一项针对心血管危险因素的多成分工作场所健康促进计划的评估——校正均值回归效应。

Evaluation of a multicomponent worksite health promotion program for cardiovascular risk factors-correcting for the regression towards the mean effect.

作者信息

Prior John O, van Melle Guy, Crisinel Annette, Burnand Bernard, Cornuz Jacques, Darioli Roger

机构信息

Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, University Hospital, Lausanne, Switzerland.

出版信息

Prev Med. 2005 Mar;40(3):259-67. doi: 10.1016/j.ypmed.2004.05.032.

DOI:10.1016/j.ypmed.2004.05.032

PMID:15533537

Abstract

BACKGROUND

We assessed the impact of a multicomponent worksite health promotion program for0 reducing cardiovascular risk factors (CVRF) with short intervention, adjusting for regression towards the mean (RTM) affecting such nonexperimental study without control group.

METHODS

A cohort of 4,198 workers (aged 42 +/- 10 years, range 16-76 years, 27% women) were analyzed at 3.7-year interval and stratified by each CVRF risk category (low/medium/high blood pressure [BP], total cholesterol [TC], body mass index [BMI], and smoking) with RTM and secular trend adjustments. Intervention consisted of 15 min CVRF screening and individualized counseling by health professionals to medium- and high-risk individuals, with eventual physician referral.

RESULTS

High-risk groups participants improved diastolic BP (-3.4 mm Hg [95%CI: -5.1, -1.7]) in 190 hypertensive patients, TC (-0.58 mmol/l [-0.71, -0.44]) in 693 hypercholesterolemic patients, and smoking (-3.1 cig/day [-3.9, -2.3]) in 808 smokers, while systolic BP changes reflected RTM. Low-risk individuals without counseling deteriorated TC and BMI. Body weight increased uniformly in all risk groups (+0.35 kg/year).

CONCLUSIONS

In real-world conditions, short intervention program participants in high-risk groups for diastolic BP, TC, and smoking improved their CVRF, whereas low-risk TC and BMI groups deteriorated. Future programs may include specific advises to low-risk groups to maintain a favorable CVRF profile.

摘要

背景

我们评估了一项多组分工作场所健康促进计划在短期干预中对降低心血管危险因素（CVRF）的影响，并针对影响此类无对照组的非实验性研究的均值回归（RTM）进行了调整。

方法

对4198名工人（年龄42±10岁，范围16 - 76岁，27%为女性）组成的队列进行了为期3.7年的分析，并根据每个CVRF风险类别（低/中/高血压[BP]、总胆固醇[TC]、体重指数[BMI]和吸烟）进行分层，同时进行了RTM和长期趋势调整。干预措施包括对中高危个体进行15分钟的CVRF筛查和由健康专业人员提供的个性化咨询，并最终转诊至医生处。

结果

高危组参与者中，190名高血压患者的舒张压改善了（-3.4 mmHg [95%CI：-5.1，-1.7]），693名高胆固醇血症患者的总胆固醇改善了（-0.58 mmol/l [-0.71，-0.44]），808名吸烟者的吸烟量改善了（-3.1支/天[-3.9，-2.3]），而收缩压变化反映了均值回归。未接受咨询的低风险个体的总胆固醇和体重指数恶化。所有风险组的体重均呈均匀增加（+0.35 kg/年）。