| Background In recent years,although the prevention and control of chronic diseases has been gradually increased,the situation remained severe.Chronic diseases,such as cerebrovascular diseases and malignant tumors,have become the main causes of death.The death toll from the chronic diseases has accounted for 86.6% of the total deaths in the country and the resulting disease burden accounts for nearly 70% of the total disease burden.Relevant studies have shown that smoking,irrational diet and insufficient physical activity were risk factors for chronic diseases.Through early detection of high-risk population of chronic diseases and timely health management,the occurrence of chronic diseases could be prevented and delayed.The staff in the institutions were the main groups serving the community,which had special nature of work,they were significantly different from those in other community groups in smoking status,diet and the level of physical activity.So conducted early detection of the characteristics of smoking,diet and physical activity of high-risk groups of chronic diseases in the institutions,understanding the influencingfactors,and timely health management interventions could help us reduce the risk of chronic diseases in groups and individuals,and prevent and delay the occurrence of chronic diseases.Objective This study used one-year intervention and follow-up data to comprehend the changes of smoking,diet and physical activity among high risk groups of chronic diseases in the institutions of Chongqing,and to evaluate the effects of interventions.So as to provide effective references and suggestions for health management intervention in the later stage.Method The subjects of the study were all over 18 years old in the institutions of Chongqing.The samples were selected by cluster sampling method.Sat Yuzhong District and Jiulongpo District as the intervention group,Dadukou District and Shapingba as the control group.And the intervention group was managed by the combination of environment,group and individual intervention.The subjects at baseline(545 in the intervention group and 749 in the control group)and the subjects of the follow-up for 1 year(380 in the intervention group and 576 in the control group)The survey was conducted from April 2017 to April 2018.Investigators who have passed the municipal-level unified training and passed the examination will participate in the on-site investigation.The survey included general information,family history,health information,smoking and drinking,diet,and physical activity.The database was built using EpiData 3.1,and all data was entered in double-blind.The data wasstatistically analyzed by SPSS 21.0.The demographic characteristics of the personnel of the institution was descriptively analyzed,and the smoking,diet and physical activity were compared between the intervention group and the control group.Single factor analysis was performed by chi-square test and evaluate the intervention effect by Difference in difference and Logistic regression.Results (1)Smoking rate and awareness of tobacco hazards After1 year of intervention,the current smoking rate and daily smoking rate of the intervention group decreased by 9.48% and 8.94%,respectively,and the differences were statistically significant(P<0.05).The current smoking rate and daily smoking rate of the control group all increased,which increased by 10.59% and 7.47%,respectively,and the differences were statistically significant(P<0.05).Logistic regression model indicated that the current smoking rate OR=0.31,95%CI(0.20-0.49),and current daily smoking rate OR=0.34,95%CI(0.21-0.54)were reduced by the intervention.In terms of the cognition of tobacco harm,the correct cognition of smoking causing serious disease,stroke,heart attack,lung cancer and low-tar cigarettes is no less harmful than ordinary cigarettes in the intervention group increased by5.79%,28.68%,23.69%,11.84% and 12.10%,respectively,and the differences were statistically significant(P<0.05).The correct cognition of smoking causing serious disease,stroke,heart attack,lung cancer and low-tar cigarettes is no less harmful than ordinary cigarettes in the controlgroup increased by 0.35%,15.98%,17.54%,2.25% and 9.03%,respectively,and the differences of smoking causing stroke,heart attack and low-tar cigarettes is no less harmful than ordinary cigarettes were statistically significant(P<0.05).Logistic regression model indicated that the subjects receiving the intervention had an improvement in the cognition of tobacco harm,such as smoking causing serious disease OR=0.46,95%CI(0.23-0.93),stroke OR=0.58,95%CI(0.39-0.86),lung cancer OR=0.46,95%CI(0.27-0.80).(2)Diet structure and cognition After 1 year of follow-up and intervention,it was found by using the difference in difference that the staple food,milk and milk products and fresh fruit in the intervention group increased by 31.73 g/d,22.67 g/d and 51.12g/d,respectively(P < 0.05).In terms of cognitive changes in dietary oil control,the knowledge of the recommended intake of dietary fats and oils of Chinese residents and the correct answer to the recommended intake of dietary oils and fats of Chinese residents all increased significantly in the intervention group,by15.52% and 48.83%,respectively,and the differences were statistically significant(P<0.05).The knowledge of the recommended intake of dietary fats and oils of Chinese residents and the correct answer to the recommended intake of dietary oils and fats of Chinese residents all increased significantly in the control group,by 11.98% and 29.60%,respectively,and the differences were statistically significant(P<0.05).Logistic regression model indicated that interventions can improve the correct answer to the recommended intake of dietary oils and fats of Chinese residents OR=0.36,95% CI(0.16-0.82).In terms of cognitive changes in dietary salt control,the knowledge of the recommended intake of dietary salt in Chinese residents,the education of accepting low-salt diet and the excessive salt intake leading to stroke,myocardial infarction,and kidney disease all increased significantly in the intervention group,which increased by 22.89%,18.42%,20.79%,15.26% and 3.15% respectively,and except for kidney disease caused by excessive salt consumption,other differences were statistically significant(P < 0.05).After 1 year follow-up,the correct cognition of the corresponding knowledge in the control group also increased significantly,and the intervention measures did showed any additional improvement effect.(3)Changes in levels of physical activity After 1-year follow-up,the number of active and regular exercise increased in the intervention group,by 4.21% and 2.89%,respectively.The number of moderate and insufficient people decreased,by 0.79% and 3.42%,respectively.Besides regular exercise,the difference was statistically significant(P < 0.05).The number of people with active,moderate and regular physical activity decreased in the control group,by 1.39%,13.03% and 9.20%,respectively.The number of insufficient people increased by 14.41%,and the difference was statistically significant(P < 0.05).Logistic regression model indicatedthat the intervention can increase the level of physical activity and he habit of making regular exercise of the investigated subjects,with moderate activity intensity OR=0.51,95% CI(0.30-0.87),active activity intensity OR=0.26,95%CI(0.10-0.70)and the habit of making regular exercise OR=0.50,95%CI(0.33-0.77).Conclusion After health management,the current smoking rate,daily smoking rate and the level of insufficient physical activity of the people in high risk groups of chronic diseases in the institutions of Chongqing have all decreased.The correct knowledge of tobacco hazard related knowledge,knowledge of partial oil control,physical activity and regular exercise have all risen.Therefore,it was necessary to carry out health management for the high risk groups of chronic diseases.However,a high proportion of some bad behaviors indicateed that the current comprehensive intervention for chronic diseases still had problems in the improvement of the diet and physical activity.It was necessary to further strengthen publicity to further improve the awareness of residents' relevant knowledge and promote the formation of healthy behaviors. |
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