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一项针对小学教师的职场健康计划对控制血压的影响:一项前后对照研究。

The Effect of a Workplace Wellness Program for Primary School Teachers in Controlling Blood Pressure: A Before and After Study.

作者信息

Purbowo Sugma Agung, Mansyur Muchtaruddin, Widyahening Indah Suci, Werdhani Retno Asti, Siregar Parlindungan, Timan Ina Susianti, Soelaeman Muhammad Faza

机构信息

Doctoral Program in Medical Science, Faculty of Medicine, Universitas Indonesia.

Department of Community Medicine, Division of Occupational Medicine, Faculty of Medicine, Universitas Indonesia.

出版信息

Acta Med Philipp. 2024 Nov 29;58(21):82-89. doi: 10.47895/amp.vi0.7147. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVE

Hypertension is a major health issue worldwide, with primary schoolteachers possessing several lifestyle risks of the disease. There have not been any health promotion programs yet for primary school-teachers in Indonesia, especially for blood pressure control. A school-based model of workplace wellness program for teachers was developed. It focused on using screening as feedback in controlling blood pressure by eating a healthy diet, doing physical activity, and having regular checks. This study aimed to assess its clinical and behavioral effects.

METHODS

This trial was a one group pre- and post-test study design without control. It was implemented purposively in three public primary school locations in Jakarta to 44 eligible teachers for approximately three months from January to March 2022. The workplace wellness program included on-site screening (blood pressure, body mass index/BMI, spot urine sodium-creatinine ratio), knowledge, motivation, and ongoing health behavior (physical activity and the dietary approach to stop hypertension/DASH), online education/training, consultation/counseling sessions with a family doctor, and self-monitoring. All screening measurements were repeated at the end of the program. A paired t-test or Wilcoxon analysis was performed using SPSS 20.0.

RESULTS

Both systolic and diastolic blood pressure decreased by 5.05 mmHg (p = 0.018) and 6.41 mmHg (p < 0.001), respectively. The spot urine sodium-creatinine ratio and BMI decreased slightly but not significant (p = 0.707; p = 0.761). Knowledge and motivation increased slightly but not significant (p = 0.529; p = 0.175). The DASH behavior significantly increased by 25% (p < 0.001). Though the overall physical activity did not change, the walking activity increased twofold significantly (p = 0.006). This study also showed that the outcome would be achieved when the participant followed the recommendations obediently.

CONCLUSION

This school-based workplace wellness program was found to have a potential effect on controlling blood pressure by changing health behaviors. A randomized controlled trial is recommended to provide stronger evidence on its effectiveness before doing a large-scale implementation in primary schools in Indonesia.

摘要

背景与目的

高血压是全球主要的健康问题,小学教师存在多种该疾病的生活方式风险。印度尼西亚尚未针对小学教师开展任何健康促进项目,尤其是血压控制方面。开发了一种针对教师的基于学校的工作场所健康项目模式。该模式侧重于通过健康饮食、体育活动和定期检查,将筛查作为控制血压的反馈。本研究旨在评估其临床和行为效果。

方法

本试验为无对照的单组前后测研究设计。于2022年1月至3月在雅加达的三个公立小学地点,对44名符合条件的教师进行了约三个月的针对性实施。工作场所健康项目包括现场筛查(血压、体重指数/BMI、即时尿钠肌酐比值)、知识、动机以及持续的健康行为(体育活动和终止高血压膳食方法/DASH)、在线教育/培训、与家庭医生的咨询/辅导课程以及自我监测。在项目结束时重复所有筛查测量。使用SPSS 20.0进行配对t检验或Wilcoxon分析。

结果

收缩压和舒张压分别下降了5.05 mmHg(p = 0.018)和6.41 mmHg(p < 0.001)。即时尿钠肌酐比值和BMI略有下降但不显著(p = 0.707;p = 0.761)。知识和动机略有增加但不显著(p = 0.529;p = 0.175)。DASH行为显著增加了25%(p < 0.001)。虽然总体体育活动没有变化,但步行活动显著增加了两倍(p = 0.006)。本研究还表明,当参与者严格遵循建议时,就能取得相应结果。

结论

发现这种基于学校的工作场所健康项目通过改变健康行为对控制血压具有潜在效果。建议在印度尼西亚的小学进行大规模实施之前,开展一项随机对照试验,以提供更有力的证据证明其有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90cf/11694031/ac8200cc01b9/AMP-58-21-7147-g001.jpg

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