Xuxi Zhang

Figure 9.1.2 Public Health Framework: the steps of public health approaches of studies on health promotion for chronic conditions (Chapter 6 ‐ 8) * This is an adaptation of an original work “The public health approach. Geneva: World Health Organization (WHO); 2010. Licence: CC BY ‐ NC ‐ SA 3.0 IGO”. This adaptation was not created by WHO. WHO is not responsible for the content or accuracy of this adaptation. The original edition shall be the binding and authentic edition. Increase of the prevalence of diabetes has led to increase in related complications in the population. 35 Diabetic retinopathy (DR), a complication of diabetes, is an important cause of preventable blindness. 36 Following the third step of public health framework, we evaluated the existing studies on interventions targeting modifiable risk factors and compared their effects to find out what works better to prevent and control DR among patients with T2DM (see Figure 9.1.2). In Chapter 7 , the effects of interventions targeting modifiable risk factors of DR (blood glucose, blood pressure, lipid, dietary, physical activity and smoking) on reducing the risk of developing DR and/or its worsening as well as the important characteristics of effective interventions are studied through a meta ‐ analysis of relevant RCTs. Interventions targeting modifiable risk factors of DR were found to be effective in reducing the risk of developing DR and DR worsening. Multifactorial interventions with individualized targets and communication between health professionals and patients were more effective than other interventions in the prevention and control of DR. According to these findings, multifactorial interventions with individualized target and communication may be recommended to prevent and control DR. What is the problem? What are the causes? Chapter 6 and 7 Chapter 8 1. Surveillance 2. Identify potential risk and protective factors 3. Develop and evaluate interventions 4. Implementation The characteristics of effective peer support on glycemic control for adults with type 2 diabetes (T2DM) The characteristics of effective interventions targeting modifiable risk factors on diabetic retinopathy (DR) Study design to implement and evaluate the Social Engagement Framework for Addressing the Chronic ‐ disease ‐ challenge (SEFAC) intervention to promote the self ‐ management of chronic conditions 9 225 General discussion