Life-style intervention at the worksite--reduction of cardiovascular risk factors in a randomized study. Effect of the Heart At Work Program on Awareness of Risk Factors, Self-Efficacy, and Health Behaviors A Randomised Controlled Trial of Counseling in a Workplace Setting for Coronary Heart Disease Risk Factor Modification: Effects on Blood Pressure Design of a RCT evaluating the (cost-) effectiveness of a lifestyle intervention for male construction workers at risk for cardiovascular disease: The Health under Construction study Primary prevention of cardiovascular disease by an occupational health service. Short and long term effects of a lifestyle intervention for construction workers at risk for cardiovascular disease: a randomized controlled trial Heart disease prevention project: a randomised controlled trial in industry. Individualised multifactorial lifestyle intervention trial for high-risk cardiovascular patients in primary care. Effect of a 4-year workplace-based physical activity intervention program on the blood lipid profiles of participating employees: the high-risk and population strategy for occupational health promotion (HIPOP-OHP) study. Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease: A Randomized Clinical Trial. Change in coronary risk and coronary risk factor levels in couples following lifestyle intervention. The British Family Heart Study. Improving Employee Health: Evaluation of a Worksite Lifestyle Change Program to Decrease Risk Factors for Diabetes and Cardiovascular Disease The Effects of a Multimodal Intervention Trial to Promote Lifestyle Factors Associated With the Prevention of Cardiovascular Disease in Menopausal and Postmenopausal Australian Women The effect of structured exercise classes and a lifestyle intervention on cardiovascular risk factors in primary schoolchildren: an exploratory trial (The A-CLASS Project). Worksite Opportunities for Wellness (WOW): effects on cardiovascular disease risk factors after 1 year. Effect of a continuous diabetes lifestyle intervention program on male workers in Korea. Take Heart II: Replication of a Worksite Health Promotion Trial
OBJECTIVES This study tested a feasible method for screening for cardiovascular risk at the worksite and investigated the effects of a long-term comprehensive program of life-style intervention to prevent cardiovascular disease . METHODS Employees in the public sector filled out a self-administered question naire with questions on social , medical , and work-related factors . The respondents numbered 454 ( 80 % ) . A score sum for cardiovascular risk was calculated ( range 1 - 20 , median 7.0 ) , and the 128 subjects with a sum above 8 were invited to a health examination including blood sampling . Thereafter the subjects were invited to participate , following r and omization , in a comprehensive , 18-month , life-style intervention program to improve cardiovascular risk or in a control group . RESULTS The intervention group significantly decreased body mass index , diastolic blood pressure , heart rate , low-density lipoprotein ( LDL ) cholesterol , and smoking habits during the intervention . The initially elevated serum cortisol , as a marker of stress reaction , normalized in the intervention group . In the control group LDL cholesterol also decreased , but the glucose and triglyceride levels increased , and smoking habits were unchanged . Sick days for a given period decreased after 1 year in the intervention group but not in the control group . CONCLUSIONS Several cardiovascular risk factors can be improved and morning serum cortisol normalized during a long-term life-style intervention program with a r and omized design using a worksite population of middle-aged subjects . The use of a 2-step screening program , with an initial question naire followed by a health check of subjects with elevated risk , is feasible for worksite setting This study evaluates the effects of the American Heart Association ’s Heart At Work program  on cardiovascular disease risk factor awareness , self-efficacy , and health behaviors . A prospect i ve , quasi-experimental research design was used to assess the impact of the program at two factory sites ( one intervention and one control ) . A total of 633 employees participated . Intervention site respondents significantly improved their knowledge of blood pressure management , the relationship between nutrition and cardiovascular disease , and heart attack risk factors . They also were more likely to begin treatment for hypertension , to report fewer sick days , and to have plans to improve their diet and lose weight . These findings suggest that the Heart At Work program had a favorable overall impact This paper review s a prospect i ve study of occupational factors in coronary heart disease risk incorporated in a r and omised controlled trial of a worksite based occupational health nurse counseling program for reducing coronary heart disease risk factors . The aim of the trial was to evaluate the longterm effectiveness of the counseling program in persons with mildly elevated risk factor levels . Of the 2 , 489 Australian government employees with mildly elevated risk factor levels who entered the intervention trial , 1 , 937 ( 78 % ) attended a followup examination three years later . This paper reports on changes in systolic and diastolic blood pressure . Multiple linear regression models were used with three-year blood pressure reduction as the dependent variable , intervention status as the main determinant , and sex , age , initial risk level and initial blood pressure as covariates . Although systolic and diastolic blood pressure fell in both the intervention and control groups , intervention was significantly associated with systolic blood pressure change only Background Of all workers in Dutch construction industry , 20 % has an elevated risk of cardiovascular disease ( CVD ) . A major risk factor for CVD risk is an unhealthy lifestyle . The aim of our study is to design a lifestyle intervention for construction workers with an elevated CVD risk , and to evaluate its ( cost- ) effectiveness . Methods / Design In a RCT , 692 participants will be r and omised to either the control or the intervention group . The control group will receive usual care . For the intervention group , a lifestyle intervention has been design ed based on interviews and current literature . The intervention will last 6 months and will comprise 3 face-to-face and 4 telephone contacts , consisting of individual counselling aim ed at increasing daily physical activity ( PA ) and improving dietary behaviour , and /or smoking cessation . Counselling will take place at the Occupational Health Service ( OHS ) , and will be done according to motivational interviewing ( MI ) . Additional written information about healthy lifestyle will also be provided to those in the intervention group . At baseline , after 6 and after 12 months , measurements will take place . Primary outcome variables will be the lifestyle behaviours of concern , i.e. daily PA , dietary intake , and smoking status . Secondary outcome variables will be body mass index ( BMI ) , systolic and diastolic blood pressure , total and HDL blood cholesterol , Hba1c and cardio-respiratory fitness ( CRF ) . Sickness absenteeism and cost-effectiveness will be assessed as well . Multilevel analysis will be performed to compare all outcome measures between the intervention group and the control group . Discussion By improving lifestyle , CVD risk may be lowered , yielding benefits for both employee and employer . If proven effective , this lifestyle intervention will be implemented on a larger scale within the Occupational Health Services in construction industry . Trial registration Current Controlled Trials IS RCT BACKGROUND Worksites are considered to be a key channel for the delivery of interventions to prevent cardiovascular disease . The aim of this study was to evaluate the effect on the blood cholesterol levels of an intervention program offered by an occupational health service . METHODS The intervention group consisted of 95 employees and the reference group consisted of 74 employees , in all , 169 subjects , with a serum cholesterol > or = 5.2 mmol/l . Both groups completed a st and ardized question naire . Occupational health nurses carried out the blood sampling before and after the program . The intervention group was then offered counseling on physical activity and a dietician offered individual counseling on healthy food habits . The reference group was not the subject of the intervention program . RESULTS The mean cholesterol level decreased by 0.3 mmol/l ( 5 % ) in the intervention group and for the men the decrease was 0.5 mmol/l , while the mean level of the reference group was unchanged . Furthermore , there was a nonsignificant decrease of the mean triglyceride level in the intervention group . CONCLUSION The results of this controlled trial indicates that risk factors for cardiovascular disease can be reduced by interventions at the worksite . Even modest reductions of cholesterol levels may reduce the risk to a tangible degree Background The prevalence of overweight and elevated cardiovascular disease ( CVD ) risk among workers in the construction industry is relatively high . Improving lifestyle lowers CVD risk and may have work-related benefits . The purpose of the study was to evaluate the effects on physical activity ( PA ) , diet , and smoking  of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease ( CVD ) . Methods In a r and omized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD , usual care was compared to a 6-month lifestyle intervention . The intervention consisted of individual counseling using motivational interviewing techniques , and was delivered by an occupational physician or occupational nurse . In three face to face and four telephone contacts , the participant 's risk profile , personal determinants , and barriers for behavior change were discussed , and personal goals were set . Participants chose to aim at either  diet and PA  , or smoking . Data were collected at baseline and after six and 12 months , by means of a question naire . To analyse the data , linear and logistic regression analyses were performed . Results The intervention had a statistically significant beneficial effect on snack intake ( β-1.9 , 95%CI -3.7 ; -0.02 ) and fruit intake ( β 1.7 , 95%CI 0.6 ; 2.9 ) at 6 months . The effect on snack intake was sustained until 12 months ; 6 months after the intervention had ended ( β -1.9 , 95%CI -3.6 ; -0.2 ) . The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant . The beneficial effect on smoking was statistically significant at 6 ( OR smoking 0.3 , 95%CI 0.1;0.7 ) , but not at 12 months ( OR 0.8 , 95%CI 0.4 ; 1.6 ) . Conclusions Beneficial effects on smoking , fruit , and snack intake can be achieved by an individual-based lifestyle intervention among male construction workers with an elevated risk of CVD . Future research should be done on strategies to improve leisure time PA and on determinants of maintenance of changed behavior . Considering the rising prevalence of unhealthy lifestyle and CVD , especially in the aging population , implementation of this intervention in the occupational health care setting is recommended . Trial registration Current Controlled Trials IS RCT Twenty-four factories or other occupational groups , employing 18 210 men aged 40 to 59 , were formed into matched pairs . One of each pair was allocated r and omly to receive a five to six year programme of medical examinations and intervention to reduce the levels of the main coronary risk factors . Men at factories in the intervention group were given advice on dietary reduction of plasma cholesterol concentrations , stopping or reducing cigarette smoking , regular exercies for the sedentary and reduced energy intake for the overweight , and hypertension was treated . The programme was delivered mainly through existing occupational medical services , helped by a small central staff . Personal consultations were largely confined to men with a high risk of developing coronary heart disease . Changes in risk factors were assessed by regular st and ardised examinations of r and om sample s of men . The spread of information by general propag and a proved easy , but a change in habits seemed to require personal contact . Small but significant reductions occurred , mainly in the high-risk group , but these were not sustained when pressure was relaxed BACKGROUND The multiprofessional teams in Finnish health centres are well placed to carry out interventions aim ed at the prevention of cardiovascular diseases . AIM To evaluate the effectiveness of an individually tailored multifactorial lifestyle intervention in primary care for individuals at high risk for cardiovascular disease . DESIGN OF STUDY A r and omised controlled trial was conducted over 24 months with interim assessment s at six and 12 months . SETTING A health centre in Finl and with a patient population of 11,000 . METHOD One hundred and fifty adults aged 18 to 65 years old with existing cardiovascular disease or multiple risk factors were r and omised to active multiprofessional risk factor intervention or to st and ard care . The main outcome measure was a change in cardiovascular risk-factor score . Secondary outcomes were changes in blood pressure , weight , body-mass index , serum cholesterol , blood glucose , smoking cessation , and exercise habits . RESULTS The cardiovascular risk score decreased by 28 % in the intervention group ( 23 % in the control group ) , body weight decreased by 3.7 % ( 2 % ) and total cholesterol decreased by 10.8 % ( 6.5 % ) , while time engaged in exercise increased by 39 % ( 43 % ) . Differences were not significant . CONCLUSIONS Cardiovascular risk levels of high-risk individuals decreased in both intervention and control groups . Primary care prevention should be targeted to high-risk persons . Long-term follow-up studies are needed Individuals who are physically fit or engage in regular physical activity have a lower incidence of cardiovascular disease and risk of mortality . We conducted a large-scale controlled trial of interventions to decrease cardiovascular risk factors , during which we assessed the effect of a workplace-based intervention program , which was part of a population strategy for promoting long-term increases in physical activity , on the blood lipid profiles  of participating employees . Data were collected from 2929 participants and this report presents the results of a survey conducted in five factories for the intervention group and five factories for the control group at baseline and year 5 . The absolute/proportional changes in HDL-cholesterol were 2.7 mg/dL ( 4.8 % ) in the intervention group and -0.6 mg/dL ( -1.0 % ) in the control group . The differences between the two groups in the change in serum levels of HDL-cholesterol were highly significant ( p<0.001 ) in each analysis of covariance , in which the number of cigarettes smoked was included or excluded . In the intervention group , the  daily walking time  increased significantly ( p<0.001 ) when compared between baseline and year 5 , whereas no significant difference was observed in daily walking time in the control group over the identical period . Our results show that an intervention program promoting physical activity raises serum HDL-cholesterol levels of middle-aged employees . Increased awareness of the benefits of physical activity , using environmental rearrangement and health promotion campaigns , which especially target walking , may have contributed to a beneficial change in serum HDL-cholesterol levels in the participants IMPORTANCE Cardiovascular disease prevention , including lifestyle modification , is important but underutilized . Mobile health strategies could address this gap but lack evidence of therapeutic benefit . OBJECTIVE To examine the effect of a lifestyle-focused semipersonalized support program delivered by mobile phone text message on cardiovascular risk factors . DESIGN AND SETTING The Tobacco , Exercise and Diet Messages ( TEXT ME ) trial was a parallel-group , single-blind , r and omized clinical trial that recruited 710 patients ( mean age , 58 [ SD , 9.2 ] years ; 82 % men ; 53 % current smokers ) with proven coronary heart disease ( prior myocardial infa rct ion or proven angiographically ) between September 2011 and November 2013 from a large tertiary hospital in Sydney , Australia . INTERVENTIONS Patients in the intervention group ( n = 352 ) received 4 text messages per week for 6 months in addition to usual care . Text messages provided advice , motivational reminders , and support to change lifestyle behaviors . Patients in the control group ( n=358 ) received usual care . Messages for each participant were selected from a bank of messages according to baseline characteristics ( eg , smoking ) and delivered via an automated computerized message management system . The program was not interactive . MAIN OUTCOMES AND MEASURES The primary end point was low-density lipoprotein cholesterol ( LDL-C ) level at 6 months . Secondary end points included systolic blood pressure , body mass index ( BMI ) , physical activity , and smoking status . RESULTS At 6 months , levels of LDL-C were significantly lower in intervention participants , with concurrent reductions in systolic blood pressure and BMI , significant increases in physical activity , and a significant reduction in smoking . The majority reported the text messages to be useful ( 91 % ) , easy to underst and ( 97 % ) , and appropriate in frequency ( 86 % ) . [ table : see text ] . CONCLUSIONS AND RELEVANCE Among patients with coronary heart disease , the use of a lifestyle-focused text messaging service compared with usual care result ed in a modest improvement in LDL-C level and greater improvement in other cardiovascular disease risk factors . The duration of these effects and hence whether they result in improved clinical outcomes remain to be determined . TRIAL REGISTRATION anzctr.org.au Identifier : ACTRN12611000161921 OBJECTIVES To measure the extent to which changes in cardiovascular risk factors were correlated among married couples following a 1-year primary care , family-centered , cardiovascular lifestyle intervention program and to identify couples who benefited most from this prevention program . DESIGN Observational study . SETTING Thirteen primary care centers in 13 towns in Britain . PARTICIPANTS A total of 1477 men aged 40 to 59 years and their female partners who attended a family health checkup in 1991 to 1992 from r and omly ordered invitations to registered families . After 1 year , 1204 ( 82 % ) partner pairs were rescreened . MAIN OUTCOME MEASURES One-year changes in cigarette smoking , systolic blood pressure , serum cholesterol level , blood glucose level , and a total coronary risk score . RESULTS Comparing men and women partners , baseline values and 1-year changes in overall coronary risk score ( Pearson r = 0.27 and r = 0.20 , respectively ) , cigarette smoking , body mass index , systolic blood pressure , cholesterol levels , and glucose levels were all positively correlated ( all P < .001 except smoking cessation , P = .03 ) . Changes in cholesterol levels and systolic blood pressure were also associated with partner 's baseline measurement ( P < or = .01 in both men and women ) . CONCLUSIONS Men and women who benefit most from risk factor reductions have partners who also tend to benefit most . Conversely , men and women who enjoy little or no benefit have partners who tend to have similarly small benefits . It is likely that lifestyle intervention targeted at men and women as couples rather than as individuals may result in a greater reduction in cardiovascular risk factors , possibly through mutual reinforcement of lifestyle changes Objective : To determine whether an evidence -based , behavioral lifestyle intervention program delivered at a worksite setting is effective in improving type 2 diabetes and cardiovascular disease risk factors .  Methods : A r and omized 6-month delayed control design was utilized , with two thirds of the participants assigned to begin intervention immediately , and one third beginning 6 months later . The year-long program ( weekly for 3 months transitioning to monthly ) focused on weight loss and increasing physical activity . Results : The immediate intervention group had greater mean weight loss ( −10.4 lb , 5.1 % , vs −2.3 lb , 1 % ; P = 0.0001 ) than the delayed control group at 6 months and relatively greater improvements in activity , HbA1c , and other risk factors . The delayed group experienced similar improvements after completing the intervention program . Conclusions : A worksite behavioral lifestyle intervention is feasible and effective in significantly improving risk factors for type 2 diabetes and cardiovascular disease The purpose of this study was to test the efficacy of a multimodal intervention ( Women 's Wellness Program ) to improve  women 's cardiovascular risk factors .  This 12-week r and omized experiment with a control group targeted women 50–65 years living in the general population . Women in the intervention group were provided with a consultation with a registered nurse at which time biophysical cardiovascular risk measures were taken and health education was provided in both verbal and written form . Women were encouraged to review their smoking , nutrition , and water intakes and to commence an exercise program that included aerobic fitness exercises . Women in the control group continued their normal activities . The sample consisted of 90 women aged 50–65 years . Pre- and postintervention assessment utilized seven measures of cardiovascular risk factors : waist-to-hip ratio ( WHR ) , body mass index ( BMI ) , blood pressure , heart rate , weight , exercise levels , and smoking . Analysis of covariance indicated that the intervention was effective in improving women 's aerobic exercise activity and decreasing smoking . The data from all five biophysical outcome measures supported the efficacy of the intervention , with significant decreases seen in the women 's WHR , BMI , blood pressure , and measured weight . Study implication s suggest that this type of intervention may provide an effective , clinical ly manageable therapy for women who prefer a self-directed approach to preventing and decreasing cardiovascular risk factors This exploratory trial evaluates the effect of a structured exercise ( STEX ) or lifestyle intervention ( PASS ) program upon  cardiovascular ( CV ) disease risk factors in children . Sixty-one schoolchildren were r and omly assigned by school to an intervention or control ( CON ) condition . The effect of the STEX ( compared with CON ) was a mean benefit of -0.018 mm for average maximum carotid intimamedia thickness . The PASS intervention did not result in clinical ly important effects , and no other substantial changes were observed . Relatively high probability of clinical ly beneficial effects of the STEX intervention suggests that a larger , definitive r and omized trial with longer follow-up is warranted OBJECTIVE To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors . METHODS In St Louis , Missouri from 2005 to 2006 , 151 employees ( 134 F , 17 M , 81 % overweight/obese ) participated in a cohort-r and omized trial comparing assessment s + intervention ( worksite A ) with assessment s only ( worksite B ) for 1 year . All participants received personal health reports containing their assessment results . The intervention was design ed to promote physical activity and favorable dietary patterns using pedometers , healthy snack cart , WeightWatchers(R ) meetings , group exercise classes , seminars , team competitions , and participation rewards . Outcomes included BMI , body composition , blood pressure , fitness , lipids , and Framingham 10-year coronary heart disease risk . RESULTS 123 participants , aged 45+/-9 yr , with BMI 32.9+/-8.8 kg/m(2 ) completed 1 year . Improvements ( P < or = 0.05 ) were observed at both worksites for fitness , blood pressure , and total- , HDL- , and LDL-cholesterol . Additional improvements occurred at worksite A in BMI , fat mass , Framingham risk score , and prevalence of the metabolic syndrome ; only the changes in BMI and fat mass were different between worksites . CONCLUSION A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors , but many of the improvements were achieved with worksite health assessment s and personalized health reports in the absence of an intervention AIMS This study was conducted to compare the effects of two years of lifestyle intervention to no intervention or one year of intervention on diabetes risk factors in male workers with impaired fasting glucose ( IFG ) or diabetes . METHODS We conducted a r and omized lifestyle intervention trial design ed to alter personal lifestyles among 123 industrial male workers ( CG ; control group , n=75 ; OIG ; one-year intervention group , n=23 ; TIG ; two-year intervention group , n=25 ) . The intervention consisted of two parts , the main program ( face-to-face counseling five times/12 weeks ) and a follow-up program ( e-mail counseling ten times/30 weeks ) . Assessment s included biochemical characteristics , anthropometry and nutrient intake at baseline and after two years . RESULTS After two years , systolic blood pressure , HOMA-IR , HDL cholesterol and total energy intake ( p<0.05 ) were reduced in the OIG group , while weight , body mass index , waist circumference , blood pressure , fasting plasma glucose ( FPG ) , HbA1c and nutrient intake ( total energy , carbohydrate , protein and sodium ) were significantly decreased ( p<0.05 , respectively ) in the TIG group . When compared to the CG , subjects in OIG and TIG showed significant improvements in the level of FPG and HbA1c ( p<0.05 ) . CONCLUSIONS Continuous lifestyle intervention for two years is more effective at improving diabetes risk factors than OIG The purpose of this study was to evaluate the effects of a revised worksite health promotion program that featured an employee steering committee/menu approach to intervention . The “ Take Heart II ” program was evaluated using a quasi-experimental matched-pair design with worksite as the unit of analysis . Experimental and control worksites did not differ on baseline organizational or employee demographic variables or on baseline levels of dependent variables . Outcome and process results revealed consistent , but modest effects favoring intervention worksites on most measures . Cross-sectional analyses generally failed to produce statistically significant intervention effects , but cohort analyses revealed significant beneficial effects of the Take Heart II intervention on eating patterns , behavior change attempts , and perceived social support . Neither analysis detected a beneficial effect of intervention on cholesterol levels
There was no statistically significant publication bias , except for systolic blood pressure .
This study examined the effect of lifestyle interventions on  cardiovascular disease risk factors among workers .