Behavioural Risk Factors For Non-communicable Diseases Research Articles

Modifying Non-communicable Disease Behaviours through Effective Health Communication and Behaviour Change: A Systematic Review

Abstract Non-communicable diseases (NCD) account for 74% of global mortality. Approximately 86% of all premature deaths occur in low- and middle-income countries majorly attributed to lifestyle changes or behavioural risk factors. The theory-based behaviour change interventions (BCIs) appear promising, but their applicability is not explored within the national programmes. The current paper aims to review the effectiveness of theory-based BCI in modifying the NCD risk factors and provide insights into the national NCD programmes. Interventions conducted to evaluate theory-based BCIs between 2002 and 2022 in modifying behavioural risk factors for NCDs were identified from multiple databases (PubMed, Scopus, Google Scholar and Cochrane Library) for systematic review. The final analysis included 35 studies that used theories and models that broadly come under one of the four approaches, i.e. intrapersonal (targets inherent individual factors for behaviour change), interpersonal (targets the family or groups), community (target socio-cultural ecosystems) and integrated (combination of other three approaches). Twenty-seven studies showed significant results. The highest number of studies were of interpersonal approach using socio-cognitive theory and integrated (11 each), and strength of evidence was moderate for both. Twenty-six studies focused on physical inactivity and unhealthy diet. The review supports the effectiveness of behaviour change interventions for mitigating NCD risk factors. Further efforts, including implementation research study methods, should be directed to evaluate effects of these interventions on population health outcomes within specific cultural and social contexts.

Prevalence and Correlates of Behavioral Risk Factors of Non-Communicable Diseases Among Undergraduates in University of Nigeria: A Cross-Sectional Study

Background: There is an increasing prevalence of behavioral risk factors of non-communicable diseases (NCDs) among the youths in low- and middle-income countries. These may later in life lead to chronic diseases with high morbidity, mortality, and undesirable economic impact. Aim: To assess and compare the prevalence of major behavioral risk factors of NCDs between medical and non-medical university students in Enugu, Nigeria. Methods: A questionnaire-based comparative cross-sectional study was carried out among 620 undergraduates of the University of Nigeria using the modified WHO STEPS questionnaire for chronic disease surveillance and the International Physical Activity Questionnaire (IPAQ). Data were analyzed with descriptive and inferential statistics at the significance level of P < 0.05. Logistic regression analysis was carried out to predict the behavioral risk factors of NCDs. Results: The mean age of all the students was 22.5 ± 2.9 years. A greater proportion were females (54.8%). Physical inactivity was the most common behavioral risk factor of NCDs and was more prevalent in the medical students (91.0%) compared to 87.4% in the non-medical students. Overall, 95.0% of all respondents had at least one behavioral risk factor. For the medical students, younger age (AOR = 1.80 CI = 1.00 – 3.22, P = 0.049) and parents’ lower educational level (AOR = 3.49, CI = 1.29 – 9.40, P = 0.014) predicted the presence of risk factors. For the non-medical students, single marital status (AOR = 3.66, CI = 1.20 –11.19, P = 0.022), lower level of study (AOR =2.92, CI = 1.13– 7.57, P = 0.027) and parents’ lower level of education (AOR =6.48, CI = 1.41 – 29.85, P = 0.017) predicted the risk factors of NCDs. Conclusion: Behavioral risk factors were highly prevalent in both groups. There is an urgent need to introduce evidence-based intervention to curb the situation.

Non-communicable Disease Risk Factors and Healthcare Worker’s Perspective on Tackling Them amongst Tribal Population: A Mixed Method Study

Abstract Introduction: Early epidemiologic transition and increase in the incidence of non-communicable diseases (NCDs) are observed amongst tribal population. The objectives of this study were to assess the prevalence of NCD Risk factors and to document the challenges faced by healthcare providers. Methodology: A mixed method study was conducted in a Tribal area of Udumalpet, Tamil Nadu. A community-based cross-sectional study amongst 362 adults of Muduvar tribes using the WHO STEPwise approach for the surveillance was done. In-depth interviews were conducted, and thematic analysis was done using WEFT-QDA software. Results: The mean age of study participants was 43.51 years. The mean age of initiation of tobacco was 19.66 years. Half had consumed alcohol at least once. The behavioural risk factors were associated with male sex, increase in age, marital status, education and employment. Qualitative analysis showed that healthcare providers faced challenges in health system and community levels. Conclusions: There is an increased prevalence of behavioural risk factors of NCDs amongst the Muduvar tribes in Tiruppur. The challenges faced by healthcare providers support the need for a WHO PEN package at every level.

A systematic scoping review characterising studies investigating workplace nutritional interventions in male employees

Non-communicable diseases (NCDs) are the predominant cause of death in the UK(1) and place an economic burden on societies(2). An unhealthy diet is one of the four main behavioural risk factors for NCDs(3) and thus, interventions targeting dietary behaviour are of particular interest in the prevention of NCDs. The workplace may be a valuable setting for these interventions as employees represent a large proportion of the population in the UK(4). In the male population, NCDs and several risk factors typically manifest at a younger age(5) and, additionally, males participate less in health-promoting activities(6).The aim of this scoping review was to identify and characterise the evidence base to determine if a future full systematic review on nutrition interventions in the workplace to improve health and well- being in males is feasible.The review was conducted adhering to the PRISMA guideline for Scoping Reviews(7). Three electronic databases (Ovid, PubMed, and The Cochrane Library) were systematically searched for relevant publications responding to the research question from inception. No restrictions were made in the search and all study types were eligible. Articles that were not available in English were excluded from the review. Eligible studies were reviewed using a pre-defined data extraction form and references hand-searched for relevant publications. Data synthesis was focused on describing application-oriented aspects and outcome analyses were reduced to anthropometric outcomes.Of the 1,224 publications from the initial database search, 46 were included in the review, with an additional 15 studies identified from hand-searching, resulting in 61 included reports on 57 interventions. Four main approaches to nutrition interventions at the workplace were identified; educational, environmental, individual counselling, and meal provision/replacement. Most interventions used multicomponent approaches. One of the 61 included reports followed a qualitative design. Anthropometric outcomes were reported in the majority (83.6%) of studies, followed by bioclinical outcomes (45.9%), other outcomes were food (34.4%) and nutrient intake (22.9%), smoking habits (14.8%) and, one study reported on Quality of Life. Of the studies reporting anthropometric outcomes 69% reported to be effective in improving body weight, 47.8% BMI and 54.5% waist circumference. No determinants of successful interventions such as type, duration, workplace participation were identified.This review suggests that nutrition interventions at the workplace are effective in improving several anthropometric outcomes. A future full systematic review is feasible but should consider narrowing the research question to account for limitations in the current evidence base as differences in reporting of design, population, intervention, and outcomes severely limited data analyses. Furthermore, to enable high-quality research, the development of a reporting tool, such as the TIDieR checklist (8) is recommended.

Behavioural risk factors for non-communicable diseases among South African Durban-based refugees: a cross-sectional study.

Behavioural risk factors for non-communicable diseases (NCDs) are rising among refugees, increasing chronic disease prevalence that causes morbidity and mortality. This study aimed to ascertain the prevalence, awareness and management of behavioural risk factors for NCDs among South African Durban-based refugees. A once-off quantitative, cross-sectional design was conducted on the behavioural risk factors for NCDs among 122 randomly selected Durban-based refugees using a modified version of the World Health Organisation (WHO) STEPwise approach to NCDs surveillance (STEPS) instrument. Participants' awareness and management of risk factors for NCDs were determined with a behavioural NCD awareness and management of behavioural NCD risk factor questionnaire. Smoking and alcohol prevalence were 4.1% and 20.7%, respectively, with 40.8% consuming fewer than five servings of fruit and/or vegetables daily. Participants performed more than 150 min of moderate physical activity per week. A significant 30.8% (p < 0.001) was aware that consuming alcohol poses an extremely large risk, similarly for smoking (38.7%; p < 0.001]. A significant 56.2% (p < 0.001) believe that regularly eating raw vegetables presents no risk, likewise for being physically active (51.7%; p < 0.001). A significant 40.6% (p < 0.001) of the participants always drink water or non-alcoholic drinks to manage their alcohol consumption, 54.2% (p < 0.001) manage their unhealthy diet by sometimes filling half their plates with fruits and vegetables, and 49.2% manage their physical activity levels by sometimes choosing a range of physical activities (p < 0.001). Refugees' lack of awareness of behavioural risk factors for NCDs highlights the importance for health service providers to present health promotion programs to make refugees aware of their behavioural NCD's risk factors and how it impacts their health.

Multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil: the analysis derived from the Brazilian national survey of school health 2019

BackgroundHealth risk behaviors often emerge or intensify during adolescence and tend to co-occur, exposing individuals to an even greater risk for the development of non-communicable diseases (NCDs). The likelihood of exhibiting multiple health risk factors also increases throughout life and is associated with sociodemographic characteristics contributing to their escalation and severity. In this context, the objective of this study was to analyze the association between sociodemographic characteristics and multiple behavioral risk factors for non-communicable diseases among the adolescent population in Brazil.MethodsThis cross-sectional study utilized data from the Brazilian National Survey of School Health 2019. The sample comprised 121,580 adolescents aged 13 to 17. The analyzed variables included irregular intake of fruits and vegetables, regular consumption of soft drinks and treats, insufficient physical activity, sedentary lifestyle, cigarette smoking, and alcohol consumption. To analyze MBRFs, a classification ranging from zero to five was created, and associations were estimated using Odds Ratio (OR) with the respective 95% confidence interval (CI). The Backward method was employed for the multivariate regression model, utilizing ordinal logistic regression.ResultsAdolescents without behavioral risk factors for NCDs constituted only 3.9% (95% CI 3.7–4.1). The most prevalent categories were two and three MBRFs, accounting for 28.3% (95% CI: 27.7–28.8) and 27.0% (95% CI: 26.5–27.5), respectively. Adolescents aged 16 and 17 (ORadj: 1.39; 95% CI: 1.32–1.48), residing in the Brazilian Southeast (ORadj: 1.66; 95% CI: 1.52–1.81), and those reporting poor or very poor self-rated health (ORadj: 2.05; 95% CI: 1.87–2.25) were more likely to exhibit multiple behavioral risk factors. Conversely, male adolescents (adjusted OR: 0.65; 95% CI: 0.62–0.69), those of mixed race (adjusted OR: 0.92; 95% CI: 0.87–0.97), and residents of rural areas (adjusted OR: 0.76; 95% CI: 0.70–0.84) were less likely to manifest MBRFs for NCDs.ConclusionThe majority of adolescents displayed MBRFs for NCDs, positively associated with age, region, and perceived health status. This underscores the necessity for healthcare promotional interventions throughout the life cycle, as these behaviors may persist into adulthood.

Exploring Behavioral Risk Factors for Non-communicable Diseases Among Undergraduate Medical Students in Western Gujarat: A Cross-Sectional Study.

Background The burden of morbidity and death caused by non-communicable diseases (NCDs) such as cancer, diabetes, and cardiovascular disease is a significant global health concern influenced by modifiable behavioral risk factors. In India, the burden of NCDs is particularly high, with medical college students being a vulnerable population. This study aims to bridge the knowledge gap by investigating the prevalence and patterns of behavioral risk factors for NCDs among medical college students. Methodology A cross-sectional study was conducted on medical students in Gujarat. Risk factors for NCDs were assessed using various tools, including the General Health Questionnaire-12 (GHQ-12) for stress, the International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, the body mass index (BMI) for obesity, and dietary factors. The chi-square test was employed as a statistical tool to determine the association between socio-demographic variables and various risk factors. A p-value of <0.05 was considered statistically significant. Results Among the 400 students surveyed, the prevalence of single behavioral NCD risk factors was as follows: 248 (62%) reported stress (GHQ-12), 215 (54%) experienced poor sleep quality (PSQI), 251 (63%) had low levels of physical activity (IPAQ), 339 (85%) had inadequate fruit and vegetable intake, 97 (24%) consumed extra salt during meals, 163 (41%) were overweight or obese, and 189 (47%) had three or more risk factors for NCDs. In bivariate logistic regression analysis, factors such as age, male gender, urban residence, hostel stay, and lower socioeconomic status were found to be statistically significant (p < 0.05). Conclusion This study reveals an alarming failure of medical colleges to positively influence students' health behaviors, despite their medical knowledge. The high rates of inactivity, stress, poor diet, and obesity among students demonstrate the curriculum's inability to instill preventative lifestyle practices. This omission in training compromises students' own health and their ability to counsel patients on NCD prevention. Urgent reform is needed to integrate health promotion into the curriculum, providing a supportive campus culture focused on wellness. By overlooking students' behaviors, medical colleges gravely disserve these future providers. This evidence compels curriculum reform to develop exemplary physician role models for NCD prevention.

Modifiable behavioral risk factors for NCDs and sleep in Brazilian adolescents.

To analyze the association between modifiable behavioral risk factors for non-communicable diseases and sleep parameters in Brazilian adolescents. This was a cross-sectional study that used data from the RPS Cohort Consortium, São Luís, Brazil for the follow-up of adolescents aged 18-19 years (n = 2,515). The outcomes were excessive daytime sleepiness (Epworth Sleepiness Scale - ESS) and sleep quality (Pittsburgh Sleep Quality Index - PSQI). The exposures of interest were the behavioral risk factors for non-communicable diseases (NCDs): screen time, physical inactivity, alcohol, smoking, illicit drugs, caffeine intake, and consumption of sugar-sweetened beverages. Excess weight was considered a possible mediator of this association between the exposures of interest and the outcomes. The models were analyzed by modeling with structural equations. Physical inactivity (standardized coefficient, SC = 0.112; p = 0.001), higher consumption of alcohol (SC = 0.168; p = 0.019) and of sugar-sweetened beverages (SC = 0.128; p < 0.001) were associated with excessive daytime sleepiness in adolescents; better socioeconomic status was also associated with this outcome (SC = 0.128; p < 0.001). Physical inactivity (SC = 0.147; p < 0.001) and higher consumption of sugar-sweetened beverages (SC = 0.089; p = 0.003) were also associated with poor sleep quality. Overweight was neither a mediator nor associated with sleep quality or excessive daytime sleepiness. The main modifiable behavioral risk factors for NCDs are associated with worse sleep parameters already in adolescence, which serves as a warning toward the accumulation of risks for sleep disorders in the future.

The Relationships between Social Capital, Metabolic, and Behavioral Risk Factors of Non-Communicable Diseases: A Systematic Review.

Contextual risk factors such as social capital have a vital role in affecting behavioral and biological risk factors of NCDs. We aimed to systematically identify the relationship between different aspects of social capital (SC) with metabolic, and behavioral risk factors of non-communicable diseases (NCDs). This is a systematic review. The period of study was 2000-2021. We searched the English international databases, i.e. PubMed/Medline, Scopus, and Web of Science. Studies that reported NCDs' metabolic and behavioral risk factors as independent variables, were excluded. We also included studies if they analyzed the association between SC and metabolic and behavioral risk factors of NCDs. After the primary and quality appraisal process, 97 studies were entered in the final phase of the analysis. Five out of 18 studies reported an inverse association between SC and the level of alcohol drinking. Twenty-seven out of 32 studies reported a significant inverse association between SC and smoking and tobacco use, while only one study reported a significant positive association. Nine studies reported a significant inverse association between SC and high blood pressure. Three studies showed a significant inverse association between SC and diabetes. Seventeen studies indicated a significant positive association between SC and physical activity. Thirteen out of 17 studies reported a significant inverse association between SC, body mass index (BMI) and overweight. High SC, people's participation and interaction are vital in tackling NCDs. Evidence shows positive effects of SC on prevention, control and improvement of NCDs' metabolic and behavioral risk factors.

Effects of age on non-communicable disease risk factors among Nepalese adults.

The growing burden of non-communicable diseases (NCDs) and an increase in the prevalence of the underlying risk factors are creating a challenge to health systems in low- and middle-income countries (LMICs). In Nepal, deaths attributable to NCDs have been increasing, as has life expectancy. This poses questions with regards to how age and various risk factors interact in affecting NCDs. We analyzed the effects of age on NCD risk factors, using data from the Nepalese STEPs survey 2019, a nationally representative cross-sectional study. Six sociodemographic determinants, four behavioral risk factors, and four biological risk factors were examined. Age effects were analyzed among three age groups: below 35 years (young), 35-59 years (middle aged) and 60 years and above (elderly). The prevalence of selected behavioral risk factors for NCDs, notably smoking, alcohol consumption and insufficient physical activity, and some biological risk factors (hypertension, hyperlipidemia) increases with age. The prevalence of most behavioral risk factors was highest among men and women aged 60 years and above. The prevalence of hypertension and hyperlipidemia was highest among the elderly, but the prevalence of diabetes and overweight/obesity was highest among the middle aged for both sexes. Age interactions in the association between behaviors and biological risk factors were surprisingly weak. However, age interactions were significant in the association between alcohol consumption and -hypertension, -overweight/obesity and -hyperlipidemia among women. While the prevalence of NCD risk factors tends to be higher among elders, the interaction between age and risk factors is complex. Most NCD risk factors are related to behaviors, which originate in young adulthood. It is necessary to diagnose and treat biological risk factors, in younger age groups before they manifest as NCDs. Similarly, behavior change interventions need to target these younger age groups to reduce the risk of NCDs later in life.

Non-Communicable Diseases (NCDs) A Global Burden in India: An Overview

Non-communicable diseases (NCDs) are a growing public health concern in India. These diseases have a high health-care demand and are costly, especially in low-resource settings. According to a WHO study, only 50% of chronic disease patients in developed countries follow treatment recommendations. The low compliance of patients with non-communicable diseases to treatment and medical advice is a major therapeutic challenge. The elderly is one of the most vulnerable and high-risk groups in terms of health. Physical inactivity, unhealthy diets, tobacco use, and harmful alcohol use are the main behavioural risk factors for NCDs. The objective of the study is to concentrate on the risk factors that contribute to non-communicable diseases like diabetes, hypertension, etc. and the necessary steps that must be taken before they have a negative effect on our health. Recommendation: A population-based strategy has been developed for the prevention, management, and screening of prevalent Non-Communicable Diseases (NCDs), such as diabetes, hypertension, and common malignancies. Increasing community awareness by use of print, electronic, and social media; promotion of a healthy lifestyle, and raising public awareness of NCDs.

Effect of nutrition education package on dietary modification and anthropometry among attendees of a noncommunicable disease clinic at a rural primary health-care facility in Delhi

Context: The global burden and threat of noncommunicable diseases (NCDs) constitutes a major public health challenge that undermines social and economic development throughout the world. NCDs are one of the leading causes of adult morbidity and mortality globally. The disease burden in India due to NCDs has increased from 30% to 55% between 1990 and 2016. Aims: We aimed to assess the effect of nutrition education intervention on dietary awareness, practices, and anthropometry. Settings and Design: This design was a facility-based before-and-after intervention study without control. Materials and Methods: This study was conducted in five phases: planning and recruitment, preintervention, intervention, washout, and postintervention. Data were collected using a pretested, semi-structured interview schedule under the following heads – personal, sociodemographic, and behavioral risk factors of NCDs. Anthropometric examination included weight, height, waist, and hip circumference measurement. Statistical Analysis: Collected data were entered into MS Excel and analyzed using IBM SPSS 25 for descriptive and inferential statistics. Results: There was a significant increase in mean score for dietary practices and knowledge regarding different food items in the study group. The mean number of servings of fruits and vegetables increased significantly following intervention in the study group (P = 0.001). Significant change in body mass index before and after intervention was found to be in the age group of &gt;60 years (P = 0.041). Conclusions: The study has shown the usefulness of intervention aimed at improving dietary behavior among patients of NCDs. With growing burden, there is a need for such innovative and cost-effective measures for halting the rising burden.

Multiple behavioural risk factors of non-communicable diseases among adolescents in four Caribbean countries: prevalence and correlates.

The study assessed the prevalence and associated factors of behavioural risk factors of non-communicable diseases (NCDs) among adolescents in four Caribbean countries. In all 9,143 adolescents (15 years=median age) participated in the cross-sectional "2016 Dominican Republic, 2016 Suriname, 2017 Jamaica, and 2017 Trinidad and Tobago Global School-Based Student Health Survey (GSHS)". Eight behavioural risk factors of NCDs were assessed by a self-administered questionnaire. Prevalence of each behavioural NCD risk factor was physical inactivity (84.2%), inadequate fruit and vegetable intake (82.2%), leisure-time sedentary behaviour (49.6%), daily≥2 soft drinks intake (46.8%), ever drunk (28.6%), twice or more days a week fast food consumption (27.6%), having overweight/obesity (27.4%), and current tobacco use (13.8%). Students had on average 3.6 (SD=1.4), and 79.0% had 3-8 behavioural NCD risk factors. In multivariable linear regression, psychological distress and older age increased the odds, and attending school and parental support decreased the odds of multiple behavioural NCD risk factors. A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered and several factors independently contributing to multiple behavioural NCD risk factors were identified.

Use of mHealth technology for modification of behavioural risk factors of noncommunicable diseases in primary health care settings

Noncommunicable diseases (NCDs) kill 41 million people each year, of which more than three-quarters occur in low- and middle-income countries. Four groups of diseases, namely cardiovascular diseases, cancers, respiratory diseases, and diabetes, account for over 80% of all premature NCD deaths, and four common modifiable behaviors, namely tobacco use, physical inactivity, unhealthy diet, and the harmful use of alcohol, increase the risk of NCDs. The use of mHealth interventions for Behavior Change Communication has been shown to be effective in modifying the behavioral risk factors, through various studies. The present study proposes to conduct a systematic review and meta-analysis to assess the effectiveness and feasibility of the use of mHealth in improving diet and increasing physical activity, which are two of the major behavioral risk factors of NCDs. Research reported on this, from countries in the South-East Asian Region, during the past 20 years, will be included in this review.

Prevalence and correlates of multiple behavioural risk factors of non-communicable diseases among university students from 24 countries.

Globally non-communicable diseases (NCDs) are on the increase. The goal of the study was to estimate the prevalence and correlates of multiple behavioural risk factors of NCDs among university students from 24 countries. In a cross-sectional study, the sample included 18 017 university students from countries in Africa, the Americas and Asia. indicate that prevalence of single behavioural NCD risk indicators were 38.2% for physical inactivity, 80.5% for inadequate fruit and vegetables intake, 23.1% for having overweight/obesity, 10.5% for heavy alcohol use and 11.8% for current tobacco use. Students had on average 1.6 (SD=0.9), and 15.9% had three or more behavioural NCD risk factors. In adjusted linear regression, male sex was positively and stronger beliefs in health benefits were negatively associated with multiple behavioural NCD risk factors. A high prevalence and co-occurrence of behavioural risk factors of NCDs was discovered. Several behavioural NCD risk factors, such as male sex and low health behaviour benefits beliefs, were found that could be utilized in targeted interventions.

Mounting an effective socio-ecological response to non-communicable diseases in Africa’s cities

ABSTRACT The burden of non-communicable diseases (NCDs) is rising rapidly in low-middle income countries. Poorly planned urbanization exponentially increases the burden of behavioral risk factors for NCDs. Contexts where people live, work, play and pray are not conducive to wellbeing, particularly the healthy behaviours people are often encouraged to adopt. An ecological framing of solutions is therefore needed to reduce non-communicable diseases across Africa. If the status quo continues, it will practically be impossible to cope with the continuing rise of NCDs on the continent. Health development in Africa must be proactive in addressing the externalities resulting from poorly planned urbanization. This commentary outlines opportunities for promoting health and wellbeing at multiple entry-points, for a robust response to NCDs. We recommend that a holistic lens continue to shape thinking, partnership-building, funding, and incentivizing action toward addressing NCDs in Africa.

Are Roma people exposed to NCD? Modifiable risk factors in a rural Roma community from Romania

Abstract Background Knowing the prevalence of modifiable risk factors for noncommunicable diseases is the first step to plan effective public health interventions. The study aims to identify the prevalence and distribution of risk factors of non-communicable diseases (NCD) among adult Roma population in a rural community. Methods Using a tool based on the WHO stepwise approach, a cross-sectional study was carried out among a sample 116 adults aged 18-85 years (52 male and 64 female), from a rural community with 800 Roma members. The study instrument included questions to record behavioral risk factors (smoking behavior, alcohol drinking, diet and physical activity and also data on anthropometry and value of blood pressure). Descriptive statistics methods were used to analyze the data. Results The smoking prevalence was 35,3% (95%CI, 27.0 to 44.3,) higher for men (49,9%, 95%CI, 36,6-63,4%) than for women (23,4%, 95%CI, 14.2-34,9), higher than the smoking prevalence recorded for Romanian population in 2017 Eurobarometer study. Prevalence of obesity (body mass index ≥30 kg/m[2]) was observed to be high among Roma respondents 34,48% (95% CI, 26,26 to 43,47) compared with self-reported obesity rates among adults in Romania (9%, Eurostat, EHIS 2014). The observed proportion of obesity is similar for both genders, but central obesity was lower for men compared to women (57,4% to 79.6%). There was observed a higher proportion of people declaring they eat fruits less than once on a week (25%, 95% CI, 17,7 to 37,4) and adding salt before tasting the dishes (58,6%). Most of interviewed people have a sedentary lifestyle with less than 30 minutes of physical activity per day. Conclusions The high prevalence of risk factors for NCD in this rural Roma community indicates the likelihood of a high future burden of illness. Key messages There is a need for both further research into the health of Roma people regarding NCD and prevention interventions to address behavioral risk factors for NCD. Knowing the prevalence of modifiable risk factors for noncommunicable diseases is the first step to plan effective public health interventions.

Non-communicable Diseases and Cognitive Impairment: Pathways and Shared Behavioral Risk Factors Among Older Chinese.

Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.

Towards reducing behavioral risk factors of non-communicable diseases among adolescents: protocol for a school-based health education program in Bangladesh

BackgroundDeveloping strategies aimed at reducing behavioral risk factors and hence the prevalence of non-communicable diseases (NCDs) is a major challenge to the policy makers today. Like the same age group worldwide, the prevalence of obesity, unhealthy dietary habit, physical inactivity, smoking and alcohol intake is high among the adolescents of Bangladesh. Studies showed promising results of an early intervention at adolescent age in reducing the likelihood of NCDs at adult age. So, this study is designed to implement a behavior change intervention and evaluate the effectiveness of the intervention in reducing the behavioral risk factors of NCDs among the adolescents of Bangladesh.MethodsA before-after designed intervention study will be conducted in two randomly selected secondary schools- one will be selected randomly as intervention school and the another as control school. A baseline survey will be conducted among the students of both schools by a pre-tested questionnaire to attain their current status of knowledge, attitude and practices related to NCDs. Afterward, students will be enrolled in the intervention group who will meet the eligibility criteria from the intervention school. The intervention will be given through a health promotion session to a group of students, not more than 25 at a time, by trained facilitators. A post-intervention end line survey will be conducted among all the participants from both schools using the same questionnaire 3 months after the baseline survey.DiscussionAn intervention has been developed based on some principals of two psychosocial theory- Motivational Interview and Social Cognitive Theory. Emphasis will be given on motivating the adolescents towards a healthy lifestyle, supporting self-efficacy to be changed, guiding self-regulatory ways along with facilitating desired changing process by empowering them with choices about the preventive measures of NCDs. This intervention is expected to increase awareness by equipping the adolescents with specific knowledge and skills and thus, facilitate an eventual change in their practiced risk behaviors. Besides, this intervention will address multiple behaviors at a time, and will be delivered to a group of adolescents, to attain the cost-effectiveness and thereby making it more realistic in the resource-poor context of Bangladesh.Trial registrationClinicalTrials.gov NCT03975335, registered on 01.06.2019. Retrospectively registered.

"Big" Food, Tobacco, and Alcohol: Reducing Industry Influence on Noncommunicable Disease Prevention Laws and Policies Comment on "Addressing NCDs: Challenges From Industry Market Promotion and Interferences".

The food, tobacco and alcohol industries have penetrated markets in low- and middle-income countries (LMICs), with a significant impact on these countries’ burden of noncommunicable diseases (NCDs). Tangcharoensathien and colleagues describe the aggressive marketing of unhealthy food, alcohol and tobacco in LMICs, as well as key tactics used by these industries to resist laws and policies designed to reduce behavioural risk factors for NCDs. This commentary expands on the recommendations made by Tangcharoensathien and colleagues for preventing or managing conflicts of interest and reducing undue industry influence on NCD prevention policies and laws, focusing on the needs of LMICs. A growing body of research proposes ways to design voluntary industry initiatives to make them more effective, transparent and accountable, but governments should also consider whether collaboration with health-harming industries is ever appropriate. More fundamentally, mechanisms for identifying, managing and mitigating conflicts of interest and reducing industry influence must be woven into – and supported by – broader governance and regulatory structures at both national and international levels.