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Behavioural interventions for CVD risk reduction for blue-collar workers: a systematic review
Melissa M Crane1, Shannon Halloway2, Zoe L Walts3
1Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois, USA Melissa_M_Crane@rush.edu.
Insights
Behavioral interventions targeting cardiovascular disease (CVD) risk factors in blue-collar workers are most effective when individualized and occupation-specific. These tailored approaches show promise for reducing CVD risk in this high-risk population.
Area of Science:
- Public Health
- Occupational Health
- Cardiovascular Disease Research
Background:
- Blue-collar occupations are associated with elevated rates of cardiovascular disease (CVD).
- Targeting CVD risk factors in this demographic is crucial for public health.
- Behavioral interventions offer a potential strategy for risk reduction.
Purpose of the Study:
- To systematically review and characterize behavioral interventions aimed at CVD risk factors in blue-collar workers.
- To evaluate the efficacy of these interventions in reducing specific CVD risk factors.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched seven databases for interventions targeting blood pressure, cholesterol, diet, physical activity, smoking, or weight.
- Included randomized controlled trials of behavioral interventions in blue-collar workers; assessed study quality using the NHLBI tool.
Main Results:
- 22 studies (31 interventions) were reviewed; 11 were rated 'good' or 'fair' quality.
- Interventions with individual contact showed greater effects, particularly for self-reported dietary changes.
- Tailored interventions in higher-quality studies successfully reduced at least one CVD risk factor.
Conclusions:
- Individualized and occupation-tailored behavioral interventions are most effective for reducing CVD risk factors in blue-collar workers.
- While many studies were of low quality, they demonstrate promising results for engaging this population.
- Future research should focus on higher-quality studies incorporating these effective intervention components.
Objectives:
Individuals working in blue-collar occupations experience high rates of cardiovascular disease (CVD). The purpose of this systematic review is to describe the characteristics and efficacy of behavioural interventions that have targeted CVD risk factors in this high-risk group.
Methods:
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched seven databases to find interventions focused on changing the following: blood pressure, cholesterol, diet, physical activity, smoking or weight. Eligible studies tested a behavioural intervention (not exclusively policy, environmental, or pharmaceutical), in individuals working in blue-collar occupations using a randomised study design. Study quality was evaluated using the National Heart, Lung, and Blood Institute's study quality assessment tool.
Results:
22 studies evaluating 31 interventions were included: 11 were rated as 'good' or 'fair' quality. Intervention intensity ranged from a single contact via a mailed letter to studies that included individual-level contacts at multiple time points between staff and participants. Studies that included at least some individual contact generally yielded the greatest effects. Interventions had the greatest observed effects on self-report changes in diet, regardless of intervention intensity. Four of the five higher quality studies that explicitly tailored the intervention to the occupational group were successful at reducing at least one risk factor.
Conclusions:
Interventions that used individual contact and tailored the intervention to the occupational setting yielded the greatest effects on CVD risk-factor reduction in individuals working in blue-collar occupations. Generally, studies were low quality but showed promising effects for reaching this high-risk population. Future work should incorporate these promising findings in higher quality studies.
Prospero Registration Number:
CRD42019136183.
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