A Systematic Review of Interventions for Workers with Cardiovascular Disease Risk Factors: Using an Ecological Model

Abstract

The purposes of this study were to review the research trends and to identify developmental direction of studies on community interventions according to the ecological model for workers with cardiovascular diseases (CVD) risk factors. Methods: Electronic databases including PsycINFO, PubMed, EMBASE, CINAHL, and Cochrane Library and the reference lists of articles were searched. All articles were assessed in relation to inclusion and exclusion criteria, resulting in 29 researches being reviewed. Each review was critically appraised by two authors using a guideline of PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses). Results: Nowadays, interventions in organizational level, integrated and web-based interventions are increasing to prevent CVD risk factors for workers. Even though the importance of psychosocial aspects to prevent CVD, the only 2 studies included psychosocial factors in the outcome variables. Also, 14% among 29 researches were based on theories. Conclusion: Psychosocial factors such as job stress, depression, and emotional labor could be CVD risk factors. Therefore, interventions including psychosocial aspects are needed to prevent workers' CVD risks more effectively. Theory-based interventions are needed to support interventions' effects and to develop the nursing science.

Interventions to Reduce the Risk of Cardiovascular Disease among Workers: A Systematic Review and Meta-Analysis

“…The studies in this analysis are not of these characteristics but are mostly of lifestyle education or counseling programs. According to previous studies [9,31,32], the level of work organization or work environment has a more sustainable effect on the health of workers than individual-based interventions. Future studies should include RCTs that apply organization-level interventions in workplaces.…”

“…Lifestyle and integrated interventions, including exercise, nutrition and other components, may reduce the risk of CVD among workers [9,30]. In addition, the development of standardized interventions for objectively monitoring the risk of CVD among workers is identified as a potential benefit of researching lifestyle interventions for workers with known CVD risk factors, including systolic and diastolic blood pressure and BMI [22].…”

“…Although some health intervention programs have been implemented for workers, the duration and outcome of programs varies [8]. The factors influencing CVD include both organizational and environmental components, and comprehensive or systematic factors [9]. To prevent and manage CVD among workers, and to provide evidence for planning an effective intervention program, a systematic review and meta-analysis is required.…”

An Exploration of Contextual Aspects that Influence Cardiovascular Disease Risks Perceived by Workers in a Small–Medium-Sized Workplace

“…Encouraging workers who spend most of their day at work to be aware of the risks arising from their relationships with colleagues at the interpersonal level and encouraging interactions that promote each other’s health behaviors is vital to improve health in the workplace. However, according to a systematic study of the intervention to prevent CVD in workers conducted from an ecological perspective [ 5 ], the number of studies, which analyzed risk factors at the interpersonal level, including subsequent intervention studies, were only three, which was the least number of studies conducted as compared to interventional studies at other levels. This is due to the lack of cooperation by employers when conducting interventional studies at a workplace, which makes it challenging to secure a time and place for group lectures or group discussions on the workers’ health management, and due to the lack of interest from workers and employers in healthcare intervention programs [ 29 ], which is at the interpersonal level, and most essentially requires interaction and collaboration, identified to be difficult.…”

“…Previous studies conducted that—although factors affecting cardiovascular disease in small–medium-sized workplaces are influenced by multidimensional factors, ranging from individual lifestyles to organizational dimensions—interventional studies to prevent and manage this issue have been mainly conducted at the individual level [ 5 , 6 ]. However, according to McLeroy’s ecological model theory [ 7 ], factors affecting a person’s health can be influenced not only by the individual, but also by the environment surrounding the individual.…”