What Is STEPs

In the 2016 Stepwise Approach to Non-Communicable Risk Factors Surveillance (STEPs) survey in Iran, the mean and prevalence of non-communicable risk factors have been estimated in province level. However, the mean and prevalence of risk factors of the non-communicable diseases are not equally distributed among districts in each province. The district level data can be considered to determine priority setting and public health policy. So, in the 429 districts of Iran, non-communicable risk factors were estimated by small area estimation using bayesian spatial mixed-effect regression model. The input data for small area estimation have been achieved from the STEPs 2016 survey in Iran and age-standardized and all-ages estimates were obtained by sex in each district.



To determine the prevalence of major preventable risk factors of non-communicable diseases in Iran (including: smoking, poor nutrition, low physical activity, high blood pressure, overweight and obesity, high blood glucose, and high blood lipids) by age and sex groups

To determine the trend of major preventable risk factors of non-communicable diseases in Iran by age and sex groups based on data generated from the annual studies

Samples under study: 31000 subjects



Proportional to sample size

Systematic random sampling

Possibility of determining the risk factor map in megacities

Fully digitalized study

Observing all activities at peripheral level through the management panel

Participation of administrative teams in the online exam

Determining the times and places of interviews via GPS

Eradicating of errors in individual registration by using the “National ID Card No.” in the datasets

All Lab exams were conducted by unique brands of devices and kits

HbA1c Test on all samples

ALT test on all samples

Urine-Na test on all samples

24h Urine Sample (PABA) on sub-samples

Specific procedure for transporting samples from all around the country

Quality control for supervision of the accuracy of data

Unique brands of all sphygmomanometers, scales, lab tubes, SIM cards, and other equipment

Designing special educational films for interviewers and lab experts


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