The Effect of Coronary Health Improvement Project (CHIP) Programs on Managing Risk Factors for Heart Disease.

摘要

This study investigates the effectiveness of the Coronary Health Improvement Projects (CHIP) intervention program to address the epidemic of obesity, chronic disease, and the progressive development of atherosclerosis. For this retrospective analysis of archival cohort data (N = 688; 60.9% female), the transtheoretical model of change and the socioecological model were used to identify how the effectiveness of the CHIP intervention program varied by gender when covariates were controlled. Dependent variables were change in body mass index (BMI) and cholesterol. Modeling of cholesterol change was not successful (r2 = 0.03), with most of the variation unexplained. Unconditional logistic regression analysis of the top 25% of participants who experienced the most weight loss showed that the odds were lower for participants age 64 years and older compared with participants 52 years of age and younger (OR = 0.48; 95% CI = 0.27-0.83; p .01); male participants responded better, compared with females (OR = 2.00; 95% CI = 1.38-2.91; p .001), and outcomes were better in selected cohorts. The analysis also showed that female participants (n = 419) who self-reported heart attacks had greater odds (OR = 10.62; 95% CI = 2.87-39.36; p .001) compared with those who did not. The implications of social change are important as health care professionals create programs with the potential of meeting the needs of an increasingly obese population with relatively poor dietary habits and sedentary lifestyle. The results have shown that tailoring programs for men and women by age group, instead of grouping all ages together, and closer monitoring of their compliance to the program is a crucial link in prospectively increasing the efficacy of lifestyle change programs.