Hornsby P P, Reeve R H, Gwaltney J M, Parsons B D, Morse R M
Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, USA.
Am J Prev Med. 1997 Jan-Feb;13(1):36-44.
Proof of effectiveness now exists for many health promotion and disease prevention practices, yet the importance of this knowledge is not widely appreciated, and a large percentage of the population does not receive this care. Universities with comprehensive academic medical centers are particularly appropriate places for providing health promotion programs. The University of Virginia began a health promotion and disease prevention program for employees in 1990.
Periodic health risk appraisal, with follow-up and selected interventions, is offered to approximately 14,000 employees as a cost-free fringe benefit. Health risks are assessed with a modification of the Carter Center Health Risk Appraisal. Results are given to participants in group sessions; referrals are made for clinical preventive services and interventions, as needed.
During the first three years, 29% of the employee population participated in the program. Participants were more likely to be young, female and not African American. Nearly 96% had one or more risk factors, with an average of 3.6 risk factors overall. Participants on average had 1.8 risk factors for cardiovascular disease; 0.3 for cancer; 0.6 for injury; 0.1 for alcohol abuse; and 0.7 for mental health. Nonparticipants were not receiving similar comprehensive health risk appraisal elsewhere.
University of Virginia employees have multiple health risks, not detected through their usual health care, for which effective interventions are available. This population probably reflects conditions throughout the state and nation. Academic medical centers should place high priority on establishing health promotion programs as part of their responsibilities to society.
现在已有证据证明许多健康促进和疾病预防措施是有效的,但这一知识的重要性并未得到广泛认可,而且很大一部分人口并未得到此类保健服务。拥有综合性学术医疗中心的大学是提供健康促进项目的特别合适场所。弗吉尼亚大学于1990年为员工启动了一项健康促进和疾病预防项目。
定期进行健康风险评估,并进行随访和选择干预措施,作为一项免费附加福利提供给约14000名员工。采用卡特中心健康风险评估的修改版来评估健康风险。结果在小组会议上向参与者公布;根据需要,转介至临床预防服务和干预措施。
在最初三年中,29%的员工参与了该项目。参与者更有可能是年轻人、女性且非非裔美国人。近96%的人有一个或多个风险因素,总体平均有3.6个风险因素。参与者平均有1.8个心血管疾病风险因素;0.3个癌症风险因素;0.6个受伤风险因素;0.1个酗酒风险因素;以及0.7个心理健康风险因素。未参与者在其他地方未接受类似的全面健康风险评估。
弗吉尼亚大学的员工存在多种通过常规医疗保健未被发现的健康风险,针对这些风险有有效的干预措施。这一群体可能反映了该州乃至全国的情况。学术医疗中心应高度重视将建立健康促进项目作为其对社会的责任的一部分。