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3. Community Efficacy for Non-Communicable Disease Management and Medication Adherence: The Sequential Mediating Role of Self-Efficacy and Depressive Symptoms.

Author

Zhu, Gangjiao, Malhotra, Rahul, Xiong, Shangzhi, Chen, Xinyue, Zhang, Mingyang, Wu, You, Gong, Enying, Wang, Zhan, Tian, Xiangyang, Peng, Weixia, Østbye, Truls, and Yan, Lijing L

Subjects
PATIENT compliance, DISEASE management, MENTAL depression, MEDICATION therapy management, SELF-efficacy, NON-communicable diseases
Abstract

Purpose: We assess whether the sequential mediating effects of self-efficacy and depressive symptoms on the relationship between community efficacy for non-communicable disease management (COEN) and medication adherence and whether these relationships differed by sex and age.Patients and Methods: Overall, 662 individuals from 12 communities in China were interviewed twice 1 year apart. Serial mediation analysis examined whether the relationship between COEN and medication adherence was mediated by self-efficacy and depressive symptoms. Model invariance across sex and age groups was assessed using multi-group analysis.Results: Serial mediation analysis indicated that self-efficacy and depressive symptoms sequentially mediated relationship between COEN and medication adherence. Multi-group analysis by sex showed that the path from self-efficacy to medication adherence was significant only for females and from depressive symptoms to medication adherence was significant only for males.Conclusion: Interventions that enhance individual self-efficacy may be beneficial in decreasing depressive symptoms and improving medication adherence. [ABSTRACT FROM AUTHOR]

Published
2023
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4. Hypertension in China: burdens, guidelines and policy responses: a state-of-the-art review

Author

Yin, Ruoyu, Yin, Lishi, Li, Lin, Silva-Nash, Jennifer, Tan, Jingru, Pan, Zixian, Zeng, Jianying, Yan, Lijing L, Yan, Lijing L [0000-0002-3029-0462], and Apollo - University of Cambridge Repository

Subjects
Male, China, Policy, Cardiovascular Diseases, Hypertension, Humans, Female
Abstract

Hypertension is a leading risk factor of cardiovascular disease and it is becoming increasingly prevalent globally. Correspondingly, the Chinese government and public health institutions have issued a series of policy documents and guidelines for hypertension. However, no comprehensive review of such documents has been conducted. Hence, this review aims to provide an up-to-date and comprehensive assessment of not only the disease burden, but also hypertension management policies and guidelines in China. A total of 15 epidemiological studies based on national population surveys, 15 Chinese Hypertension Guidelines, and seven policy documents were identified. We found a larger burden of hypertension in men, while the awareness, treatment, and control rates have remained low in both sexes. The ranges of hypertension prevalence, awareness, treatment, and control rate among hypertensive patients were 18.0-44.7%, 23.6-56.2%, 14.2-48.5%, and 4.2-30.1% respectively. Chinese hypertension guidelines provide evidence-based instructions to healthcare practitioners over hypertension management in which primary healthcare is increasingly emphasized. Finally, the policy documents set national goals for hypertension management and standardized the services provided in primary healthcare. The findings highlight the importance of integrating new guidelines into hypertension management provided by primary healthcare practitioners and the need to evaluate the implementation of guidelines and policies.

Published
2022

6. A Smart and Multifaceted Mobile Health System for Delivering Evidence-Based Secondary Prevention of Stroke in Rural China: Design, Development, and Feasibility Study

Author

Wu, Na, Gong, Enying, Wang, Bo, Gu, Wanbing, Ding, Nan, Zhang, Zhuoran, Chen, Mengyao, Yan, Lijing L, Oldenburg, Brian, and Xu, Li-Qun

Subjects
Adult, Male, China, Telemedicine, 020205 medical informatics, Health Informatics, Context (language use), 02 engineering and technology, Information technology, Health informatics, 03 medical and health sciences, 0302 clinical medicine, Nursing, Surveys and Questionnaires, 11. Sustainability, Health care, Secondary Prevention, 0202 electrical engineering, electronic engineering, information engineering, Humans, 030212 general & internal medicine, mHealth, Aged, Original Paper, Evidence-Based Medicine, business.industry, End user, rural health services, Evidence-based medicine, mobile application, Middle Aged, T58.5-58.64, stroke, software design, Mobile Applications, 3. Good health, Feasibility Studies, Female, Business, Rural area, Public aspects of medicine, RA1-1270
Abstract

BackgroundMobile health (mHealth) technologies hold great promise in improving the delivery of high-quality health care services. Yet, there has been little research so far applying mHealth technologies in the context of delivering stroke care in resource-limited rural regions. ObjectiveThis study aimed to introduce the design and development of an mHealth system targeting primary health care providers and to ascertain its feasibility in supporting the delivery of a System-Integrated techNology-Enabled Model of cAre (SINEMA) service for strengthening secondary prevention of stroke in rural China. MethodsThe SINEMA mHealth system was designed by a multidisciplinary team comprising public health researchers, neurologists, and information and communication technology experts. The iterative co-design and development of the mHealth system involved the following 5 steps: (1) assessing the needs of relevant end users through in-depth interviews of stakeholders, (2) designing the functional modules and evidence-based care content, (3) designing and building the system and user interface, (4) improving and enhancing the system through a 3-month pilot test in 4 villages, and (5) finalizing the system and deploying it in field trial, and finally, evaluating its feasibility through a survey of the dominant user group. ResultsFrom the in-depth interviews of 49 relevant stakeholders, we found that village doctors had limited capacity in caring for village-dwelling stroke patients in rural areas. Primary health care workers demonstrated real needs in receiving appropriate training and support from the mHealth system as well as great interests in using the mHealth technologies and tools. Using these findings, we designed a multifaceted mHealth system with 7 functional modules by following the iterative user-centered design and software development approach. The mHealth system, aimed at 3 different types of users (village doctors, town physicians, and county managers), was developed and utilized in a cluster-randomized controlled trial by 25 village doctors in a resource-limited county in rural China to manage 637 stroke patients between July 2017 and July 2018. In the end, a survey on the usability and functions of the mHealth system among village doctors (the dominant group of users, response rate=96%, 24/25) revealed that most of them were satisfied with the essential functions provided (71%) and were keen to continue using it (92%) after the study. ConclusionsThe mHealth system was feasible for assisting primary health care providers in rural China in delivering the SINEMA service on the secondary prevention of stroke. Further research and initiatives in scaling up the SINEMA approach and this mHealth system to other resource-limited regions in China and beyond will likely enhance the quality and accessibility of essential secondary prevention among stroke patients. ClinicalTrialClinicalTrials.gov NCT03185858; https://clinicaltrials.gov/ct2/show/NCT03185858 International Registered Report Identifier (IRRID)RR2-10.1016/j.ahj.2018.08.015

Published
2019

7. Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries : an analysis from the Global Burden of Disease Study 2016

Author

Fullman, Nancy, Barber, Ryan M, Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M, Abd-Allah, Foad, Abdulkader, Rizwan Suliankatchi, Abdulle, Abdishakur M, Abera, Semaw Ferede, Aboyans, Victor, De Steur, Hans, Gupta, Vipin, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Srinivasan, Vinay, Nguyen, Quyen Le, Stanaway, Jeffrey D, Atre, Sachin R, Kim, Daniel, Criqui, Michael H, Aryal, Krishna Kumar, Ahmadieh, Hamid, Stein, Dan J, Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Strub, Bryan, Aichour, Miloud Taki Eddine, Nguyen, Trang Huyen, Defo, Barthelemy Kuate, Sufiyan, Muawiyyah Babale, Dandona, Rakhi, Mantovani, Lorenzo G, Sunguya, Bruno F, Sur, Patrick J, Mazidi, Mohsen, Kimokoti, Ruth W, Swaminathan, Soumya, Sykes, Bryan L, Avila-Burgos, Leticia, Sylte, Dillon O, Nguyen, Grant, Schwebel, David C, Szoeke, Cassandra E I, Murthy, Gudlavalleti Venkata Satyanarayana, Tabarés-Seisdedos, Rafael, Hafezi-Nejad, Nima, Tadakamadla, Santosh Kumar, Degenhardt, Louisa, McAlinden, Colm, Tandon, Nikhil, Kinfu, Yohannes, Tao, Tianchan, Schwendicke, Falk, Tarekegn, Yihunie L, Giref, Ababi Zergaw, Ahmed, Muktar Beshir, Tavakkoli, Mohammad, Taveira, Nuno, Tegegne, Teketo Kassaw, Avokpaho, Euripide Frinel G Arthur, Terkawi, Abdullah Sulieman, Hailu, Gessessew Bugssa, Alla, François, Seedat, Soraya, Tessema, Gizachew Assefa, Thakur, JS, Alam, Khurshid, Rajsic, Sasa, Nguyen, Minh, Deiparine, Selina, Thankappan, Kavumpurathu Raman, Thrift, Amanda G, Tiruye, Tenaw Yimer, Tobe-Gai, Ruoyan, Martin, Randall V, Topor-Madry, Roman, Torre, Anna, McGaughey, Madeline, Tortajada, Miguel, Ram, Usha, Hamadeh, Randah Ribhi, Nichols, Emma, Awasthi, Ashish, Fürst, Thomas, Tran, Bach Xuan, Sepanlou, Sadaf G, Troeger, Christopher, Deribe, Kebede, Truelsen, Thomas, Tsoi, Derrick, Tuem, Kald Beshir, Ranabhat, Chhabi Lal, McGrath, John J, Tuzcu, Emin Murat, Majeed, Azeem, Tyrovolas, Stefanos, Servan-Mori, Edson E, Ukwaja, Kingsley N, Hammami, Mouhanad, Kisa, Adnan, Uneke, Chigozie Jesse, Updike, Rachel, Azzopardi, Peter, Rao, Puja C, Uthman, Olalekan A, Adetokunboh, Olatunji, McKee, Martin, Griswold, Max, Cárdenas, Rosario, van Boven, Job F M, Varughese, Santosh, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Vidavalur, Ramesh, Abu-Raddad, Laith J, Rawaf, Salman, Hankey, Graeme J, Violante, Francesco S, Altirkawi, Khalid A, Vladimirov, Sergey K, Vlassov, Vasiliy Victorovich, Ningrum, Dina Nur Anggraini, Mehata, Suresh, Vollset, Stein Emil, Bacha, Umar, deVeber, Gabrielle A, Vos, Theo, Antonio, Carl Abelardo T, Wadilo, Fiseha, Rafay, Anwar, Wakayo, Tolassa, Kissimova-Skarbek, Katarzyna A, Wallin, Mitchell T, Harb, Hilda L, Nomura, Marika, Wang, Yuan-Pang, Mehndiratta, Man Mohan, Weichenthal, Scott, Weiderpass, Elisabete, Khader, Yousef Saleh, Carrero, Juan Jesus, Weintraub, Robert G, Weiss, Daniel J, Werdecker, Andrea, Ding, Eric L, Badawi, Alaa, Kivimaki, Mika, Chitheer, Abdulaal A, Westerman, Ronny, Whiteford, Harvey A, Chang, Hsing-Yi, Shackelford, Katya Anne, Reidy, Patrick, Hareri, Habtamu Abera, Wijeratne, Tissa, Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D A, Woodbrook, Rachel, Xavier, Denis, Alvis-Guzman, Nelson, Xu, Gelin, Shaheen, Amira, Kokubo, Yoshihiro, Reiner, Robert C, Djalalinia, Shirin, Karema, Corine Kakizi, Yadgir, Simon, Balakrishnan, Kalpana, Hassanvand, Mohammad Sadegh, Yakob, Bereket, Yan, Lijing L, Yano, Yuichiro, Shahraz, Saeid, Nong, Vuong Minh, Yaseri, Mehdi, Musa, Kamarul Imran, Ye, Pengpeng, Yimam, Hassen Hamid, Kopec, Jacek A, Meier, Toni, Yip, Paul, Yonemoto, Naohiro, Do, Huyen Phuc, Shaikh, Masood Ali, Yoon, Seok-Jun, Butt, Zahid A, Norheim, Ole F, Geleto, Ayele, Yotebieng, Marcel, Bannick, Marlena S, Younis, Mustafa Z, Zaidi, Zoubida, Zaki, Maysaa El Sayed, Breitborde, Nicholas J K, Shamsipour, Mansour, Kosen, Soewarta, Zavala-Arciniega, Luis, Zhang, Xueying, Zipkin, Ben, Reinig, Nikolas, Noubiap, Jean Jacques N, Zodpey, Sanjay, Dokova, Klara, Havmoeller, Rasmus, Lim, Stephen S, Dargan, Paul I, Murray, Christopher J L, Barac, Aleksandra, Meles, Kidanu Gebremariam, Barker-Collo, Suzanne L, Koul, Parvaiz A, Reitsma, Marissa B, Bärnighausen, Till, Obermeyer, Carla Makhlouf, Barrero, Lope H, Basu, Sanjay, Martinez-Raga, Jose, Battle, Katherine E, Baune, Bernhard T, Beardsley, Justin, Hawley, Caitlin, Doku, David Teye, Memish, Ziad A, Goldberg, Ellen M, Bedi, Neeraj, Beghi, Ettore, Gishu, Melkamu Dedefo, Asayesh, Hamid, Koyanagi, Ai, Béjot, Yannick, Bell, Michelle L, Bennett, Derrick A, Bennett, James R, Bensenor, Isabela M, Berhane, Adugnaw, Cromwell, Elizabeth A, Berhe, Derbew Fikadu, Mendoza, Walter, Shamsizadeh, Morteza, Aichour, Amani Nidhal, Malekzadeh, Reza, Bernabé, Eduardo, Donkelaar, Aaron van, Kravchenko, Michael, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Remuzzi, Giuseppe, Bhala, Neeraj, Ansari, Hossein, Bhansali, Anil, Bhatt, Samir, Mengesha, Melkamu Merid, Ogbo, Felix Akpojene, Bhutta, Zulfiqar A, Bicer, Burcu Kucuk, Hay, Simon I, Bidgoli, Hassan Haghparast, Furtado, Joao M, Renzaho, Andre M N, Kawakami, Norito, Bikbov, Boris, Dorsey, E Ray, Bilal, Arebu I, Birungi, Charles, Biryukov, Stan, Friedman, Joseph, Allebeck, Peter, Bizuayehu, Habtamu Mellie, Blosser, Christopher D, Boneya, Dube Jara, Shariful Islam, Sheikh Mohammed, Resnikoff, Serge, Bose, Dipan, He, Jiawei, Krohn, Kristopher J, Bou-Orm, Ibrahim R, Brauer, Michael, Driscoll, Tim R, Oh, In-Hwan, Dubey, Manisha, Mengistie, Mubarek Abera, Sharma, Jayendra, Afshin, Ashkan, Rezaei, Satar, Duncan, Bruce Bartholow, Ebel, Beth E, Ebrahimi, Hedyeh, El-Khatib, Ziad Ziad, Enayati, Ahmadali, Alam, Noore, Hendrie, Delia, Oladimeji, Olanrewaju, Khosravi, Ardeshir, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Khalil, Ibrahim A, Mensah, George A, Erskine, Holly E, Eshrati, Babak, Eskandarieh, Sharareh, Agrawal, Anurag, Esteghamati, Alireza, Estep, Kara, Gugnani, Harish Chander, Faraon, Emerito Jose Aquino, Olagunju, Andrew Toyin, Carter, Austin, Naghavi, Mohsen, Farinha, Carla Sofia e Sa, Henry, Nathaniel J, Mensink, Gert B M, Faro, André, Farzadfar, Farshad, Fazeli, Mir Sohail, Sharma, Rajesh, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Olagunju, Tinuke Oluwasefunmi, Rios Blancas, Maria Jesus, Agrawal, Sutapa, Fernandes, João C, Kulikoff, Xie Rachel, Ferrari, Alize J, Kasaeian, Amir, She, Jun, Feyissa, Tesfaye Regassa, Heredia-Pi, Ileana Beatriz, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Kamal, Ritul, Christensen, Hanne, Flaxman, Abraham D, Foigt, Nataliya, Foreman, Kyle J, Shi, Peilin, Frank, Tahvi, Kumar, G Anil, Mereta, Seid Tiku, Ahmad Kiadaliri, Aliasghar, Franklin, Richard C, Hoek, Hans W, Rivas, Jacqueline Castillo, Holmberg, Mollie, Olivares, Pedro R, Cahuana-Hurtado, Lucero, Shibuya, Kenji, Horita, Nobuyuki, Hosgood, H Dean, Hostiuc, Sorin, Aichour, Ibtihel, Hoy, Damian G, Chang, Jung-Chen, Kumar Lal, Dharmesh, Anwari, Palwasha, Hsairi, Mohamed, Htet, Aung Soe, Martins-Melo, Francisco Rogerlândio, Amare, Azmeraw T, Huang, John J, Huang, Hsiang, Huynh, Chantal, Cameron, Ewan, Iburg, Kim Moesgaard, Ikeda, Chad, Inoue, Manami, Roba, Kedir Teji, Gemechu, Bikila Lencha, Rahimi-Movaghar, Vafa, Irvine, Caleb Mackay Salpeter, Kutz, Michael J, Olsen, Helen E, Aiyar, Sneha, Jacobsen, Kathryn H, Jahanmehr, Nader, Jakovljevic, Mihajlo B, Jauregui, Alejandra, Javanbakht, Mehdi, Rojas-Rueda, David, Shields, Chloe, Campuzano, Julio Cesar, Jeemon, Panniyammakal, Meretoja, Tuomo J, Jha, Vivekanand, Malhotra, Rajesh, John, Denny, Kyu, Hmwe H, Johnson, Catherine O, Johnson, Sarah Charlotte, Akinyemi, Rufus Olusola, Majdzadeh, Reza, Gona, Philimon N, Jonas, Jost B, Jürisson, Mikk, Kabir, Zubair, Kadel, Rajendra, Meretoja, Atte, Olusanya, Bolajoko Olubukunola, Carabin, Hélène, Kahsay, Amaha, Lalloo, Ratilal, Shifa, Girma Temam, Lansingh, Van C, Rokni, Mohammad Bagher, Gakidou, Emmanuela, Larsson, Anders, Lazarus, Jeffrey Victor, Lee, Paul H, Casey, Daniel C, Alasfoor, Deena, Giussani, Giorgia, Mezgebe, Haftay Berhane, das Neves, José, Leigh, James, Leung, Janni, Crump, John A, Leung, Ricky, Levi, Miriam, Li, Yongmei, Garcia-Basteiro, Alberto L, Liben, Misgan Legesse, Linn, Shai, Liu, Patrick Y, Shiferaw, Mekonnen Sisay, Keiyoro, Peter Njenga, Liu, Shiwei, Micha, Renata, Roshandel, Gholamreza, Castañeda-Orjuela, Carlos A, Lodha, Rakesh, Alene, Kefyalew Addis, Looker, Katharine J, Lopez, Alan D, Lorkowski, Stefan, Asgedom, Solomon Weldegebreal, Gebrehiwot, Tsegaye Tewelde, Lotufo, Paulo A, Olusanya, Jacob Olusegun, Lozano, Rafael, Naheed, Aliya, Lucas, Timothy C D, Millear, Anoushka, Lunevicius, Raimundas, Mackay, Mark T, Castro, Ruben Estanislao, Khubchandani, Jagdish, Maddison, Emilie R, Magdy Abd El Razek, Hassan, Alizadeh-Navaei, Reza, Magdy Abd El Razek, Mohammed, Ong, Kanyin, Roth, Gregory A, Geleijnse, Johanna M, Majdan, Marek, Miller, Ted R, Allen, Christine, Shigematsu, Mika, Kassebaum, Nicholas J, Minnig, Shawn, Mirarefin, Mojde, Mirrakhimov, Erkin M, Gething, Peter W, Charlson, Fiona J, Al-Aly, Ziyad, Oren, Eyal, Misganaw, Awoke, Mishra, Shiva Raj, Gupta, Rajeev, Mitchell, Philip B, Mohammad, Karzan Abdulmuhsin, Mohammed, Kedir Endris, Akseer, Nadia, Mohammed, Shafiu, Mohan, Murali B V, Al-Raddadi, Rajaa, Alkerwi, Ala'a, Mokdad, Ali H, Ortiz, Alberto, Shin, Min-Jeong, Gibney, Katherine B, Mollenkopf, Sarah K, Chew, Adrienne, Monasta, Lorenzo, Montañez Hernandez, Julio Cesar, Montico, Marcella, Kastor, Anshul, Moradi-Lakeh, Maziar, Roy, Ambuj, Moraga, Paula, Rahman, Mohammad Hifz Ur, Morawska, Lidia, Owolabi, Mayowa O, Morrison, Shane D, Moses, Mark W, Gill, Paramjit Singh, Alsharif, Ubai, Mountjoy-Venning, Cliff, Abu-Rmeileh, Niveen M E, Mueller, Ulrich O, Rubagotti, Enrico, Shiri, Rahman, Katikireddi, Srinivasa Vittal, Muller, Kate, PA, Mahesh, Christopher, Devasahayam Jesudas, Malta, Deborah Carvalho, Pana, Adrian, Panda, Basant Kumar, Amini, Erfan, Kelbore, Sefonias Getachew, Glenn, Scott D, Cercy, Kelly, Sadat, Nafis, Panda-Jonas, Songhomitra, Papachristou, Christina, Park, Eun-Kee, Patton, George C, Paulson, Katherine, Catalá-López, Ferrán, Pereira, David M, Perico, David Norberto, Cirillo, Massimo, Chisumpa, Vesper Hichilombwe, Pesudovs, Konrad, Safdarian, Mahdi, Kemmer, Laura, Petzold, Max, Godwin, William W, Phillips, Michael Robert, Ammar, Walid, Pigott, David M, Mamun, Abdullah A, Pillay, Julian David, Shirkoohi, Reza, Pinho, Christine, Piradov, Michael A, Safi, Sare, Pishgar, Farhad, Poulton, Richie G, Kengne, Andre Pascal, Cooper, Cyrus, Pourmalek, Farshad, Brugha, Traolach S, Qorbani, Mostafa, Shirude, Shreya, Manguerra, Helena, Radfar, Amir, Arora, Megha, Goodridge, Amador, Naidoo, Kovin S, Safiri, Saeid, Sagar, Rajesh, Dandona, Lalit, Manyazewal, Tsegahun, Khan, Ejaz Ahmad, Shishani, Kawkab, Salama, Joseph, Salomon, Joshua A, Samy, Abdallah M, Sanabria, Juan Ramon, Santomauro, Damian, Gillum, Richard F, Santos, Itamar S, Santos, João Vasco, Gopalani, Sameer Vali, Santric Milicevic, Milena M, Shoman, Haitham, Mapoma, Chabila C, Artaman, Al, Khang, Young-Ho, Sartorius, Benn, Adedeji, Isaac Akinkunmi, Satpathy, Maheswar, Nangia, Vinay, Sawhney, Monika, Saxena, Sonia, Saylan, Mete I, Shrime, Mark G, Schmidt, Maria Inês, Schneider, Ione J C, Marks, Guy B, Goryakin, Yevgeniy, Schneider, Matthew T, Frostad, Joseph J, Schöttker, Ben, Natarajan, Gopalakrishnan, Schutte, Aletta E, Davitoiu, Dragos V, Kieling, Christian, Rahman, Muhammad Aziz, Silberberg, Donald H, Silva, Diego Augusto Santos, Gupta, Tanush, Negoi, Ruxandra Irina, Martopullo, Ira, Assadi, Reza, Silva, João Pedro, Silveira, Dayane Gabriele Alves, Singh, Jasvinder A, Singh, Virendra, Kesavachandran, Chandrasekharan Nair, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Kim, Jun Y, Slepak, Erica Leigh, Negoi, Ionut, de Courten, Barbora, Mathur, Manu Raj, Sligar, Amber, Bulto, Lemma Negesa Bulto, Smith, David L, Rahman, Mahfuzar, Smith, Alison, Atey, Tesfay Mehari, Smith, Mari, Sobaih, Badr H A, Sobngwi, Eugene, Nguyen, Cuong Tat, Kim, Yun Jin, Soljak, Michael, Karch, André, Soneji, Samir, Rai, Rajesh Kumar, Sorensen, Reed J D, Halk Sağlığı, Veritati - Repositório Institucional da Universidade Católica Portuguesa, Fullman, Nancy, Barber, Ryan M., Abajobir, Amanuel Alemu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbas, Kaja M., Abd-Allah, Foad, Abdulle, Abdishakur M., Abera, Semaw Ferede, Aboyans, Victor, Abu-Raddad, Laith J., Abu-Rmeileh, Niveen M.E., Adedeji, Isaac Akinkunmi, Adetokunboh, Olatunji, Afshin, Ashkan, Agrawal, Anurag, Agrawal, Sutapa, Kiadaliri, Aliasghar Ahmad, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Aiyar, Sneha, Akinyemi, Rufus Olusola, Akseer, Nadia, Al-Aly, Ziyad, Alam, Khurshid, Alam, Noore, Alasfoor, Deena, Alene, Kefyalew Addi, Alizadeh-Navaei, Reza, Alkerwi, Ala'a, Alla, Françoi, Allebeck, Peter, Allen, Christine, Al-Raddadi, Rajaa, Alsharif, Ubai, Altirkawi, Khalid A., Alvis-Guzman, Nelson, Amare, Azmeraw T., Amini, Erfan, Ammar, Walid, Antonio, Carl Abelardo T., Ansari, Hossein, Anwari, Palwasha, Arora, Megha, Artaman, Al, Aryal, Krishna Kumar, Asayesh, Hamid, Asgedom, Solomon Weldegebreal, Assadi, Reza, Atey, Tesfay Mehari, Atre, Sachin R., Avila-Burgos, Leticia, Arthur Avokpaho, Euripide Frinel G., Awasthi, Ashish, Azzopardi, Peter, Bacha, Umar, Badawi, Alaa, Balakrishnan, Kalpana, Bannick, Marlena S., Barac, Aleksandra, Barker-Collo, Suzanne L., Bärnighausen, Till, Barrero, Lope H., Basu, Sanjay, Battle, Katherine E., Baune, Bernhard T., Beardsley, Justin, Bedi, Neeraj, Beghi, Ettore, Béjot, Yannick, Bell, Michelle L., Bennett, Derrick A., Bennett, James R., Bensenor, Isabela M., Berhane, Adugnaw, Berhe, Derbew Fikadu, Bernabé, Eduardo, Betsu, Balem Demtsu, Beuran, Mircea, Beyene, Addisu Shunu, Bhala, Neeraj, Bhansali, Anil, Bhatt, Samir, Bhutta, Zulfiqar A., Bikbov, Bori, Bilal, Arebu I., Birungi, Charle, Biryukov, Stan, Bizuayehu, Habtamu Mellie, Blosser, Christopher D., Boneya, Dube Jara, Bose, Dipan, Bou-Orm, Ibrahim R., Brauer, Michael, Breitborde, Nicholas J.K., Brugha, Traolach S., Bulto, Lemma Negesa Bulto, Butt, Zahid A., Cahuana-Hurtado, Lucero, Cameron, Ewan, Campuzano, Julio Cesar, Carabin, Hélène, Cárdenas, Rosario, Carrero, Juan Jesu, Carter, Austin, Casey, Daniel C., Castañeda-Orjuela, Carlos A., Rivas, Jacqueline Castillo, Castro, Ruben Estanislao, Catalá-López, Ferrán, Cercy, Kelly, Chang, Hsing-Yi, Chang, Jung-Chen, Charlson, Fiona J., Chew, Adrienne, Chisumpa, Vesper Hichilombwe, Chitheer, Abdulaal A., Christensen, Hanne, Christopher, Devasahayam Jesuda, Cirillo, Massimo, Cooper, Cyru, Criqui, Michael H., Cromwell, Elizabeth A., Crump, John A., Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I., Das Neves, José, Davitoiu, Dragos V., De Courten, Barbora, De Steur, Han, Degenhardt, Louisa, Deiparine, Selina, Deribe, Kebede, DeVeber, Gabrielle A., Ding, Eric L., Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Dorsey, E. Ray, Driscoll, Tim R., Dubey, Manisha, Duncan, Bruce Bartholow, Ebel, Beth E., Ebrahimi, Hedyeh, El-Khatib, Ziad Ziad, Enayati, Ahmadali, Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Erskine, Holly E., Eshrati, Babak, Eskandarieh, Sharareh, Esteghamati, Alireza, Estep, Kara, Faraon, Emerito Jose Aquino, Sofia E Sa Farinha, Carla, Faro, André, Farzadfar, Farshad, Fazeli, Mir Sohail, Feigin, Valery L., Feigl, Andrea B., Fereshtehnejad, Seyed-Mohammad, Fernandes, João C., Ferrari, Alize J., Feyissa, Tesfaye Regassa, Filip, Irina, Fischer, Florian, Fitzmaurice, Christina, Flaxman, Abraham D., Foigt, Nataliya, Foreman, Kyle J., Frank, Tahvi, Franklin, Richard C., Friedman, Joseph, Frostad, Joseph J., Fürst, Thoma, Furtado, Joao M., Gakidou, Emmanuela, Garcia-Basteiro, Alberto L., Gebrehiwot, Tsegaye Tewelde, Geleijnse, Johanna M., Geleto, Ayele, Gemechu, Bikila Lencha, Gething, Peter W., Gibney, Katherine B., Gill, Paramjit Singh, Gillum, Richard F., Giref, Ababi Zergaw, Gishu, Melkamu Dedefo, Giussani, Giorgia, Glenn, Scott D., Godwin, William W., Goldberg, Ellen M., Gona, Philimon N., Goodridge, Amador, Gopalani, Sameer Vali, Goryakin, Yevgeniy, Griswold, Max, Gugnani, Harish Chander, Gupta, Rajeev, Gupta, Tanush, Gupta, Vipin, Hafezi-Nejad, Nima, Bidgoli, Hassan Haghparast, Hailu, Gessessew Bugssa, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Hareri, Habtamu Abera, Hassanvand, Mohammad Sadegh, Havmoeller, Rasmu, Hawley, Caitlin, Hay, Simon I., He, Jiawei, Hendrie, Delia, Henry, Nathaniel J., Heredia-Pi, Ileana Beatriz, Hoek, Hans W., Holmberg, Mollie, Horita, Nobuyuki, Hosgood, H. 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C, Al-Raddadi, R, Alsharif, U, Altirkawi, K, Alvis-Guzman, N, Amare, A, Amini, E, Ammar, W, Antonio, C, Ansari, H, Anwari, P, Arora, M, Artaman, A, Aryal, K, Asayesh, H, Asgedom, S, Assadi, R, Atey, T, Atre, S, Avila-Burgos, L, Arthur Avokpaho, E, Awasthi, A, Azzopardi, P, Bacha, U, Badawi, A, Balakrishnan, K, Bannick, M, Barac, A, Barker-Collo, S, Bärnighausen, T, Barrero, L, Basu, S, Battle, K, Baune, B, Beardsley, J, Bedi, N, Beghi, E, Béjot, Y, Bell, M, Bennett, D, Bennett, J, Bensenor, I, Berhane, A, Berhe, D, Bernabé, E, Betsu, B, Beuran, M, Beyene, A, Bhala, N, Bhansali, A, Bhatt, S, Bhutta, Z, Bikbov, B, Bilal, A, Birungi, C, Biryukov, S, Bizuayehu, H, Blosser, C, Boneya, D, Bose, D, Bou-Orm, I, Brauer, M, Breitborde, N, Brugha, T, Bulto, L, Butt, Z, Cahuana-Hurtado, L, Cameron, E, Campuzano, J, Carabin, H, Cárdenas, R, Carrero, J, Carter, A, Casey, D, Castañeda-Orjuela, C, Rivas, J, Castro, R, Catalá-López, F, Cercy, K, Chang, H, Chang, J, Charlson, F, Chew, A, Chisumpa, V, Chitheer, A, Christensen, H, Christopher, D, Cirillo, M, Cooper, C, Criqui, M, Cromwell, E, Crump, J, Dandona, L, Dandona, R, Dargan, P, Das Neves, J, Davitoiu, D, De Courten, B, De Steur, H, Degenhardt, L, Deiparine, S, Deribe, K, Deveber, G, Ding, E, Djalalinia, S, Do, H, Dokova, K, Doku, D, Dorsey, E, Driscoll, T, Dubey, M, Duncan, B, Ebel, B, Ebrahimi, H, El-Khatib, Z, Enayati, A, Endries, A, Ermakov, S, Erskine, H, Eshrati, B, Eskandarieh, S, Esteghamati, A, Estep, K, Faraon, E, Sofia E Sa Farinha, C, Faro, A, Farzadfar, F, Fazeli, M, Feigin, V, Feigl, A, Fereshtehnejad, S, Fernandes, J, Ferrari, A, Feyissa, T, Filip, I, Fischer, F, Fitzmaurice, C, Flaxman, A, Foigt, N, Foreman, K, Frank, T, Franklin, R, Friedman, J, Frostad, J, Fürst, T, Furtado, J, Gakidou, E, Garcia-Basteiro, A, Gebrehiwot, T, Geleijnse, J, Geleto, A, Gemechu, B, Gething, P, Gibney, K, Gill, P, Gillum, R, Giref, A, Gishu, M, Giussani, G, Glenn, S, Godwin, W, Goldberg, E, Gona, P, Goodridge, A, Gopalani, S, Goryakin, Y, Griswold, M, Gugnani, H, Gupta, R, Gupta, T, Gupta, V, Hafezi-Nejad, N, Bidgoli, H, Hailu, G, Hamadeh, R, Hammami, M, Hankey, G, Harb, H, Hareri, H, Hassanvand, M, Havmoeller, R, Hawley, C, Hay, S, He, J, Hendrie, D, Henry, N, Heredia-Pi, I, Hoek, H, Holmberg, M, Horita, N, Hosgood, H, Hostiuc, S, Hoy, D, Hsairi, M, Htet, A, Huang, H, Huang, J, Huynh, C, Iburg, K, Ikeda, C, Inoue, M, Irvine, C, Jacobsen, K, Jahanmehr, N, Jakovljevic, M, Jauregui, A, Javanbakht, M, Jeemon, P, Jha, V, John, D, Johnson, C, Johnson, S, Jonas, J, Jürisson, M, Kabir, Z, Kadel, R, Kahsay, A, Kamal, R, Karch, A, Karema, C, Kasaeian, A, Kassebaum, N, Kastor, A, Katikireddi, S, Kawakami, N, Keiyoro, P, Kelbore, S, Kemmer, L, Kengne, A, Kesavachandran, C, Khader, Y, Khalil, I, Khan, E, Khang, Y, Khosravi, A, Khubchandani, J, Kieling, C, Kim, D, Kim, J, Kim, Y, Kimokoti, R, Kinfu, Y, Kisa, A, Kissimova-Skarbek, K, Kivimaki, M, Kokubo, Y, Kopec, J, Kosen, S, Koul, P, Koyanagi, A, Kravchenko, M, Krohn, K, Defo, B, Bicer, B, Kulikoff, X, Kumar, G, Kutz, M, Kyu, H, Lal, D, Lalloo, R, Lansingh, V, Larsson, A, Lazarus, J, Lee, P, Leigh, J, Leung, J, Leung, R, Levi, M, Li, Y, Liben, M, Linn, S, Liu, P, Liu, S, Lodha, R, Looker, K, Lopez, A, Lorkowski, S, Lotufo, P, Lozano, R, Lucas, T, Lunevicius, R, Mackay, M, Maddison, E, El Razek, H, El Razek, M, Majdan, M, Majdzadeh, R, Majeed, A, Malekzadeh, R, Malhotra, R, Malta, D, Mamun, A, Manguerra, H, Mantovani, L, Manyazewal, T, Mapoma, C, Marks, G, Martin, R, Martinez-Raga, J, Martins-Melo, F, Martopullo, I, Mathur, M, Mazidi, M, Mcalinden, C, Mcgaughey, M, Mcgrath, J, Mckee, M, Mehata, S, Mehndiratta, M, Meier, T, Meles, K, Memish, Z, Mendoza, W, Mengesha, M, Mengistie, M, Mensah, G, Mensink, G, Mereta, S, Meretoja, A, Meretoja, T, Mezgebe, H, Micha, R, Millear, A, Miller, T, Minnig, S, Mirarefin, M, Mirrakhimov, E, Misganaw, A, Mishra, S, Mitchell, P, Mohammad, K, Mohammed, K, Mohammed, S, Mohan, M, Mokdad, A, Mollenkopf, S, Monasta, L, Hernandez, J, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Morrison, S, Moses, M, Mountjoy-Venning, C, Mueller, U, Muller, K, Murthy, G, Musa, K, Naghavi, M, Naheed, A, Naidoo, K, Nangia, V, Natarajan, G, Negoi, I, Negoi, R, Nguyen, C, Nguyen, G, Nguyen, M, Nguyen, Q, Nguyen, T, Nichols, E, Ningrum, D, Nomura, M, Nong, V, Norheim, O, Noubiap, J, Obermeyer, C, Ogbo, F, Oh, I, Oladimeji, O, Olagunju, A, Olagunju, T, Olivares, P, Olsen, H, Olusanya, B, Olusanya, J, Ong, K, Oren, E, Ortiz, A, Owolabi, M, Mahesh, P, Pana, A, Panda, B, Panda-Jonas, S, Papachristou, C, Park, E, Patton, G, Paulson, K, Pereira, D, Perico, D, Pesudovs, K, Petzold, M, Phillips, M, Pigott, D, Pillay, J, Pinho, C, Piradov, M, Pishgar, F, Poulton, R, Pourmalek, F, Qorbani, M, Radfar, A, Rafay, A, Rao, P, Rahimi-Movaghar, V, Rahman, M, Ur Rahman, M, Rai, R, Rajsic, S, Ram, U, Ranabhat, C, Rawaf, S, Reidy, P, Reiner, R, Reinig, N, Reitsma, M, Remuzzi, G, Renzaho, A, Resnikoff, S, Rezaei, S, Blancas, M, Roba, 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Zavala-Arciniega, L, Zhang, X, Zipkin, B, Zodpey, S, Lim, S, and Murray, C

Subjects
Adult, Male, Adolescent, DEVELOPMENT ASSISTANCE, Global Health, projection indicators to 2030, CHINA, Global Burden of Disease, Health Statu, MEXICO, Noncommunicable Disease, Young Adult, SYSTEMS, Quality-Adjusted Life Year, General & Internal Medicine, Infant Mortality, Medicine and Health Sciences, Conservation of Natural Resource, gains and gaps for the health-related SDGs,annualized rates of change, projection indicators to 2030, Health Status Indicator, annualized rates of change, Child, Medicine (all), MORTALITY, Infant, Newborn, Infant, Child Abuse, Sexual, Middle Aged, PREPAID PRIVATE, CARE, COVERAGE, Sex Offense, Child, Preschool, Female, 40-PERCENT, GOVERNMENT, gains and gaps for the health-related SDGs, Human
Abstract

Background The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030. Methods We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 2.5th percentile estimated between 1990 and 2030, and 100 as the 97.5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment. Findings Globally, the median health-related SDG index was 56.7 (IQR 31.9-66.8) in 2016 and country-level performance markedly varied, with Singapore (86.8, 95% uncertainty interval 84.6-88.9), Iceland (86.0, 84.1-87.6), and Sweden (85.6, 81.8-87.8) having the highest levels in 2016 and Afghanistan (10.9, 9.6-11.9), the Central African Republic (11.0, 8.8-13.8), and Somalia (11.3, 9.5-13.1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past. Interpretation GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations. Copyright The Authors. Published by Elsevier Ltd. This is an Open Access article published under the CC BY 4.0 license.

Published
2017

8. Cost and cost-effectiveness of a school-based education program to reduce salt intake in children and their families in China.

Author

Li, Xian, Jan, Stephen, Yan, Lijing L., Hayes, Alison, Chu, Yunbo, Wang, Haijun, Feng, Xiangxian, Niu, Wenyi, He, Feng J., Ma, Jun, Han, Yanbo, MacGregor, Graham A., and Wu, Yangfeng

Subjects
SYSTOLIC blood pressure, REGULATION of blood pressure, PUBLIC health, SALT in the body, BODY composition
Abstract

Objective: The School-based Education Program to Reduce Salt Intake in Children and Their Families study was a cluster randomized control trial among grade five students in 28 primary schools and their families in Changzhi, China. It achieved a significant effect in lowering systolic blood pressure (SBP) in all family adults by 2.3 mmHg and in elderlies (aged > = 60 years) by 9.5 mmHg. The aim of this study was to assess the cost-effectiveness of this salt reduction program. Methods: Costs of the intervention were assessed using an ingredients approach to identify resource use. A trial-based incremental cost-effectiveness ratio (ICER) was estimated based on the observed effectiveness in lowering SBP. A Markov model was used to estimate the long-term cost-effectiveness of the intervention, and then based on population data, extrapolated to a scenario where the program is scaled up nationwide. Findings were presented in terms of an incremental cost per quality-adjusted life year (QALY). The perspective was that of the health sector. Results: The intervention cost Int$19.04 per family and yielded an ICER of Int$2.74 (90% CI: 1.17–12.30) per mmHg reduction of SBP in all participants (combining children and adult participants together) compared with control group. If scaled up nationwide for 10 years and assumed deterioration in treatment effect of 50% over this period, it would reach 165 million families and estimated to avert 42,720 acute myocardial infarction deaths and 107,512 stroke deaths in China. This would represent a gain of 635,816 QALYs over 10-year time frame, translating into Int$1,358 per QALY gained. Conclusion: Based on WHO-CHOICE criteria, our analysis demonstrated that the proposed salt reduction strategy is highly cost-effective, and if scaled up nationwide, the benefits could be substantial. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Published
2017
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9. The Effects of a Community-Based Sodium Reduction Program in Rural China – A Cluster-Randomized Trial.

Author

Li, Nicole, Yan, Lijing L., Niu, Wenyi, Yao, Chen, Feng, Xiangxian, Zhang, Jianxin, Shi, Jingpu, Zhang, Yuhong, Zhang, Ruijuan, Hao, Zhixin, Chu, Hongling, Zhang, Jing, Li, Xian, Pan, Jianhong, Li, Zhifang, Sun, Jixin, Zhou, Bo, Zhao, Yi, Yu, Yan, and Engelgau, Michael

Subjects
*PHYSIOLOGICAL effects of sodium, *FOOD consumption, *EXCRETION, *CEREBROVASCULAR disease, *RANDOMIZED controlled trials
Abstract

Background: Average sodium intake and stroke mortality in northern China are both among the highest in the world. An effective, low-cost strategy to reduce sodium intake in this population is urgently needed. Objective: We sought to determine the effects of a community-based sodium reduction program on salt consumption in rural northern China. Design: This study was a cluster-randomized trial done over 18 months in 120 townships (one village from each township) from five provinces. Sixty control villages were compared to 60 intervention villages that were given access to a reduced-sodium, added-potassium salt substitute in conjunction with a community-based health education program focusing on sodium reduction. The primary outcome was the difference in 24-hour urinary sodium excretion between randomized groups. Results: Among 1,903 people with valid 24-hour urine collections, mean urinary sodium excretion in intervention compared with control villages was reduced by 5.5% (-14mmol/day, 95% confidence interval -26 to -1; p = 0.03), potassium excretion was increased by 16% (+7mmol/day, +4 to +10; p<0.001), and sodium to potassium ratio declined by 15% (-0.9, -1.2 to -0.5; p<0.001). Mean blood pressure differences were -1.1 mm Hg systolic (-3.3 to +1.1; p = 0.33) and -0.7 mm Hg diastolic (-2.2 to +0.8, p = 0.35) and the difference in the proportion with hypertension was -1.3% (-5.1 to 2.5, p = 0.56). Conclusion: There were clear differences in population sodium and potassium intake between villages that were most likely a consequence of increased use of salt substitute. The absence of effects on blood pressure reflects the moderate changes in sodium and potassium intake achieved. Trial Registration: Clinicaltrials.gov identifier: . [ABSTRACT FROM AUTHOR]

Published
2016
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10. An mHealth Intervention to Improve Medication Adherence and Health Outcomes Among Patients With Coronary Heart Disease: Randomized Controlled Trial.

Author

Ni, Zhao, Wu, Bei, Yang, Qing, Yan, Lijing L, Liu, Changqing, and Shaw, Ryan J

Abstract

Background: The treatment of many chronic illnesses involves long-term pharmaceutical therapy, but it is an ongoing challenge to find effective ways to improve medication adherence to promote good health outcomes. Cardioprotective medications can prevent the enlargement of harmful clots, cardiovascular symptoms, and poor therapeutic outcomes, such as uncontrolled high blood pressure and hyperlipidemia, for patients with coronary heart disease. Poor adherence to cardioprotective medications, however, has been reported as a global health concern among patients with coronary heart disease, and it is particularly a concern in China.Objective: This study aimed to evaluate the efficacy of a mobile health (mHealth) intervention using 2 mobile apps to improve medication adherence and health outcomes.Methods: A randomized, placebo-controlled, 2-arm parallel study was conducted in a major university-affiliated medical center located in Chengdu, China. Participants were recruited by flyers and health care provider referrals. Each participant was observed for 90 days, including a 60-day period of mHealth intervention and a 30-day period of nonintervention follow-up. The study coordinator used WeChat and Message Express to send educational materials and reminders to take medication, respectively. Participants used WeChat to receive both the educational materials and reminders. Participants in the control group only received educational materials. This study received ethics approval from the Duke Health Institutional Review Board (Pro00073395) on May 5, 2018, and was approved by West China Hospital (20170331180037). Recruitment began on May 20, 2018. The pilot phase of this study was registered on June 8, 2016, and the current, larger-scale study was retrospectively registered on January 11, 2021 (ClinicalTrials.gov).Results: We recruited 230 patients with coronary heart disease. Of these patients, 196 completed the baseline survey and received the intervention. The majority of participants were married (181/196, 92.4%), male (157/196, 80.1%), and lived in urban China (161/196, 82.1%). Participants' average age was 61 years, and half were retired (103/191, 53.9%). More than half the participants (121/196, 61.7%) were prescribed at least 5 medications. The mean decrease in medication nonadherence score was statistically significant at both 60 days (t179=2.04, P=.04) and 90 days (t155=3.48, P<.001). Systolic blood pressure and diastolic blood pressure decreased in the experimental group but increased in the control group. The mean decrease in diastolic blood pressure was statistically significant at both 60 days (t160=2.07, P=.04) and 90 days (t164=2.21, P=.03). The mean decrease in systolic blood pressure was significantly different in the groups at 90 days (t165=3.12, P=.002).Conclusions: The proposed mHealth intervention can improve medication adherence and health outcomes, including systolic blood pressure and diastolic blood pressure.Trial Registration: ClinicalTrials.gov NCT02793830; https://clinicaltrials.gov/ct2/show/NCT02793830 and ClinicalTrials.gov NCT04703439; https://clinicaltrials.gov/ct2/show/NCT04703439. [ABSTRACT FROM AUTHOR]

Published
2022
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11. Evaluating the effectiveness and cost-effectiveness of free influenza vaccination policy for older adults in Yinzhou, China: Study protocol of a real-world analyses.

Author

Zhang, Xian, Shen, Peng, Liu, Jinyang, Ji, Xinyue, Su, Kehan, Hu, Rundong, Chen, Chen, Fang, Hai, Jin, Xurui, Lin, Hongbo, Sun, Yexiang, and Yan, Lijing L.

Subjects
*INFLUENZA vaccines, *OLDER people, *HEALTH information systems, *VACCINATION policies, *COST effectiveness
Abstract

Influenza causes excessive morbidity and mortality among older adults. While influenza vaccine provides protection against its infection, the vaccination coverage in China among older adults has been very low. Previous evidence on the cost-effectiveness of government-sponsored free influenza vaccination programs in China was primarily based on literature data, which might not always reflect real-world patient populations. The Yinzhou Health Information System (YHIS) is a regional database that captures electronic health records, insurance claims data, etc. for all residents in Yinzhou district, Zhejiang province, China. We will use YHIS to study the effectiveness, influenza-related direct medical cost and cost-effectiveness analysis (CEA) of the free influenza vaccination program for older adults. In this paper, we describe the study design and innovations in detail. We will establish a retrospective cohort of permanent older residents aged 65 and over, using YHIS between 2016 and 2021. We will estimate the vaccine coverage rate, influenza incidence rate and influenza-related direct medical cost from 2016 to 2021. Regression discontinuity will be used to estimate vaccine effectiveness for the 2020/2021 season. We will build a decision tree model to compare the cost-effectiveness of three influenza vaccination options (free trivalent influenza vaccine, free quadrivalent influenza vaccine, and no policy) from both societal and health system perspectives. Parameter inputs will be gathered from both YHIS and published literature. We will calculate the incremental cost-effectiveness ratio with cost and quality-adjusted life years (QALYs) discounted at 5 % annually. Our CEA solidifies multiple sources including regional real-world data and literature for a rigorous evaluation of the government-sponsored free influenza vaccination program. The results will provide real-world evidence from real-world data on the cost-effectiveness of a real-world policy. Our findings are expected to support evidence-based policy making and to promote health for older adults. [ABSTRACT FROM AUTHOR]

Published
2023
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12. Changes in physical activity and all-cause mortality in the oldest old population: Findings from the Chinese Longitudinal Healthy Longevity Survey (CLHLS).

Author

Yin, Ruoyu, Wang, Yinsu, Li, Yaxi, Lynn, Henry S., Zhang, Yueqian, Jin, Xurui, and Yan, Lijing L.

Subjects
*PHYSICAL activity, *MORTALITY, *LONGEVITY, *OLDER people, DEVELOPED countries
Abstract

Insufficient or decreasing physical activity is common in older adults. Most studies on physical activity changes and mortality were conducted in adults younger than 80 years old in developed countries. We aimed to investigate the relationship between changes in physical activity and longevity in the oldest old (80 years or older) population using the Chinese Longitudinal Healthy Longevity Survey. Participants aged 80 or older at baseline were categorized into four groups: 1) remaining physically inactive (n = 14,287), 2) remaining physically active (n = 5411), 3) shifting from being inactive to active (n = 1364), and 4) shifting from being active to inactive (n = 1401). We fitted accelerated failure time Weibull survival regression models, adjusting for baseline sociodemographics, lifestyle factors and disease status. We further examined whether the associations differed by subgroups. A total of 15,707 participants died during follow-up (median duration of follow-up = 3.0 years). Compared with participants who remained physically inactive, those who remained active (fully adjusted event time ratio (ETR): 1.14, 95%CI: 1.11–1.17) or shifted from being inactive to active (fully adjusted ETR: 1.14, 95%CI: 1.08–1.20) had statistically significant longer survival time. No significant association was observed between remaining physically inactive and shifting from being active to inactive. Subgroup analyses showed consistent associations in nearly all strata. Maintaining frequent physical activity or shifting from being physically inactive to active was consistently associated with longer survival time in the oldest old population. Our findings provide evidence for encouraging older adults to regularly engage in physical activity to gain longevity benefits. • Maintaining frequent physical activity was associated with longer survival time. • Frequent physical activity at present, irrespective of past physical activity, was positively associated with longevity. • Participants who were physically inactive at present had higher mortality. • The associations were consistent regardless of age, sex, and disease status. [ABSTRACT FROM AUTHOR]

Published
2023
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