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Zhou YF, Chen S, Chen JX, Chen S, Wang G, Pan XF, Wu S, Pan A. Cost-Effectiveness of a Workplace-Based Hypertension Management Program in Real-World Practice in the Kailuan Study. J Am Heart Assoc 2024; 13:e031578. [PMID: 38563379 DOI: 10.1161/jaha.123.031578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND In 2009, a workplace-based hypertension management program was launched among men with hypertension in the Kailuan study. This program involved monitoring blood pressure semimonthly, providing free antihypertensive medications, and offering personalized health consultations. However, the cost-effectiveness of this program remains unclear. METHODS AND RESULTS This analysis included 12 240 participants, with 6120 in each of the management and control groups. Using a microsimulation model derived from 10-year follow-up data, we estimated costs, quality-adjusted life years (QALYs), life-years, and incremental cost-effectiveness ratios (ICERs) for workplace-based management compared with routine care in both the study period and over a lifetime. Analyses are conducted from the societal perspective. Over the 10-year follow-up, patients in the management group experienced an average gain of 0.06 QALYs with associated incremental costs of $633.17 (4366.85 RMB). Projecting over a lifetime, the management group was estimated to increase by 0.88 QALYs or 0.92 life-years compared with the control group, with an incremental cost of $1638.64 (11 301.37 RMB). This results in an incremental cost-effectiveness ratio of $1855.47 per QALY gained and $1780.27 per life-year gained, respectively, when comparing workplace-based management with routine care. In probabilistic sensitivity analyses, with a threshold willingness-to-pay of $30 765 per QALY (3 times 2019 gross domestic product per capita), the management group showed a 100% likelihood of being cost-effective in 10 000 samples. CONCLUSIONS Workplace-based management, compared with routine care for Chinese men with hypertension, could be cost-effective both during the study period and over a lifetime, and might be considered in working populations in China and elsewhere.
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Affiliation(s)
- Yan-Feng Zhou
- Department of Social Medicine, School of Public Health Guangxi Medical University Nanning China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital North China University of Science and Technology Tangshan China
| | - Jun-Xiang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Simiao Chen
- Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital Heidelberg University Heidelberg Germany
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital North China University of Science and Technology Tangshan China
| | - Xiong-Fei Pan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital Chengdu China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital North China University of Science and Technology Tangshan China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College Huazhong University of Science and Technology Wuhan China
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Hu Z, Wang X, Zheng C, Zhang L, Cao X, Tian Y, Gu R, Cai J, Tian Y, Shao L, Wang Z. Association Between the Improvement of Knowledge, Attitude and Practice of Hypertension Prevention and Blood Pressure Control-A Cluster Randomized Controlled Study. Am J Health Promot 2024:8901171241237016. [PMID: 38610124 DOI: 10.1177/08901171241237016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND Hypertension-related knowledge, attitude and practice (KAP) of hypertensive patients can affect the awareness, treatment and control of hypertension. However, little attention has been paid to the association between the change of hypertension preventive KAP and blood pressure (BP) control in occupational population using longitudinal data. We assess the effectiveness of a workplace-based multicomponent hypertension intervention program on improving the level of KAP of hypertension prevention, and the association between improvement in KAP and BP control during intervention. METHODS From January 2013 to December 2014, workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20) using a cluster randomized control method. All employees in each workplace were asked to complete a cross-sectional survey to screen for hypertension patients. Hypertension patients in the intervention group were given a 2-year workplace-based multicomponent hypertension intervention for BP control. The level of hypertension prevention KAP and BP were assessed before and after intervention in the two groups. RESULTS Overall, 3331 participants (2658 in the intervention group and 673 in the control group) were included (mean [standard deviation] age, 46.2 [7.7] years; 2723 men [81.7%]). After 2-year intervention, the KAP qualified rate was 63.2% in the intervention groups and 50.1% in the control groups (odds ratio = 1.65, 95% CI, 1.36∼2.00, P < .001). Compared with the control group decreased in the qualified rate of each item of hypertension preventive KAP questionnaire, all the items in the intervention group increased to different degrees. The increase of KAP score was associated with the decrease of BP level after intervention. For 1 point increase in KAP score, systolic blood pressure (SBP) decreased by .28 mmHg and diastolic blood pressure (DBP) decreased by .14 mmHg [SBP: β = -.28, 95%CI: -.48∼-.09, P = .004; DBP: β = -.14, 95%CI: -.26∼-.02, P = .024]. SBP and DBP was significantly in manual labor workers (SBP: β = -.34, 95%CI: -.59∼-.09, P = .008; DBP: β = -.23, 95%CI: -.38∼-.08, P = .003), workers from private enterprise, state-owned enterprise (SOE) (SBP: β = -.40, 95%CI: -.64∼-.16, P = .001; DBP: β = -.21, 95%CI: -.36∼-.06, P = .005) and a workplace with an affiliated hospital (SBP: β = -.31, 95%CI: -.52∼-.11, P = .003; DBP: β = -.16, 95%CI: -.28∼-.03, P = .016). The improvement of knowledge (SBP: β = -.29, 95%CI: -.56∼-.02, P = .038; DBP: β = -.12, 95%CI: -.29∼.05, P = .160), as well as attitude (SBP: β = -.71, 95%CI: -1.25∼-.18, P = .009; DBP: β = .18, 95%CI: -.23∼.59, P = .385) and behavior (SBP: β = -.73, 95%CI: -1.22∼-.23, P = .004; DBP: β = -.65, 95%CI: -.97∼-.33, P < .001) was gradually strengthened in relation to BP control. CONCLUSION This study found that workplace-based multicomponent hypertension intervention can effectively improve the level of hypertension preventive KAP among employees, and the improvement of KAP levels were significantly associated with BP control. TRIAL REGISTRATION Chinese Clinical Trial Registry No. ChiCTR-ECS-14004641.
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Affiliation(s)
- Zhen Hu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Runqing Gu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiayin Cai
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Ye Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Lan Shao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
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Majed L, Ibrahim R, Lock MJ, Jabbour G. Walking around the preferred speed: examination of metabolic, perceptual, spatiotemporal and stability parameters. Front Physiol 2024; 15:1357172. [PMID: 38405123 PMCID: PMC10884095 DOI: 10.3389/fphys.2024.1357172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024] Open
Abstract
Walking is the most accessible and common type of physical activity. Exercising at one's self-selected intensity could provide long-term benefits as compared to following prescribed intensities. The aim of this study was to simultaneously examine metabolic, perceptual, spatiotemporal and stability parameters at an absolute 3 km·h-1 speed range around the individual preferred walking speed (PWS). Thirty-four young sedentary adults (18 women) volunteered to walk at seven speeds relative to their PWS in 3-min trials interspaced with 3-min rest intervals. Results indicated a significant main effect of speed on all studied variables. While metabolic, perceptual and spatiotemporal values were sensitive to the smallest change in speed (i.e., 0.5 km·h-1), a significant increase in the rate of carbohydrate oxidation and decrease in %fat oxidation were only observed at speeds above PWS. Results also revealed significantly higher coefficients of variation for stride characteristics at speeds below PWS only. Moreover, analyses of best fit models showed a quadratic relationship between most variables and speed, with the exceptions of metabolic cost of transport, rating of perceived exertion and stride duration that changed exponentially with speed. PWS coincided with optimized mechanical efficiency, fuel oxidation and gait stability. This indicated that walking below PWS decreased both mechanical efficiency and stability of gait, while walking above PWS increased carbohydrate oxidation. Those factors seem to play an important role as determinants of PWS. We suggest that walking at PWS may provide benefits in terms of fat oxidation while optimizing gait stability.
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Affiliation(s)
- Lina Majed
- Exercise Science, Health and Epidemiology Division, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Rony Ibrahim
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Merilyn Jean Lock
- Exercise Science, Health and Epidemiology Division, College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Georges Jabbour
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
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Hu Z, Wang X, Hong C, Zheng C, Zhang L, Chen Z, Zhou H, Tian Y, Cao X, Cai J, Gu R, Tian Y, Shao L, Wang Z. Workplace-based primary prevention intervention reduces incidence of hypertension: a post hoc analysis of cluster randomized controlled study. BMC Med 2023; 21:214. [PMID: 37316876 DOI: 10.1186/s12916-023-02915-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND A workplace-based primary prevention intervention be an effective approach to reducing the incidence of hypertension (HTN). However, few studies to date have addressed the effect among the Chinese working population. We assessed the effect of a workplace-based multicomponent prevention interventions program for cardiovascular disease on reducing the occurrence of HTN through encouraging employees to adopt a healthy lifestyle. METHODS In this post hoc analysis of cluster randomized controlled study, 60 workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20). All employees in each workplace were asked to complete a baseline survey after randomization for obtaining sociodemographic information, health status, lifestyle, etc. Employees in the intervention group were given a 2-year workplace-based primary prevention intervention program for improving their cardiovascular health, including (1) cardiovascular health education, (2) a reasonable diet, (3) tobacco cessation, (4) physical environment promotion, (5) physical activity, (6) stress management, and (7) health screening. The primary outcome was the incidence of HTN, and the secondary outcomes were improvements of blood pressure (BP) levels and lifestyle factors from baseline to 24 months. A mix effect model was used to assess the intervention effect at the end of the intervention in the two groups. RESULTS Overall, 24,396 participants (18,170 in the intervention group and 6,226 in the control group) were included (mean [standard deviation] age, 39.3 [9.1] years; 14,727 men [60.4%]). After 24 months of the intervention, the incidence of HTN was 8.0% in the intervention groups and 9.6% in the control groups [relative risk (RR) = 0.66, 95% CI, 0.58 ~ 0.76, P < 0.001]. The intervention effect was significant on systolic BP (SBP) level (β = - 0.7 mm Hg, 95% CI, - 1.06 ~ - 0.35; P < 0.001) and on diastolic BP (DBP) level (β = - 1.0 mm Hg, 95% CI, - 1.31 ~ - 0.76; P < 0.001). Moreover, greater improvements were reported in the rates of regular exercise [odd ratio (OR) = 1.39, 95% CI, 1.28 ~ 1.50; P < 0.001], excessive intake of fatty food (OR = 0.54, 95% CI, 0.50 ~ 0.59; P < 0.001), and restrictive use of salt (OR = 1.22, 95% CI, 1.09 ~ 1.36; P = 0.001) in intervention groups. People with a deteriorating lifestyle had higher rates of developing HTN than those with the same or improved lifestyle. Subgroup analysis showed that the intervention effect of BP on employees with educational attainment of high school above (SBP: β = - 1.38/ - 0.76 mm Hg, P < 0.05; DBP: β = - 2.26/ - 0.75 mm Hg, P < 0.001), manual labor workers and administrative worker (SBP: β = - 1.04/ - 1.66 mm Hg, P < 0.05; DBP: β = - 1.85/ - 0.40 mm Hg, P < 0.05), and employees from a workplace with an affiliated hospital (SBP: β = - 2.63 mm Hg, P < 0.001; DBP: β = - 1.93 mm Hg, P < 0.001) were significantly in the intervention group. CONCLUSIONS This post hoc analysis found that workplace-based primary prevention interventions program for cardiovascular disease were effective in promoting healthy lifestyle and reducing the incidence of HTN among employees. TRIAL REGISTRATION Chinese Clinical Trial Registry No. ChiCTR-ECS-14004641.
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Affiliation(s)
- Zhen Hu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Conglin Hong
- Department of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, 215006, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Linfeng Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Haoqi Zhou
- Department of Biostatistics, Peking University, Beijing, China
| | - Yixin Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Xue Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Jiayin Cai
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Runqing Gu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Ye Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Lan Shao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China
| | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Peking Union Medical College & Chinese Academy of Medical Sciences, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, No. 15 (Lin), Fengcunxili, Mentougou District, Beijing, 102308, China.
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Korshøj M, Poulsen VR, Sköld MB, Autrup SK, Oldenburg B, Mortensen OS. An integrated approach to health, wellbeing, and productivity at work: a design of a stepped wedge worksite intervention study. BMC Public Health 2023; 23:1057. [PMID: 37268907 DOI: 10.1186/s12889-023-16014-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/30/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Despite an intensive focus on workers' health during recent decades, the prevalence of work-related diseases remains unchanged in Denmark and internationally. Therefore, USA and Australian researchers have initiated new paradigms for integration of health promotion, prevention of work-related disease, and organization of work. Inspired by the Australian WorkHealth Improvement Network program (WIN), this paper describes the background, design, intervention methodologies, and evaluation methods of an Integrated Approach to Health, Wellbeing, and Productivity at Work (ITASPA) intervention aiming to prevent work-related injuries and diseases and promote the health, safety, and wellbeing of the worker. METHODS Using a stepped wedge design, worksites will be enrolled at baseline and offered the intervention starting at different times. Data will be collected at baseline, before the off-set of the intervention, and after each implementation period. The effect evaluation will be based on a mixed-methods approach. The qualitative data are based on semi-structured interviews and focus groups. The quantitative data consists of questionnaires, anthropometrics, and resting blood pressure and will be analyzed based on the intention-to-treat principle in linear mixed models with random slope and intercept. DISCUSSION Integrated interventions are shown to increase overall health and safety at worksites more effectively and rapidly than more narrowly focused programs. Still, previous integrated interventions are lacking successful implementation. In ITASPA, the effects of the intervention is tested in a strong scientific mixed-methods design. Thus, the ITASPA project contributes to the knowledge about what characterizes a best practice for the implementation of integrated worksite interventions. TRIAL REGISTRATION ITASPA is retrospectively registered in Clinicaltrials.gov on May 19, 2023 (NCT05866978).
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Affiliation(s)
- Mette Korshøj
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
| | - Vivian Rueskov Poulsen
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark.
| | - Margrethe Bordado Sköld
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
| | - Sanna Koch Autrup
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
| | - Brian Oldenburg
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Hospital Holbæk, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Halling Ullberg O, Toivanen S, Tillander A, Bälter K. Workplace health promotion to facilitate physical activity among office workers in Sweden. Front Public Health 2023; 11:1175977. [PMID: 37124789 PMCID: PMC10133573 DOI: 10.3389/fpubh.2023.1175977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/28/2023] [Indexed: 05/02/2023] Open
Abstract
Office workers spend most of their working time being sedentary, contributing to a sedentary lifestyle that increases the risk of developing disease and disability. A gradual decline in cardiorespiratory fitness among adults, along with increased rate of non-communicable diseases across developed countries, makes the workplace an important opportunity for promoting healthy behaviors. This study aimed to investigate: how office companies in Sweden organize and provide workplace health promotion services related to physical activity; the companies' vision for providing workplace health promotion; and potential facilitators and barriers. Nine informants from eight companies participated in the study, and both qualitative and quantitative data were collected by semi-structured interviews. Informants were selected through purposive sampling in collaboration with eight companies in the office market, including companies that own and develop office buildings, shared workspaces, interior design, sustainable solutions, or consult on issues related to the office sector. The framework method was used to analyze the data in a flexible and systematic way. The results showed that workplace health promotion is implemented to maintain employee health, productivity, and employee branding. Also, a significant number of financial resources, organizational support and office space are devoted to workplace health promotion. Convenience and easy access to storage and fitness facilities are key facilitators. In conclusion, this study highlights the importance of employees' engagement in developing and improving workplace health promotion and addressing work-life balance constraints that hinder a healthy lifestyle. Removing barriers on an organizational level may improve the usage of workplace health promotion related to physical activity among office employees.
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Affiliation(s)
- Oskar Halling Ullberg
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- *Correspondence: Oskar Halling Ullberg
| | - Susanna Toivanen
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Annika Tillander
- Department of Statistics and Machine Learning, Linköping University, Linköping, Sweden
| | - Katarina Bälter
- Division of Public Health Sciences, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
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Olson R, Cunningham TR, Nigam JAS, Anger WK, Rameshbabu A, Donovan C. Total Worker Health® and Organizational Behavior Management: Emerging Opportunities for Improving Worker Well-being. JOURNAL OF ORGANIZATIONAL BEHAVIOR MANAGEMENT 2022. [DOI: 10.1080/01608061.2022.2146256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ryan Olson
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
- Oregon Health & Science University-Portland State University, School of Public Health, Portland, Oregon, USA
- Portland State University, Department of Psychology, Portland, Oregon, USA
| | - Thomas R. Cunningham
- Division of Science Integration, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health,Cincinnati, USA
| | - Jeannie A. S. Nigam
- Division of Science Integration, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health,Cincinnati, USA
| | - W. Kent Anger
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
| | - Anjali Rameshbabu
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
| | - Courtney Donovan
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
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Wang D, Qiang D, Xu W, Wang J, Liu J, Qin Y, Zhang Y, Liu Q, Xiang Q. Smoking causes the disorder of glucose metabolism under different levels of blood pressure in male occupational population. J Clin Hypertens (Greenwich) 2022; 24:1276-1284. [PMID: 35942933 PMCID: PMC9581103 DOI: 10.1111/jch.14557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 11/30/2022]
Abstract
Smoking is an important modifiable factor in the risk of type 2 diabetes. Type 2 diabetes and hypertension overlap in the population. The present study investigated effects of smoking on glucose metabolism under different blood pressure (BP) levels in occupational population. A smoking survey among occupational groups was conducted in 2018. The general linear model was used to analyze the differences of glucose metabolism indexes and BP indexes influenced by different smoking intensity (never 0, mild <10, moderate <20, heavy ≥20 pack‐years). Odds ratios of developing diabetes and β‐cell deficiency were analyzed by using logistic regression model. BP was further taken into account in the relationship between smoking and glucose metabolism. As a result, 1730 male workers aged 21 to 60 years were included in the analysis finally. Compared to never smokers, heavy smokers had significantly increased fasting plasma glucose. Moderate and above smokers had significantly increased glycosylated hemoglobin, decreased fasting plasma insulin and β‐cell function, after adjustment for covariates. Further, smoking intensity was found to have a dose‐dependent relationship with impaired β‐cell function and diabetes. In conclusion, smoking has a positive dose‐dependent relationship with β‐cell deficiency and diabetes. Male smoking workers, especially the moderate or higher smoking, with high‐normal and high BP levels are at high risk of abnormal glucose metabolism.
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Affiliation(s)
- Dan Wang
- School of Public Health, Southeast University, Nanjing, China
| | - Deren Qiang
- Department of Chronic Non-communicable Disease Control, Wujin District Center for Disease Control and Prevention, Changzhou, China
| | - Wenchao Xu
- Department of Chronic Non-communicable Disease Control, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Jiaqi Wang
- School of Public Health, Southeast University, Nanjing, China
| | - Jiali Liu
- School of Public Health, Southeast University, Nanjing, China
| | - Yu Qin
- Department of Chronic Non-communicable Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yongqing Zhang
- Department of Chronic Non-communicable Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Qizhan Liu
- Center for Global Health, The Key Laboratory of Modern Toxicology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Quanyong Xiang
- School of Public Health, Southeast University, Nanjing, China.,Department of Chronic Non-communicable Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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9
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Zhou YF, Chen S, Wang G, Chen S, Zhang YB, Chen JX, Tu ZZ, Liu G, Wu S, Pan A. Effectiveness of a Workplace-Based, Multicomponent Hypertension Management Program in Real-World Practice: A Propensity-Matched Analysis. Hypertension 2021; 79:230-240. [PMID: 34878893 DOI: 10.1161/hypertensionaha.121.18305] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Limited studies had investigated the potential benefits of workplace-based hypertension management programs on long-term blood pressure (BP) control and health outcomes. This study used the propensity score matching to examine the effectiveness of a workplace-based hypertension management program on BP control and risks of major adverse cardiovascular events and all-cause mortality. Within the Kailuan study, a workplace-based hypertension management program was initiated in 2009 among men with hypertension, which included regular BP measuring (twice a month), free antihypertensive medications, and individualized health consultation. Participants were followed until loss to follow-up, death, or December 31, 2019. Among 17 724 male hypertensives aged 18 to 60 years, 6400 participated in the program. The propensity score matching yielded 6120 participants in the management group and 6120 participants in the control group. Both systolic and diastolic BPs were significantly lower in the management group than in the control group over follow-up, and the mean between-group difference at the 10th year was -7.83 (95% CI, -9.06 to -6.62) mm Hg for systolic BP and -4.72 (95% CI, -5.46 to -3.97) mm Hg for diastolic BP. Participants in the program were more likely to achieve BP control (odds ratio, 1.70 [95% CI, 1.41-2.06]) and had significantly lower risks of major adverse cardiovascular events (hazard ratio, 0.83 [95% CI, 0.72-0.94]) and all-cause mortality (hazard ratio, 0.71 [95% CI, 0.58-0.86]), compared with those who were not in the program. A workplace-based hypertension management program was related to reduced BP levels and lower risks of major adverse cardiovascular events and mortality in Chinese men with hypertension.
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Affiliation(s)
- Yan-Feng Zhou
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Lab of Environment and Health (Y.-F.Z., Y.-B.Z., J.-X.C., Z.-Z.T., A.P.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Simiao Chen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Germany (Simiao Chen).,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Simiao Chen).,Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China (G.W., Shuohua Chen, S.W.)
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China (G.W., Shuohua Chen, S.W.)
| | - Shuohua Chen
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Lab of Environment and Health (Y.-F.Z., Y.-B.Z., J.-X.C., Z.-Z.T., A.P.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Bo Zhang
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Lab of Environment and Health (Y.-F.Z., Y.-B.Z., J.-X.C., Z.-Z.T., A.P.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun-Xiang Chen
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Lab of Environment and Health (Y.-F.Z., Y.-B.Z., J.-X.C., Z.-Z.T., A.P.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhou-Zheng Tu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Lab of Environment and Health (Y.-F.Z., Y.-B.Z., J.-X.C., Z.-Z.T., A.P.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, and Hubei Key Laboratory of Food Nutrition and Safety (G.L.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China (G.W., Shuohua Chen, S.W.)
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Lab of Environment and Health (Y.-F.Z., Y.-B.Z., J.-X.C., Z.-Z.T., A.P.), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Nanda S, Chon TY, Mahapatra S, Lindeen SA, Fischer KM, Krüger M, Schierwater B, Schmidt CO, Wahner-Roedler DL, Bauer BA. Preventiometer, a Novel Wellness Assessment Device, Used With Healthy Volunteers: A Phase 2 Study. Glob Adv Health Med 2021; 10:21649561211045016. [PMID: 34840917 PMCID: PMC8619782 DOI: 10.1177/21649561211045016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 08/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background We previously reported on a pilot study to assess the incorporation of a novel wellness assessment device, the Preventiometer (iPEx5 GmbH, Greifswald, Germany), into an academic medical practice. The present follow-up study expands on those data and evaluates the acceptability of the assessment process in a larger sample population. Objective The aim of this study was to evaluate participant satisfaction with the Preventiometer wellness assessment. Methods A total of 60 healthy volunteers participated. Each participant underwent a comprehensive wellness assessment with the Preventiometer and received data from more than 30 diagnostic tests. A 32-question survey (with a numeric rating scale from 0 to 10) was used to rate the wellness assessment tests and participants' impressions of the wellness assessment. Results Each assessment had a significantly higher rating than 7 (P < .001), and the majority of participants agreed or strongly agreed that they were satisfied (98.3%), and they strongly agreed that they were engaged the entire time (93.2%), and liked the instant test results feature of the Preventiometer device (93.2%). Conclusion This study confirms findings from our previous pilot study regarding the feasibility of the Preventiometer as a wellness assessment tool. The study further demonstrated that 98% of participants were satisfied with the assessment and that all of them would recommend it to others.
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Affiliation(s)
| | - Tony Y Chon
- Division of General Internal Medicine, MN, USA
| | | | | | | | - Markus Krüger
- Institute for Community Medicine, Mayo Clinic, Rochester, MN, USA.,Center for Oral Health, Universitätsmedizin Greifswald, Germany
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11
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Nelson-Wong E, Corrigan J, Mertz P, Kutcher S, Carlson I, DiRocco T, Hall-Nelson B. Office-workers maintain decreased workplace sitting time long-term following participation in a sit-stand desk intervention study. ERGONOMICS 2021; 65:1-9. [PMID: 34694213 DOI: 10.1080/00140139.2021.1998647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
Previous studies report decreased workplace sitting time when standing desk interventions are provided to office workers. It is unclear whether decreased sedentary behaviours are maintained long-term. This was a follow-up to a previous intervention study to investigate whether observed sitting time decreases of 30-50% were sustained 12-24 months later. A secondary aim was to compare overall physical activity between office workers with and without standing desks. Although sitting time increased over the follow-up period, this did not reach significance and reductions in workplace sitting remained significantly lower (23.5% decrease) from baseline values. There were no differences in the physical activity measures between workers with and without access to standing desks, although this was a small sample size and further research is needed. Individuals who are motivated to try standing desks at work can benefit through decreased sitting time long-term, however this may not extend to increased overall physical activity levels. Practitioner summary: Providing standing desk options to office-based employees can have long-lasting impacts with reducing sitting time at work. Office workers who choose to stand at work do not appear to compensate with overall activity level reduction outside of work.Abbreviations: LBP: low back pain; OSPAQ: occupational sitting and physical activity questionnaire; VAS: visual analog scale; ANOVA: analysis of variance; BMI: body mass index; ICC: intraclass correlation coefficient.
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Affiliation(s)
- Erika Nelson-Wong
- Augustana University Department of Physical Therapy, Sioux Falls, SD, USA
- Regis University School of Physical Therapy, Denver, CO, USA
| | - John Corrigan
- Regis University School of Physical Therapy, Denver, CO, USA
| | - Patrick Mertz
- Regis University School of Physical Therapy, Denver, CO, USA
| | | | - Ingrid Carlson
- Regis University School of Physical Therapy, Denver, CO, USA
| | - Tara DiRocco
- Regis University School of Physical Therapy, Denver, CO, USA
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12
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Di Fusco SA, Spinelli A, Castello L, Mocini E, Gulizia MM, Oliva F, Gabrielli D, Imperoli G, Colivicchi F. Impact of Working from Home on Cardiovascular Health: An Emerging Issue with the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211882. [PMID: 34831636 PMCID: PMC8621324 DOI: 10.3390/ijerph182211882] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 12/18/2022]
Abstract
Mandatory working from home is one of the consequences of the COVID-19 pandemic for a large number of workers. Transition to working from home may significantly impact lifestyle, psychosocial status, and the overall health of workers. This review summarizes available data about the effects of lockdown measures, particularly working from home, on cardiovascular risk factors including sedentary lifestyle, unhealthy diet pattern, psychological distress, smoking, alcohol misuse, and cardiometabolic parameters. Finally, we suggest countermeasures that can attenuate the negative health impact of working from home. Indeed, timely and tailored interventions implemented by companies in cooperation with the health care system could allow workers to benefit more from some of the advantages associated with working from home.
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Affiliation(s)
- Stefania Angela Di Fusco
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
- Correspondence: ; Tel.: +39-06-33061
| | - Antonella Spinelli
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
| | - Lorenzo Castello
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy;
| | - Michele Massimo Gulizia
- Cardiology Division, Garibaldi-Nesima Hospital, 95122 Catania, Italy;
- ANMCO Heart Care Foundation, 50121 Florence, Italy
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, 20162 Milano, Italy;
| | - Domenico Gabrielli
- Cardiology/CCU Unit, Cardiovascular Department, San Camillo Hospital, 00152 Rome, Italy;
| | - Giuseppe Imperoli
- Medicine Unit, Emergency Department, San Filippo Neri Hospital, 00135 Rome, Italy;
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Martinotti Street 20, 00135 Rome, Italy; (A.S.); (L.C.); (F.C.)
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13
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Qasem Surrati AM, Mohammedsaeed W, Shikieri ABE. Cardiovascular Risk Awareness and Calculated 10-Year Risk Among Female Employees at Taibah University 2019. Front Public Health 2021; 9:658243. [PMID: 34671586 PMCID: PMC8520983 DOI: 10.3389/fpubh.2021.658243] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 08/30/2021] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular diseases (CVD) are the most common cause of death and disability worldwide. Saudi Arabia, one of the middle-income countries has a proportional CVD mortality rate of 37%. Knowledge about CVD and its modifiable risk factors is a vital pre-requisite to change the health attitudes, behaviors, and lifestyle practices of individuals. Therefore, we intended to assess the employee knowledge about risk of CVD, symptoms of heart attacks, and stroke, and to calculate their future 10-years CVD risk. An epidemiological, cross-sectional, community-facility based study was conducted. The women aged ≥40 years who are employees of Taibah University, Al-Madinah Al-Munawarah were recruited. A screening self-administrative questionnaire was distributed to the women to exclude those who are not eligible. In total, 222 women met the inclusion criteria and were invited for the next step for the determination of CVD risk factors by using WHO STEPS questionnaire: It is used for the surveillance of non-communicable disease risk factor, such as CVD. In addition, the anthropometric measurements and biochemical measurements were done. Based on the identified atherosclerotic cardiovascular disease (ASCVD) risk factors and laboratory testing results, risk calculated used the Framingham Study Cardiovascular Disease (10-year) Risk Assessment. Data were analyzed using GraphPad Prism 7 software (GraphPad Software, CA, USA). The result showed the mean age of study sample was 55.6 ± 9.0 years. There was elevated percentage of obesity and rise in abdominal circumference among the women. Hypertension (HTN) was a considerable chronic disease among the participants where more than half of the sample had it, i.e., 53%. According to the ASCVD risk estimator, the study participants were distributed into four groups: 63.1% at low risk, 20.2% at borderline risk, 13.5% at intermediate risk, and 3.2% at high risk. A comparison between these categories based on the CVD 10-year risk estimator indicated that there were significant variations between the low-risk group and the intermediate and high-risk groups (P = 0.02 and P = 0.001, respectively). The multivariate analysis detected factors related to CVD risk for women who have an intermediate or high risk of CVD, such as age, smoking, body mass index (BMI), unhealthy diet, blood pressure (BP) measurements, and family history of CVD (P < 0.05). The present study reports limited knowledge and awareness of CVD was 8.6 that is considered as low knowledge. In conclusion, the present study among the university sample in Madinah reported limited knowledge and awareness of CVD risk. These findings support the need for an educational program to enhance the awareness of risk factors and prevention of CVD.
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Affiliation(s)
- Amal M Qasem Surrati
- Family and Community Medicine Department, College of Medicine, Taibah University, Medina, Saudi Arabia
| | - Walaa Mohammedsaeed
- Medical Laboratories Technology Department, College of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia
| | - Ahlam B El Shikieri
- Clinical Nutrition Department, College of Applied Medical Science, Taibah University, Medina, Saudi Arabia
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14
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Calitz C, Pratt C, Pronk NP, Fulton JE, Jinnett K, Thorndike AN, Addou E, Arena R, Brown AGM, Chang C, Latts L, Lerner D, Majors M, Mancuso M, Mills D, Sanchez E, Goff D. Cardiovascular Health Research in the Workplace: A Workshop Report. J Am Heart Assoc 2021; 10:e019016. [PMID: 34459251 PMCID: PMC8649235 DOI: 10.1161/jaha.120.019016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Heart disease and stroke are the first and fifth leading causes of death in the United States, respectively. Employers have a unique opportunity to promote cardiovascular health, because >60% of US adults are employed, and most spend half of their waking hours at work. Despite the scope of the opportunity, <1 in 5 businesses implement evidence-based, comprehensive workplace health programs, policies, and practices. Integrated, systems-based workplace health approaches that harness data science and technology may have the potential to reach more employees and be cost-effective for employers. To evaluate the role of the workplace in promoting cardiovascular health across the lifespan, the National Heart, Lung, and Blood Institute, the National Institute for Occupational Safety and Health, and the American Heart Association convened a workshop on March 7, 2019, to share best practices, and to discuss current evidence and knowledge gaps, practical application, and dissemination of the evidence, and the need for innovation in workplace health research and practice. This report presents the broad themes discussed at the workshop and considerations for promoting worker cardiovascular health, including opportunities for future research.
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Affiliation(s)
| | | | | | | | - Kimberly Jinnett
- University of California San Francisco and GenentechSan FranciscoCA
| | | | - Ebyan Addou
- National Heart Lung and Blood InstituteBethesdaMD
| | - Ross Arena
- University of Illinois at ChicagoIL
- Healthy Living for Pandemic Event Protection NetworkChicagoIL
| | | | - Chia‐Chia Chang
- National Institute for Occupational Safety and Health/Centers for Disease Control and PreventionWashingtonDC
| | - Lisa Latts
- Colorado Department of Health Care Policy and FinancingDenverCO
| | | | | | | | | | | | - David Goff
- National Heart Lung and Blood InstituteBethesdaMD
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15
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Schorch K, Stamm R, Priddy D, Taylor C. A Wellness Program to Decrease Pediatric Postanesthesia Care Unit Staff Compassion Fatigue. J Pediatr Health Care 2021; 35:526-541. [PMID: 34112529 DOI: 10.1016/j.pedhc.2021.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/22/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Health care workers, especially those in pediatrics, have a high risk for compassion fatigue (CF). A wellness program (WP) might help decrease CF and increase compassion satisfaction (CS). METHOD This project implemented and evaluated a WP in a pediatric postanesthesia care unit at a large children's hospital. The project evaluated the effectiveness of a WP using pre- and post-WP surveys, which assessed CF (i.e., burnout and secondary traumatic stress), CS, and overall satisfaction with the WP. RESULTS Overall results demonstrated decreases in CF and increases in CS, self-care, healthy behaviors, and knowledge of CF. The perceived level of teamwork, morale, recognition, social support, and positive coworker interactions also increased. Overall, 77% of the respondents thought the WP helped decrease CF. DISCUSSION Implementing a WP that incorporates social support, education, and healthy behaviors had significant benefits, including a reduction in CF.
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16
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Lucini D, Pagani E, Capria F, Galliano M, Marchese M, Cribellati S. Evidence of Better Psychological Profile in Working Population Meeting Current Physical Activity Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178991. [PMID: 34501580 PMCID: PMC8430491 DOI: 10.3390/ijerph18178991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022]
Abstract
Workplace Health Promotion (WHP) may improve health, productivity and safety and reduce absenteeism. However, although desirable, it is difficult to design tailored (and thus effective) WHP programs, particularly in small-medium companies, which rarely have access to sufficient economic and organizational resources. In this study, 1305 employees filled out an online anonymous lifestyle questionnaire hosted on the website of a non-profit organization, which aims to promote a healthy lifestyle among workers. The data show gender differences regarding stress perception and, in the working population meeting current physical activity recommendations (threshold = 600 MET·min/week), they point out the evidence of a better psychological and nutrition profile, a perception of better job performance, and improved sleep and health quality. Moreover, a unitary index (ranging from 0-100 (with higher scores being healthier)), combining self-reported metrics for diet, exercise and stress, was significantly higher in active employees (67.51 ± 12.46 vs. 39.84 ± 18.34, p < 0.001). The possibility of assessing individual lifestyle in an easy, timely and cost-effective manner, offers the opportunity to collect grouped data useful to drive tailored WHP policies and to have metric to quantify results of interventions. This potentiality may help in creating effective programs and in improving employees' and companies' motivation and attitude towards a feasible WHP.
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Affiliation(s)
- Daniela Lucini
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano IRCCS, 20135 Milan, Italy
- Correspondence: or ; Tel.: +39-02-619-112-808
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17
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Slim AM, Fentanes E, Cheezum MK, Parsons IT, Maroules C, Chen B, Abbara S, Branch K, Nagpal P, Shah NR, Thomas DM, Villines TC, Blankstein R, Shaw LJ, Budoff M, Nicol E. The role of cardiovascular CT in occupational health assessment for coronary heart disease: An expert consensus document from the Society of Cardiovascular Computed Tomography (SCCT). J Cardiovasc Comput Tomogr 2021; 15:290-303. [PMID: 33926854 DOI: 10.1016/j.jcct.2021.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
| | | | | | | | | | - Billy Chen
- Cedars-Sinai Medical Center, Baldwin Park, CA, USA
| | - Suhny Abbara
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Prashant Nagpal
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Nishant R Shah
- Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Dustin M Thomas
- Parkview Health, Parkview Research Center, Fort Wayne, IN, USA
| | - Todd C Villines
- University of Virginia Health System, Charlottesville, VA, USA
| | - Ron Blankstein
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Ed Nicol
- Royal Brompton Hospital, London, UK
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18
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Work Productivity Losses and Associated Risk Factors Among University Employees in the CAMMPUS Wellness Program. J Occup Environ Med 2021; 62:25-29. [PMID: 31651600 DOI: 10.1097/jom.0000000000001734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to comprehensively measure work productivity losses of employees enrolled in a pharmacist-led wellness program and assess associated risk factors. METHODS The study sample was employees at least 18 years old with a Framingham Risk Score (FRS) at least 10% or 1+ medication-modifiable cardiovascular risk factor (196 participants at baseline and 166 at 12-month endpoint). Total work hour losses (WHL) were measured using the Valuation of Lost Productivity questionnaire. The factors anticipated to be associated with WHL included work habits, FRS, body mass index (BMI), physical activity, and health-related quality of life (HRQoL). RESULTS Sedentary work habits, higher BMI, and lower HRQoL were significantly associated with more WHL for males. Among females, only a lower HRQoL was significantly associated with more WHL. CONCLUSIONS Our findings help identify employees at greater risk for WHL and provide insights on how workplace wellness programs can be modified.
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Behzadnia N, Sharif-Kashani B, Ahmadi ZH, Naghashzadeh F, Dorudinia A, Jahangirifard A, Hamarz H, Abbasi P. Evaluation of cardiomyopathy diagnosis in heart transplant recipients: comparison of echocardiographic and pathologic classification. Egypt Heart J 2021; 73:29. [PMID: 33765208 PMCID: PMC7994484 DOI: 10.1186/s43044-021-00154-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 03/16/2021] [Indexed: 12/28/2022] Open
Abstract
Background Definite diagnosis of cardiomyopathy types can be challenging in end-stage disease process. New growing data have suggested that there is inconsistency between echocardiography and pathology in defining type of cardiomyopathy before and after heart transplantation. The aim of the present study was to compare the pre-heart transplant echocardiographic diagnosis of cardiomyopathy with the results of post-transplant pathologic diagnosis. Results In this retrospective cross-sectional clinicopathological study, 100 consecutive patients have undergone heart transplantation in Masih-Daneshvari hospital, Tehran, Iran, between 2010 and 2019. The mean age of patients was 40 ± 13 years and 79% of patients were male. The frequency of different types of cardiomyopathy was significantly different between two diagnostic tools (echocardiography versus pathology, P < 0.001). On the other hand, in 24 patients, the results of echocardiography as regard to the type of cardiomyopathy were inconsistent with pathologic findings. Conclusion Based on the findings of the present study, it could be concluded that there is a significant difference between echocardiographic and pathologic diagnosis of cardiomyopathy; therefore, it is necessary to use additional tools for definite diagnosis of cardiomyopathy like advanced cardiac imaging or even endomyocardial biopsy before heart transplantation to reach an appropriate treatment strategy.
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Affiliation(s)
- Neda Behzadnia
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Babak Sharif-Kashani
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zargham Hossein Ahmadi
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farah Naghashzadeh
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atosa Dorudinia
- Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Jahangirifard
- Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamoun Hamarz
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Abbasi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Nikan Education and Research Center, Tehran, Iran.
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Abstract
Home-based teleworking, associated with sedentary behavior, may impair self-reported adult health status. Current exercise recommendations, based on universal recipes, may be insufficient or even misleading to promote healthy teleworking. From the Network Physiology of Exercise perspective, health is redefined as an adaptive emergent state, product of dynamic interactions among multiple levels (from genetic to social) that cannot be reduced to a few dimensions. Under such a perspective, fitness development is focused on enhancing the individual functional diversity potential, which is better achieved through varied and personalized exercise proposals. This paper discusses some myths related to ideal or unique recommendations, like the ideal exercise or posture, and the contribution of recent computer technologies and applications for prescribing exercise and assessing fitness. Highlighting the need for creating personalized working environments and strengthening the active contribution of users in the process, new recommendations related to teleworking posture, home exercise counselling, exercise monitoring and to the roles of healthcare and exercise professionals are proposed. Instead of exercise prescribers, professionals act as co-designers that help users to learn, co-adapt and adequately contextualize exercise in order to promote their somatic awareness, job satisfaction, productivity, work–life balance, wellbeing and health.
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21
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Zhang T, Ham J, Ren X. Why Exercise at Work: Development of the Office Exercise Behavior Determinants Scale. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052736. [PMID: 33800378 PMCID: PMC7967457 DOI: 10.3390/ijerph18052736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/16/2022]
Abstract
The constant increase in work pressure and the penetration of labor-saving technologies have significantly reduced physical activity in office-based work routines, threatening employees’ physical and mental well-being. Encouraging physical exercises at the office seems a potential solution. However, while there is a wealth of research into occupational health and workplace exercise promotion, little is known about which factors can influence the engagement of physical exercises in the office context. It is crucial to understand these determinants, in order to support the design of office exercise promoting intervention. This study explored the determinants of office workers’ exercise behavior by proposing and developing the Office Exercise Behavior Determinants (OEBD) scale based on existing behavioral and environmental research. The OEBD scale was assessed through an online questionnaire study involving 479 office workers. The results indicated that four factors (Intrinsic Motivation, Extrinsic Motivation, Social Environment, and Work Environment) contribute to office workers’ exercise behavior. Furthermore, confirmatory factor analysis of our obtained data provided evidence for the internal validity of the OEBD scale. Thereby, this research can support increased office exercise with valid measurements for behavioral determinants.
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Affiliation(s)
- Tianmei Zhang
- School of Design and Arts, Beijing Institute of Technology, Beijing 100081, China;
| | - Jaap Ham
- Department of Industrial Engineering and Innovation Sciences, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands;
| | - Xipei Ren
- School of Design and Arts, Beijing Institute of Technology, Beijing 100081, China;
- Correspondence:
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Dickson VV, Jun J, Melkus GD. A mixed methods study describing the self-care practices in an older working population with cardiovascular disease (CVD): Balancing work, life and health. Heart Lung 2021; 50:447-454. [PMID: 33639529 DOI: 10.1016/j.hrtlng.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Self-care is essential to cardiovascular disease (CVD) health outcomes, but may be challenging for older working adults. OBJECTIVE Describe self-care and the relationship of work-related characteristics to self-care among older workers with CVD. METHODS Convergent mixed methods design (n = 108) assessed self-care, organization of work, job-level and clinical factors; qualitative data (n = 40) explored self-care and working. Data integrated in the final analytic phase. RESULTS Sixty-eight percent reported adequate self-care maintenance (SC-CHDI maintenance ≥70); only 22% had adequate self-care management (SC-CHDI management ≥ 70). Controlling for physical capacity, work-related factors explained 22% variance in self-care maintenance; physical capacity was only significant determinant of self-care management. Individuals with poor self-care described low job control, job stress and work-life imbalance that interfered with routine self-care. Individuals with poor self-care management reported "feeling stressed out" and "extreme fatigue" attributed to their job. CONCLUSIONS Interventions targeting self-care, stress management and work-life balance among older workers with CVD are needed.
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Affiliation(s)
| | - Jin Jun
- New York University Rory Meyers College of Nursing, 433 First Ave, New York, NY, 10010 USA; The Ohio State University, College of Nursing, 1585 Neil Avenue, Columbus, OH 43210 USA
| | - Gail D'Eramo Melkus
- New York University Rory Meyers College of Nursing, 433 First Ave, New York, NY, 10010 USA
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Sagong H, Jang AR, Kim DE, Won CW, Yoon JY. The Cross-Lagged Panel Analysis between Frailty and Physical Activity among Community-Dwelling Older Adults by Age Groups. J Aging Health 2021; 33:387-395. [PMID: 33517827 DOI: 10.1177/0898264320987365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: This study was to investigate the reciprocal relationship between frailty and physical activity among older adults by age group (middle-old: 70-79 years; oldest-old: 80-84 years) within 2 years using cross-lagged panel analysis. Methods: The study data were derived from the Korean Frailty and Aging Cohort Study, and a total of 1092 participants were included. Results: Frailty and high physical activity had significant reciprocal relationships in the middle-old group, which indicates that frailty was associated with less high physical activity, and high physical activity predicts less frailty after 2 years. In the oldest-old group, there was no statistically significant reciprocal relationship between frailty and any level of physical activity reference to low physical activity and vice versa after 2 years. Discussion: Further studies on the relationship between frailty and physical activity of the oldest-old population and specific physical activity guidelines for older adults are needed.
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Affiliation(s)
- Hae Sagong
- College of Nursing, 26725Seoul National University, Seoul, Korea
| | - Ah Ram Jang
- College of Nursing, 26725Seoul National University, Seoul, Korea.,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, 26725Seoul National University, Seoul, Korea
| | - Da Eun Kim
- Research Institute of Nursing Science, College of Nursing, 34986Kyungpook National University, Daegu, Korea
| | - Chang Won Won
- College of Medicine, 26723Kyung Hee University, Seoul, Korea
| | - Ju Young Yoon
- College of Nursing, 26725Seoul National University, Seoul, Korea.,Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, 26725Seoul National University, Seoul, Korea.,Research Institute of Nursing Science, 26725Seoul National University, Seoul, Korea
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Wang Z, Wang X, Shen Y, Li S, Chen Z, Zheng C, Kang Y, Jiang L, Hao G, Chang C, Gao R. Effect of a Workplace-Based Multicomponent Intervention on Hypertension Control: A Randomized Clinical Trial. JAMA Cardiol 2021; 5:567-575. [PMID: 32129791 DOI: 10.1001/jamacardio.2019.6161] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance A workplace-based intervention could be an effective approach to managing high blood pressure (BP). However, few studies to date have addressed hypertension control among the Chinese working population. Objective To assess the effect of a workplace-based, multicomponent intervention strategy on improving BP control. Design, Setting, and Participants A cluster randomized clinical trial of a hypertension management program was conducted from January 2013 to December 2014 in 60 workplaces across 20 urban regions in China. Workplaces were randomized to either the intervention group (n = 40) or control group (n = 20). Employee participants in each workplace were asked to complete a cross-sectional survey. Data analysis on an evaluable population was conducted from January 2016 to January 2017. Interventions The 2-year intervention included 2 components: (1) a workplace wellness program for improving employees' cardiovascular health and (2) a guidelines-oriented hypertension management protocol with a community health center intervention accompanied by monthly visits for achieving BP control over a period of 24 months. Main Outcomes and Measures The primary outcome was the change in BP control rate from baseline to 24 months among employees with hypertension in the intervention and control groups. The secondary outcomes were the changes in BP level and lifestyle factors by the end of the trial. Results Overall, 4166 participants (3178 in the intervention group and 988 in the control group) were included (mean [SD] age, 46.3 [7.6] years; 3451 men [82.8%]). Blood pressure control rate at baseline was 19.5% in the intervention group and 20.1% in the control group. After 24 months of the intervention, the BP control rate for the intervention group compared with the control group was significantly higher (66.2% vs 44.0%; odds ratio, 1.77; 95% CI, 1.58-2.00; P < .001). The intervention effect on systolic BP level was -5.8 mm Hg (95% CI, -6.8 to -4.9 mm Hg; P < .001) and on diastolic BP level was -3.6 mm Hg (95% CI, -4.4 to -2.9 mm Hg; P < .001). The BP control rate showed a gradual increment throughout the whole duration in the intervention group. Moreover, greater reduction was reported in the rates of drinking (-18.4%; 95% CI, -20.6% to -16.2%; P < .001), perceived stress (-22.9%; 95% CI, -24.8% to -21.1%; P < .001), and excessive use of salt (-32.0%; 95% CI, -33.7% to -30.4%; P < .001). Conclusions and Relevance This trial found that a workplace-based, multicomponent intervention appeared to be more effective than usual care, leading to measurable benefits such as lower blood pressure, improved hypertension control, and adoption of healthy lifestyle habits. The intervention can therefore be considered for large-scale use or inclusion in hypertension control programs in workplaces in China and other countries. Trial Registration Chinese Clinical Trial Registry No. ChiCTR-ECS-14004641.
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Affiliation(s)
- Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, The State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, The State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yang Shen
- School of Public Health, Department of Social Medicine and Health Education, Peking University, Beijing, China
| | - Suning Li
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, The State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Zuo Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, The State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Congyi Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, The State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Yuting Kang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, The State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Linlin Jiang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, The State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Guang Hao
- School of Medicine, Department of Epidemiology, Jinan University, Guangzhou, China
| | - Chun Chang
- School of Public Health, Department of Social Medicine and Health Education, Peking University, Beijing, China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
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Gu JK, Charles LE, Fekedulegn D, Allison P, Ma CC, Violanti JM, Andrew ME. Temporal trends in prevalence of cardiovascular disease (CVD) and CVD risk factors among U.S. older workers: NHIS 2004-2018. Ann Epidemiol 2020; 55:78-82. [PMID: 33049395 DOI: 10.1016/j.annepidem.2020.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/01/2020] [Accepted: 10/06/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE This study examined trends in the prevalence of cardiovascular disease (CVD) and CVD risk factors among U.S. older adults and workers. We also investigated correlations between the temporal prevalence of CVD and selected risk factors (hypertension, obesity, physical inactivity, smoking, and treated diabetes) among participants. METHODS Data were obtained from the National Health Interview Survey (2004-2018) for U.S. adults aged greater than or equal to 50 years (n = 207,539), of which 84,180 were employed. Temporal trends in prevalence were assessed by fitting weighted regression models to the age-standardized prevalence to the 2010 U.S. POPULATION The relationship between temporal prevalence of CVD with each risk factor was assessed using Spearman's correlation coefficient. RESULTS Among all older adults, the prevalence of CVD significantly declined (β = -0.16, P < .001) during 2004-2018; similar decline was observed among employed adults (β = -0.16, P = .001). Temporal prevalence in CVD was positively correlated to physical inactivity (r = 0.73, P = .002) and smoking (r = 0.81, P < .001), but not to any of the other risk factors. CONCLUSIONS Among employed adults aged greater than or equal to 50 years, the prevalence of CVD, physical inactivity, and smoking dramatically declined over the past 15 years. The temporal decline in prevalence of CVD was significantly associated with decline prevalence of physical inactivity and smoking.
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Affiliation(s)
- Ja K Gu
- Bioanalytics Branch, Health Effects Laboratory Division, NIOSH, CDC, Morgantown, WV.
| | - Luenda E Charles
- Bioanalytics Branch, Health Effects Laboratory Division, NIOSH, CDC, Morgantown, WV
| | - Desta Fekedulegn
- Bioanalytics Branch, Health Effects Laboratory Division, NIOSH, CDC, Morgantown, WV
| | - Penelope Allison
- Bioanalytics Branch, Health Effects Laboratory Division, NIOSH, CDC, Morgantown, WV
| | - Claudia C Ma
- Bioanalytics Branch, Health Effects Laboratory Division, NIOSH, CDC, Morgantown, WV
| | - John M Violanti
- School of Public Health and Health Professions, Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York, Buffalo, NY
| | - Michael E Andrew
- Bioanalytics Branch, Health Effects Laboratory Division, NIOSH, CDC, Morgantown, WV
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Barnes LA, Eng A, Corbin M, Denison HJ, 't Mannetje A, Haslett S, McLean D, Jackson R, Douwes J. The Prevalence of Cardiovascular Risk Factors in Different Occupational Groups in New Zealand. Ann Work Expo Health 2020; 64:645-658. [PMID: 32318690 DOI: 10.1093/annweh/wxaa040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/26/2020] [Accepted: 04/02/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Although cardiovascular disease (CVD) risk has been shown to differ between occupations, few studies have specifically evaluated the distribution of known CVD risk factors across occupational groups. This study assessed CVD risk factors in a range of occupational groups in New Zealand, stratified by sex and ethnicity. METHODS Two probability-based sample surveys of the general New Zealand adult population (2004-2006; n = 3003) and of the indigenous people of New Zealand (Māori; 2009-2010; n = 2107), for which occupational histories and lifestyle factors were collected, were linked with routinely collected health data. Smoking, body mass index, deprivation, diabetes, high blood pressure, and high cholesterol were dichotomized and compared between occupational groups using age-adjusted logistic regression. RESULTS The prevalence of all known CVD risk factors was greater in the Māori survey than the general population survey, and in males compared with females. In general for men and women in both surveys 'Plant and machine operators and assemblers' and 'Elementary workers' were more likely to experience traditional CVD risk factors, while 'Professionals' were less likely to experience these risk factors. 'Clerks' were more likely to have high blood pressure and male 'Agricultural and fishery workers' in the general survey were less likely to have high cholesterol, but this was not observed in the Māori survey. Male Māori 'Trades workers' were less likely to have high cholesterol and were less obese, while for the general population survey, this was not observed. CONCLUSIONS This study showed differences in the distribution of known CVD risk factors across occupational groups, as well as between ethnic groups and males and females.
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Affiliation(s)
- Lucy A Barnes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Amanda Eng
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Marine Corbin
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Hayley J Denison
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Andrea 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Stephen Haslett
- Centre for Public Health Research, Massey University, Wellington, New Zealand
- School of Fundamental Sciences-Statistics, College of Sciences, Massey University, Palmerston North, New Zealand
- Research School of Finance, Actuarial Studies and Statistics, The Australian National University, Canberra, Australian National Territory, Australia
| | - Dave McLean
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Rod Jackson
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jeroen Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
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Nelson-Wong E, Gallagher K, Johnson E, Antonioli C, Ferguson A, Harris S, Johnson H, Miller JB. Increasing standing tolerance in office workers with standing-induced back pain. ERGONOMICS 2020; 63:804-817. [PMID: 32330093 DOI: 10.1080/00140139.2020.1761034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 04/13/2020] [Indexed: 05/28/2023]
Abstract
Sit-stand desks are popular however many people have standing-induced low back pain (LBP). People with LBP have fewer standing weight shifts compared with back-healthy people. Participants were classified as standing-tolerant or intolerant. Participants were provided sit-stand desks for 12 weeks. Participants were assigned to intervention (graded standing exposure and exercise) or control (no instruction) conditions. Participants reported weekly sitting time and average/worst LBP. Standing weight shifts and LBP were re-assessed post-intervention. All groups decreased sitting time (range: 30-50%) over 12 weeks. Sitting time and average LBP were correlated in all standing-intolerant individuals, worst LBP and sitting time were correlated for intervention group only. All standing-intolerant individuals increased standing weight shifts and decreased LBP after 12-weeks. Standing-intolerant individuals benefitted from 12-weeks of sit-stand desk use regardless of intervention. Motivated individuals with standing-induced LBP may increase standing tolerance with sit-stand desk use. Additional benefits may exist when structured guidance is provided. Practitioner summary: Many people are standing-intolerant due to low back pain (LBP). This lab and field-based study showed some benefits from structured approaches to gradually progress standing time when transitioning to standing work. Using a sit-stand desk for 12 weeks resulted in decreased LBP and sitting time in standing-intolerant people. Abbreviations: LBP: low back pain; OSPAQ: Occupational Sitting and Physical Activity Questionnaire; VAS: visual analog scale; GRF: ground reaction force; WeekVASMAX: worst low back pain reported on visual analog scale for prior week; WeekVASAVE: average low back pain reported on visual analog scale for prior week; ICC: intraclass correlation coefficient; LabVASMAX: worst low back pain reported on visual analog scale during lab-based standing; LabVASAVE: average low back pain reported on visual analog scale during lab-based standing; FvR,L: vertical ground reaction force for right and left force plate; BWSSMALL: small (10-29% body weight) body weight shift; BWSLARGE: large (> 30% body weight) body weight shift; ActivPALSED: ActivePAL data for sedentary time; ActivPALSTND: ActivePAL data for standing time; ANOVA: analysis of variance; Standing Intolerant-INT: standing intolerant participants assigned to intervention condition; Standing Intolerant-CON: standing intolerant participants assigned to control condition; Standing Tolerant-INT: standing tolerant participants assigned to intervention condition; Standing Tolerant-CON: standing tolerant participants assigned to control condition; SI: standing intolerant; ST: standing tolerant; INT: intervention; CON: control.
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Affiliation(s)
| | - Kaitlin Gallagher
- College of Education and Health Professions, University of Arkansas, Fayetteville, AR, USA
| | | | - Clare Antonioli
- School of Physical Therapy, Regis University, Denver, CO, USA
| | | | - Staci Harris
- School of Physical Therapy, Regis University, Denver, CO, USA
| | - Holly Johnson
- School of Physical Therapy, Regis University, Denver, CO, USA
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Punnett L, Cavallari JM, Henning RA, Nobrega S, Dugan AG, Cherniack MG. Defining 'Integration' for Total Worker Health®: A New Proposal. Ann Work Expo Health 2020; 64:223-235. [PMID: 32003780 PMCID: PMC7064271 DOI: 10.1093/annweh/wxaa003] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/01/2020] [Accepted: 01/07/2020] [Indexed: 12/22/2022] Open
Abstract
The effects of work and the conditions of employment on health behaviors and intermediate health conditions have been demonstrated, to the extent that these relationships should be addressed in efforts to prevent chronic disease. However, conventional health promotion practice generally focuses on personal risk factors and individual behavior change. In an effort to find solutions to the myriad of health challenges faced by the American workforce, the U.S. National Institute for Occupational Safety and Health (NIOSH) established the Total Worker Health® (TWH) program. Originally organized around the paradigm of integrating traditional occupational safety and health protections with workplace health promotion, TWH has evolved to a broader emphasis on workplace programs for enhancing worker safety, health, and well-being. Among the research programs and approaches developed by investigators at NIOSH Centers of Excellence for TWH and elsewhere, definitions of 'integration' in workplace interventions vary widely. There is no consensus about which organizational or individual outcomes are the most salient, how much to emphasize organizational contexts of work, or which program elements are necessary in order to qualify as 'Total Worker Health'. Agreement about the dimensions of integration would facilitate comparison of programs and interventions which are self-defined as TWH, although diverse in content. The specific criteria needed to define integration should be unique to that concept-i.e. distinct from and additive to conventional criteria for predicting or evaluating the success of a workplace health program. We propose a set of four TWH-specific metrics for integrated interventions that address both program content and process: (i) coordination and interaction of workplace programs across domains; (ii) assessment of both work and non-work exposures; (iii) emphasis on interventions to make the workplace more health-promoting; and (iv) participatory engagement of workers in pivotal ways during intervention prioritization and planning to develop self-efficacy in addressing root causes, skill transfer, building program ownership, empowerment, and continuous improvement. Thus we find that integration requires organizational change, both to engage two managerial functions with different goals, legal responsibilities, and (often) internal incentives & resources, and also to orient the organization toward salutogenesis. Examples from research activity within the Center for the Promotion of Health in the New England Workplace illustrate how these criteria have been applied in practice.
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Affiliation(s)
- Laura Punnett
- Center for Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, MA, USA
| | - Jennifer M Cavallari
- Department of Public Health Sciences, UConn School of Medicine, Farmington, CT, USA
| | - Robert A Henning
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Suzanne Nobrega
- Center for Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, MA, USA
| | - Alicia G Dugan
- Division of Occupational and Environmental Medicine, UConn Health, Farmington, CT, USA
| | - Martin G Cherniack
- Division of Occupational and Environmental Medicine, UConn Health, Farmington, CT, USA
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Hassani B, Amani R, Haghighizadeh MH, Araban M. A priority oriented nutrition education program to improve nutritional and cardiometabolic status in the workplace: a randomized field trial. J Occup Med Toxicol 2020; 15:2. [PMID: 32082404 PMCID: PMC7020354 DOI: 10.1186/s12995-020-0252-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 01/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background Workplace nutrition has been identified as a priority setting that can significantly reduce cardiovascular diseases (CVD) risk factors. This study was conducted as a part of the workplace education program to improve nutritional practices and cardiometabolic status in industrial personnel. Methods The present research was a randomized controlled field trial conducted on employees of a regional petrochemical company. The health-related priorities of the program were defined and addressed in the study in which 104 employees with dyslipidemia were randomly divided into two groups of education and control. Data were collected pre- and post-intervention, using valid and reliable multi-session questionnaires on demographic data, nutritional knowledge, and nutritional intake. Anthropometric measures, serum FBS, HbA1C, hs-CRP and homocysteine (Hcy) were assessed in both groups. In the education group, the nutrition program included five educational workshops about healthy nutrition and regular exercise along with educational messages over a 3-month period. The controls did not receive any education during the study. Results There were no statistically significant differences between the two groups regarding the baseline variables. The education group significantly improved their nutritional knowledge (p < 0.001), dietary intakes (p < 0.005), serum FBS (p < 0.001) and Hcy levels (p < 0.001) and anthropometric indices. Conclusion Workplace nutrition education programs can improve knowledge and reduce important CVD risk factors.
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Affiliation(s)
- Bahar Hassani
- 1Department of Nutrition, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Health Safety and Environment (HSE), Razi Petrochemical Company, Mahshahr, Iran
| | - Reza Amani
- 3Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hussein Haghighizadeh
- 4Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Araban
- 5Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Effects of a comprehensive intervention on hypertension control in Chinese employees working in universities based on mixed models. Sci Rep 2019; 9:19187. [PMID: 31844146 PMCID: PMC6914772 DOI: 10.1038/s41598-019-55849-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 12/03/2019] [Indexed: 01/27/2023] Open
Abstract
We conducted a comprehensive intensive intervention for hypertension patients working in universities or colleges. From July 2015 to March in 2016, 220 hypertension subjects were recruited, with 165 cases in intensive intervention group and 55 in standard intervention group. After 24 months of intervention, 208 ones including of 157 in intensive intervention group and 51 in standard intervention group were included in the final analysis. The patients in standard intervention group were given routine intervention, which mainly including of drug treatment and health education. The patients in intervention group were given comprehensive intensive intervention in addition to routine intervention, including follow-up management of hypertension, emotional, lifestyle intervention and else. The study and experimental protocols were approved by institutional review board of Zhejiang Hospital and Fu Wai Hospital and registered (ChiCTR-ECS-14004641, date of registration: May 8, 2014). After 2 years, compared with the standard intervention group, SBP/DBP in the intensive intervention group decreased by 3.7/4 mmHg and BP control rate increased by 8.9%, and the unhealthy behaviors and life quality including tension and pressure were also improved in the intensive intervention group. We used mixed effect model to analyze the intervention effect which could solve the problems of missing values and correlation. The intensive intervention of hypertension control including follow-up management, emotional and lifestyle intervention in occupational places could promote the development of the prevention, treatment and control of hypertension among staff in colleges and universities.
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Reynolds RY. Prevalence and characteristics of prediabetes in workers in industry. J Adv Nurs 2019; 76:803-813. [PMID: 31773753 DOI: 10.1111/jan.14276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/02/2019] [Accepted: 11/03/2019] [Indexed: 11/30/2022]
Abstract
AIM To examine the prevalence of work stress and prediabetes in computer technology company employees; to analyse the relationships among stress, work stress, and prediabetes; and to explore the potential mediating effects sleep on the relationship between work stress and prediabetes. DESIGN A descriptive, cross-sectional design was used. A convenience sample included employees from a large computer technology company in central Texas. METHODS Data collection during March-October 2015 included: retrospective electronic medical record review and online surveys. Electronic medical record review data included: height, weight, waist circumference, blood pressure, high-density lipids, triglycerides, and fasting glucose. Online surveys collected demographic, global stress, diet, exercise, coping, sleep and work stress data from participants. Spearman rho calculations analyzed associations between demographic, socio-cultural factors, health behaviours, work stress, and prediabetes variables. Logistic regression analyses identified probability variables. A structural equation model examined mediating variables. RESULTS Prediabetes prevalence was lower and prevalence of work stress was higher in the participant sample than in the USA population. Findings suggested that low job imbalance increases the probability for prediabetes. Job imbalance was inversely related to prediabetes. Three variables increased the probability prediabetes: alcohol, job imbalance, and sleep. Sleep potentially modified the relationship between job imbalance and prediabetes. Participants were college-educated males working in white-collar, technical jobs. Participants had high rates of work stress. Job imbalance was inversely related to prediabetes, which challenges previous empirical data. Future research should continue to explore the relationship between work stress and prediabetes in this population. CONCLUSIONS This study explored the relationship between work stress and prediabetes in a white-collar worker population in technical industry. Findings suggested that workers in industry have a unique type of stress. Nurses who learn to recognize the non-traditional risk factors for prediabetes can improve screening for prediabetes by including work stress and poor sleep questions.
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Nanda S, Mahapatra S, Lindeen SA, Bernau JL, Cutshall SM, Schierwater B, Chon TY, Wahner-Roedler DL, Bauer BA. Evaluation of a Novel Wellness Assessment Device (Preventiometer): A Feasibility Pilot Study. Glob Adv Health Med 2019; 8:2164956119881096. [PMID: 31637111 PMCID: PMC6785912 DOI: 10.1177/2164956119881096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/14/2019] [Accepted: 09/05/2019] [Indexed: 12/20/2022] Open
Abstract
Background Periodic wellness assessments can provide an estimate of a person’s relative risks for major diseases, but wellness visits are underused. Our suggestion is to use a comprehensive device during a single visit. Objective The goal of this pilot study was to evaluate the feasibility of a novel one-stop wellness device (Preventiometer; iPEx5 GmbH, Greifswald, Germany) for performing multiple tests and providing a comprehensive wellness assessment in a short period. Methods A Preventiometer was used to provide wellness assessments for 10 healthy volunteers who then answered a 25-question survey to rate their satisfaction with the testing and their overall impression. Results All volunteers agreed or strongly agreed with the following: The assessment reports were easy to understand, the Preventiometer met their satisfaction, the participants were comfortable during the assessment, and all measurements and testing were well coordinated. Participants liked the instant test result feature. Most (90%) agreed that the machine was useful for a quick health assessment for busy people, and 70% felt that it was time efficient. Conclusion In this feasibility pilot study, the Preventiometer performed multiple tasks and provided a comprehensive wellness assessment in a short period. Participants reported remarkably high satisfaction with the tests. A larger study is needed to prove that this is a pragmatic approach to help individuals improve their health.
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Affiliation(s)
- Sanjeev Nanda
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Saswati Mahapatra
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | | | - Susanne M Cutshall
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Tony Y Chon
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | | | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.,Center For Innovation, Mayo Clinic, Rochester, Minnesota
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Shrestha A, Tamrakar D, Karmacharya BM, Shrestha A, Shrestha R, Bhatta RD, Pyakurel P, Khudyakov P, Malik V, Mattei J, Spiegelman D. Nepal Pioneer Worksite Intervention Study to lower cardio-metabolic risk factors: design and protocol. BMC Cardiovasc Disord 2019; 19:48. [PMID: 30819098 PMCID: PMC6393979 DOI: 10.1186/s12872-019-1025-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 02/19/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND To increase cardiovascular disease prevention efforts, worksite interventions can promote healthy food choices, facilitate health education, increase physical activity and provide social support. This pioneer study will measure the effectiveness of a cafeteria and a behavioral intervention on cardio-metabolic risk in a worksite in Nepal. METHODS The Nepal Pioneer Worksite Intervention Study is a two-step intervention study conducted in Dhulikhel Hospital in eastern Nepal. In the first step, we will assess the effectiveness of a 6-month cafeteria intervention on cardio-metabolic risk using a pre-post design. In the second step, we will conduct a 6-month, open-masked, two-arm randomized trial by allocating half of the participants to an individual behavioral intervention based on the 'diabetes prevention program' for the prevention of cardio-metabolic risk. We will recruit 366 full time employees with elevated blood pressure, fasting blood sugar, or glycosylated haemoglobin (HbA1c). At baseline, we will measure their demographic variables, lifestyle factors, anthropometry, fasting blood sugar, HbA1c,and lipid profiles. We will measure cardio-metabolic outcomes at 6 months, 12 months, and 18 months. At 12 months, we will compare the proportion of participants who have attained two or more cardio-metabolic risk factor reduction goals (HbA1c decrease ≥0.5%; systolic blood pressure decrease ≥5 mmHg; or triglycerides decrease ≥10 mg/dL) during the cafeteria intervention period and the control period using generalized estimating equations. At 18 months, we will compare the proportion from the 'cafeteria only arm' to the 'cafeteria and behavior arm' for the same outcome using a chi-square test. DISCUSSION This pioneer study will estimate the effect of environmental-level changes on lowering cardio-metabolic risks; and added benefit of an individual-level dietary intervention. If the study demonstrates a significant effect, a scaled up approach could produce an important reduction in cardiovascular disease burden through environmental and individual level prevention programs in Nepal and similar worksites worldwide. TRIAL REGISTRATION The trial was retrospectively registered on clincaltrials.gov (Identification Member: NCT03447340 ; Date of Registration: February 27, 2018).
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Affiliation(s)
- Archana Shrestha
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA
| | - Dipesh Tamrakar
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal
| | - Biraj Man Karmacharya
- Department of Community Medicine, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal
| | - Abha Shrestha
- Department of Community Programs, Dhulikhel Hospital-Kathmandu University Hospital, Dhulikhel, Nepal
| | - Rajeev Shrestha
- Department of Pharmacology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Rajendra Dev Bhatta
- Department of Biochemistry, Dhulikhel Hospital- Kathmandu University Hospital, Dhulikhel, Nepal
| | - Prajjwal Pyakurel
- Department of Community Medicine, BP Koirala Institute of Health Science, Dharan, Nepal
| | - Polyna Khudyakov
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, USA
| | - Vasanti Malik
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
| | - Donna Spiegelman
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, USA
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, USA
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, USA
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Ryan M, Erck L, McGovern L, McCabe K, Myers K, Nobrega S, Li W, Lin WC, Punnett L. "Working on Wellness:" protocol for a worksite health promotion capacity-building program for employers. BMC Public Health 2019; 19:111. [PMID: 30683102 PMCID: PMC6347764 DOI: 10.1186/s12889-019-6405-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 01/07/2019] [Indexed: 12/05/2022] Open
Abstract
Background In the United States, worksite wellness programs are more often offered by larger employers. The Massachusetts Working on Wellness (WoW) program is an innovative, statewide capacity-building model designed to increase the number of smaller employers (200 or fewer workers) adopting health promotion initiatives. This article describes the WoW program design and approaches to recruitment, implementation, and evaluation. Methods/design WoW provides employer training, technical assistance and seed funding, utilizing a Wellness Program Development framework based on recognized good practices. For-profit employers with 200 employees or fewer are eligible for and encouraged to apply for a Massachusetts Small Business Wellness Tax Credit. During the phase described in this paper, employer organizations applied to the program and committed to designating a champion responsible for program implementation. Interventions were to include policy and environmental supports, as well as those targeting individual behavior change through raising awareness and education. Supports provided to employers included seed grants for qualifying activities (up to $10,000 with matching required), community linkages, data collection and organization-specific feedback tools, an on-line curriculum supplemented with technical assistance, and an expert webinar series. Data collection at multiple time points, from the initial application through program completion, provides information for evaluation of recruitment, planned and completed activities. Discussion This model is grounded in literature on good practices as well as in local knowledge about Massachusetts employers. It does not directly address the influence of working conditions, which can affect both worker participation and health behaviors. Implementation may be less successful with some organizations, such as those with many workers who are part-time or geographically distributed rather than in a centralized physical location. Program evaluation will assess the extent to which WoW achieves its goals. The data are expected to increase understanding of the needs of smaller employers and industries not traditionally implementing employee wellness programs. Electronic supplementary material The online version of this article (10.1186/s12889-019-6405-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mari Ryan
- AdvancingWellness, Watertown, MA, USA
| | - Lisa Erck
- AdvancingWellness, Watertown, MA, USA
| | | | | | | | | | - Wenjun Li
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Laura Punnett
- University of Massachusetts Lowell, Lowell, MA, USA.
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Gobis B, Kapanen AI, Reardon J, Min J, Li KH, Lynd LD, Zed PJ. Cardiovascular Risk Reduction in the Workplace With CAMMPUS (Cardiovascular Assessment and Medication Management by Pharmacists at the UBC Site). Ann Pharmacother 2019; 53:574-580. [DOI: 10.1177/1060028018823330] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Cardiovascular (CV) disease is a leading cause of death despite being largely preventable. Employers increasingly offer preventive health programs in the workplace, and pharmacists are well suited to provide these programs. Objective: To evaluate the impact of a pharmacist-led service on CV risk in University of British Columbia (UBC) employees. Methods: This was a prospective observational pre-and-post design study, with participants as their own controls. Employees >18 years of age in the UBC health plan with a Framingham Risk Score (FRS) ≥10% or ≥1 medication-modifiable CV risk factor were included. Participants received a baseline assessment, individualized consultation for 12 months, and a final assessment by a pharmacist at the UBC Pharmacists Clinic. The primary end point was FRS reduction. Results: Baseline assessment of 512 participants between September 2015 and October 2016 yielded 207 (40%) participants, of whom 178 (86%) completed the 12-month intervention. Participants were 54% female and 55% Caucasian, with an average age of 51 (SD = 9.1) years. FRS at baseline was <10 in 45.8%, 10 to 19.9 in 37.9%, and ≥20 in 16.4% of participants. Over 12 months, significant reductions in average FRS (from 11.7 [SD = 7.7] to 10.7 [SD = 7.3]; P = 0.0017) and other parameters were observed. Significant improvements in quality of life (EQ5D change of 0.031 [95% CI = 0.001, 0.062] P = 0.023) and medication adherence (MMAS-8 change of 0.42 [ P = 0.019]) were also noted. Conclusions and Relevance: UBC employees had improvements in health markers, self-reported quality of life, and medication adherence after receiving a 12-month pharmacist-led intervention. Pharmacists are encouraged to provide CV risk reduction services in workplaces.
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Affiliation(s)
- Barbara Gobis
- The University of British Columbia, Vancouver, BC, Canada
| | | | | | - Jason Min
- The University of British Columbia, Vancouver, BC, Canada
| | - Kathy H. Li
- The University of British Columbia, Vancouver, BC, Canada
| | - Larry D. Lynd
- The University of British Columbia, Vancouver, BC, Canada
| | - Peter J. Zed
- The University of British Columbia, Vancouver, BC, Canada
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Christiansen K, Gadhoke P, Pardilla M, Gittelsohn J. Work, worksites, and wellbeing among North American Indian women: a qualitative study. ETHNICITY & HEALTH 2019; 24:24-43. [PMID: 28393559 DOI: 10.1080/13557858.2017.1313964] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to understand what factors influenced work-family balance and related health behaviors among a sample of rural North American Indian women. We interviewed 89 women through both in-depth interviews and focus groups across four tribal communities in the American Southwest and Upper Midwest between July 2010 and August 2011. Interviews were transcribed, coded, and analyzed for emerging themes related to work- family demands placed on women and resources available to cope with those demands. Three prominent themes emerged: structural characteristics (the context of rural reservation life), role stressors (women's multiple and conflicting roles) and the influence of social support (communal nature of care in the family and institutional support in the workplace). We found that women in participating rural reservation communities often acted as primary caregivers for both immediate and extended family, and often placed the needs of others before themselves. The context of rural reservations, with high rates of unemployment, poverty, and chronic illnesses associated with the collective trauma of colonization, placed high demands on female caregivers. Social support from within the workplace, family, and cultural traditions helped some female caregivers balance the demands of home and work. Tribal worksites could be a resource for promoting health and work-life balance by being responsive to the particular demands placed on women that often interfere with engaging in positive health behaviors in general and tribal wellness programs in particular.
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Affiliation(s)
- Karina Christiansen
- a Department of Health Policy and Management , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Preety Gadhoke
- b Department of Pharmacy Administration and Public Health , College of Pharmacy and Health Sciences of St. John's University , Queens , USA
| | - Marla Pardilla
- c Center for Human Nutrition within the Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
| | - Joel Gittelsohn
- c Center for Human Nutrition within the Department of International Health , Johns Hopkins Bloomberg School of Public Health , Baltimore , USA
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Levy DE, Gelsomin ED, Rimm EB, Pachucki M, Sanford J, Anderson E, Johnson C, Schutzberg R, Thorndike AN. Design of ChooseWell 365: Randomized controlled trial of an automated, personalized worksite intervention to promote healthy food choices and prevent weight gain. Contemp Clin Trials 2018; 75:78-86. [PMID: 30414448 PMCID: PMC6258180 DOI: 10.1016/j.cct.2018.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/25/2018] [Accepted: 11/04/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND/AIMS Behavioral nudges in the food environment increase healthy choices, but it is unknown if they improve diet and health. The ChooseWell 365 study will determine if an automated, personalized worksite intervention to nudge healthier choices improves overall diet and cardiometabolic health. DESIGN Randomized controlled trial of 602 hospital employees who regularly use on-site cafeterias and pay with an employee ID. INTERVENTION The intervention combines an environmental strategy (traffic-light labeling) with objective feedback and personalized nudges (health/lifestyle tips, social norms, incentives) to promote healthy food choices. The ChooseWell 365 software platform automatically generates personalized emails and letters that integrate employees' weight goals with health, lifestyle, and cafeteria purchasing data. Over one year, the intervention group receives two weekly emails. One provides a log of daily purchases; the second provides personalized health/lifestyle tips. The intervention group receives monthly mailed letters with social norm comparisons and financial incentives for healthier purchases. The one-year intervention will be completed in February 2019; all follow-up will be completed March 2020. OUTCOMES Weight, cardiometabolic risk factors, and dietary intake at one and two-year follow-up. Other outcomes include worksite food purchases by study participants and other non-participant employees who are socially connected (inferred from purchasing data) to participants. CONCLUSIONS ChooseWell 365 tests a novel strategy to deliver a scalable worksite prevention program that is integrated into the workday. The intervention is personalized but automated and therefore does not require costlier individual counseling. In the future, this program could be applied broadly in other worksite settings.
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Affiliation(s)
- Douglas E Levy
- Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Emily D Gelsomin
- Department of Nutrition and Food Services, Massachusetts General Hospital, Boston, MA, United States
| | - Eric B Rimm
- Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Mark Pachucki
- Sociology and Computational Social Science Institute, University of Massachusetts, Amherst, MA, United States
| | - Jenny Sanford
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Emma Anderson
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | | | - Rose Schutzberg
- University of Massachusetts Medical School, Worcester, MA, United States
| | - Anne N Thorndike
- Harvard Medical School, Boston, MA, United States; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.
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Medical Claims According to Wellness Program Participation for a Large Insurance Company in the United States. J Occup Environ Med 2018; 60:985-989. [DOI: 10.1097/jom.0000000000001417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Relationships Between Physical Activity and Cardiometabolic Risk Factors Among Women Participating in a University-Based Worksite Wellness Program. J Occup Environ Med 2018; 60:1098-1107. [PMID: 30188493 DOI: 10.1097/jom.0000000000001439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Associations between changes in physical activity (PA) and cardiometabolic risk factors among women with overweight/obesity enrolled in a university-based worksite wellness program (WWP) were examined. METHODS Data from 173 women who completed a 26-week WWP were analyzed retrospectively. Participants completed diet and PA assessments and received client-centered diet/lifestyle counseling at baseline, and 12 and 26 weeks thereafter. Anthropometrics, blood pressure, and total cholesterol were measured; PA was self-reported using the International Physical Activity Questionnaire-short form at each visit. RESULTS Significant improvements in anthropometrics (P < 0.001), blood pressure (P < 0.001), total cholesterol (P = 0.014), and PA (P = 0.007) were found at 26 weeks. In adjusted linear regression models, a 10 metabolic-equivalent-minute increase in PA was associated with 0.01% corresponding decreases in weight and waist circumference. CONCLUSION Among women who completed this WWP, increased PA was associated with reductions in anthropometric measures.
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Webber A. South Dakota Healthy Vending & Snack Bar Toolkit. Health Promot Pract 2018. [DOI: 10.1177/1524839918782928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Biffi A, Fernando F, Adami PE, Messina M, Sirico F, Di Paolo F, Coluccia R, Borghi C, D'Ascenzi F, Volpe M. Ferrari Corporate Wellness Program: Results of a Pilot Analysis and the "Drag" Impact in the Workplace. High Blood Press Cardiovasc Prev 2018; 25:261-266. [PMID: 29956111 DOI: 10.1007/s40292-018-0266-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 06/20/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Preventive strategies based on advice and interventions on lifestyle habits represent the most powerful resource available to reduce the burden of cardiovascular (CV) diseases. Workplace represents an unmissable context for lifestyle changes at population level. AIM To evaluate the mid-term efficacy of a corporate wellness program in a cohort of healthy and physically active employees of the Ferrari car manufacturer. METHODS A corporate wellness program, named "Ferrari Formula Benessere", was proposed to adult individuals working in a Ferrari car company at Maranello, Modena (Italy). Employees who voluntarily agreed to the program received healthy nutritional advice and were trained three times a week (60 min per session), and periodically re-evaluated during a 4-year follow-up period. RESULTS Among the 719 Ferrari employees that joined the program, 168 (23%) subjects (88.5% males, age 30.8 ± 5.9 years) were considered the most active participants, based on a self-administered standardized questionnaire, and included in the study. A relevant improvement of several CV risk factors (body mass index, total and LDL cholesterol, triglycerides, blood pressure) and cardio-respiratory fitness parameters (estimated VO2max, Wattpeak, METs) was observed compared to baseline values. Furthermore, it was recorded a clear "drag effect" towards non-participating and sedentary peers, resulting in a 90% adherence increase over the years. CONCLUSIONS The "Ferrari Formula Benessere" corporate wellness project proved to be effective in improving CV risk profile and cardio-respiratory fitness in a population of already physically active employees.
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Affiliation(s)
- Alessandro Biffi
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Via Vittorio Veneto 108, 00186, Rome, Italy.
| | - Fredrick Fernando
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Via Vittorio Veneto 108, 00186, Rome, Italy
| | - Paolo Emilio Adami
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Via Vittorio Veneto 108, 00186, Rome, Italy
| | - Michele Messina
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Via Vittorio Veneto 108, 00186, Rome, Italy
| | - Felice Sirico
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Via Vittorio Veneto 108, 00186, Rome, Italy
| | - Fernando Di Paolo
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, Via Vittorio Veneto 108, 00186, Rome, Italy
| | | | - Claudio Borghi
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Flavio D'Ascenzi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Massimo Volpe
- IRCCS Neuromed, Pozzilli, Italy.,Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital University of Rome Sapienza, Rome, Italy
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Roy S, Hansen AR, Ross L, Larson R. A Qualitative Study to Assess Barber Perceptions of the Feasibility of the Employer as a Health Advisor for Obesity Prevention. Am J Mens Health 2018; 12:1450-1462. [PMID: 29658399 PMCID: PMC6142171 DOI: 10.1177/1557988318768586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Obesity has become a serious issue affecting millions of Americans, especially in the southern United States. One avenue for addressing obesity is the workplace setting. This formative research study examined the feasibility of an obesity prevention worksite intervention in the barbershop for African American barbershop owners (employers) and barbers (employees). The study proposes an intervention where the owner of the barbershop would be trained to educate his barbers about obesity prevention. Twenty in-depth interviews were conducted with the owners (n = 5) and barbers (n = 15) of five barbershops in Statesboro, Georgia, to determine the feasibility of the intervention. The results of this study indicated that the owners and barbers all felt that the intervention was feasible and could be implemented in the barbershop. The owners and barbers felt that obesity was an important issue in their community. Additional themes identified include program benefits, empowerment of owners and barbers, and motivational components to help produce healthy habits. The owners felt comfortable educating their barbers about obesity prevention, and the barbers were receptive toward the idea of being educated by their employer. In order for this intervention to be implemented and effective, it must be tailored to fit within the barbershop environment. This intervention addresses known health disparities that exist in the African American community and underscores the need for additional worksite health promotion programs in medically underserved communities.
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Affiliation(s)
| | - Andrew R Hansen
- 2 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Levi Ross
- 3 The University of Alabama, Tuscaloosa, AL, USA
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Im HW, Baek S, Jee S, Ahn JM, Park MW, Kim WS. Barriers to Outpatient Hospital-Based Cardiac Rehabilitation in Korean Patients With Acute Coronary Syndrome. Ann Rehabil Med 2018; 42:154-165. [PMID: 29560336 PMCID: PMC5852219 DOI: 10.5535/arm.2018.42.1.154] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/23/2017] [Indexed: 01/07/2023] Open
Abstract
Objective To investigate factors associated with enrollment and participation in cardiac rehabilitation (CR) in Korea. Methods Patients admitted to four university hospitals with acute coronary syndrome between June 2014 and May 2016 were enrolled. The Cardiac Rehabilitation Barriers Scale (CRBS) made of 21-item questionnaire and divided in four subdomains was administered during admission. CRBS items used a 5-point Likert scale and ≥2.5 was considered as a barrier. Differences between CR non-attender and CR attender, or CR non-enroller and CR enroller in subscale and each items of CRBS were examined using the chi-square test. Results The CR participation rate in four hospitals was 31% (170 of the 552). Logistical factors (odds ratio [OR]=7.61; 95% confidence interval [CI], 4.62-12.55) and comorbidities/functional status (OR=6.60; 95% CI, 3.95-11.01) were identified as a barrier to CR enrollment in the subdomain analysis. Among patients who were enrolled (agreed to participate in CR during admission), only work/time conflict was a significant barrier to CR participation (OR=2.17; 95% CI, 1.29-3.66). Conclusion Diverse barriers to CR participation were identified in patients with acute coronary syndrome. Providing the tailored model for CR according to the individual patient's barrier could improve the CR utilization. Further multicenter study with large sample size including other CR indication is required.
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Affiliation(s)
- Hyo Won Im
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sora Baek
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Korea.,Kangwon Regional Cardiocerebrovascular Center, Chuncheon, Korea
| | - Sungju Jee
- Daejeon-Chungnam Cardiocerebrovascular Center and Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jung-Min Ahn
- Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Myung Woo Park
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Gyeonggi Regional Cardiocerebrovascular Center, Seongnam, Korea
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Prevalence, awareness, treatment, and control of hypertension among Chinese working population: results of a workplace-based study. ACTA ACUST UNITED AC 2018; 12:311-322.e2. [PMID: 29483001 DOI: 10.1016/j.jash.2018.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/18/2018] [Accepted: 01/30/2018] [Indexed: 12/21/2022]
Abstract
We investigated the prevalence, awareness, treatment, and control of hypertension and the related risk factors among Chinese working population. From 2012 to 2013, a total of 37,856 employees aged 18-60 years from 61 workplaces were sampled. Standard questionnaire surveys and physical examinations were undertaken. Multilevel logistic regression models were performed to identify the risk factors. Overall, the age-standardized prevalence of hypertension was 23.3% (95% confidence interval [CI]: 22.9%-23.7%). Among the hypertensives, 47.8% (95% CI: 46.8%-48.8%) were aware of their condition, 20.6% (95% CI: 19.8%-21.4%) were in treatment, but only 8.5% (95% CI: 7.9%-9.1%) had controlled hypertension. White-collar employees had a lower odds of hypertension compared with the blue-collar (odds ratio: 0.77, 95% CI: 0.71-0.84), whereas the state-owned enterprise employees had a higher odds compared with their private enterprise counterparts (odds ratio: 1.69, 95% CI: 1.07-2.65). Lower awareness and treatment were associated with being younger, higher education, and those from workplace without affiliated hospital. Higher occupation status individuals were more likely to be treated but no sign of better control. There is substantial room for improvement in hypertension diagnosis and treatment among the employees. Effective intervention programs are urgently needed at the workplaces.
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Strandberg TE, Räikkönen K, Salomaa V, Strandberg A, Kautiainen H, Kivimäki M, Pitkälä K, Huttunen J. Increased Mortality Despite Successful Multifactorial Cardiovascular Risk Reduction in Healthy Men: 40-Year Follow-Up of the Helsinki Businessmen Study Intervention Trial. J Nutr Health Aging 2018; 22:885-891. [PMID: 30272088 DOI: 10.1007/s12603-018-1099-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES In a 5-year multifactorial risk reduction intervention for healthy men with at least one cardiovascular disease (CVD) risk factor, mortality was unexpectedly higher in the intervention than the control group during the first 15-year follow-up. In order to find explanations for the adverse outcome, we have extended mortality follow-up and examined in greater detail baseline characteristics that contributed to total mortality. DESIGN Long-term follow-up of a controlled intervention trial. SETTING The Helsinki Businessmen Study Intervention Trial. PARTICIPANTS AND INTERVENTION The prevention trial between 1974-1980 included 1,222 initially healthy men (born 1919-1934) at high CVD risk, who were randomly allocated into intervention (n=612) and control groups (n=610). The 5-year multifactorial intervention consisted of personal health education and contemporary drug treatments for dyslipidemia and hypertension. In the present analysis we used previously unpublished data on baseline risk factors and lifestyle characteristics. MAIN OUTCOME MEASURES 40-year total and cause-specific mortality through linkage to nation-wide death registers. RESULTS The study groups were practically identical at baseline in 1974, and the 5-year intervention significantly improved risk factors (body mass index, blood pressure, serum lipids and glucose), and total CVD risk by 46% in the intervention group. Despite this, total mortality has been consistently higher up to 25 years post-trial in the intervention group than the control group, and converging thereafter. Increased mortality risk was driven by CVD and accidental deaths. Of the newly-analysed baseline factors, there was a significant interaction for mortality between intervention group and yearly vacation time (P=0.027): shorter vacation was associated with excess 30-year mortality in the intervention (hazard ratio 1.37, 95% CI 1.03-1.83, P=0.03), but not in the control group (P=0.5). This finding was robust to multivariable adjustments. CONCLUSION After a multifactorial intervention for healthy men with at least one CVD risk factor, there has been an unexpectedly increased mortality in the intervention group. This increase was especially observed in a subgroup characterised by shorter vacation time at baseline. Although this adverse response to personal preventive measures in vulnerable individuals may be characteristic to men of high social status with subclinical CVD, it clearly deserves further investigation.
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Affiliation(s)
- T E Strandberg
- Timo E. Strandberg, MD, PhD, Professor of Geriatric Medicine, University of Helsinki, Clinicum, Haartmaninkatu 4, PO Box 340, FIN-00029 Helsinki, Finland; ; tel: +358 40 672 4533
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Viswanathan S. The Art of Health Promotion: Linking research to practice. Am J Health Promot 2017; 32:233. [PMID: 29277124 DOI: 10.1177/0890117117743584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults. Am J Prev Med 2017; 53:854-865. [PMID: 29051018 DOI: 10.1016/j.amepre.2017.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 06/12/2017] [Accepted: 08/03/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. METHODS The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. RESULTS Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, p<0.001), blood pressure check (OR=2.46, 95% CI=2.17, 2.78, p<0.001), diabetes check (OR=1.30, 95% CI=1.12, 1.50, p<0.001), cholesterol check (OR=1.48, 95% CI=1.33, 1.67, p<0.001), and mammogram (OR=1.57, 95% CI=1.24, 1.98, p<0.001). However, there was no significant difference between access to employee wellness programs and the use of Pap smear test and colon cancer screening services. CONCLUSIONS Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with <50 employees.
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Wanik JA, Marcus AF, Radler DR, Byham-Gray LD, Touger-Decker R. Physical Activity Level Is Associated With Maintaining Anthropometric Improvements Among Participants in a Worksite Wellness Program. Am J Lifestyle Med 2017; 11:489-500. [PMID: 30202375 PMCID: PMC6125004 DOI: 10.1177/1559827615624420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/12/2015] [Accepted: 12/07/2015] [Indexed: 11/16/2022] Open
Abstract
Background. Physical activity (PA) can facilitate weight loss, help avoid weight regain, and improve body composition. This study examined the relationships between PA level and changes in anthropometric measures among university employees in a worksite wellness program. Methods. A registered dietitian provided individualized assessments at baseline followed by a 12-week education intervention with follow-up at 12 and 26 weeks. The International Physical Activity Questionnaire-Short Form was used to calculate PA ≤150 or ≥150 min/wk, median min/wk, and metabolic equivalent of task (MET) min/wk at each time point. Repeated-measures general linear model and nonparametric tests were used to assess significant differences over time. Results. Of the 64 participants, 89% were women and 50% were non-Hispanic white. At 12 and 26 weeks, participants experienced significant decreases in weight (P = .001). Among women, waist circumference and abdominal obesity decreased significantly (P < .01). PA ≥150 min/wk (n = 21) was associated with continued weight loss (P = .03) and decreases in body fat percentage (P = .02) between 12 and 26 weeks whereas PA ≤150 min/wk was associated with weight and body fat percentage regain during the same time period. Conclusion. Among women in a worksite wellness program, higher levels of PA were associated with avoiding weight and body fat regain following successful loss.
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Affiliation(s)
- Jillian A. Wanik
- Department of Nutritional Sciences, School of Health Related Professions, Rutgers University, Newark, New Jersey
| | - Andrea F. Marcus
- Department of Nutritional Sciences, School of Health Related Professions, Rutgers University, Newark, New Jersey
| | - Diane R. Radler
- Department of Nutritional Sciences, School of Health Related Professions, Rutgers University, Newark, New Jersey
| | - Laura D. Byham-Gray
- Department of Nutritional Sciences, School of Health Related Professions, Rutgers University, Newark, New Jersey
| | - Riva Touger-Decker
- Department of Nutritional Sciences, School of Health Related Professions, Rutgers University, Newark, New Jersey
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Program Development and Effectiveness of Workplace Health Promotion Program for Preventing Metabolic Syndrome among Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080878. [PMID: 28777320 PMCID: PMC5580582 DOI: 10.3390/ijerph14080878] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 12/18/2022]
Abstract
This paper aims to develop and analyze the effects of a socio-ecological model-based intervention program for preventing metabolic syndrome (MetS) among office workers. The intervention program was developed using regular health examinations, a “health behavior and need” assessment survey among workers, and a focus group study. According to the type of intervention, subjects took part in three groups: health education via an intranet-based web magazine (Group 1), self-monitoring with the U-health system (Group 2), and the target population who received intensive intervention (Group 3). The intervention programs of Group 1 and Group 2, which relied on voluntary participation, did not show significant effects. In Group 3, which relied on targeted and proactive programs, showed a decrease in waist circumference and in fasting glucose (p < 0.001). The MetS score in both males (−0.61 ± 3.35 versus −2.32 ± 2.55, p = 0.001) and females (−3.99 ± 2.05 versus −5.50 ± 2.19, p = 0.028) also showed a statistically significant decrease. In light of the effectiveness of the intensive intervention strategy for metabolic syndrome prevention among workers used in this study, companies should establish targeted and proactive health care programs rather than providing a healthcare system that is dependent on an individual’s voluntary participation.
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