Abstract
Objective
To clarify the methodological issues for the High-risk and population Strategy for Occupational Health Promotion Study (HIPOP-OHP study), which is a 4-year non-randomized control trial, an interim assessment of male participants was performed 3 years after the baseline survey.
Methods
We had approximately 2,500 and 4,000 participants in the intervention and control groups, respectively. The population measures and prevalence of risk factors at each year, and between the baseline and 4th examinations were compared between the two groups. The personal trends of returning participants who were in the study at the 1st and 4th examinations were also evaluated.
Results
During the 3 years, an increase in serum HDL cholesterol (2.7 mg/dl), and a reduction in the prevalence of hypertriglycemia detected with fasting blood samples (3.6%) and current smokers (5.4%) were observed in the intervention group. The mean HDL cholesterol level was significantly higher in the intervention group than in the control group at the 4th examination, reversed from the baseline survey. The serum non-HDL cholesterol level was significantly increased only in the control group. There was also a significant increase in the prevalence of hypertriglycemia nad high plasma glucose detected with fasting blood samples in the control group. The return participation rate after 3 years was 72.2% for the intervention group and 74.9% for the control group. The above-mentioned changes for risk factors were mainly due to returning participants at each examination.
Conclusion
These interventional methods may be effective in improving overall cardiovascular risk factors in the population. However, the low return participation rate will dilute the effect of the intervention.
Key words: population strategy, intervention, interim assessment, return participation, cardiovascular risk factor
References
- (1).Ueshima H, Mikawa K, Baba S, Sasaki S, Ozawa H, Tsushima M, et al. Effect of reduced alcohol consumption on blood pressure in untreated hypertensive men. Hypertension 1993; 21: 248–252. [DOI] [PubMed]
- (2).Fielding JE, Knight K, Mason T, Klesges RC, Pelletier KR. Evaluation of the IMPACT blood pressure program. J Occup Med 1994; 36: 743–746. [PubMed]
- (3).Iso H, Imano H, Nakagawa Y, Kiyama M, Kitamura A, Sato S, et al. One-year community-based education program for hypercholesterolemia in middle-aged Japanese: a long-term outcome at 8-year follow-up. Atherosclerosis 2002; 164: 195–202. [DOI] [PubMed]
- (4).Fisher KJ, Glasgow RE, Terborg JR. Worksite smoking cessation: a meta-analysis of long-term quit rates from controlled studies. J Occup Med 1990; 32: 429–439. [DOI] [PubMed]
- (5).Kadowaki T, Watanabe M, Okayama A, Hishida K, Ueshima H. Effectiveness of smoking-cessation intervention in all of the smokers at a worksite in Japan. Ind Health 2000; 38: 396–403. [DOI] [PubMed]
- (6).Muto T, Yamauchi K. Evaluation of a multicomponent workplace health promotion program conducted in Japan for improving employees' cardiovascular disease risk factors. Prev Med 2001; 33: 571–577. [DOI] [PubMed]
- (7).Rose G. Sick individuals and sick populations. Int J Epidemiol 2001; 30: 427–432 (Reiteration). [DOI] [PubMed]
- (8).Stamler J, Rose G, Stamler R, Elliott P, Dyer A, Marmot M. INTERSALT study findings. Public health and medical care implications. Hypertension 1989; 14: 570–577. [DOI] [PubMed]
- (9).Scheuermann W, Razum O, Scheidt R, Wiesemann A, von Frankenberg H, Topf G, et al. Effectiveness of a decentralized, community-related approach to reduce cardiovascular disease risk factor levels in Germany. Eur Heart J 2000; 21: 1591–1597. [DOI] [PubMed]
- (10).Steyn K, Steyn M, Swanepoel AS, Jordaan PC, Jooste PL, Fourie JM, et al. Twelve-year results of the Coronary Risk Factor Study (CORIS). Int J Epidemiol 1997; 26: 964–971. [DOI] [PubMed]
- (11).Luepker RV, Rastam L, Hannan PJ, Murray DM, Gray C, Baker WL, et al. Community education for cardiovascular disease prevention. Morbidity and mortality results from the Minnesota Heart Health Program. Am J Epidemiol 1996; 144: 351–362. [DOI] [PubMed]
- (12).Fortmann SP, Varady AN. Effects of a community-wide health education program on cardiovascular disease morbidity and mortality: the Stanford Five-City Project. Am J Epidemiol 2000; 152: 316–323. [DOI] [PubMed]
- (13).World Health Organisation European Collaborative Group. European collaborative trial of multifactorial prevention of coronary heart disease: final report on the 6-year results. Lancet 1986; 1(8486): 869–872. [PubMed]
- (14).Vartiainen E, Jousilahti P, Alfthan G, Sundvall J, Pietinen P, Puska P. Cardiovascular risk factor changes in Finland, 1972–1997. Int J Epidemiol 2000; 29: 49–56. [DOI] [PubMed]
- (15).Iso H, Shimamoto T, Naito Y, Sato S, Kitamura A, Iida M, et al. Effects of a long-term hypertension control program on stroke incidence and prevalence in a rural community in north-eastern Japan. Stroke 1998; 29: 1510–1518. [DOI] [PubMed]
- (16).Iso H, Shimamoto T, Yokota K, Ohki M, Sankai T, Kudo M, et al. Changes in 24-hour urinary excretion of sodium and potassium in a community-based health education program on salt reduction (in Japanese). Nippon Koshu Eisei Zasshi 1999; 46: 894–903. [PubMed]
- (17).Okamura T, Tanaka T, Yoshita K, Chiba N, Takebayashi T, Kikuchi Y, et al. Specific alcoholic beverage and blood pressure in a middle-aged Japanese population: the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study. J Hum Hypertens 2004; 18: 9–16. [DOI] [PubMed]
- (18).Okamura T, Tanaka T, Babazono A, Yoshita K, Chiba N, Takebayashi T, et al. The High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP). Study. Study Design and Cardiovascular Risk Factors at the Baseline Survey. J Hum Hypertens (in press 2004 Jan 29, Epub ahead of print). [DOI] [PubMed]
- (19).Tamaki J, Kikuchi Y, Yoshita K, Takebayashi T, Chiba N, Tanaka T, et al. Stages of Change for salt intake and urinary salt excretion: Baseline results from the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study. Hypertens Res 2004; 27: 157–166. [DOI] [PubMed]
- (20).Tanaka T, Okamura T, Miura K, Kadowaki T, Ueshima H, Nakagawa H, et al. A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens 2002; 16: 97–103. [DOI] [PubMed]
- (21).Nakamura M, Sato S, Shimamoto T. Improvement in Japanese clinical laboratory measurements of total cholesterol and HDL-cholesterol by the US cholesterol reference method laboratory network. J Atheroscler Thromb 2003; 10: 145–153. [DOI] [PubMed]
- (22).Stamler J. The INTERSALT Study: background, methods, findings, and implications. Am J Clin Nutr 1997; 65 (2 Suppl): 626S-642S. [DOI] [PubMed]
- (23).Rose G, Heller RF, Pedoe HT, Christie DG. Heart disease prevention project: a randomised controlled trial in industry. BMJ 1980; 280(6216): 747–751. [DOI] [PMC free article] [PubMed]
- (24).Crawford D. Population strategies to prevent obesity. Only few studies attempted so far and with limited success. BMJ 2002; 325: 728–729. [DOI] [PMC free article] [PubMed]