Changes in risk factors for non-communicable diseases associated with the ‘Healthy choices at work’ programme, South Africa

Abstract

Background Globally 71% of deaths are attributed to non-communicable diseases (NCD). The workplace is an opportune setting for health promotion programs and interventions that aim to prevent NCDs. However, much of the current evidence is from high-income countries. Objective The aim of this study was to evaluate changes in NCD risk factors, associated with the Healthy Choices at Work programme (HCWP), at a commercial power plant in South Africa. Methods This was a before-and-after study in a randomly selected sample of 156 employees at baseline and 137 employees at 2-years. The HCWP focused on food services, physical activity, health and wellness services and managerial support. Participants completed questionnaires on tobacco smoking, harmful alcohol use, fruit and vegetable intake, physical activity, psychosocial stress and history of NCDs. Clinical measures included blood pressure, total cholesterol, random blood glucose, body mass index, waist circumference and waist-to-hip ratio. The 10-year cardiovascular risk was calculated using a validated algorithm. Sample size calculations evaluated the power of the sample to detect meaningful changes in risk factors Results Paired data was obtained for 137 employees, the mean age was 42.7 years (SD 9.7) and 64% were male. The prevalence of sufficient fruit and vegetable intake increased from 27% to 64% (p < 0.001), those meeting physical activity guidelines increased from 44% to 65% (p < 0.001). Harmful alcohol use decreased from 21% to 5% (p = 0.001). There were clinical and statistically significant improvements in systolic and diastolic blood pressure (mean difference −10.2 mmHg (95%CI: −7.3 to −13.2); and −3.9 mmHg (95%CI: −1.8 to −5.8); p < 0.001) and total cholesterol (mean difference −0.45 mmol/l (−0.3 to −0.6)). There were no significant improvements in BMI. Psychosocial stress from relationships with colleagues, personal finances, and personal health improved significantly. The cardiovascular risk score decreased by 4.5% (> 0.05). Conclusion The HCWP was associated with clinically significant reductions in behavioural, metabolic and psychosocial risk factors for NCDs.

Pharmaceutical workers’ perceptions of physical activity and healthy eating: a qualitative study

“…These findings are in support of earlier studies showing poor nutrition and diet variety in lowincome South African workers [6,16,17]. A recent twoyear intervention study in South African had promising results, demonstrating that nutritious foods could be subsidised and sold at a reduced cost through healthy eating initiatives at work [10]. The proportion of participants consuming inadequate fruits and vegetables was reduced and a significant drop in metabolic disease risk factors was observed.…”

“…The prevalence of insufficient physical activity in South African workers is higher than community estimates and ranges from ~ 64% to 77% [6,14]. Previous South African [9,10] and international studies [15] confirm that the physical activity during working hours improves the cardiovascular and mental health of employees. In our study, workers valued the role of physical activity promotion in the workplace and assigned great importance on lowering time spent in sedentary activities.…”

“…Short-term improvements in weight and blood pressure were observed in female employees of a South African university following a 12-week walking programme [9]. A longitudinal two-year lifestyle intervention study showed similar positive changes in physical activity, diet, blood pressure and cholesterol in workers at a South African power plant [10]. Organisational support, acceptance from employees, and tangible employee benefits were noted as important components of long-standing success of this intervention [10].…”

“…A longitudinal two-year lifestyle intervention study showed similar positive changes in physical activity, diet, blood pressure and cholesterol in workers at a South African power plant [10]. Organisational support, acceptance from employees, and tangible employee benefits were noted as important components of long-standing success of this intervention [10]. Further research on sustainable workplace programmes is required across various sectors to align with the concept of a healthy South African workforce [11].…”

Evaluation of factors associated with medical male circumcision in South Africa: A case-control study

“…29 Similarly, the workplace can be an effective place for health promotion, and MMC could be one of the issues addressed. 30 Local media that reaches the whole community, such as radio and newspapers, may also be helpful in reaching the community.…”