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Protocol
CIH has three main component parts, which are integral to the design of the interventions:
- Community coalition-building – key stakeholders work together to encourage healthy lifestyle changes throughout the community. Examples include advocating for bicycle paths and smoke-free environments or creating farmers’ markets
- Health education – disseminating health messages is vital for success. This can be done through training of health professionals, using local media, social marketing or peer educators
- Structural change – structural interventions include advocating for and implementing policy change, environmental change (for example, improving the opportunities for physical activity in schools and workplaces) and economic change (such as reducing taxes on healthy foods). These combine to create communities in which the healthy choices are the easy choices.
CIH has a combined focus on five key areas, which give it a unique scope:
- Developing and in-transition communities
- Children and families
- Assessment of the interventions through a rigorously designed research study
- The roles played by poverty and accessibility in chronic disease death and disability
- Comparative analysis between the different sites, using a shared set of measures, with a view to building the roadmap of best practice in chronic disease prevention.
The four settings
Workplaces
Over 1,000 adult employees will be recruited across one or more workplaces in each of the two districts. Interventions will include the following:
- health education, lifestyle coaching and disease management
- personalised health risk assessments for employees
- win support from the workplace managers
- develop policy and systems to support the changes of practice, environment and behaviours.
Specifically, we will focus on:
- smoke-free policies
- safety in production (workplace safety)
- physical activity
- healthy foods
- health knowledge.
Neighbourhoods
- Creation of a network of stakeholders: local government, health sectors, safety officials, media, town planners, the private sector, community members and voluntary organisations
- Screen and identify, educate and refer high-risk individuals.
Specifically, we will focus on:
- smoke-free policies
- physical activity
- healthy foods
- safe communities to encourage outdoor physical activity
- knowledge about health.
Health centres
Over 400 health professionals and 1,000 non-clinical staff, will be recruited across one or more health centres in each of the two districts. Patients who visit the hospital will be covered. Interventions include:
- develop training courses and best practice guideline
- win the support from the hospital managers
- develop policy as well as a system to create a healthy hospital environment and influence the practice of health professionals.
Specifically, we will focus on:
- Smoke-free policies
- Health professionals will be encouraged to counsel their patients to adopt a healthier lifestyle.
Schools
Over 2,000 students and 700-1,000 staff/faculty, will be recruited across 10 or more schools with the maximum of 20 schools in each of the two districts. Interventions include:
- providing teachers with training required to address intervention in schools
- developing health-education courses and materials
- winning the support from the school managers and senior managers in the local education authourity
- developing policy and a system to support the changes of practice, environment and behaviours.
Specifically, we will focus on:
- smoke-free
- healthy foods
- physical activity
- knowledge relevant to health.
