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Prof K Srinath Reddy President Public Health Foundation of India & Professor of Cardiology

INTRODUCTION TO THE INDIAN WORKSITE WELLNESS PROGRAM. Based on Sentinel Surveillance for CVD in Indian Industrial Population-SSIIP. Prof K Srinath Reddy President Public Health Foundation of India & Professor of Cardiology All India Institute of Medical Sciences, New Delhi.

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Prof K Srinath Reddy President Public Health Foundation of India & Professor of Cardiology

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  1. INTRODUCTION TO THE INDIAN WORKSITE WELLNESS PROGRAM Based on Sentinel Surveillance for CVD in Indian Industrial Population-SSIIP Prof K Srinath Reddy President Public Health Foundation of India & Professor of Cardiology All India Institute of Medical Sciences, New Delhi

  2. Deaths In India (2005) Source : WHO

  3. Rising Chronic Disease Burdens

  4. Worksite Survey: Study Settings • Ten large/ medium industries across India, employing 1500-5000 people (public & private) twinned to medical colleges (public & private) • Employees and their family members • Surveillance of CVD risk factors • Age Group : 20-69 years (n=19973 for the questionnaire survey and n= 10442 for biochemical investigations).

  5. Worksite Wellness Programme Age adjusted prevalence of risk factors 2002-2003 KS Reddy et al WHO Bulletin 2006

  6. COEXISTENCE OF MULTIPLE RISK FACTORS (SSIP 20-69 YRS) Age>50, Current regular use of tobacco, SBP>=120 to <140, PG 100-125.9 mg/dl, Tg>150 mg/dl, Tc/HDl >=4.5, HDL <40 (m)/HDL<50 (f) BMI>23, WC >80 (f), or WC>90 (m) and Family history of CVD

  7. CVD Risk Factor Survey in 10 Industries Risk Factors by Educational Status in Men ES I: Post Graduate; ES II: Graduate; ES III: Secondary or High School; ES IV : Primary or Illiterate (Ongoing Indian Industrial Surveillance Study; Baseline Survey in 2002-03)

  8. YEARS OF LIFE LOST DUE TO CVD IN POPULATIONSAGED 35-64 YEARS PPYLL= Potentially Productive Years of Life Lost

  9. Health Promotion Component

  10. Health Interventions at other sites Population approach: Pamphlets, posters, health talks, health promos on visual medium, health melas, healthy cooking competitions, High Risk Approach: Individual counseling, group counseling, referral to medical doctor for management of hypertension, diabetes and dyslipidemia Environmental changes: Provided healthier alternatives at canteen, banned tobacco inside the premises etc

  11. Interventions were targeted to • Create readiness to change • Influence aspiration to change and espouse new behaviors • Improve engagement of the individuals and the community-interaction, self-efficacy, relapses • Change environmental barriers( work-site, educational inst., canteens, hotels, overcoming cost factors, availability) • Eliminate environmental societal stimulants • Introduce behavioral supports

  12. Worksite Wellness ProgrammeIntermediate changes (2004-2005)

  13. Age adjusted prevalence of risk factors in females (before and after intervention)

  14. Trends in mean levels of variables in Men (six centre data)

  15. Proportion of individuals above the Framingham 10 year CVD risk of >=10%

  16. PRIMARY PREVENTION OF CVD Risk Detection + Risk Reduction in Individuals People Professionals Self -Referral + Opportunistic Screening EDUCATION HBP, Overweight, Tobacco, Physical Inactivity, Diet, Age, Gender, Personal/Family History Risk stratification (Step I) Targeted Screening GUIDELINES (Diagnostic Algorithms) Diabetes, Dyslipidemia, Assessment for CVD GUIDELINES (Management Algorithms) Risk Stratification (Step II) Appropriate Therapy Lifestyle Measures + Drugs

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