Clustering of lifestyle risk factors in employees: A quasi-experimental study in Sousse, Tunisia

Abstract

Background:A better understanding of the prevalence and clustering patterns of multiple lifestyle-related health factors may support efforts to handle efficiently chronic diseases, reduce their incidence and improve overall health outcomes. This study aimed to evaluate the effectiveness of a three-year based intervention in the workplace on clustering of non-communicable diseases' risk factors. Methods:We based our study on a quasi-experimental intervention study (pre and post assessments with intervention and control groups) between 2010 and 2014 in two districts in the governorate of Sousse. The evaluation before and after the intervention focused on the attitudes and behaviors of participants. The intervention program team conducted several actions for the employees at the workplace focusing on physical activity, healthy diet promotion and smoking cessation. Results:In the intervention group, participants who had no risk factor increased significantly from 5.9% to 10.3% (p<0.001) but not significantly in the control group from 9.5% to 12.5 (p=0.064). Those who had only one risk factor increased significantly from 24.8% to 29.2% (p=0.03) in the intervention group but decreased in the control group from 32.2% to 28.8% (p=0.14). Furthermore, the proportion of employees who had 4 risk factors increased in the control group significantly, from 3.3% to 6.8% (p<10 -3 ). Conclusion:The positive co-variation represents one novel approach in which effective action on one handled behavior increases the odds of effective change on a second targeted behavior. Hence, the concept of intervening simultaneously on multiple risk behaviors might be a focus of attention as a means of preventing chronic diseases.

Clustering of behavioral risk factors for chronic noncommunicable diseases in climacteric women

“…Studies indicate that programs focused on health promotion intervention and awareness on multiple risk factors, such as smoking, physical activity and diet simultaneously, are more effective in reducing chronic NCD. (13,14) It is believed that people with clustering of risk factors can be motivated and sensitized more quickly, so that they are more responsive to intervention programs. (13) The low consumption of fruit, the second most prevalent factor, may be related to the high cost it represents, especially when considering low-income populations, or even because they are being neglected, given the wide availability of fast foods and processed products.…”

“…(13,14) It is believed that people with clustering of risk factors can be motivated and sensitized more quickly, so that they are more responsive to intervention programs. (13) The low consumption of fruit, the second most prevalent factor, may be related to the high cost it represents, especially when considering low-income populations, or even because they are being neglected, given the wide availability of fast foods and processed products. (27) A study evaluating markers of food consumption found, with the greater purchasing power through the Bolsa Família Program, there was an increase in the consumption of foods considered unhealthy.…”

“…(11) Although the role of each of these risk factors has been well established individually, their clustering occurs repeatedly, and some have synergistic action; this simultaneous exposure is a reason for worsening and poor prognosis. (12)(13)(14) There is little information on clustering of risk factors in the literature and even less addressing the group of climacteric women. It is believed that a better understanding of clustering of inappropriate behaviors in this population should enable implementing public policies, which are more effective to reduce injuries and deaths due to chronic NCD.…”

Risk Behaviors for Chronic Noncommunicable Diseases in Medical Students

“…Os fatores de risco para as Doenças Crônicas Não-Transmissíveis (DCNT) estão relacionados aos hábitos de vida, entre eles se destacam a obesidade, o sedentarismo, a dieta inadequada e o tabagismo 11 . Apesar do papel de cada um desses fatores de risco estar bem estabelecido, a aglomeração deles, além de ocorrer sistematicamente, é agravante e favorece um pior prognóstico, considerando o efeito multiplicativo da associação 12,13 . É relevante destacar que a simultaneidade ou aglomeração desses fatores é relativamente comum, considerando a grande interrelação entre eles.…”