A primary care lifestyle programme suitable for socioeconomically vulnerable groups - an observational study

作者:Waller Maria*; Blomstrand Ann; Hogberg Tine; Ariai Nashmil; Thorn Jorgen; Hange Dominique; Bjorkelund Cecilia
来源:Scandinavian Journal of Primary Health Care, 2016, 34(4): 352-359.
DOI:10.1080/02813432.2016.1248628

摘要

Objective: To explore whether a primary health care (PHC) health promotion programme reaches and engages socioeconomically vulnerable groups in a community to the same extent as higher socioeconomic groups.Design: Comparison of level of engagement and lifestyle improvements stratified by socioeconomic vulnerability level.Setting: Hisingen PHC catchment area (130,000 inhabitants) Gothenburg, Sweden.Participants: Men and women aged 18-79, visiting any of the eight public PHC centres during an eight-month period 2007-2008, were presented with a short intervention health questionnaire and offered a health dialogue with a nurse, including a health profile, p-glucose and blood pressure check. Participants were classified according to four socioeconomic vulnerability factors: education, employment, ethnicity and living situation.Results: Out of 3691 participants, 27% had low education (Hisingen community level 23%), 18% were unemployed (community level 22%), and 16% were born outside Scandinavia (community level 22%). At the one-year follow-up, 2121 (57%) attended. At baseline, 3% of the individuals in the sample had three out of four socioeconomic vulnerability factors, 17% had two vulnerability factors, 43% had one vulnerability factor, and 37% had no vulnerability factors. Improved biological markers were seen in all vulnerability groups (1-3) and odds ratios for improvement were significantly higher in the most socioeconomically vulnerable group for smoking and stress compared to the group with no vulnerability factors.Conclusion: Socioeconomically vulnerable groups were reached and lifestyle changes were accomplished to the same extent as in the higher socioeconomic groups in a PHC lifestyle intervention programme.