Identified evidence suggests that cardiovascular disease ( CVD ) prevention services should consider regulation of blood glucose as a key target for intervention .
The primary objective of this study was to analyze the most up-to- date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review .
Social network targeting to maximise population behaviour change: a cluster randomised controlled trial
BACKGROUND Information and behaviour can spread through interpersonal ties . By targeting influential individuals , health interventions that harness the distributive properties of social networks could be made more effective and efficient than those that do not . Our aim was to assess which targeting methods produce the greatest cascades or spillover effects and hence maximise population -level behaviour change . METHODS In this cluster r and omised trial , participants were recruited from villages of the Department of Lempira , Honduras . We blocked villages on the basis of network size , socioeconomic status , and baseline rates of water purification , for delivery of two public health interventions : chlorine for water purification and multivitamins for micronutrient deficiencies . We then r and omised villages , separately for each intervention , to one of three targeting methods , introducing the interventions to 5 % sample s composed of either : r and omly selected villagers ( n=9 villages for each intervention ) ; villagers with the most social ties ( n=9 ) ; or nominated friends of r and om villagers ( n=9 ; the last strategy exploiting the so-called friendship paradox of social networks ) . Participants and data collectors were not aware of the targeting methods . Primary endpoints were the proportions of available products redeemed by the entire population under each targeting method . This trial is registered with Clinical Trials.gov , number NCT01672580 . FINDINGS Between Aug 4 , and Aug 14 , 2012 , 32 villages in rural Honduras ( 25 - 541 participants each ; total study population of 5773 ) received public health interventions . For each intervention , nine villages ( each with 1 - 20 initial target individuals ) were r and omised , using a blocked design , to each of the three targeting methods . In nomination-targeted villages , 951 ( 74·3 % ) of 1280 available multivitamin tickets were redeemed compared with 940 ( 66·2 % ) of 1420 in r and omly targeted villages and 744 ( 61·0 % ) of 1220 in indegree-targeted villages . All pairwise differences in redemption rates were significant ( p<0·01 ) after correction for multiple comparisons . Targeting nominated friends increased adoption of the nutritional intervention by 12·2 % compared with r and om targeting ( 95 % CI 6·9 - 17·9 ) . Targeting the most highly connected individuals , by contrast , produced no greater adoption of either intervention , compared with r and om targeting . INTERPRETATION Introduction of a health intervention to the nominated friends of r and om individuals can enhance that intervention 's diffusion by exploiting intrinsic properties of human social networks . This method has the additional advantage of scalability because it can be implemented without mapping the network . Deployment of certain types of health interventions via network targeting , without increasing the number of individuals targeted or the re sources used , could enhance the adoption and efficiency of those interventions , thereby improving population health . FUNDING National Institutes of Health , The Bill & Melinda Gates Foundation , Star Family Foundation , and the Canadian Institutes of Health Research
Identified evidence suggests that cardiovascular disease ( CVD ) prevention services should consider regulation of blood glucose as a key target for intervention .
The primary objective of this study was to analyze the most up-to- date evidence regarding whether and how blood sugar regulation influences cardiovascular health promotion and disease prevention by carrying out an umbrella review .