202 Saudi Med J 2013; Vol. 34 (2) www.smj.org.sa Methods and status of a comprehensive community-based intervention focusing on non-communicable diseases and the major risk factors in the Kingdom of Saudi Arabia. he Crown Health Project Ziad A. Memish, MD, Abu S. Abdullah, MD, PhD, Mohammad Y. Saeedi, MD, Riad M. Salloum, MD, Ahmed J. Almadani, MD, Omer Abid, MD, MPH. I n the Eastern Mediterranean Region (EMR), non- communicable diseases (NCDs) (cardiovascular disease, diabetes mellitus, cancer and chronic pulmonary disease) accounted for 50% of all deaths in 2005. 1 Total deaths from NCDs are projected to increase by 25% over the next 10 years in the region. 1 he prevalence of risk factors for NCDs is also high in most countries of the region. 1 In a World Health Organization (WHO) STEPS (STEPwise approach for surveillance) survey conducted among adults aged 15-65 years in the EMR, almost 25% were hypertensive, and between 20-40% had hypercholesterolemia. he Kingdom of Saudi Arabia (KSA) was among the 10 countries with the highest prevalence of diabetes in the world. 1 In the EMR, high levels of overweight was found, with the prevalence of overweight/obesity ranging between 74% and 86% in women, and between 69% and 77% in men. 1 Furthermore, 17.9% of adults in KSA have diabetes, 21.1% have hypertension, 36.1% are obese, 19.3% have hypercholesterolemia, 12.9% were smokers, and 33.8% were physically inactive. 2 However, limited data is available on the prevalence of NCDs and the risk factors in KSA. he growing need for costly healthcare services due to the increase in NCDs will afect both the healthcare infrastructure and the entire economy. herefore, there is an urgent need for evidence-based interventions to combat the threat from NCDs. Preventing NCDs is most efectively carried out through a combination of community-based intervention and individually- focused intervention for risk reduction. 3 However, there is no proven intervention implemented in KSA that has addressed the Saudi cultural values and lifestyle factors. herefore, a community-based intervention- the Crown Health Project (CHP) - was developed and implemented on a small-scale, to assess the feasibility and efectiveness of the program, in order to potentially scale it up. he objectives of the CHP are: 1. To determine the prevalence of common NCDs and their risk factors; 2. To raise awareness regarding risk factors for NCDs and preventive measures among the public; 3. To improve the early detection and management of NCDs; 4. To build capacity among health care workers (HCWs) on preventive services for NCDs; and 5. To improve diagnostic, curative, and rehabilitative services for patients. In this paper, the CHP which was initiated and cleared for ethical approval by the Ministry of Health’s Public Health Directorate, will be described along with the irst results on the implementation of the program. he CHP was conducted in the Al-Jouf Region of KSA. his region was chosen, because most health services are delivered through the facilities of the Ministry of Health (MOH) (3 hospitals and 29 primary healthcare centers (PHCs). he CHP was delivered through the PHCs and reached the whole population of the region. he following activities corresponding to the previously numbered objectives were planned to be conducted in the Al-Jouf region from 2008 to 2013: 1. A survey among a representative sample of adults aged 15 years and older using the WHO STEPS methodology to determine the prevalence of common NCDs and their risk factors. he survey included both questionnaire data (demographic and socioeconomic, lifestyle factors, past medical history) and clinical data (physical measures, biochemical measures); 2. Public health education and prevention programs provided by Health Promotion Units, both to clients attending the unit (through individual counseling, group sessions, and the distribution of materials), and to the general public. he latter in collaboration with other agencies and included general health promotion programs (in local newspapers and magazines, and on television and radio) and targeted programs (programs at educational institutions, women recreation clubs, work-site programs); 3. Periodic examinations (physical and laboratory examinations) are performed by the screening units. he screening program includes the following: a) lifestyle factors (smoking, diet, physical activity); b) medical history (hypertension, diabetes etc.); c) physical measurements (height, weight, waist circumference, heart rate, blood pressure); and d) biochemical measurements (fasting blood glucose, total cholesterol). In the case of any abnormal indings, clients are referred to other health care facilities for Brief Communication Disclosure. Authors have no conlict of interests, and the work was not supported or funded by any company/ organization.