ArticleBulletin of the World Health Organization2009
Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran.
Article in Bulletin of the World Health Organization, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 8 of them syntheses that pooled it.
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Who cites it
84 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Health-promotion interventions targeting multiple behaviors: A meta-analytic review of general and behavior-specific processes of change.Psychological bulletin · 2024Pooled it
- Dietary outcomes of community-based CVD preventive interventions: a systematic review and meta-analysis.Public health nutrition · 2023Pooled it
- Whole systems approaches to obesity and other complex public health challenges: a systematic review.BMC public health · 2019Pooled it
- Mass media interventions for smoking cessation in adults.The Cochrane database of systematic reviews · 2017Pooled it
- Cardiac rehabilitation delivery model for low-resource settings.Heart (British Cardiac Society) · 2016Guideline
- When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change.Psychological bulletin · 2015Pooled it
- Community wide interventions for increasing physical activity.The Cochrane database of systematic reviews · 2015Pooled it
- A RE-AIM evaluation of evidence-based multi-level interventions to improve obesity-related behaviours in adults: a systematic review (the SPOTLIGHT project).The international journal of behavioral nutrition and physical activity · 2014Pooled it
- The Effectiveness of a Traditional Chinese Medicine-Based Mobile Health App for Individuals With Prediabetes: Randomized Controlled Trial.JMIR mHealth and uHealth · 2023Trial
- Lifestyle Interventions to Promote Healthy Nutrition and Physical Activity in Middle-Age (40-60 Years) Adults: A Randomized Controlled Trial in the North of Iran.Journal of research in health sciences · 2019Trial
- 'Red Ruby': an interactive web-based intervention for lifestyle modification on metabolic syndrome: a study protocol for a randomized controlled trial.BMC public health · 2014Trial
- Community based interventions for the primary prevention of cardiovascular disease in women living in rural, regional and remote areas: a scoping review.BMC health services research · 2026Article
- Study protocol for a randomized controlled trial to evaluate the effectiveness of an artificial intelligence-based health education accurately linking system based on traditional Chinese medicine body constitution in patients with chronic disease multimorbidity.Frontiers in public health · 2026Article
- Effective policies on prevention and control of cardiovascular diseases in different countries: A realistic review.Journal of education and health promotion · 2026Review
- The Role of Different Domains of Perceived Stress in the Development of Cardiovascular Events: A Cohort Study.Advanced biomedical research · 2026Article
- The Association between Maladaptive Coping Strategies and Cardiovascular Risk Factors: A 12-Year Evaluation from the Isfahan Cohort Study.International journal of preventive medicine · 2025Article
- Are different perceived stressors associated with metabolic syndrome: a longitudinal cohort study of adults in central Iran.Journal of diabetes and metabolic disorders · 2023Article
- Ethnic differences in the lifestyle behaviors and premature coronary artery disease: a multi-center study.BMC cardiovascular disorders · 2023Article
- Population food intake clusters and cardiovascular disease incidence: a Bayesian quantifying of a prospective population-based cohort study in a low and middle-income country.Frontiers in nutrition · 2023Article
- Shared Lifestyle-Related Risk Factors of Cardiovascular Disease and Cancer: Evidence for Joint Prevention.TheScientificWorldJournal · 2023Review
24 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors.
Funding
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Abstract
objectiveTo assess the effects of a comprehensive, integrated community-based lifestyle intervention on diet, physical activity and smoking in two Iranian communities.
methodsWithin the framework of the Isfahan Healthy Heart Program, a community trial was conducted in two intervention counties (Isfahan and Najaf-Abad) and a control area (Arak). Lifestyle interventions targeted the urban and rural populations in the intervention counties but were not implemented in Arak. In each community, a random sample of adults was selected yearly by multi-stage cluster sampling. Food consumption, physical exercise and smoking behaviours were quantified and scored as 1 (low-risk) or 0 (other) at baseline (year 2000) and annually for 4 years in the intervention areas and for 3 years in the control area. The scores for all behaviours were then added to derive an overall lifestyle score.
findingsAfter 4 years, changes from baseline in mean dietary score differed significantly between the intervention and control areas (+2.1 points versus -1.2 points, respectively; P < 0.01), as did the change in the percentage of individuals following a healthy diet (+14.9% versus -2.0%, respectively; P < 0.001). Daily smoking had decreased by 0.9% in the intervention areas and by 2.6% in the control area at the end of the third year, but the difference was not significant. Analysis by gender revealed a significant decreasing trend in smoking among men (P < 0.05) but not among women. Energy expenditure for total daily physical activities showed a decreasing trend in all areas, but the mean drop from baseline was significantly smaller in the intervention areas than in the control area (-68 metabolic equivalent task (MET) minutes per week versus -114 MET minutes per week, respectively; P < 0.05). Leisure time devoted to physical activities showed an increasing trend in all areas. A significantly different change from baseline was found between the intervention areas and the control area in mean lifestyle score, even after controlling for age, sex and baseline values.
conclusionThe results suggest that community-based lifestyle intervention programmes can be effective in a developing country setting.
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