Preventive cardiology
Effectiveness of a Volunteer-Delivered Lifestyle Modification Program for Reducing Cardiovascular Disease Risk Factors

https://doi.org/10.1016/j.amjcard.2011.07.069Get rights and content

Lifestyle modification has been demonstrated to effectively reduce the risk factors associated with cardiovascular disease, but there is a perception that it is costly to administer and resource. The present study examined the results achieved by a 30-day lifestyle modification program (Coronary Health Improvement Project) delivered by volunteers in a community setting. Changes in selected biometric measures of 5,070 participants in the Coronary Health Improvement Project programs delivered throughout North America (January 2006 to October 2009), were assessed. Overall, significant reductions (p < 0.001) were recorded in body mass (−3.2%), systolic and diastolic blood pressure (−4.9% and −5.3%, respectively), total cholesterol (−11.0%), low-density lipoprotein cholesterol (−13.0%), triglycerides (−7.7%), and fasting plasma glucose (−6.1%). Stratification of the data revealed more dramatic responses in those presenting with the greatest risk factor levels. Those presenting with cholesterol levels >280 mg/dl recorded an average reduction of 19.8%. A mean decrease of 16.1% in low-density lipoprotein levels was observed among those who entered the program with a low-density lipoprotein level >190 mg/dl. Individuals who presented with triglycerides >500 mg/dl recorded a mean reduction of 44.1%. The Framingham assessment forecast that approximately 70 cardiac events would be averted during the subsequent decade in the cohort because of the program. In conclusion, significant reductions in cardiovascular disease risk factors can be achieved in a 30-day lifestyle intervention delivered by volunteers, providing a cost-effective mode of administering lifestyle medicine.

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Methods

The study was observational and evaluated the pre- to postbiometric changes of 5,070 subjects who had self-selected to participate in a CHIP program. A total of 176 CHIP programs (mean group size 29, range 3 to 228) were conducted at 136 sites throughout North America from January 2006 to October 2009. The Avondale College human research ethics committee approved the study (approval number 20:10:07).

The CHIP programs were facilitated by volunteer directors, sourced primarily through the

Results

The 5,070 participants (mean age 57.2 ± 12.9 years) included 1,694 men (57.8 ± 13.0 years) and 3,372 women (56.9 ± 12.9 years). Of these participants, 210 (4.1%) self-reported a history of myocardial infarction, 111 (2.1%) had undergone bypass surgery, 101 (2.0%) had experienced a stroke, and 439 (8.7%) had a history of cancer.

The mean changes from baseline to after the intervention for all participants combined are presented in Table 1. Significant reductions were recorded in all the risk

Discussion

Although the study results represent observational data in that the participants were self-selected and no control group was included, the results are nonetheless noteworthy. Clearly, significant reductions in body weight and CVD risk factors can be achieved through a lifestyle intervention program delivered in a community setting by volunteers. Furthermore, those with the greatest risk benefited the most. Harnessing the energy of volunteer directors, who need not be health professionals,

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