Evaluation of a multicomponent worksite health promotion program for cardiovascular risk factors—correcting for the regression towards the mean effect

Abstract

Background We assessed the impact of a multicomponent worksite health promotion program for0 reducing cardiovascular risk factors (CVRF) with short intervention, adjusting for regression towards the mean (RTM) affecting such nonexperimental study without control group. Methods A cohort of 4,198 workers (aged 42 ± 10 years, range 16–76 years, 27% women) were analyzed at 3.7-year interval and stratified by each CVRF risk category (low/medium/high blood pressure [BP], total cholesterol [TC], body mass index [BMI], and smoking) with RTM and secular trend adjustments. Intervention consisted of 15 min CVRF screening and individualized counseling by health professionals to medium- and high-risk individuals, with eventual physician referral. Results High-risk groups participants improved diastolic BP (−3.4 mm Hg [95%CI: −5.1, −1.7]) in 190 hypertensive patients, TC (−0.58 mmol/l [−0.71, −0.44]) in 693 hypercholesterolemic patients, and smoking (−3.1 cig/day [−3.9, −2.3]) in 808 smokers, while systolic BP changes reflected RTM. Low-risk individuals without counseling deteriorated TC and BMI. Body weight increased uniformly in all risk groups (+0.35 kg/year). Conclusions In real-world conditions, short intervention program participants in high-risk groups for diastolic BP, TC, and smoking improved their CVRF, whereas low-risk TC and BMI groups deteriorated. Future programs may include specific advises to low-risk groups to maintain a favorable CVRF profile.