Development and Economic Evaluation of Efficient Lifestyle-related Disease Prevention Programs Based on Health Behavior Theories

为明确企业对职场生活方式疾病预防计划的需求，对1,372家企业进行了问卷调查。目前该计划的实施率和未来的实施计划均低于精神卫生问题计划，这表明需要对职业卫生人员进行生活方式疾病预防教育，并需要制定有吸引力的计划。对职业医生和保健护士的听力调查结果表明，考虑到由于信息技术的发展而出现的多样化工作方式，以及引入参与式研讨会或从经验中学习的重要性。基于这些调查结果，我们开发了一种生活方式自我评估的教育工具，名为健康管理(HM)21，融合了阶段理论、先行模型、行为理论和社会学习理论。由Health NU…开展的健康教育计划随着HM21的使用，还开发了更多用于改善饮食和体育活动习惯的RSE。这些方案在三个不同工作类别的工作场所实施。受试者是患有肥胖、糖耐量异常、高血压或高脂血症等异常的男性员工，但没有服用药物。采用准实验设计，控制组由在同一工作场所工作的年龄匹配的男性员工组成。在销售代表的情况下，干预组使用HM21由健康护士提供健康指导(每名员工30分钟)，对照组通过公司内邮寄服务获得生活方式相关疾病的预防信息。与对照组相比，干预组的总胆固醇明显降低。在一家建筑相关公司，干预组员工的配偶接受为期2小时的集体营养教育，对照组在不使用HM21的情况下接受健康护士的健康指导(每名员工10分钟)。与对照组相比，干预组的总胆固醇也有明显下降。在某健康相关公司总部，干预组在公司内部网络中展示受试者的身体形象，并利用行为理论和工作环境为其提供减肥教育方案。干预组的体重、肥胖度、腰围均明显低于对照组。从雇主的角度对这些计划进行了经济评估，成本效益分析表明，这些计划在降低总胆固醇和体重方面具有成本效益。较少

A questionnaire survey was conducted in 1,372 companies to clarify the needs of companies for the lifestyle disease prevention program in the workplace. The current rate of implementation of the program and future plan of implementation were lower compared with the program for mental health issues, suggesting the education of lifestyle disease prevention for occupational health staff and the need of development of attractive programs. The results of the hearing survey for occupational physicians and health nurses suggested the importance of considering the diversified work-styles due to the development of information technology, and introduction of participatory seminars or learning by experiences. Based on these survey results, we developed an educational tool for the self-assessment of lifestyles with the name of Health Management (HM) 21, incorporating stage theory, PRECEDE model, behavioral theories, and social learning theory. Health education programs to be conducted by health nu … More rses for the improvement of dietary and physical activities habits with the use of HM21 were also developed. These programs were implemented in three workplaces with different job categories. Subjects were male employees with one of those abnormalities : obesity, glucose intolerance, hypertension, or hyperlipidemia, but without medication. Quasi-experimental design was used, and control groups were consisted of age-matched male employees working in the same workplace. In the case of sales representatives, intervention group was provided with health guidance (30 minutes per employee) from health nurses by using HM21, and control group was given information on the prevention of lifestyle related diseases through in-company mailing services. There was a significant decrease in total cholesterol in the intervention group compared with the control group. In a construction related company, spouses of the employees in the intervention group was given a collective nutrition education for two hours, and the control group was provided with health guidance (10 minutes per employee) from health nurses without using HM21. There was also a significant decrease in total cholesterol in the intervention group compared with the control group. At a headquarter of health related company, intervention group was provided with weight loss education program using behavioral theories and workplace environment in that body images of the subjects were shown in the intra-net of the company. There were significant decrease in body weight, adiposity and waist circumference in the intervention group than in the control group. Economic evaluation of these programs was conducted from the viewpoint of employers, and cost-effective analysis revealed that these programs were cost-effective in the reduction of total cholesterol and body weight. Less