Fouad M N, Kiefe C I, Bartolucci A A, Burst N M, Ulene V, Harvey M R
Department of Medicine, University of Alabama at Birmingham 35205-4785, USA.
Ethn Dis. 1997 Autumn;7(3):191-9.
A comprehensive worksite health promotion program designed to reduce risk factors for cardiovascular disease among 4000 city of Birmingham employees was used to develop and implement a tailored antihypertensive educational intervention. The mean age of the underlying population was 36 years, 89% were blue-collar or unskilled workers, 50% were African Americans and 20% were female.
First, we identified barriers to hypertension control: low literacy, difficulty understanding the need for treatment of asymptomatic disease, and wide variability of health beliefs and priorities. We then tailored an educational program, which offered employees health education sessions on a variety of different topics, including heart disease, cancer, sleep disorders and back injury. All program materials focused on lifestyle changes and the need to seek medical care. This program was offered to all hypertensive workers; 130 chose to enroll, and 81 completed the program. These 81 participants were matched by age, sex, race and baseline BP with nonparticipating hypertensive workers (controls). Changes in SBP and DBP from before to after the educational program were used to evaluate the program.
Overall, intervention participants had a decrease of 4.5 mm Hg in mean SBP (different from zero, [p = 0.03]). African American participants showed a significant decrease (7.4 mm Hg, [p = 0.004]), as did unskilled intervention participants (SBP changes = 7.7 mm Hg, [p = 0.004]). Although not statistically significant, controls showed decreases in BP in the same direction.
An educational intervention tailored to the specific health perceptions and working conditions of a low literacy population is feasible, and may have a significant effect on hypertension control.
一项旨在降低4000名伯明翰市员工心血管疾病风险因素的综合工作场所健康促进项目被用于开发和实施一项针对性的抗高血压教育干预措施。目标人群的平均年龄为36岁，89%为蓝领或非技术工人，50%为非裔美国人，20%为女性。
首先，我们确定了高血压控制的障碍：低文化水平、难以理解无症状疾病的治疗必要性以及健康观念和优先事项的广泛差异。然后，我们制定了一个教育项目，为员工提供关于各种不同主题的健康教育课程，包括心脏病、癌症、睡眠障碍和背部损伤。所有项目材料都侧重于生活方式的改变以及寻求医疗护理的必要性。该项目面向所有高血压员工；130人选择报名参加，81人完成了该项目。这81名参与者在年龄、性别、种族和基线血压方面与未参与的高血压员工（对照组）进行了匹配。通过教育项目前后收缩压和舒张压的变化来评估该项目。
总体而言，干预参与者的平均收缩压下降了4.5毫米汞柱（与零不同，[p = 0.03]）。非裔美国参与者显示出显著下降（7.4毫米汞柱，[p = 0.004]），非技术干预参与者也是如此（收缩压变化 = 7.7毫米汞柱，[p = 0.004]）。尽管无统计学意义，但对照组的血压也呈相同方向下降。
针对低文化水平人群的特定健康认知和工作条件量身定制的教育干预措施是可行的，并且可能对高血压控制产生显著影响。
