2015.3.14

Ethics approval and consent to participate

The study was conducted in accordance with the guidelines of the Declaration of Helsinki and the National Ethical Guidelines in Biomedical Research in Iran. The study was approved by the Ethics Committee of the Shahrekord University of Medical Sciences (SKUMS) (IR.SKUMS.REC.1394.286) at regional and national scales in 2014.

November 2015

the pre-pilot phase of the study from 22 Nov 2015 to 10 Sept 2016.

The aims of the Shahrekord PERSIAN Cohort Study (SPCS) are: i) to evaluate the prevalence and long-term trends of NCDs and their outcomes in an Iranian province with unique geographical, ethnic, and socioeconomic characteristics, ii) to investigate associations of environmental and genetic/ethnic factors with the prevalence and incidence of NCDs and their outcomes, iii) to examine the interplay between genetic/ethnic and environmental factors in the etiology and prevention of NCDs, iv) to provide the basis for various types of epidemiological studies (e.g., social, spatial, molecular epidemiology) and generate scientific evidence that may contribute to improving public health in the Chaharmahal and Bakhtiari (CH&B) province, v) to provide a research and education platform and a resource for national and international collaboration and to make the research community aware of the existence of large cohorts around the world.

This population-based prospective cohort study recruited participants from the Chahrmahal & Bakhtiari province in Southwest Iran. A total of 10075 participants were recruited from the districts of Shahrekord and Ardal, situated in urban (7034 participants) and rural (3041 participants) areas, respectively.

Shahrekord cohort center included people between the ages of 35 and 75 (both sexes), living in ten urban areas in Shahrekord and ten rural areas in Ardal district.

The multistage sampling method (stratified proportional cluster sampling) was applied to recruit participants. N=10075

Socio-demographic characteristics of participants at baseline of the Shahrekord PERSIAN Cohort Study, by sex and residence area

Questionnaires, checklist, observation, interview

Questionnaires and research tools used in the Shahrekord PERSIAN Cohort Study

Phone, Annual follow-ups (200,000 person-year) of the cohort were designed to be conducted up to 2036.

The follow-up process aimed to register new cases of common NCDs and their outcomes, including death, cause of death, hospital admissions, and update information on exposures. The SPCS focuses primarily on the most common NCDs, including cardiovascular diseases, cancers, and the main endocrine, digestive, hepatic, renal, psychiatric, and respiratory disorders, defined using the International Classification of Diseases 10th version (ICD-10). The annual follow-up of the SPCS began in October 2017 and included questionnaires, medical examinations, and linkage with other databases (death, cancer registry). The study follow-up is done annually through telephone calls and links with health databases to identify disease outcomes. More specifically, the follow-up of participants is performed in two forms: an active form including phone interviews and face-to-face interviews (when outcomes occur), and an inactive form, including self-reports.

The study collected data on a large number of exposures such as demographics, general health, lifestyle, dietary habits, nutrition and eating habits, employment, social integration, quality of life (e.g., sleep patterns, stress), physical activity, anthropometric indexes, occupational history, living place, family medical history and use of medication, and the number of anthropometric and physiological measures (e.g., respiratory capacity tests, electrocardiograms).

A rich biobank was created by collecting, in all cohort participants, samples from whole blood, serum, plasma, buffy coat, hair, nail, and urine. Diseases were ascertained from clinical examinations, biochemical variables, interviews, and linkage with medical records registered in the integrated health information system.

Co-Investigators

• Morteza Hashemzadeh, PhD
• Arsalan Khaledifar, MD
• Seyed Kamal Solati, PhD