Erfurt J C, Foote A, Heirich M A
Worker Health Program, Institute of Labor and Industrial Relations, The University of Michigan, Ann Arbor 48109.
Am J Health Promot. 1991 Jul-Aug;5(6):438-48. doi: 10.4278/0890-1171-5.6.438.
Worksite wellness programs vary considerably in their design. This study tested four models to compare effectiveness at controlling high blood pressure, obesity, and cigarette smoking.
Baseline screening was conducted in four manufacturing plants. Site 1 offered screening only, with referral recommendations for those found to have CVD risks. Site 2 also provided health education information and classes. Site 3 added routine follow-up counseling and a menu of intervention types, and Site 4 added social organization within the plant. Random samples of 400 to 500 employees were rescreened at the end of three years.
Major improvements in risk levels were found with the addition of routine follow-up counseling and a menu of interventions (Sites 3 and 4, compared with Sites 1 and 2). More hypertensives entered treatment and showed greater reductions in blood pressure. Participation in worksite weight loss and smoking cessation programs was significantly increased, and those who participated showed significantly better maintenance of improvements where follow-up was provided.
The program models that offered short-term interventions promoted through local media suffered in comparison with models that included personal outreach to people at risk, a variety of health improvement intervention modalities, and ongoing follow-up counseling to help people make decisions and sustain health improvements.
工作场所健康促进项目的设计差异很大。本研究测试了四种模式，以比较其在控制高血压、肥胖和吸烟方面的效果。
在四家制造工厂进行了基线筛查。1号工厂只提供筛查，并为那些被发现有心血管疾病风险的人提供转诊建议。2号工厂还提供健康教育信息和课程。3号工厂增加了常规的随访咨询和一系列干预类型，4号工厂增加了工厂内的社会组织。在三年结束时，对400至500名员工的随机样本进行了重新筛查。
与1号和2号工厂相比，增加常规随访咨询和一系列干预措施（3号和4号工厂）后，风险水平有了显著改善。更多的高血压患者开始接受治疗，血压下降幅度更大。参与工作场所减肥和戒烟项目的人数显著增加，并且在提供随访的情况下，参与者在维持改善方面表现出显著更好的效果。
与那些包括对高危人群进行个人 outreach、多种健康改善干预方式以及持续随访咨询以帮助人们做出决策并维持健康改善的模式相比，通过当地媒体推广的提供短期干预的项目模式效果较差。
