背景:高血压相关知识,高血压患者的态度和行为(KAP)会影响认知,治疗和控制高血压。然而,使用纵向数据很少关注职业人群中高血压预防性KAP的变化与血压(BP)控制之间的关系。我们评估了基于工作场所的多组分高血压干预计划对提高高血压预防KAP水平的有效性,以及干预期间KAP改善与BP控制之间的关联。
方法:从2013年1月至2014年12月,中国20个城市地区的工作场所被随机分为干预组(n=40)或对照组(n=20)。要求每个工作场所的所有员工完成横断面调查,以筛查高血压患者。干预组高血压患者采用为期2年的基于工作场所的多成分高血压干预来控制血压。观察两组干预前后高血压防治KAP、BP水平。
结果:总体而言,纳入3331名参与者(干预组2658名,对照组673名)(平均[标准差]年龄,46.2[7.7]岁;2723名男性[81.7%])。经过两年的干预,干预组KAP合格率为63.2%,对照组为50.1%(比值比=1.65,95%CI,1.36~2.00,P<.001)。与对照组比较,高血压预防KAP问卷各项目合格率下降,干预组所有项目均有不同程度的增加。干预后KAP评分的升高与BP水平的降低有关。KAP得分增加1分,收缩压(SBP)下降0.28mmHg,舒张压(DBP)下降0.14mmHg[SBP:β=-0.28,95CI:-.48~-.09,P=.004;DBP:β=-.14,95CI:-.26-.02,P=.024]。体力劳动工人的SBP和DBP显着(SBP:β=-.34,95CI:-.59~-.09,P=.008;DBP:β=-.23,95CI:-.38-.08,P=.003),私营企业的工人,国有企业(SOE)(SBP:β=-.40,95CI:-.64~-.16,P=.001;DBP:β=-.21,95CI:-.36--.06,P=.005)和附属医院的工作场所(SBP:β=-.31,95CI:-.11,P=.003;DBP:0-.28=β知识的改进(SBP:β=-.29,95CI:-.56~-.02,P=.038;DBP:β=-.12,95CI:-.29~.05,P=.160),以及态度(SBP:β=-.71,95CI:-1.25~-.18,P=.009;DBP:β=.18,95CI:-.23~.59,P=.385)和行为(SBP:β=-.73,95CI:-1.22~.23,P=.23,P=.
结论:这项研究发现,基于工作场所的多组分高血压干预可以有效提高员工的高血压预防KAP水平,KAP水平的改善与血压控制显著相关。
背景:中国临床试验登记号.ChiCTR-ECS-14004641。
BACKGROUND: Hypertension-related knowledge, attitude and practice (
KAP) of hypertensive patients can affect the awareness, treatment and control of hypertension. However, little attention has been paid to the association between the change of hypertension preventive KAP and blood pressure (BP) control in occupational population using longitudinal data. We assess the effectiveness of a workplace-based multicomponent hypertension intervention program on improving the level of KAP of hypertension prevention, and the association between improvement in KAP and BP control during intervention.
METHODS: From January 2013 to December 2014, workplaces across 20 urban regions in China were randomized to either the intervention group (n = 40) or control group (n = 20) using a cluster randomized control method. All employees in each workplace were asked to complete a cross-sectional survey to screen for hypertension patients. Hypertension patients in the intervention group were given a 2-year workplace-based multicomponent hypertension intervention for BP control. The level of hypertension prevention KAP and BP were assessed before and after intervention in the two groups.
RESULTS: Overall, 3331 participants (2658 in the intervention group and 673 in the control group) were included (mean [standard deviation] age, 46.2 [7.7] years; 2723 men [81.7%]). After 2-year intervention, the KAP qualified rate was 63.2% in the intervention groups and 50.1% in the control groups (odds ratio = 1.65, 95% CI, 1.36∼2.00, P < .001). Compared with the control group decreased in the qualified rate of each item of hypertension preventive KAP questionnaire, all the items in the intervention group increased to different degrees. The increase of
KAP score was associated with the decrease of BP level after intervention. For 1 point increase in KAP score, systolic blood pressure (SBP) decreased by .28 mmHg and diastolic blood pressure (DBP) decreased by .14 mmHg [SBP: β = -.28, 95%CI: -.48∼-.09, P = .004; DBP: β = -.14, 95%CI: -.26∼-.02, P = .024]. SBP and DBP was significantly in manual labor workers (SBP: β = -.34, 95%CI: -.59∼-.09, P = .008; DBP: β = -.23, 95%CI: -.38∼-.08, P = .003), workers from private enterprise, state-owned enterprise (SOE) (SBP: β = -.40, 95%CI: -.64∼-.16, P = .001; DBP: β = -.21, 95%CI: -.36∼-.06, P = .005) and a workplace with an affiliated hospital (SBP: β = -.31, 95%CI: -.52∼-.11, P = .003; DBP: β = -.16, 95%CI: -.28∼-.03, P = .016). The improvement of knowledge (SBP: β = -.29, 95%CI: -.56∼-.02, P = .038; DBP: β = -.12, 95%CI: -.29∼.05, P = .160), as well as attitude (SBP: β = -.71, 95%CI: -1.25∼-.18, P = .009; DBP: β = .18, 95%CI: -.23∼.59, P = .385) and behavior (SBP: β = -.73, 95%CI: -1.22∼-.23, P = .004; DBP: β = -.65, 95%CI: -.97∼-.33, P < .001) was gradually strengthened in relation to BP control.
CONCLUSIONS: This
study found that workplace-based multicomponent hypertension intervention can effectively improve the level of hypertension preventive KAP among employees, and the improvement of
KAP levels were significantly associated with BP control.
BACKGROUND: Chinese Clinical
Trial Registry No. ChiCTR-ECS-14004641.