Dowell A C, Ochera J J, Hilton S R, Bland J M, Harris T, Jones D R, Katbamna S
Research in Primary Care, University of Leeds, UK.
Fam Pract. 1996 Aug;13(4):357-62. doi: 10.1093/fampra/13.4.357.
The effectiveness of health promotion activity in general practice on risk factor reduction for coronary heart disease remains the subject of active debate.
The study aimed to assess the impact of practice-based health check-ups on health behaviours over a 2-year period.
A general practice cohort of 7123 patients from 18 practices was surveyed. Eight hundred and forty (12%) patients had been offered a health check within a 12-month period from September 1992 and 621 (9%) received one. Two hundred and fifty patients (40%) were asked back for follow-up after their health check.
Over a 2-year period there was no difference in smoking cessation, alcohol consumption, weight loss nor the amount of exercise taken between those who attended for a health check and those who did not. The food score chosen to assess dietary change (Oxcheck) showed a statistically significant 1.16-point rise for the whole sample over the survey period. There was a significant difference in mean food score change between health check attenders and non-attenders (Mann-Whitney U test: P < 0.002). Maintenance of dietary improvement over a 2-year period was not affected by health check attendance.
This study confirms the low impact of health checks on the self reported modification of cardiovascular risk factors and shows that maintenance of appropriate health behaviour change is no more likely in those who have received a health check.
全科医疗中健康促进活动对降低冠心病危险因素的有效性仍是一个活跃的争论话题。
本研究旨在评估基于实践的健康检查在两年时间内对健康行为的影响。
对来自18个诊所的7123名患者组成的全科医疗队列进行了调查。在1992年9月起的12个月内，有840名（12%）患者接受了健康检查提议，621名（9%）接受了检查。250名患者（40%）在健康检查后被要求进行随访。
在两年时间里，接受健康检查的患者和未接受健康检查的患者在戒烟、饮酒、体重减轻及运动量方面均无差异。用于评估饮食变化的食物评分（Oxcheck）显示，在整个调查期间，整个样本有统计学显著意义的1.16分上升。健康检查参与者和非参与者之间的平均食物评分变化存在显著差异（曼-惠特尼U检验：P < 0.002）。两年期间饮食改善的维持情况不受是否参加健康检查的影响。
本研究证实了健康检查对自我报告的心血管危险因素改变影响较小，并表明接受健康检查的人并不更有可能维持适当的健康行为改变。
