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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

The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health

Vaduganathan, M.; Mensah, G.A.; Turco, J.V. et al. Journal of the American College of Cardiology (2022) CC

Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 a... more

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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Management and Prevention Strategies for Non-communicable Diseases (NCDs) and Their Risk Factors

Budreviciute, A.; Damiati, S.; Khdr Sabir, D. et al. (2020) CC

Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified into the categories of self-management, genetic factors, environmental factors, factors of medical co... more

Regional Action Framework on Communication for Health: A vision for using communication to improve public health in the Western Pacific Region

World Health Organization WHO (2024) C_WHO

Strategic communication is at the heart of public health and more important than ever in the digital age. Using communication strategically requires expertise, skills and resources to plan, implement and evaluate interventions that encourage governments to implement policies that improve people’s ... more

Infection Prevention and Control Guidelines 3rd Edition 2023

Government of the Republic of Namibia (2024) CC

The Infection Prevention and Control (IPC) Guidelines aim to support healthcare workers improve quality and safety health care. The Guidelines further aim to promote and facilitate the overall goal of IPC by providing evidence-based recommendations on the critical aspects of IPC, focusing on the fun... more

Improving the health and wellbeing of children and adolescents: guidance on scheduled child and adolescent well-care visits

UN Children's Fund UNICEF; World Health Organization WHO (2024) CC

To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities for personal autonomy and self-realization. To prom... more

Global technical consultation report on proposed terminology for pathogens that transmit through the air

World Health Organization WHO (2024) C_WHO

Terminology used to describe the transmission of pathogens through the air varies across scientific disciplines, organizations and the general public. While this has been the case for decades, during the coronavirus disease (COVID-19) pandemic, the terms ‘airborne’, ‘airborne transmission’ a... more

Diabetes prevention, screening and management

International Pharmaceutical Federation (2021) CC2

Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202... more

National Guidelines for the Management of Cardiovascular Diseases

Ministry of Health Ghana Republic of Ghana (2019) CC

Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... more

Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update

Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al. African Journal of Thoracic and Critical Care Medicine (2021) CC

sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ... more

Hypertension - Screening, Diagnosis, Assessment, and Management of Primary Hypertension in Adultd in India

Ministry of Health & Family Welfare India Government of India (2017) CC

Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven ... more

Community Health Worker Training Curriculum - Facilitator's Guide

Baylor Tingathe Community Outreach Programme Baylor College of Medicine Children’s Foundation Malawi (2016) CC

This curriculum was designed to train newly recruited health care workers (HCW) in the basic knowledge and skills needed to improve different HIV services within the health facility including identification, linkage, retention and support. In addition to HIV basics, the training has supplementary un... more

Therapy of Type 1 Diabetes

Haak, T.; Gölz, S.; Fritsche, A.; et al. German Diabetes Association (DDG) (2022) CC2

The document provides detailed clinical guidelines for the therapy of Type 1 Diabetes as developed by the German Diabetes Association (DDG). It focuses on individualized insulin therapy, structured patient training, and monitoring of blood glucose levels. The guidelines emphasize preventing complica... more

Management of Type 2 Diabetes Mellitus

Richardson, C.R.; Borgeson, J. R.; Harrison, V.; et al. National Library of Medicine (2021) CC2

The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio... more

ICMR Guidlines for management of type 2 Diabetes

Indian Council of Medical Research (2018) CC2

In recent decades, India has witnessed a rapidly exploding epidemic of diabetes. Indeed, India today has the second largest number of people with diabetes in the world. The International Diabetes Federation (IDF) estimates that there are 72.9 million people with diabetes in India in 2017, which is... more

Air pollution and the noncommunicable disease prevention agenda: opportunities for public health and environmental science

Howse, E.; Crane, M.; Hanigan, I. et al. Environmental Research Letters (2021) CC

Air pollution is a major environmental risk factor and contributor to chronic, noncommunicable diseases (NCDs). However, most public health approaches to NCD prevention focus on behavioural and biomedical risk factors, rather than environmental risk factors such as air pollution. This article discus... more

Air pollution exposure—the (in)visible risk factor for respiratory diseases

Bălă, G.P.; Râjnoveanu, R.M.; Tudorache, E. et al. Environmental Science and Pollution Research (2021) CC

There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... more

Global air pollution exposure and poverty

Rentschler, J.; Leonova, N. Nature Communications (2023) CC

Air pollution is one of the leading causes of health complications and mortality worldwide, especially affecting lower-income groups, who tend to be more exposed and vulnerable. This study documents the relationship between ambient air pollution exposure and poverty in 211 countries and territories.... more

Interim Guidlines for the clinical management of diabetes in Jamaica

Ministry of Health and Wellness (2020) CC2

Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the pancreas in sufficient quantities or is not utilized effectively by the body to control blood glucose levels. As a result, blood glucose levels are abnormally high (hypergl... more