference | Non elastic measuring tapes (Seca) |
Anthropometry | Tanita BC-601 segmental body composition analyser, WHO Steps Protocol |
Blood pressure measurement | Electronic BP monitor (OMRON 7080) Instrument validated by International Protocol for device validation O’Brien et al., (Working Group on Blood Pressure Monitoring of the European Society of Hypertension) |
Blood sample collection
Laboratory measurements
Clinical Parameter | Laboratory parameter | Method |
---|---|---|
Diabetes | Plasma glucose | Enzymatic Colorimetric Assay method (modified GOD-PAP method based on the work of Trinder, 1969) |
Dyslipidemia | Cholesterol | Enzymatic In vitro Calorimetric method (automated clinical chemistry analyzer Roche/Hitachi 902) |
Triglycerides | Enzymatic Calorimetric test (Based on the work by Wahlefeld using lipoprotein lipase from microorganisms for rapid and complete hydrolysis of triglycerides to glycerol followed by oxidation to dihydroxyacetone phosphate and hydrogen peroxide | |
High density lipoprotein cholesterol (HDL) | Automated method for direct determination | |
Triglycerides | Estimation using Friedewald and Fredrickson Formula, 1972 | |
Low density lipoprotein cholesterol (LDL) | Homogeneous Enzymatic Assay for direct quantitative determination (automated clinical chemistry analyzer Roche/Hitachi 902), for samples with triglycerides more than 400 mg/dl | |
Very low density lipoprotein cholesterol (VLDL) | Estimation using Friedewald and Fredrickson Formula, 1972 | |
Blood Routine | Hemoglobin | Indirect Cyanmethemoglobin method |
Data entry and database
Intervention development
Level of Intervention | Method | Frequency | Tools |
---|---|---|---|
Individual Level | Household visits and one to one counselling of household members | Once every two months (9 visits) | Booklet,18- month calendar, hypertension-specific leaflets, healthy lifestyle-specific leaflets, salt spoon to quantify use of salt, oil dispenser to quantify use of oil. |
Group | Group meetings with specific target groups such as men, women, youth, persons with hypertension | Once a month (18 meetings) | Recipe demonstrations, video screenings , street theatre, peer led discussions, competitions |
Mass | Display of posters or banners with key messages in public places or at gatherings. Distribution of leaflets. | 1 poster changed every 3 months | Posters, banners, leaflets |