Protocol Design for Surveillance of Risk Factors of Non–communicable Diseases During the COVID-19 Pandemic: An Experience from Iran STEPS Survey 2021

Background: Regarding the growing burden of non-communicable diseases (NCDs) and exposure to their risk factors, continuous need for nationwide data, we aimed develop latest round STEPwise Approach NCD Risk Factor Surveillance (STEPS) survey in 2021 Iran, while COVID-19 pandemic was still present. Methods: In addition three main steps this survey, including questionnaires, physical measurements, laboratory assessments, adapted with situation caused by pandemic, adding various aspects study phases changing some scientific executive procedures STEPS Iran. These changes were beyond initial novelties embedded within before refining protocol benefiting from previous experiences survey. Results: By amending required changes, could include a total 27874 individuals first step This number 27745 18119 second third steps. Comparing preliminary results surveys, highly representative on both national provincial levels. Also, implementing prevention control strategies all stages led least infection transmission between investigators participants. Conclusion: The novel initiatives developed Iran provide state-of-the-art surveys presence an overwhelming catastrophe like triggered limitations shortages resources.