The purpose of this study was to explore the fundamental factors for the development of a prevention program for life-style related diseases using a health examination and follow-up services in primary care setting for community health. The research subjects were 22 persons (4 males and 18 females) who had any factors for life-style related diseases in a health examination carried out in the 2001 fiscal year in a city. They included five persons (who judged as to be needed a lifestyle improvement by a medical doctor), five public-health-service participants, and twelve members of self-promotion group in the community. For six months from October, 2001 to March, 2002, the program was provided through a regular(once a month) health learning class for 90 minutes per session. After the health examination, subjects were selected as a life-style related disease high-risked population. The health status was assessed by a self-reported questionnaire and a fitness test before and after the class. They set up the goal for change in behaviors individually with having the support from the health staffs. The program repeated practice of goal behavior, the target revision by individual consultation, and the group work in the classes. They consulted the health examination one year after. In the class, the participant learned how to exercise at home and self-monitoring method for exercise and dietary practices by receiving lectures and instructions concerning exercise and diet in daily life. The utility was evaluated by the implementation and the process of the program. The implementation was assessed by a participating rate (defined as the number of persons consulted the two health examinations divided by the numbers of the subjects), an attendance rate (defined as the attendance times divided by six times), and a submit rate (defined as the number of submitted sheets divided by five sheets) and an entry rate (defined as the number of entering days divided by one hundred forty days) of the self-monitoring sheets. The process was assessed by an attending rate (defined as the monthly number of attendants divided by the number of the subjects), a collecting rate of the self-monitoring sheets (defined as the monthly number of the sheets collected divided by the number of the subjects), and self-monitoring for exercise (daily average number of steps). The effectiveness was assessed by the changes in behavioral (the exercise and diet stage of change), physical (the 3-minute walk distance), and medical indices (the life-style instruction category). The results obtained as follows: 1) The participating rate was 100%, mean (standard deviation) of the attendance rate was 82.6 (20.9)%. 2) The submit rate and the entry rate of the self-monitoring sheets was 83.6 (14.7)% and 67.3 (18.0)%, respectively. 3) The attending rate was 81.8% at the first, 90.9% at the second, 81.8% at the third, 90.9% at the fourth, 72.7% at the fifth, and 77.3% at the sixth class. The collecting rate was 90.9% at the first, 95.5% at the second, 100% at the third, 81.8% at the fourth, and 50.0% at the fifth month. The mean (standard deviation) of daily average number of steps was 6784 (2582) before the intervention, 8,198 (2732) at the first, 6798 (2121) at the second, 7171 (2599) at the third, 7294 (2140) at the fourth, and 7900 (2760) at the fifth month. The main effect of time was not significant. 4) Those who improved the exercise and diet stage of change between before and after the intervention were three and seven subjects, respectively. There were no significant changes both in exercise (p=0.83) and in diet (p=0.29) behavior. 5) The 3-minute walk distance significantly increased after the intervention both in male (24m, p<0.01) and in female (20m, p=0.05). 6) Those who changed for improvement, not changed, and changed for the worse in the life-style instruction category were eleven, nine and two subjects, respectively. There was significantly improvement after the intervention (p=0.01). The program can be highly utilized for a life-style related disease high-risk population screened by a health examination in community because of very good implementation (the participating rate, the attendance rate, and the submit rate) and acceptable process (the attending rate). The results indicated the effectiveness of the program concerning of the physical and medical indices. On the other hand, the program should be improved for the less of the entry rate, the collecting rate, and self-monitoring for exercise and further sophisticated to support changes for exercise and diet behaviors. The changes in these indices couldn't be elucidated by the program because of the intra group design without the control group. For further development, screening and recruiting the participants, supportive tools need improvement in order to widely applicable for the high-risk population and effectively for the change in exercise and diet behaviors.
|ジャーナル||Bulletin of the Physical Fitness Research Institute|
|出版ステータス||Published - 2004 3月|
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