Evaluation of the Cardiovascular Diseases Prevention Program on changing health behaviors implemented in the local community of Ropczyce and Sędziszów district in Poland
Keywords:
cardiovascular diseases, prevention, health behaviors, program evaluation, the Transtheoretical Model (TTM)Abstract
Introduction: Cardiovascular diseases are the main causes of death in Poland and Europe. They are caused as a result of a variety of risk factors, including lifestyle, which from the point of view of prevention, is an important modifiable factor. Effective prevention programs should not only be aimed at early identification of individuals at increased risk of cardiovascular disease. The actions taken within the framework of these programs should be aimed at the promotion of healthy lifestyles related to education on changing health behaviors.
Aim of study: The aim of this study was to evaluate the effectiveness of the Cardiovascular Diseases Prevention Program implemented on the local level, in the scope of changing health behaviors among program participants.
Method: The study was conducted in 2010 and 2011 in Ropczyce district town in the province of Podkarpackie. The Transtheoretical Model (TTM) was applied to evaluate the results of health education implemented in the program. One year after the intervention, a survey study was conducted by the questionnaire. The following behaviors were analyzed: smoking, low-fat diet, physical activity, regular monitoring of blood pressure, glucose, cholesterol and its fractions in the blood tests and control of the body weight. The study group was consisted of the 104 randomly selected participants of the program residents of the Ropczyce and Sedziszów districts , the ages of 35 to 55 years (mean age 44),. To evaluate the effectiveness of the program the model of “Pretest-Post-Test Only” (Before and After the Program) was applied.
Results: The results showed significant changes in the prevalence of recommended health behaviors among participants in the program. The following health behaviors have been changed significantly: smoking, the use of low-fat diet, physical activity, regular monitoring of blood pressure, glucose, cholesterol and its fractions in blood tests and the body weight. It was also observed significant differences in the prevalence of recommended behaviors due to selected socio - economic characteristics such as: gender, age, level of education. Women were more likely than men to adhere to recommendations for smoking cessation and dietary change. The youngest and the oldest participants of the programme have complied with the recommendations of weight control more often than other age groups respondents. People with low level of education have changed all of the recommended behaviors, except smoking cessation, more likely than those with higher level of education.
Conclusions: It has been shown that participation in this prevention program was associated with a change in health behaviors among a large part of the participants. The change of these behaviors was different due to: age, gender and level of education of the respondents. The success and sustainability of this type of intervention focused on changing behaviors related to prevention of cardiovascular disease conducted on the level of local primary health care depends on the one hand, on professional training in patient’s education, which should use individually tailored educational methods and materials. On the other hand, effective program should consist a long-term implementation of repeated interventions and systematic monitoring and evaluation of its actions.
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Majewicz A, Marcinkowski J.T. Epidemiologia chorób układu krążenia. Dlaczego w Polsce jest tak małe zainteresowanie istniejącymi programami profilaktycznymi? Probl Hig Epidemiol, 2008; 89(3): 322-325.
Bellwon J, Rynkiewicz A. Stan epidemii chorób serca i naczyń. Komu profilaktyka pierwotna, komu wtórna w schorzeniach układu sercowo – naczyniowego? Przew Lek, 2009; 1: 43 – 46.
Janion M. Profilaktyka pierwotna chorób układu krążenia. Stud Med, 2006; 3: 107-119.
Podolec P, Kopeć G, Pająk A. Czynniki ryzyka chorób sercowo - naczyniowych. W: Podolec P. (red.) Podręcznik Polskiego Forum Profilaktyki, Tom I. Medycyna Praktyczna, Kraków 2007; 60 – 74.
Podolec P, Karch I, Pająk A, Kopeć G, Broda G, Drygas W, Rynkiewicz A, Zdrojewski T, Cieśliński A. Najważniejsze polskie programy epidemiologiczne i prewencyjne W: Podolec P. (red.) Podręcznik Polskiego Forum Profilaktyki, Tom I. Medycyna Praktyczna, Kraków 2007; 103 – 109.
Velicer, W. F, Prochaska, J. O, Fava, J. L, Norman, G. J. Smoking cessation and stress management: Applications of the Transtheoretical Model of behavior change. Homeostasis, 1998; 38, 216-233.
Prochaska J.O, Refdding C.A, Evers K. The Transtheoretical Model and Stages of Change. W: K. Glanz, F.M. Lewis F.M., & B.K. Rimer (red,) Health behavior and health education: theory, research and practice (2nded). Jossey-Bass, San Francisco 1997; 60-8.
Malinowska-Cieślik M, Wilczek-Ruzyczka E. Komunikowanie interpersonalne w kształtowaniu motywacji pacjenta do zmiany zachowań zdrowotnych. Zastosowanie modelu transteoretycznego. W: Szczerbińska K, Wilczek-Ruzyczka E. (red.) Jak promować zdrowy styl życia i zmieniać zdrowotne zachowania osób starszych. Wydawnictwo ZiZ, Kraków 2010; 98-107
Łuszczyńska A. Podejścia teoretyczne do zmiany zachowań zdrowotnych:: modele fazowe. W: Łuszczyńska A. Zmiana zachowań zdrowotnych: dlaczego dobre chęci nie wystarczają? Gdańskie Wyd. Psychologiczne, Gdańsk, 2004; 38 – 40.
Zarządzenie Nr 72/2009/DSOZ Prezesa Narodowego Funduszu Zdrowia z dnia 3 listopada 2009 r. w sprawie określenia warunków zawierania i realizacji umów o udzielanie świadczeń w rodzaju: podstawowa opieka zdrowotna
McKenzie J.F, Juris J.L. Planning, Implementing, and Evaluating Health Promotion Programs. New York: Macmllian Publ. Company, New York 1993; 191-223.
Klasyfikacja Zawodów i Specjalności. MPiPS i GUS, Warszawa 2007
Wierucki Ł, Zdrojewski T, Mogilnaya I, Zarzeczna-Baran M, Wizner B, Mędraś M, Popowski P, Jędrzejczyk T, Rutkowski M, Grodzicki T, Wyrzkowski B. Polski Projekt 400 Miast – wyniki badań pilotażowych, Arterial Hypertension, 2004; 8(5): 307 – 317.
Piwońska A, Piwoński P, Piotrowski W, Posadzy-Małaczyńska A, Drygas W, Wiercińska E, Kozakiewicz K, Zdrojewski T. Realizacja zasad prewencji chorób układu krążenia przez lekarzy POZ w populacji generalnej. Wyniki programu WOBASZ. Kardiologia Polska, 2005; 63(6): 1-4.
Rywik S, Kupść W, Piotrowski W, Broda G, Piwoński J, Kurjata P, Waśkiewicz A, Gaździk D. Wieloośrodkowe ogólnopolskie badanie stanu zdrowia ludności – projekt WOBASZ. Założenia metodyczne oraz logistyka. Kardiologia Polska 2005; 63 (6): 1-9.
Sulicka J, Fornal M, Gryglewska B, Wizner B, Grodzicki T. Wybrane czynniki ryzyka chorób sercowo – naczyniowych u pacjentów podstawowej opieki zdrowotnej, Nadciśnienie Tętnicze, 2006; 10(5): 370–376.
Fanaian M, Laws RA, Passey M, McKenzie S, Wan Q, Davies GP, Lyle D, Harris MF. Health improvement and prevention study (HIPS) - evaluation of an intervention to prevent vascular disease in general practice. BMC Fam Pract, 2010; 5: 11-57.
Balcazar HG, Byrd TL, Ortiz M, Tondapu SR, Chavez M. A randomized community intervention to improve hypertension control among Mexican Americans: using the promotoras de salud community outreach model. J Health Care Poor Underserved, 2009; 20(4): 1079-94.
Balcazar H, Alvarado M, Hollen M.L, Gonzalez-Cruz Y, Pedregón V. Evaluation of Salud Para Su Corazon (Health for Your Heart) – National Council of La Raza Promotora Qutreach Program. Preventing Chronic Disease. Public Health Research, Practice and Policy, 2005; 2(3): 1-9.
Rocha-Goldberg Mdel P, Corsino L, Batch B, Voils CI, Thorpe CT, Bosworth HB, Svetkey LP. Hypertension Improvement Project (HIP) Latino: results of a pilot study of lifestyle intervention for lowering blood pressure in Latino adults. Ethn Health, 2010; 15(3): 269 – 282.
Sarrafzadegan N, Kelishadi R, Esmaillzadeh A, Mohammadifard N, Rabiei K, Roohafza H, Azadbakht L, Bahonar A, Sadri G, Amani A, Heidaric S, Malekafzali H. Do lifestyle interventions work in developing countries? Findings from the Isfahan Healthy Heart Program in the Islamic Republic of Iran. Bull World Health Organ, 2009; 87(1): 39-50.
Bellwon J. Prospektywa ocena zmian profilu ryzyka oraz częstości występowania incydentów sercowo – naczyniowych w kohorcie pracowników Portu Gdańskiego w siedmioletniej obserwacji [rozprawa doktorska] Gdańsk 2007.
Merrill RM, Aldana SG, Ellrodt G, Orsi R, Grelle-Laramee J. Efficacy of the Berkshire Health System Cardiovascular Health Risk Reduction Program. J Occup Environ Med., 2009; 51(9): 1024-31.
Kubica A. Edukacja zdrowotna w chorobach układu krążenia — możliwości i zagrożenia, Folia Cardiologica Excerpta, 2006; 1(4): 177–181.
Szczęch R, Szyndler A, Wierucki Ł, Zdrojewski T, Narkiewicz K, Wyrzykowski B. Jak poprawić skuteczność terapii nadciśnienia tętniczego? Doświadczenia z programu edukacji pacjentów w ramach Polskiego Projektu 400 Miast, Arterial Hypertension, 2006; 10(5): 350 – 36.
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