Data from: A village doctor-led mobile health intervention for cardiovascular risk reduction in rural China: cluster randomised controlled trial

Published May 10, 2025 on Dryad. https://doi.org/10.5061/dryad.tmpg4f58w

Data files

May 10, 2025 version files 498.45 KB

README.md

5.17 KB
smarter_anonymised_data.csv

493.27 KB

Abstract

Objective: To assess the effectiveness of a village doctor-led mobile health intervention on cardiovascular risk reduction among residents in rural China.

Design: Cluster randomised controlled trial.

Setting: 127 villages from five provinces and autonomous regions in China.

Participants: 4533 participants from 127 villages: 2297 (64 villages) were randomly assigned to the intervention group and 2236 (63 villages) to the control group. Participants were aged ≥35 years, had no established atherosclerotic cardiovascular disease (ASCVD) but a predicted 10 year risk of ≥10%, had contracted a family doctor service with the local village doctor, and owned a smart phone.

Interventions: In addition to usual clinical care and basic public health services provided for the control group, the intervention led by village doctors included five components: assessing risk factors to identify individualised intervention targets, setting gradual goals based on doctor-participant communication, providing targeted short videos on health education, conducting health monitoring with periodic feedback, and providing motivation to reduce risk based on gamification.

Main Outcome Measures: Mean change in predicted 10 year risk of ASCVD from baseline to 12 months.

Results: Enrolment took place between March 2023 and May 2023. During the 12 month follow-up (complete rate 99.4%), the 10 year risk of ASCVD decreased from 18.0% to 11.7% in the intervention group and from 17.8% to 13.6% in the control group (absolute difference −1.88% (95% confidence interval (CI) −2.57% to −1.19%; P<0.001). Compared with the control group, the intervention group showed larger reductions in lifetime ASCVD risk (−15.9% vs. −11.0%; difference −4.59%; P<0.001), systolic blood pressure (−23.2 mmHg vs. −15.2 mmHg; difference −7.64 mmHg; P<0.001), diastolic blood pressure (−10.9 mmHg vs. −6.9 mmHg; difference −3.59 mmHg; P<0.001), fasting blood glucose (−0.9 mmol/L vs. −0.5 mmol/L; difference −0.30 mmol/L; P=0.008), proportion of daily smokers (−3.1% vs. −0.6%; odds ratio 0.60, 95%CI 0.43 to 0.84; P=0.003), and insufficient physical activity (−3.0% vs. 1.3%; odds ratio 0.63, 0.42 to 0.95; P=0.03). No significant differences were observed for change in non-high density lipoprotein cholesterol or proportion of participants with obesity.

Conclusions: The village doctor-led mobile health intervention was effective at reducing cardiovascular risk and improving control of behavioural and metabolic risk factors. This feasible approach could be scaled up in rural China and other under-resourced settings to improve health management based on the local primary healthcare system.

Trial registration: ClinicalTrials.gov NCT05645640.

Dataset DOI: 10.5061/dryad.tmpg4f58w

Description of the data and file structure

This dataset is the rawdata for the SMARTER (Strategy for cardiovascular disease prevention through tailored health Management and its effectiveness Assessment through a cluster Randomised Trial in individuals with Elevated Risk) study, and corresponds to the paper entitled "A village doctor-led mobile health intervention for cardiovascular risk reduction in rural China: cluster randomised controlled trial".

Files and variables

File: smarter_anonymised_data.csv

Description: Rawdata for the SMARTER study

Variables

ID: Identification number of the participants (anonymized code)
village_id: Identification number of the villages (anonymized code)
group: 1= intervention group; 2=control group
vc_age_grp: one of the village minimisation factors, participants' mean age (1=below the county’s median; 2=above the county’s median)
vc_sbp_grp: one of the village minimisation factors, participants' mean SBP (1=below the county’s median; 2=above the county’s median)
vc_risk_grp: one of the village minimisation factors, participants' mean 10 year risk of ASCVD (1=below the county’s median; 2=above the county’s median)
doctor_college_above: one of the village minimisation factors, educational attainment of the village doctors (1= college education or higher; 2=below college level)
age: age of the participants (years)
male: sex of the participants (1=male; 0=female)
education_high_above: education of the participants (1=high school or above; 0=below high school level)
occupation_farmer: occupation of the participants (1=farmers; 0=non-farmers)
Last_year_income_lt_10k: annual household income level of the participants (1=less than 10000 yuan per year; 0=no less than 10000 yuan per year)
marriage_yes: marriage status of the participants (1=currently married; 0=widowed, separated, divorced, or single)
insure_yes: social medical insurance of the participants (1=insured; 0=uninsured)
BMI0_grp: categorical variable for BMI levels at baseline (1="<18.5"; 2="18.5_{24"; 3="24}28"; 4=">28")
waist0_normal: categorical variable for waist circumstance at baseline (1="normal " which was defined as a waist circumstance <85 cm for men and <80 cm for women; 0=abnormal)
risk0: participants' 10 year risk of ASCVD at baseline (%)
risk4: participants' 10 year risk of ASCVD at the 12-month follow-up visit (%)
risk_lifetime_0: participants' lifetime risk of ASCVD at baseline (%)
risk_lifetime_4: participants' lifetime risk of ASCVD at the 12-month follow-up visit (%)
SBP0: participants' systolic blood pressure at baseline (mmHg)
SBP4: participants' systolic blood pressure at the 12-month follow-up visit (mmHg)
DBP0: participants' diastolic blood pressure at baseline (mmHg)
DBP4: participants' diastolic blood pressure at the 12-month follow-up visit (mmHg)
GLU0: participants' fasting blood glucose at baseline (mmol/L)
GLU4: participants' fasting blood glucose at the 12-month follow-up visit (mmol/L)
NHDL0: participants' non-high density lipoprotein cholesterol at baseline (mmol/L)
NHDL4: participants' non-high density lipoprotein cholesterol at the 12-month follow-up visit (mmol/L)
obesity_0: obesity at baseline (1=obesity which was defined as a BMI>28; 0=non-obese)
obesity_4: obesity at the 12-month follow-up visit (1=obesity which was defined as a BMI>28; 0=non-obese)
smk_daily_0: daily smoking at baseline (1=smoking daily; 0=non-smoking or not smoking daily)
smk_daily_4: daily smoking at the 12-month follow-up visit (1=smoking daily; 0=non-smoking or not smoking daily)
PA_lt3000_0: Insufficient physical activity at baseline (1=insufficient which was defined as a physical activity level less than 3000 MET·min/week; 0=sufficient physical activity)
PA_lt3000_4: Insufficient physical activity at the 12-month follow-up visit (1=insufficient which was defined as a physical activity level less than 3000 MET·min/week; 0=sufficient physical activity)
LTPA0: Insufficient leisure time activity at baseline (1=insufficient which was defined as a leisure time activity level <150 minutes moderate intensity aerobic activities or <75 minutes vigorous intensity aerobic activities weekly; 0=sufficient leisure time activity)
LTPA4: Insufficient leisure time activity at the 12-month follow-up visit (1=insufficient which was defined as a leisure time activity level <150 minutes moderate intensity aerobic activities or <75 minutes vigorous intensity aerobic activities weekly; 0=sufficient leisure time activity)

Code/software

Software Requirements:

SAS 9.4 or later versions.

Code Availability Statement:

Analysis code for this study is available at https://github.com/nccd2024/SMARTER.

Access information

Other publicly accessible locations of the data:

None.

Data was derived from the following sources:

None.