Case Study - John, Changing A Bad Habit

Janice's sons, Mike's grandsons, are tall athletic young men who, unlike their mother, are physically active. The eldest son John is 27 has completed a university degree and is working in large local company. John has smoked since he was 13 and since starting a regular job has gained 15 pounds. His brother Jason, 23 is currently at community college and is a non-smoker. Both young men enjoy a variety of sports and usually participate in games or do other athletic activities a couple times a week. Neither worries much about his diet, since neither has a weight problem.

Both John and Jason say they drink average amounts of alcohol compared to their friends but are open about consuming considerable amounts of beer perhaps twice a month. Both claim neither they nor their friends drink and drive, although it was not always the case before they moved to a community with public transportation.

John is engaged to Annie who was a fellow student. Annie is ‘a great cook' and enjoys experimenting with vegetarian and low fat dishes. She is a runner and non-smoker and is eager to have John quit smoking.

At Annie's urging John agreed to be screened for the workplace wellness initiative.Although young and active, his desire to stop smoking led to a full health screening. During the screening, he learned that his blood pressure is high normal' and he was encouraged to participate in the company's unique cardiovascular health initiative.

PRIMARY PREVENTION FOR JOHN

Goal: Help John to identify the risks of smoking and to quit .

• Information about quitting smoking is well-advertised in John's community, and he also can attend a stop smoking program in his workplace

POPULATION HEALTH PREVENTION APPROACHES THAT WORKED FOR JOHN

Population health initiatives are multi-faceted and include policy decisions, for example, the adoption by the school board of a physical activity program or a community's creation of free or inexpensive recreation facilities where residents can be active.

• John and Jason were raised in a community that emphasized active kids. For example, a priority for the public health unit in this community has been to promote Quality Daily Physical Activity (QDPA) for all children. Each school day students are active for a minimum of 30 minutes. QDPA was important for John and Jason since they were raised in a single parent home by a parent who is not a good model for healthy active living.
• The community has developed available and inexpensive ways for families to stay active. Recreation centres, walking trails, community swimming pools, ice arenas are partners along with the schools to help children become and stay physically active.
• Stop smoking awareness programs and counselling are available, and include a comprehensive assessment of a person's lifestyle and behaviour.

WORKPLACE WELLNESS

Most adults spend at least eight hours each day in the workplace and Health promoters have recognized the potential of the work site to reach adults with healthy living messages. Workplace health promotion programs often involve multiple partnerships to find ways to keep their employees Healthy. An example of a pilot workplace wellness program is described below.

A MODEL WORKPLACE WELLNESS INITIATIVE - Daimler Chrysler Cardiovascular Wellness Program- Tune Up Your Heart ^TM

Tune Up Your Heart^TM is a unique corporate partnership between Pfizer Canada Ind., DaimlerChrysler and the Canadian Auto Workers (CAW) to provide new approaches to improve cardiovascular health of DaimlerChrysler employees. The objective of Tune Up Your Heart ^TM is to improve cardiovascular health through a comprehensive worksite wellness program to:

• Empower employees to take charge of their cardiovascular health;
• Reduce specific risk factors (hypertension, hypercholestrolemia) and risk behaviours (smoking, physical inactivity, obesity);
• Improve individual cardiovascular risk profiles;
• Improve compliance with cardiac medications.

The program takes place in DaimlerChrysler facilities in Windsor, Ontario. A cardiovascular risk assessment using CardioView^TM is offered to all employees. CardioView^TM is a risk assessment program based on validated epidemiological model developed at the Centre for Cardiovascular Risk Assessment at the Montreal General Hospital. The program measures blood pressure, cholesterol and information on other risk factors such as age, family history, weight and cigarette smoking. The model estimates an individual's current risk of developing a cardiovascular disease over the next 10 years compared to what happens ‘on average' to Canadians of the same age and sex.

Employees at risk of developing a cardiac disease, as identified by the assessment, will have the opportunity to participate in an intervention program, which targets high blood pressure, abnormal cholesterol and cigarette smoking. The target sample size for the program has been established at 900 employees and participation is voluntary and confidential. At the end of the program, the proportion of employees with high blood pressure and cholesterol targeted to treat will be measured as well as the proportion of participants who attained their goals. Employees not taking part in the program will still learn about specific cardiovascular activities throughout the duration of the project. Preliminary results are available.