RHP&EO is the electronic journal of the International Union for Health Promotion and Education

A Community-Based Diabetes Primary Prevention Program In Sweden - Experience From The First Year Of Intervention

Gunilia Bjaras, Ph.D., M.P.H, Claes-Goran Ostenson, M.D., Ph.D.

Diabetes Prevention Unit, Karolinska Hospital, S-171 76 Stockholm, Sweden

Non-insulin-dependent diabetes mellitus (NIDDM) is the most common type of diabetes with a prevalence of at least 4% in Sweden. There is convincing evidence that, in addition to genetic predisposition, exogenous factors such as poor dietary habits (high fat, low fibre content), low physical activity and obesity are serious risk factors for NIDDM. A program aimed to reduce the incidence of NIDDM by 25% over a ten-year period has been developed. By influencing the risk factors in the population (age 35-54) of three intervention municipalities, the program will develop approaches for community intervention. This will be performed through two approaches; "community intervention", and "intervention within community". An organization for intervention, research and evaluation has been established. This organization includes researchers, politicians, administrators and health planners. The three municipalities have set up task forces for the intervention. These groups are led by local health planners. The intervention within the community focuses on the organizational and the population levels. Work sites, residential areas, food markets and canteens are now involved in the intervention activities. Specific groups at risk, as truckdrivers, will also be target and motivated to increase physical activities and improve diet. Evaluation of the program will be performed by monitoring the prevalence and incidence of diabetes in the target population and by assessing the effects of strategies designed to increase physical exercise and improve diet. Furthermore, changes in awareness, knowledge, attitudes and practices related to prevention of diabetes, will be assessed. For this purpose, a baseline study has been performed in the three intervention municipalities and the two selected control municipalities. A follow-up study after 5 and 10 years will be made. The presentation outlines how the program is planned and conceived, with regard to research objectives, intervention strategies and organizational framework. It will also focus on some of the efforts made during the first year of intervention.

Key words: Diabetes mellitus; community intervention; intervention within community; evaluation.

Internet Explorer 5.0 or later version gives the optimal visual effect of this website.