Evaluation of a multicomponent worksite health promotion program for cardiovascular risk factors-correcting for the regression towards the mean effect.
BACKGROUND
We assessed the impact of a multicomponent worksite health promotion program for0 reducing cardiovascular risk factors (CVRF) with short intervention, adjusting for regression towards the mean (RTM) affecting such nonexperimental study without control group.


METHODS
A cohort of 4,198 workers (aged 42 +/- 10 years, range 16-76 years, 27% women) were analyzed at 3.7-year interval and stratified by each CVRF risk category (low/medium/high blood pressure [BP], total cholesterol [TC], body mass index [BMI], and smoking) with RTM and secular trend adjustments. Intervention consisted of 15 min CVRF screening and individualized counseling by health professionals to medium- and high-risk individuals, with eventual physician referral.


RESULTS
High-risk groups participants improved diastolic BP (-3.4 mm Hg [95%CI: -5.1, -1.7]) in 190 hypertensive patients, TC (-0.58 mmol/l [-0.71, -0.44]) in 693 hypercholesterolemic patients, and smoking (-3.1 cig/day [-3.9, -2.3]) in 808 smokers, while systolic BP changes reflected RTM. Low-risk individuals without counseling deteriorated TC and BMI. Body weight increased uniformly in all risk groups (+0.35 kg/year).


CONCLUSIONS
In real-world conditions, short intervention program participants in high-risk groups for diastolic BP, TC, and smoking improved their CVRF, whereas low-risk TC and BMI groups deteriorated. Future programs may include specific advises to low-risk groups to maintain a favorable CVRF profile.
Prior
John O
JO
Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, University Hospital, Lausanne, Switzerland.
van Melle
Guy
G
Crisinel
Annette
A
Burnand
Bernard
B
Cornuz
Jacques
J
Darioli
Roger
R
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation; D012044:Regression Analysis; D012307:Risk Factors; D017678:Sex Distribution; D013557:Switzerland / Q000453:epidemiology; D017132:Workplace