title: Effectiveness of the Complete Health Improvement Program in Reducing Risk Factors for Cardiovascular Disease in an Appalachian Population.
abstract: BACKGROUND
  In 11 counties in Appalachian Ohio, the self-reported prevalence of diabetes mellitus (11.3%) is higher than the state (7.8%) or national (7.2%) average. Direct medical costs for diabetes in the United States are estimated at $176 billion annually. Indirect costs from disability, work loss, and premature death add up to another $69 billion.
  
  
  OBJECTIVE
  To determine the effectiveness of the Complete Health Improvement Program (CHIP) in reducing cardiovascular disease (CVD) risk factors in a sample of Appalachian participants with elevated fasting blood glucose (FBG) levels or a diagnosis of type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  In a retrospective study, data from 6 CHIP cohorts conducted in Appalachian Ohio from 2011 to 2012 were combined and analyzed for short-term changes in CVD risk factors from baseline. This study focused on a subsample of the overall CHIP, whose participants had elevated FBG levels or T2DM. Statistical analysis was completed by calculating means and SDs and using paired t tests to compare differences in variables.
  
  
  RESULTS
  After the CHIP intervention, 110 participants with baseline elevated FBG levels showed notable reductions in FBG levels, total cholesterol, low-density lipoprotein cholesterol, body mass index, and systolic blood pressure (all P values <.001). Likewise, participants in the subsample with T2DM experienced reductions in all CVD risk factors (all P values <.05).
  
  
  CONCLUSIONS
  The CHIP lifestyle intervention was effective in reducing CVD risk factors in this Appalachian population with elevated FBG levels or with T2DM.
authors.forename: Christopher
authors.initials: C
authors.lastname: Leibold
authors.forename: Jay H
authors.initials: JH
authors.lastname: Shubrook
authors.forename: Masato
authors.initials: M
authors.lastname: Nakazawa
authors.forename: David
authors.initials: D
authors.lastname: Drozek
mesh_terms: D001061:Appalachian Region / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009820:Ohio / Q000453:epidemiology; D015397:Program Evaluation; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D040242:Risk Reduction Behavior