长期个性化健康管理对重庆市机关事业单位慢性病高风险人群健康干预效果分析

Effect of long-term personalized health management on health intervention for people with high risk of chronic diseases in government organs and public institutions in Chongqing

目的 评估长期个性化健康管理对重庆市机关事业单位慢性病高风险人群慢性病风险因素认知、生活方式与健康指标的影响,为进一步优化机关事业单位人群的健康管理模式提供依据。方法 于2017—2019年选择重庆市4个经济文化相当的主城区随机分为干预组和对照组,每组各2个区,在每个区中各随机整群抽取15个机关事业单位,被抽中单位的全体职工纳入筛查,分别有314与447名机关事业单位高风险人员纳入研究。干预组按照风险分级进行2年个性化健康管理,对照组不采取任何干预措施。使用SPSS 25.0软件进行配对χ^(2)检验,干预前后的净效应采用倍差法拟合logistic回归模型进行分析。结果 干预组与对照组平均年龄分别为(41.3±9.5)、(39.6±9.2)岁。倍差法回归分析的结果显示,2年个性化健康管理可以提升研究对象的成人每日摄盐量知晓率(OR=3.040,95%CI:1.952~4.734);降低吸烟率(OR=0.267,95%CI:0.155~0.460)、饮酒率(OR=0.317,95%CI:0.169~0.594)和蔬菜水果摄入不足比例(OR=0.475,95%CI:0.298~0.757);增加红肉摄入过多的比例(OR=3.399,95%CI:2.200~5.253);降低高血压前期(OR=0.387,95%CI:0.242~0.617)及中心性肥胖(OR=0.616,95%CI:0.394~0.963)的比例。结论 机关事业单位慢性病高风险人群经长期个性化健康管理,能有效提高部分膳食知识知晓率,促进相关健康行为的形成,改善健康指标,降低该人群的慢性病高风险水平。

Objective To evaluate the impact of long-term personalized health management on the cognition of chronic disease risk factors,lifestyle and health indicators among people with high risk of chronic diseases in government offices and public institutions in Chongqing,and provide the basis for further optimization of health management models in people of government offices and public institutions.Methods From 2017 to 2019,four main urban areas with economic and cultural similarity in Chongqing were selected and randomly divided into intervention group and control group.Each group had 2 districts,and 15 government institutions were randomly selected in each district.All employees of the selected units were included in the screening,and 314 and 447 high-risk personnels from government offices and public institutions were included in the study,respectively.The intervention group underwent personalized health management for 2 years according to the risk classification,and the control group had no intervention measures.Pairedx2test was used to analyze the data.The net effect before and after the intervention was analyzed by fitting the logistic regression models with the fold difference method.The used software was SPSS 25.0.Results The average ages of the intervention group and the control group were(41.3±9.5)and(39.6±9.2)years old,respectively.The results of the fold difference method regression analysis showed that two-year personalized health management could improve the daily awareness rate of adult salt intake among the study subjects(OR=3.040,95%CI:1.952-4.734);reduce smoking rate(OR=0.267,95%CI:0.155-0.460),alcohol consumption rate(OR=0.317,95%CI:0.169-0.594)and insufficient proportion of vegetables and fruits(OR=0.475,95%CI:0.298-0.757);increase the excess intake of red meat(OR=3.399,95%CI:2.200-5.253);reduce the proportions of pre-hypertension(OR=0.387,95%CI:0.242-0.617),and central obesity(OR=0.616,95%CI:0.394-0.963).Conclusion Through long-term personalized health management,people with high risk of chronic diseases in government organs and public institutions can effectively improve the awareness rate of some dietary knowledge,promote the formation of related health behaviors,improve health indicators,and reduce the high risk level of chronic diseases.