Three-Year Intervention Program to Prevent Hypertension in Workplaces in Tunisia: A Pre-Post Quasi-Experimental Design with Control Group

Abstract

Objectives: to evaluate the effectiveness of a three-year workplace intervention for healthy lifestyle promotion in the prevention of hypertension among employees. Methods: A quasi-experimental study design was employed to assess the effectiveness of a health promotion intervention program for corporate employees, which mainly consisted of educational videos and interactive teaching sessions with occupational physicians, healthy eating and smoking cessation workshops, free physical activity sessions for employees and free smoking cessation consultation in workplace. There were three workplace sites in the intervention and control groups, respectively. Results: The prevalence of screened hypertension decreased significantly in the intervention arm from 16.2% to 12.8% (p=0.02), but increased significantly in the control arm from 13.3% to 23.3% (p<0.001). Of note, obesity increased both in intervention and control arms. Assessment of hypertension prevalence according to weight status demonstrated a significant decrease in the intervention group among normal weight participants from 11.5% to 6.6% (p=0.009), but an increase in the control group albeit not statistically significant. Among overweight participants, hypertension decreased in intervention group from 18.9% to 13.5% (p=0.058), but increased significantly in control group from 13.1% to 23.1% (p=0.001). Among obese participants, the decrease in the prevalence of hypertension was not significant in intervention group (27.8% to 24.4%, p=0.48), however, it increased significantly in the control group from 22.4% to 34.3% (p=0.009). Determinants of hypertension were age > 35 years, male sex, overweight and obesity in the two groups. Overall, the intervention was negatively associated with hypertension in intervention group (OR= 0.61, CI 95% [0.47-0.8]). Conclusion: The intervention program was effective in decreasing the prevalence of hypertension among normal weight workers. However, additional strategies and/or time are need to combat hypertension among overweight and obese individuals.