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The China Seven Cities Study (CSCS) consortium: adapting evidence-based prevention science from west to east

  • Published:
Translational Behavioral Medicine

Abstract

Chronic, noncommunicable diseases (NCDs) have surpassed infectious diseases as the primary cause of death and disability in most developing nations. Nowhere is this more evident than in China where NCDs account for 80% of all deaths and skyrocketing medical costs. Driving the escalation of NCDs are high rates of tobacco use, longer life spans, and changes in the traditional Chinese diet and lifestyle bolstered by unprecedented economic growth and the new global culture. Despite the epidemic of NCDs, few evidence-based interventions either to prevent or retard their progression exist in China. We present a case for the development and adoption of such strategies as effective tools to combat China’s greatest health threat. Finally, we offer an example of a collaborative network linking Chinese public health and academic institutions with US researchers to promote the translation of western evidence-based interventions that fully incorporate local knowledge, culture, and capacity.

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References

  1. World Health Organization (2010). 2008–2013 action plan for the global strategy for the prevention and control of noncommunicable diseases. http://www.who.int/nmh/publications/9789241597418/en/index.html. Accessed 20 Oct 2010.

  2. Pietinen, P., Lahti-Koski, M., Vartiainen, E., & Puska, P. (2001). Nutrition and cardiovascular disease in Finland since the early 1970s: a success story. Journal of Nutrition, Health & Aging, 5(3), 150–154.

    CAS  Google Scholar 

  3. Nugent, R. (2008). Chronic diseases in developing countries: health and economic burdens. Annals of the New York Academy of Sciences, 1136, 70–79.

    Article  PubMed  Google Scholar 

  4. He, J., Gu, D., Wu, X., et al. (2005). Major causes of death among men and women in China. The New England Journal of Medicine, 353(11), 1124–1134.

    Article  PubMed  CAS  Google Scholar 

  5. Wang, L., Kong, L., Wu, F., Bai, Y., & Burton, R. (2005). Preventing chronic diseases in China. Lancet, 366(9499), 1821–1824.

    Article  PubMed  Google Scholar 

  6. World Health Organization (2005). Preventing chronic disease a vital investment. http://www.who.int/chp/chronic_disease_report/en/. Accessed 10 Oct 2010.

  7. Zhao, W., Zhai, Y., Hu, J., et al. (2008). Economic burden of obesity-related chronic diseases in Mainland China. Obesity Reviews, 9(Suppl 1), 62–67.

    Article  PubMed  Google Scholar 

  8. Normile, D. (2010). A sense of crisis as China confronts ailments of affluence. Science, 328(5977), 422–424.

    Article  PubMed  CAS  Google Scholar 

  9. Haslam, D. W., & James, W. P. (2005). Obesity. Lancet, 366, 197–209.

    Article  Google Scholar 

  10. Wild, S., Roglic, G., Green, A., Sicree, R., & King, H. (2004). Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care, 27, 1047–1053.

    Article  PubMed  Google Scholar 

  11. Yang, W., Lu, J., Weng, J., et al. (2010). Prevalence of diabetes among men and women in China. The New England Journal of Medicine, 362(12), 1090–1101.

    Article  PubMed  CAS  Google Scholar 

  12. Gu, D., Kelly, T. N., Wu, X., et al. (2009). Mortality attributable to smoking in China. The New England Journal of Medicine, 360(2), 150–159.

    Article  PubMed  CAS  Google Scholar 

  13. Johnson, C. A., Palmer, P. H., Chou, C. P., et al. (2006). Tobacco use among youth and adults in Mainland China: the China Seven Cities Study. Public Health, 120(12), 1156–1169.

    Article  Google Scholar 

  14. Gonhuan, Y. (2010). China wrestles with tobacco control. Interview by Weiyuan Cui. Bulletin of the World Health Organization, 88(4), 251–252.

    Article  PubMed  Google Scholar 

  15. Ho, M. G., Ma, S., Chai, W., et al. (2010). Smoking among rural and urban young women in China. Tobacco Control, 19(1), 13–18.

    Article  PubMed  Google Scholar 

  16. Zhang, H., & Cai, B. (2003). The impact of tobacco on lung health in China. Respirology, 8(1), 17–21.

    Article  PubMed  Google Scholar 

  17. Turkkan, J. S., Kaufman, N. J., & Rimer, B. K. (2000). Transdisciplinary tobacco use research centers: a model collaboration between public and private sectors. Nicotine & Tobacco Research, 2(1), 9–13.

    Article  CAS  Google Scholar 

  18. Unger, J. B., Cruz, T., Shakib, S., et al. (2003). Exploring the cultural context of tobacco use: a transdisciplinary framework. Nicotine & Tobacco Research, 5(Suppl 1), S101–S117.

    Article  Google Scholar 

  19. Chou, C. P., Li, Y., Unger, J. B., et al. (2006). A randomized intervention of smoking for adolescents in urban Wuhan, China. Preventive Medicine, 42(4), 280–285.

    Article  PubMed  Google Scholar 

  20. Sun, P., Unger, J. B., Guo, Q., et al. (2007). Comorbidity between depression and smoking moderates the effect of a smoking prevention program among boys in China. Nicotine & Tobacco Research, 9(Suppl 4), S599–S609.

    Article  Google Scholar 

  21. Johnson, C. A., Cen, S., Gallaher, P., et al. (2007). Why smoking prevention programs sometimes fail. Does effectiveness depend on sociocultural context and individual characteristics? Cancer Epidemiology, Biomarkers & Prevention, 16(6), 1043–1049.

    Article  Google Scholar 

  22. Chen, X., Stacy, A., Zheng, H., et al. (2003). Sensations from initial exposure to nicotine predicting adolescent smoking in China: a potential measure of vulnerability to nicotine. Nicotine & Tobacco Research, 5(4), 455–463.

    Article  Google Scholar 

  23. Ritt-Olson, A., Unger, J., Valente, T., et al. (2005). Exploring peers as a mediator of the association between depression and smoking in young adolescents. Substance Use & Misuse, 40(1), 77–98.

    Article  Google Scholar 

  24. Guo, Q., Johnson, C. A., Unger, J. B., et al. (2007). Utility of the theory of reasoned action and theory of planned behavior for predicting Chinese adolescent smoking. Addictive Behaviors, 32(5), 1066–1081.

    Article  PubMed  Google Scholar 

  25. Grenard, J. L., Guo, Q., Jasuja, G. K., et al. (2006). Influences affecting adolescent smoking behavior in China. Nicotine & Tobacco Research, 8(2), 245–255.

    Article  Google Scholar 

  26. Xiao, L., Bechara, A., Grenard, L. J., et al. (2009). Affective decision-making predictive of Chinese adolescent drinking behaviors. Journal of the International Neuropsychological Society, 15(4), 547–557

    Article  PubMed  CAS  Google Scholar 

  27. Johnson, C. A., Xiao, L., Palmer, P., et al. (2008). Affective decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in 10th grade Chinese adolescent binge drinkers. Neuropsychologia, 46(2), 714–726.

    Article  PubMed  Google Scholar 

  28. Xiao, L., Bechara, A., Cen, S., et al. (2008). Affective decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in 10th-grade Chinese adolescent smokers. Nicotine & Tobacco Research, 10(6), 1085–1097.

    Article  Google Scholar 

  29. Okamoto, J., Sakuma, K.L., Yan, H., Peiyuan, Q., Palmer, P.H., Johnson, A. (2010). A qualitative exploration of youth in the "New" China: perspectives on tobacco use from adolescents in Southwest China. Asia-Pacific Journal of Public Health (in press).

  30. Islam, S. M., & Johnson, C. A. (2007). Western media's influence on Egyptian adolescents' smoking behavior: the mediating role of positive beliefs about smoking. Nicotine & Tobacco Research, 9(1), 57–64.

    Article  Google Scholar 

  31. Xie, B., Chou, C., Spruijt-Metz, D., et al. (2006). Weight perceptions and weight-related socio-cultural and behavioral factors in Chinese adolescents. Preventive Medicine, 42(3), 229–234.

    Article  PubMed  Google Scholar 

  32. Johnson, C. A., Xie, B., Liu, C., et al. (2006). Socio-demographic and cultural comparison of overweight and obesity risk and prevalence in adolescents in Southern California and Wuhan, China. Journal of Adolescent Health, 39(6), 925.e1–925.e8.

    Article  Google Scholar 

  33. Xie, B., Chou, C. P., Spruijt-Metz, D., et al. (2007). Socio-demographic and economic correlates of overweight status in Chinese adolescents. American Journal of Health Behavior, 31(4), 339–352.

    PubMed  Google Scholar 

  34. Lessov-Schlaggar, C. N., Pang, Z., Swan, G. E., et al. (2006). Heritability of cigarette smoking and alcohol use in Chinese male twins: the Qingdao twin registry. International Journal of Epidemiology, 35(5), 1278–1285.

    Article  PubMed  Google Scholar 

  35. Li, D., London S.J., Liu, J., et al. (2011). Association of the Calcyon Neuron-Specific Vesicular Protein Gene (CALY) With Adolescent Smoking Initiation in China and California. American Journal of Epidemiology. doi:http://10.1093/aje/kwq471.

  36. Xie, B., Palmer, P. H., Pang, Z., et al. (2010). Environmental tobacco use and indicators of metabolic syndrome in Chinese adults. Nicotine & Tobacco Research, 12(3), 198–206.

    Article  CAS  Google Scholar 

  37. Liu, C., Xie, B., Zhou, D., et al. (2006). Development and reliability of a Chinese youth food frequency questionnaire. Chinese Journal of Public Health, 22(suppl), 62–64.

    CAS  Google Scholar 

  38. Ma, H., Unger, J. B., Chou, C. P., et al. (2008). Risk factors for adolescent smoking in urban and rural China: findings from the China seven cities study. Addictive Behaviors, 33(8), 1081–1085.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the Pacific Rim Transdisciplinary Tobacco and Alcohol Use Research Center (TTAURC) and funded by the National Institutes of Health (grant no. 1 P50 CA84735-01). The authors thank the China Seven Cities Study (CSCS) directors and project staff at the Center for Disease Control and Prevention in the cities of Chengdu, Hangzhou, Harbin, Qingdao, Shenyang, and Wuhan and the Institute for Health Education in Kunming, People’s Republic of China for assistance with project coordination and data collection. We also thank the principals, physicians, and teachers in the participating schools for their cooperation. Finally, we express our gratitude to the national Chinese Center for Disease Control and Prevention, Peking University School of Public Health, and the municipal government, health bureau, and education committee in participating cities for their support.

Author information

Authors and Affiliations

  1. School of Community & Global Health, Claremont Graduate University, 180 East Via Verde, Suite 100, San Dimas, CA, 91773, USA

    Paula H Palmer PhD, Bin Xie PhD, Bree Hemingway BA & C. Anderson Johnson PhD

  2. Chinese Academy of Medical Sciences & Peking Union Medical College, DongDan SanTiao 9, DongCheng District, Beijing, 100730, China

    Liming Lee MD, PhD

  3. Institute for Health Promotion and Disease Prevention Research, University of Southern California, 1000 S. Fremont Ave, Alhambra, CA, 91803, USA

    Chih-Ping Chou PhD & Ping Sun

Authors
  1. Paula H Palmer PhD
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  2. Bin Xie PhD
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  3. Liming Lee MD, PhD
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  4. Chih-Ping Chou PhD
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  5. Ping Sun
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  6. Bree Hemingway BA
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  7. C. Anderson Johnson PhD
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Corresponding author

Correspondence to Paula H Palmer PhD.

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Implications

Practice: When adapted to local culture and circumstances, evidence-based, prevention-focused strategies derived from western models can be effective in the reduction of noncommunicable diseases in developing nations, such as China.

Policy: Given China’s size, population, and healthcare system in transition, the utilization of population-based interventions can provide a cost-effective means of improving health outcomes.

Research: Research in developing nations should fully involve local collaborators, build capacity, and be drawn upon applicable western models and theories.

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Palmer, P.H., Xie, B., Lee, L. et al. The China Seven Cities Study (CSCS) consortium: adapting evidence-based prevention science from west to east. Behav. Med. Pract. Policy Res. 1, 283–288 (2011). https://doi.org/10.1007/s13142-011-0036-0

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  • DOI: https://doi.org/10.1007/s13142-011-0036-0

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