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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Socioeconomic status and risk of cardiovascular disease in 20 low-income, middle-income, and high-income countries: the Prospective Urban Rural Epidemiologic (PURE) study

Rosengren, A.; Smyth, A.; Rangarajan, S. et al. The Lancet Global Health (2019) CC

Socioeconomic status is associated with differences in risk factors for cardiovascular disease incidence and outcomes, including mortality. However, it is unclear whether the associations between cardiovascular disease and common measures of socioeconomic status—wealth and education—differ among... more

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Public knowledge of cardiovascular disease and response to acute cardiac events in three municipalities in Brazil

Bartlett, E. S.; Flor, L.S.; Souto Medeiros, D. et al. Open Heart (2020) CC

Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil. Metho... more

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Miners

M. Smelyanskaya, J. Duncan (The Focus Group Consulting); D. Daniels, et al. Stop TB Partnership; UNOPS; END TB (2016) C1

Key popupations brief.

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People who use drugs

M. Smelyanskaya, J. Duncan (The Focus Group Consulting); C. Daniels, et al. Stop TB Partnership; UNOPS; END TB (2016) C1

Key populations brief.

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Prisoners

M. Smelyanskaya, J. Duncan (The Focus Group Consulting); C. Daniels, et al. Stop TB Partnership; UNOPS; END TB (2016) C1

Key population brief.

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Mobile Populations

M. Smelyanskaya, J. Duncan (The Focus Group Consulting); C. Daniels, et al. Stop TB Partnership; UNOPS; END TB (2015) C1

Key populations brief.

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Combined global demand forecasts for antiretroviral medicines and HIV diagnostic in low- and middle-income countries from 2015 to 2020

A. Adesina; J. Stover; M. Auton; et al. World Health Organization (2016) C_WHO

Technical Report AIDS Medicines and diagnostics service September 2016

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Individual-level data in 680 102 adults, The state of diabetes treatment coverage in 55 low-income and middle-income countries: a cross-sectional study of nationally representative

Flood, D.; Seiglie, J.A.; Dunn, M.; et al. The Lancet healthy Longevity (2021) C2

Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns... more

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Challenges in management and prevention of ischemic heart disease in low socioeconomic status people in LLMICs

Gupta, R.; Yusuf, S. BMC Medicine (2019) CC

Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (... more

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Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

Schwalm, J.; McKee, M.; Huffman, M. et al. Circulation (2016) CC

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... more

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World Heart Federation Roadmap for Heart Failure

Ferreira, J.P.; Kraus, S.; Mitchell, S. et al. Global Heart (2019) CC

In 2012, all Member States of the World Health Organization (WHO) endorsed a historical target to reduce premature mortality from noncommunicable diseases (NCD). This commitment was echoed in 2015 by the United Nations Sustainable Development Goals, which included a target to reduce premature morta... more

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Infections of the nervous system

V. Parikh; V. Tucci; S. Galwankar PMC (US National Library of Medicine National Institutes of Health) (2012) C2

Int J Crit Illn Inj Sci. 2012 May-Aug; 2(2): 82–97. doi: 10.4103/2229-5151.97273 PMCID: PMC3401822 PMID: 22837896

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Operational Guidelines on Quality Assurance in Public Health Facilities

Ministry of Health & Family Welfare Government of India Ministry of Health & Family Welfare Government of India (2013) C1

For the Assesor's Guide Vol 1 and 2 see: nrhm.gov.in/images/pdf/programmes/maternal-health/guidelines/Operational_Guidelines_for_Quality_Assurance_in_Public_Health_Facilities_and_checklists-3_books.zip

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Injury Prevention and Environmental Health. Disease Control Priorities, Third Edition : Volume 7

Mock, Charles N.; Nugent, Rachel; Kobusingye, Olive; et al. World Bank (2017) CC

The substantial burden of death and disability that results from interpersonal violence, road traffic injuries, unintentional injuries, occupational health risks, air pollution, climate change, and inadequate water and sanitation falls disproportionally on low- and middle-income countries. Injury Pr... more

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Landscape for HIV rapid diagnostic tests for HIV self-testing - 4th edition

World Health Organization (WHO); UNITAID World Health Organization (WHO); UNITAID (2018) C2

July 2018 This fourth edition of the Unitaid/WHO market and technology landscape: HIV rapid diagnostic tests for self-testing report summarizes the current HIV testing gap; the challenges facing efforts to scale up; and the potential role HIV self-testing (HIVST) could play to achieve the United... more

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Thailand: Disaster Management Reference Handbook

Center for Excellence in Disaster Management and Humanitarian Assistance (2022) C1

Thailand is exposed to flooding, landslides, drought, earthquakes, tsunamis, heat waves, forest fires, and epidemics. Thailand is also exposed to technological hazards such as chemical accidents. Flooding is the natural hazard with the most significant impact on human life, livelihoods, and the econ... more

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Caregiver skills training for families of children with developmental delays or disabilities - Introduction

World Health Organization WHO (2022) C_WHO

This is the first part of a five-part package that provides guidance on caregiver skills training for families of children aged 2–9 years with developmental delays or disabilities. The Caregiver skills training for families of children with developmental delays or disabilities (CST) aims to pro... more

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Caregiver Skills Training for Families of Children with Developmental Delays or Disabilities Participants’ guide: group sessions 1–9

World Health Organization WHO (2022) C_WHO

This participants’ guide is part of a five-part Caregiver skills training for families of children with developmental delays or disabilities (CST) package providing guidance on caregiver skills training for families of children aged 2–9 years with developmental delays or disabilities. This pa... more

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World Malaria Report 2021

World Health Organization WHO (2021) C_WHO

TNew data from the World Health Organization reveal that the COVID-19 pandemic has disrupted malaria services, leading to a marked increase in cases and deaths. According to WHO’s latest World malaria report, there were an estimated 241 million malaria cases and 627 000 malaria deaths worldwide i... more