Abstract
Objectives: to evaluate the effectiveness of a three-year workplace intervention for healthy lifestyle promotion in the prevention of hypertension among employees. Methods: A quasi-experimental study design was employed to assess the effectiveness of a health promotion intervention program for corporate employees, which mainly consisted of educational videos and interactive teaching sessions with occupational physicians, healthy eating and smoking cessation workshops, free physical activity sessions for employees and free smoking cessation consultation in workplace. There were three workplace sites in the intervention and control groups, respectively. Results: The prevalence of screened hypertension decreased significantly in the intervention arm from 16.2% to 12.8% (p=0.02), but increased significantly in the control arm from 13.3% to 23.3% (p<0.001). Of note, obesity increased both in intervention and control arms. Assessment of hypertension prevalence according to weight status demonstrated a significant decrease in the intervention group among normal weight participants from 11.5% to 6.6% (p=0.009), but an increase in the control group albeit not statistically significant. Among overweight participants, hypertension decreased in intervention group from 18.9% to 13.5% (p=0.058), but increased significantly in control group from 13.1% to 23.1% (p=0.001). Among obese participants, the decrease in the prevalence of hypertension was not significant in intervention group (27.8% to 24.4%, p=0.48), however, it increased significantly in the control group from 22.4% to 34.3% (p=0.009). Determinants of hypertension were age > 35 years, male sex, overweight and obesity in the two groups. Overall, the intervention was negatively associated with hypertension in intervention group (OR= 0.61, CI 95% [0.47-0.8]). Conclusion: The intervention program was effective in decreasing the prevalence of hypertension among normal weight workers. However, additional strategies and/or time are need to combat hypertension among overweight and obese individuals.
Highlights
In 2009, the World Health Organization (WHO) attributed 13% of all deaths globally to high blood pressure, making it an issue of prime public health importance for both developing and developed nations [1].Tunisia exemplifies the reason for the WHO sentiments because hypertension affects more than 30% of adults as part of an evolving epidemiological transition within the African region [2,3,4]
The intervention group included workplaces located in the delegations of Sousse Jawhara and Sousse Erriadh, while the control group was from workplaces located in the neighboring delegation of Msaken (Figure 1)
The population was composed of 1775 workers with 914 in the intervention group and 861 in the control group
Summary
In 2009, the World Health Organization (WHO) attributed 13% of all deaths globally to high blood pressure, making it an issue of prime public health importance for both developing and developed nations [1].Tunisia exemplifies the reason for the WHO sentiments because hypertension affects more than 30% of adults as part of an evolving epidemiological transition within the African region [2,3,4]. High blood pressure is preventable, and is directly related to lifestyle habits such as poor diet, low levels of physical activity, tobacco use, and obesity. These behavioral risk factors are responsible for about 80% of serious heart conditions [5]. During the past few decades, in both the USA and inEuropean countries, worksite health promotion programs have increasingly was implemented [12,13] Mainfactors addressed in such programs involve physicalactivity or fitness, nutrition, and tobacco use. It was demonstrated that these programs on cardiovascular risk factors can be implemented and can have a positive impact on intermediate cardiovascular disease outcomes in developing countries [14]. In Tunisia, few worksite interventions have been implemented to prevent hypertension, and they were of limited duration
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