Effectiveness of Tailored Health Promotion Program for Reducing Cardiovascular Risk Factors in subway Workers

일부 지하철 근로자에서의 뇌심혈관질환 위험요인 개선을 위한 맞춤형 건강증진프로그램의 효과

이선영;이강숙;구정완;임현우;박정일;김형렬;김형렬

  • Published : 20060300

Abstract

Objectives : This study explores the effects of a tailored health promotion program, in order to reduce cardiovascular risk, in areas which include hypertension, dyslipidemia, abnormal blood glucose and body mass index. Methods : In this paper, health risk appraisal relating to lifestyle was surveyed and physical fitness, blood pressure and blood lipid profile and glucose were checked. Then, a 12 week tailored health promotion program with 40 subway workers of Seoul was conducted. The Tailored health promotion program included a smoking cessation program, drinking restriction, diet, exercise prescription and a stress management program. Results : The number of subjects engaging in regular exercise increased from 42.5% to 100%, and the number of smokers reduced from 72.5% to 60%, and 12.5% of contemplate stage was shift to action stage. The mean level of drinking per day, significantly decreased from 34.9 g to 24.2. The body mass index, systolic blood pressure, total cholesterol, triglyceride, and Fasting blood glucose significantly decreased after the intervention program. In addition the tailored health promotion program resulted in a significant reduction in two factors for the cardiovascular high risk group, hypertension above 140 mmHg in systolic blood pressure and dyslipidemia above 200 mg/dl in triglyceride. Conclusion : In this paper, it is demonstrated that the tailored health promotion program, including the smoking cessation program, drinking restriction, diet, exercise prescription and stress management program, resulted in effective reduction in cardiovascular risk factor. Therefore associated workplace tailored health promotion programs relating to specific individual risk factor, should be developed and implemented.

Keywords

References

  1. American College of Sports medicine : The recommended quality of exercise for developing and maintaining fitness in healthy adults. Sports Med Bull 1978;3:1-4
  2. Bruce RA, Kusumi F, Hosmer D. Maximal oxygen intake and nomographic assessment of funtional aerobic impairment in cardiovascular disease. Am Heart J 1973;8:546-55
  3. Campbell MK, Tessaro I, Devellis B, Benedict S, Kelsey K, Belton L, Sanhueza A.Effects of a tailored health promotion program for female blue-collar workers : health works for women. Prev Med 2002;34(3):313-23 https://doi.org/10.1006/pmed.2001.0988
  4. Castelli WP, Doyle JT, Gordon T. Alcohol and blood lipid. The cooperative lipoprotein phenotyping study 1984;2:153
  5. Christenson GM. The national survey of worksite health promotion activities. AAOHN 1988;36(6):155-63
  6. Cushman WC, Cutler JA, Hanna E. Prevention and treatment of hypertention study(PATHS):Effects of an Alcohol Treatment Program on Blood Pressure Ach Inter Med 1998;158(11):1197-207
  7. Dawson DA, Grant BF, Chou PS. Gender differences in alcohol intake. In:Hunt WA & Zakhari S(eds). Stress, gender and alcohol-seeking behavior. NIAAA research monograph No 29. NIH Pub No 95-3893. Bethesda, 1995. 1-21
  8. Dishman RK, Sallis JF, Orenstein DR. The determinants of physical activity and exercise. Public Health Rep 1985;100:158-71
  9. Emmons KM, Linnan LA, Shadel WG, Marcus B, Abrams DB. The working healthy project : a worksite health-promotion trial targeting physical activity, diet, and smoking. J Occup Environ Med 1999;41(7):545-55 https://doi.org/10.1097/00043764-199907000-00003
  10. Eriksen L. Cancer prevention in workplace health promotion. AAOHN J 1988;36(6):266-71
  11. Fagerstrom KO. Measuring degree of physician dependence to tobacco smoking with reference to individualization of treatment. Addict Behav 1987;3:235-41
  12. Ferrara A, Barrett-Connor E, Shan J. Total LDL and HDL cholesterol decrease with age in older men and women. Circulation 1997;96(1):37-43 https://doi.org/10.1161/01.CIR.96.1.37
  13. Fielding JE, Piserchia PV. Frequency of worksite health promotion activities. Am J Public Health 1989;79(1):16-20 https://doi.org/10.2105/AJPH.79.1.16
  14. Golaszewski T, Snow D, Lynch W, Yen L, Solomita D. A benefit to cost of a worksite health promotion program. J Occup Med 1992;34(12):1164-72
  15. Goldbourt U, Neufeld HN. Genetic aspects of arteriosclerosis. Arteriosclerosis 1986;6:357-77 https://doi.org/10.1161/01.ATV.6.4.357
  16. Gordon T, Castelli WP, Hijortland MC. High density lipoprotein as a protective factor against coronary heart disease. Am J Med 1997;62:707-12 https://doi.org/10.1016/0002-9343(77)90874-9
  17. Hagberg JM, Park JJ, Brown MD. The role of exercise training the treatment of hypertension: an update. Sports Med 2000;30(3):193-206 https://doi.org/10.2165/00007256-200030030-00004
  18. Jacobson MI, Yenny SL, Bigard JC. An organizational perpective on worksite health promotion. Occup Med: state of the art review 1990;5(4):653-64
  19. Kannel WB. High density lipoproteins : Epidemiologic profile and risks of coronary artery disease. Am J Cardiol 1983;52:913-16 https://doi.org/10.1016/0002-9149(83)90443-5
  20. Lakka TA, Salonen JT. Physical activity and serum lipids; a cross sectional population study in eastern Finnish men. Am J Epidemiol 1992;136:806-8 https://doi.org/10.1093/aje/136.7.806
  21. Lechner L, Vries HD. Participation in an employee fitness program: determinants of high adherence, low adherence, and dropout. J Occup Environ Med 1995;37(4):429-36 https://doi.org/10.1097/00043764-199504000-00014
  22. Lee KS. The effectiveness and development of health promotion program for cardiovascular risk factors KIHASA. 2000. (Korean)
  23. Lee KS, Lee JW, Lee WC. The factors associated with relapse of smoking in male workers of an electronics industries. Korean J Occup Heal 2003;42(2):39-48. (Korean)
  24. Linder CW, Durant RH, Mahoney OM. The effect of physical conditioning on serum lipids and lipoproteins in white made adolescents. Med Sci Sports Exerc 1983;15(3):232-6
  25. Maheswaran R, Beevers M, Beevers DG. Effectiveness of advice to reduce alcohol consumption in hypertensive patients. Hypertension 1992;19(1):79-84 https://doi.org/10.1161/01.HYP.19.1.79
  26. Manson JE, Gaziano JM, Jonas MA, Hennekens CH: Antioxidants and cardiovascular disease: A review. J Am Coll Nutr 1993;12(4):426-32 https://doi.org/10.1080/07315724.1993.10718332
  27. Merz C, Dwyer J, Nordstrom CK, Walton K, Salerno J, Schneider R. Psychosocial stress and cardiovascular disease : Pathophysiological links. Behav Med 2002;27(4):141-7 https://doi.org/10.1080/08964280209596039
  28. McGill HC. Smoking and the pathogenesis of atherosclerosis. Adv Exp Med Biol 1990;273(1):9-16
  29. Murphy LR, Stress management in work setting:A critical review of the health effects. Am J Health Promot 1996;11(2):112-35 https://doi.org/10.4278/0890-1171-11.2.112
  30. Nisbeth O, Klausen K, Andersen L.B. Effectiveness of counselling over 1 year on change in lifestyle and coronary heart disease risk factors. Patient Educ Couns 2000;40(2):121-31 https://doi.org/10.1016/S0738-3991(99)00053-1
  31. Prior JO, Melle G, Crisinel A, Burnand B, Cornuz J, Darioli R. Evluation of a multicomponent worksite health promotion program for cardiovascular risk factors - correcting for the regression towards the mean effect. Prev Med 2005;40(3):259-67 https://doi.org/10.1016/j.ypmed.2004.05.032
  32. Powell KE, Blair SN. The public health burdens of sedentary living habits:: theoretical but realistic estimates. Med Sci Sports Exerc 1994;26(7):851-6
  33. Sawatzky JV, Maimark BJ. Physical activity and cardiovascular health in aging women : a health promotion perspective. J Aging Phys Act 2002;10(4):396-412 https://doi.org/10.1123/japa.10.4.396
  34. Schuler CS, Hambrecht RH, Schlierf G, et al. Regular physical exercise and low-fat diet: effects on progression of coronary artery disease. Cirulation 1992;86(1):1-11 https://doi.org/10.1161/01.CIR.86.1.1
  35. Sorensen G, Stoddard AM, LaMontagne AD, et al. A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial(United state). J Public Health Policy 2003;24(1):5-25 https://doi.org/10.2307/3343174
  36. Tipton CM. Exercise training and hypertension: an update. In:Holloszy JO, editor. Exerc Sport Sci Rev. Baltimore (MD): Williams & Wilkins, 1991:19:447-506
  37. Tran ZV. The effects of exercise on blood lipids and lipoproteins. Med Sci Sports Exerc 1983;15:393-402
  38. Ueshima H, Ogihara T, Baba S, Tabuchi Y, Mikawa K, Hashizume K, Mandai T, Oazwa H, Kumahara Y, Asakura S. The effect of reduced alcohol consumption on blood pressure: a randomised, controlled, single blind study. J Hum Hypertens 1987;1(2):113-9S.
  39. Woollard J, Beilin L, Lord T, Puddey I, MacAdam D, Rouse I. A controlled trial of nurse counselling on lifestyle change for hypertensives treated in general practive : preliminary results. Clin Exp Pharmacol Physiol 1995;22(6-7):466-8 https://doi.org/10.1111/j.1440-1681.1995.tb02046.x
  40. Wallace J.P. Exercise in hypertension; a clinical review. Sports Med 2003:33(8);585-98 https://doi.org/10.2165/00007256-200333080-00004