title: Effectiveness of comprehensive health education combining lifestyle education and hot spa bathing for male white-collar employees: a randomized controlled trial with 1-year follow-up.
abstract: BACKGROUND
  Physical activity is known to prevent obesity and metabolic syndrome in middle-aged and elderly people; however, the effectiveness of a comprehensive health education program for male white-collar employees is uncertain.
  
  
  METHODS
  Forty-three men volunteered to participate in this study and were randomly assigned into 2 groups. The intervention group participated in a 2-hour program comprising comprehensive health education and hot spa bathing, offered once every 2 weeks, in addition to individualized programs once a week, for 24 weeks. The control group received only general health guidance. We compared their lifestyle characteristics and physical and mental health criteria at baseline, immediately after the intervention, and 1 year after the end of the intervention.
  
  
  RESULTS
  Rates of adherence to individualized programs were 60.0 +/- 27.2% and 30.5 +/- 29.6% at the end of the intervention and at 1 year after the end of the intervention, respectively. Significant (P < 0.05) interaction of criteria was observed for cluster of differentiation 4+ (CD4+) cells and the ratio of cluster of differentiation 4+ to 8+ (CD4/8) cells, which were used to represent the participants' immunological function. We divided the intervention group into 2 subgroups on the basis of their attendance. Among the resulting 3 groups, significant interaction of criteria was observed for CD4+ and CD4/8 cells. In addition, the high attendance group had the highest CD4+ count and CD4/8 ratio.
  
  
  CONCLUSIONS
  Participants who attended classes and/or performed the supplementary individualized programs tended to maintain their immunological function and to experience a decrease in body fat percentage. However, few effects were noted in participants with poor adherence, even in the intervention group.
authors.affiliation: Faculty of Regional Environment Science, Tokyo University of Agriculture, Tokyo 156-8502, Japan. h1kamiok@nodai.ac.jp
authors.forename: Hiroharu
authors.initials: H
authors.lastname: Kamioka
authors.forename: Yosikazu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Shinpei
authors.initials: S
authors.lastname: Okada
authors.forename: Jun
authors.initials: J
authors.lastname: Kitayuguchi
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Kamada
authors.forename: Takuya
authors.initials: T
authors.lastname: Honda
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Matsui
authors.forename: Yoshiteru
authors.initials: Y
authors.lastname: Mutoh
mesh_terms: D000328:Adult; D001452:Balneology / Q000379:methods*; D004651:Employment; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods*; D006304:Health Status; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D015397:Program Evaluation; D012959:Socioeconomic Factors
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