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An evaluation of the effect of a worksite delivered lifestyle intervention programme on anthropometric risk factors for type 2 diabetes and cardiovascular disease
Author(s) -
Di Battista E. M.,
Williams M.,
Rice S.,
Bracken R. M.,
Mellalieu S. D.
Publication year - 2011
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/j.1365-277x.2011.01177_14.x
Subject(s) - medicine , anthropometry , waist , body mass index , physical therapy , intervention (counseling) , type 2 diabetes , gerontology , family medicine , diabetes mellitus , nursing , endocrinology
Background: The government recommend an integrated programme to detect and support those at high risk of developing both type 2 diabetes (T2D) and cardiovascular disease (CVD) (Department of Health, 2008). Prosiect Sir Gâr (the Carmarthenshire Project) a multi‐agency collaboration, was formed to provide risk assessment at the workplace of employees over the age of 40 years, in Carmarthenshire, South Wales. To support those with increased cardiovascular risk, a lifestyle intervention programme (LIP) was developed as a component of Prosiect Sir Gâr and delivered across the Carmarthenshire Health Service and Tata Steel Works, Llanelli, with the aim of facilitating behaviour change to reduce risk factors for CVD and T2D. The aim of this study was to evaluate this programme. Methods: Employees received eight 75 min sessions delivered at their workplace (in Glangwili Hospital, Prince Philip Hospital or Tata Steel Works, Llanelli) by a dietitian (seven sessions) and an exercise specialist (one session) with an emphasis on education and motivation for behaviour change. Weight, body mass index (BMI), waist circumference, and a health and lifestyle questionnaire (HLQ) score were collected at programme commencement and completion. Participant satisfaction was also captured. A maximum of 10 participants were enrolled on a LIP. All employees who undertook the risk screen are reassessed in 6 months, 12 months or 5 years depending on their initial risk profile. Results: To date, six 8‐week programmes have been evaluated and 21 participants have completed. Two participants refused anthropometric measurements post‐LIP. Four participants gained weight with a BMI of 29.5 (5) kg/m − 2 pre‐LIP and a BMI of 29.8 (4.8) kg m − 2 post‐LIP [mean (SD)], respectively. A mean percentage weight gain of 1.1% (0.9%) was observed amongst the four participants. Fifteen participants demonstrated weight reduction post‐LIP with mean a BMI of 35.2 (3.4) kg m − 2 pre‐LIP and a mean of BMI 34.3 (3.3) kg m − 2 post‐LIP, respectively. Among the fifteen participants, mean percentage weight loss was 2.7% (2%) post‐LIP. Among these weight reducers, two participants had a raised waist circumference (WC) post‐LIP; however, mean reduction in WC was 4.9 (3.2) cm. Sixteen participants completed the HLQ, of which 15 demonstrated improved scores. Observations from the post‐pilot phase at 3 months indicates ongoing weight loss in a cohort of six participants where data was taken from CVD risk screening, with a mean percentage weight loss of 6.5% (2.6%). Discussion: In participants motivated to lose weight, observations during the LIP suggest modest changes in anthropometric risk factors of 2.7% mean weight loss and a mean waist circumference reduction of 4.9 cm. Commonly, lifestyle changes begin at the start of intensive intervention. However, the above cohort of six participants suggests that the CVD risk screening may be the point of intervention where participants begin with lifestyle changes. Currently, data are only available up to 3 months post‐LIP and the longer‐term outcomes are yet to be observed. Initial results of 6.5% weight loss suggest that behaviour change can be maintained following an intensive intervention, which suggests the LIP is adhering to current guidelines (SIGN, 2010). Conclusions: Positive anthropometric and health and lifestyle questionnaire results were observed with the pilot phase of this workplace‐based intervention. The results suggest that a lifestyle intervention programme represents a positive start towards behavioural change. Providing a long‐term service structure to support participants with maintaining behavioural changes will offer a complete evaluation and may point towards an effective workplace‐based strategy in CVD and T2D risk reduction. References: Department of Health (2008) Putting Prevention First. Vascular Checks: Risk Assessment and Management. London: Department of Health. Scottish Intercollegiate Guideline Network (SIGN) (2010) Management of Obesity – A National Clinical Guideline .