Gomel M, Oldenburg B, Simpson J M, Owen N
Department of Public Health, University of Sydney, Australia.
Am J Public Health. 1993 Sep;83(9):1231-8. doi: 10.2105/ajph.83.9.1231.
This study reports an efficacy trial of four work-site health promotion programs. It was predicted that strategies making use of behavioral counseling would produce a greater reduction in cardiovascular disease risk factors than screening and educational strategies.
Twenty-eight work sites were randomly allocated to a health risk assessment, risk factor education, behavioral counseling, or behavioral counseling plus incentives intervention. Participants were assessed before the intervention and at 3, 6, and 12 months.
Compared with the average of the health risk assessment and risk factor education conditions, there were significantly higher validated continuous smoking cessation rates and smaller increases in body mass index and estimated percentage of body fat in the two behavioral counseling conditions. The behavioral counseling condition was associated with a greater reduction in mean blood pressure than was the behavioral counseling plus incentives condition. On average among all groups, there was a short-term increase in aerobic capacity followed by a return to baseline levels.
Work-site interventions that use behavioral approaches can produce lasting changes in some cardiovascular risk factors and, if implemented routinely, can have a significant public health impact.
本研究报告了四项工作场所健康促进项目的疗效试验。据预测,与筛查和教育策略相比,采用行为咨询的策略能更大程度地降低心血管疾病风险因素。
28个工作场所被随机分配到健康风险评估、风险因素教育、行为咨询或行为咨询加激励干预组。在干预前以及干预后3个月、6个月和12个月对参与者进行评估。
与健康风险评估和风险因素教育组的平均值相比,在两种行为咨询组中,经证实的持续戒烟率显著更高,体重指数和估计体脂百分比的增幅更小。行为咨询组比行为咨询加激励组的平均血压下降幅度更大。在所有组中,平均而言,有氧运动能力短期内有所提高,随后又回到基线水平。
采用行为方法的工作场所干预措施可在一些心血管风险因素方面产生持久变化,若常规实施,可对公共卫生产生重大影响。