Maintenance of blood pressure treatment and control after discontinuation of work site follow-up

Article Abstract:

In the United States the control of high blood pressure is unsatisfactory, despite improvements in nationwide educational programs and campaigns. In 1978, four manufacturing plants were selected for inclusion in a three-year study that evaluated the feasibility and cost-effectiveness of four methods of hypertension intervention and control. Each industrial site provided one method of hypertension treatment and/or follow-up. The present study evaluated the adequacy of blood pressure control four years after the original study ended. The first site, known as the control site, referred those with elevated blood pressure (BP) to their personal physicians. No further contact was made with these individuals for three years. The second site, modified follow-up, referred those with elevated BP to community physicians and, in addition, provided on-site hypertension follow-up and counselling every six months. Full follow-up, the third site, was the same as site two, but also provided hypertension follow-up as needed on-site and communicated with personal physicians. The fourth site, on-site treatment, was the same as site two, but offered a choice of complete on-site or community-based treatment and follow-up. The intervention period ended in 1981 and rescreening began in 1985. The number of persons with hypertension who were aided by participating in any of the programs declined after the intervention stopped. The principal predictors associated with continued blood pressure control were the numbers of blood pressure checks and physician visits. Monitoring did not reduce hypertension, but it made those with elevated BP aware of the need for follow-up treatment. Although demographic factors, such as age and sex, are associated with hypertension, they were not barriers to control in this study. Many of the persons whose blood pressure was controlled as a result of monitoring and counseling efforts, appeared to be at risk of returning to their original status as control efforts ceased. The benefits of on-site hypertension monitoring and counseling suggest that these services be available at the work site as permanent programs. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Services, Hypertension, Testing, Occupational health services

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The cost-effectiveness of work-site wellness programs for hypertension control, weight loss, and smoking cessation

Article Abstract:

Work-site wellness programs have been initiated to reduce employees' risks of cardiovascular disease (CVD). A review was conducted of control programs aimed at three CVD risk factors: hypertension (high blood pressure), obesity, and smoking. Prior to initiating such programs, employers and employee groups need to know their approximate cost and effectiveness. Four different programs were initiated at four automobile manufacturing facilities. The cost of implementing these different models and their relative cost effectiveness in reducing and preventing the above mentioned risk factors were studied. Each of the four plants established a wellness committee with labor, management, and medical services representatives. A wellness screening program was conducted for four weeks that included blood pressure, height, and weight measurements, along with information on exercise, smoking, and alcohol consumption. Participants were predominantly white males, between 39 and 43 years old. Site 1 was the control site, which provided additional post screening activity. Site 2 maintained an active wellness committee, using a variety of ongoing health education methods to supplement the initial screening. Site 3 added a follow-up, one-to-one counselling program to the health education program. Site 4 added an on-site plant based organization, which conducted the support activities. As the programs were expanded, the cost per employee also rose. Costs ranged from $2.97 for site 1 to $38. 31 for site 4. Program effectiveness, measured by reduction in targeted risks, were identified by a 20 percent weight loss; cessation of smoking; and high blood pressure reduced to borderline or normal levels. Sites 3 and 4 produced more beneficial effects than the other program organizations. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Cardiovascular diseases, Prevention

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Health promotion in small business: what works and what doesn't work

Article Abstract:

A worksite wellness program implemented in sites with 1,500 to 3,000 employees was used as a model from which a similar project could be developed and implemented without loss of benefits and advantages for worksites with 5 to 500 employees. The adapted programs were installed in three worksites having 5 to 296 employees. The sites were a school district with 296 employees; an aircraft maintenance shop with 77 employees; and a gasoline station with five workers. Included in the program were: screening for blood pressure, blood cholesterol, percent overweight, physical fitness, stress and cigarette smoking, and other clinically significant tests; referral of at-risk employees to medical intervention and treatment; implementation of on-site wellness programs, with a menu of services; and provision of long-term follow-up and one-to-one counselling of employees at high risk of cardiovascular disease. The programs and menus offered to the participants, and the results of the trial period, are described in detail. Employee participation was satisfactory in the sites where employers paid the cost of the programs. Responses to individual intervention efforts at each site are described and discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Small business, Medical screening, Health screening, Workers

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