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针对心血管风险增加且与教育水平和社会经济区域相关的个体的结构化生活方式教育项目的效果

Effects of Structured Lifestyle Education Program for Individuals With Increased Cardiovascular Risk Associated With Educational Level and Socioeconomic Area.

作者信息

Lidin Matthias, Hellenius Mai-Lis, Rydell Karlsson Monica, Ekblom-Bak Elin

机构信息

Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Stockholm, Sweden.

Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.

出版信息

Am J Lifestyle Med. 2020 Aug 29;15(1):28-38. doi: 10.1177/1559827620951143. eCollection 2021 Jan-Feb.

Abstract

Differences in socioeconomic status contribute to inequalities in lifestyle habits and burden of noncommunicable diseases. We aimed to examine how the effects of a 1-year structured lifestyle education program associate with the participant's educational level and socioeconomic area (SEA) of residence. One hundred individuals (64% women) with high cardiovascular risk were included. Education level (nonuniversity vs university degree) was self-reported and SEA (low vs high) defined by living in different SEAs. Lifestyle habits and quality of life were self-reported, cardiovascular risk factors and Framingham 10-year cardiovascular disease risk were measured at baseline and after 1 year. Sedentary behavior decreased in both nonuniversity degree and low SEA group over 1 year, with a significantly greater improvement in daily activity behavior in low- compared with high-SEA group. Abdominal obesity decreased significantly more in the nonuniversity compared with the university degree group. Cardiovascular risk and quality of life improved in all groups, however, with greater discrimination when using educational level as the dichotomization variable. The results are clinically and significantly relevant, suggesting that low socioeconomic status measured both as educational level and SEA are no barriers for changing unhealthy lifestyle habits and decreasing cardiovascular risk after participation in a lifestyle program.

摘要

社会经济地位的差异导致生活方式习惯和非传染性疾病负担的不平等。我们旨在研究一项为期1年的结构化生活方式教育项目的效果如何与参与者的教育水平和居住的社会经济区域(SEA)相关联。纳入了100名心血管疾病高风险个体(64%为女性)。教育水平(非大学学历与大学学历)通过自我报告获得,SEA(低与高)根据居住在不同的SEA来定义。生活方式习惯和生活质量通过自我报告获取,心血管危险因素和弗明汉10年心血管疾病风险在基线和1年后进行测量。在1年的时间里,非大学学历组和低SEA组的久坐行为均有所减少,与高SEA组相比,低SEA组的日常活动行为改善更为显著。与大学学历组相比,非大学学历组的腹部肥胖显著降低更多。所有组的心血管风险和生活质量均有所改善,然而,以教育水平作为二分变量时,区分度更大。这些结果在临床上具有显著相关性,表明以教育水平和SEA衡量的低社会经济地位并非参与生活方式项目后改变不健康生活方式习惯和降低心血管风险的障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7ed/7781060/e1dbdf2374b3/10.1177_1559827620951143-fig1.jpg

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