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

在1,372家企业中进行了问卷调查，以明确企业对工作场所生活方式疾病预防计划的需求。与精神卫生问题方案相比，方案的当前执行率和未来执行计划较低，这表明需要对职业卫生人员进行预防生活方式疾病的教育，并需要制定有吸引力的方案。对职业医师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，并引入参与式研讨会或经验学习的多样化的工作方式的重要性。基于这些调查结果，我们开发了一个教育工具的生活方式的自我评估的名称为健康管理（HM）21，结合阶段理论，PRECEDE模型，行为理论，社会学习理论。卫生署推行健康教育计划 ...更多信息 还开发了使用HM 21改善饮食和体育活动习惯的方法。这些方案在三个不同工作类别的工作场所实施。受试者为男性员工，有以下异常之一：肥胖、葡萄糖耐受不良、高血压或高脂血症，但未接受药物治疗。采用准实验设计，控制组由年龄匹配的男性员工在同一工作场所。在销售代表的情况下，干预组由保健护士使用HM 21提供健康指导（每位员工30分钟），对照组通过公司内部邮件服务提供预防生活方式相关疾病的信息。与对照组相比，干预组的总胆固醇显著降低。在一家建筑相关公司，对干预组员工的配偶进行为期2小时的集体营养教育，对照组由保健护士提供健康指导（每位员工10分钟），但不使用HM 21。与对照组相比，干预组的总胆固醇也有显着下降。在一家健康相关公司总部，以行为理论及工作环境为指导，透过公司内部网路呈现被试者的身体意象，以提供减重教育。干预组体重、肥胖度、腰围均较对照组明显下降。从雇主的角度对这些方案进行了经济评估，成本效益分析表明，这些方案在降低总胆固醇和体重方面具有成本效益。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