Community interventions for health (CIH) reduce risk factors for non-communicable disease in adults

Background. Non-communicable disease (NCD) is increasing rapidly in low and middle-income countries (LMIC), and is associated with tobacco use, unhealthy diet and physical inactivity. Community approaches are recommended to reduce risk of NCD, but there is limited high-grade evidence in LMIC. Methods. The Community Interventions for Health (CIH) program was a non-randomised, controlled study undertaken in three communities in China, India and Mexico. Culturally appropriate interventions to reduce risk factors were delivered in the intervention areas. Two independent cross-sectional surveys of a stratified sample of adults aged 18-64 years were conducted at baseline and follow-up, after 18-24 months of intervention activities. Results. 6,194 adults completed surveys at baseline, and 6,022 at follow-up. There were significant reductions in all risk factors (except tobacco) in the intervention group (I) compared to control (C). The proportion of people meeting physical activity recommendations decreased significantly in C but not in I (C: 44.1 to 30.2%, p=<0.001; I: 38·0 to 36·1%, p=0.128). The proportion eating >5 portions of fruit and vegetables daily decreased significantly in C (19.2 to 17.2%, p=0.037) but did not change in I (20.0 to 19.6%, p=0.42). The proportion adding salt to food remained unchanged in C (C: 24.9 to 23.9%, p=0.709) but decreased in I (25.9 to 19.6%, p<0.001). Prevalence of obesity increased in C (8.3 to 11.2%, p<0.001) with no significant change in I (8.6 to 9.7%, p=0.175). Conclusions. CIH reduced risk factors for NCD following interventions in community settings in China, India and Mexico.