Effectiveness of the Complete Health Improvement Program in Reducing Risk Factors for Cardiovascular Disease in an Appalachian Population

J Am Osteopath Assoc. 2016 Feb;116(2):84-91. doi: 10.7556/jaoa.2016.020.

Abstract

Context: In 11 counties in Appalachian Ohio, the self-reported prevalence of diabetes mellitus (11.3%) is higher than the state (7.8%) or national (7.2%) average. Direct medical costs for diabetes in the United States are estimated at $176 billion annually. Indirect costs from disability, work loss, and premature death add up to another $69 billion.

Objective: To determine the effectiveness of the Complete Health Improvement Program (CHIP) in reducing cardiovascular disease (CVD) risk factors in a sample of Appalachian participants with elevated fasting blood glucose (FBG) levels or a diagnosis of type 2 diabetes mellitus (T2DM).

Methods: In a retrospective study, data from 6 CHIP cohorts conducted in Appalachian Ohio from 2011 to 2012 were combined and analyzed for short-term changes in CVD risk factors from baseline. This study focused on a subsample of the overall CHIP, whose participants had elevated FBG levels or T2DM. Statistical analysis was completed by calculating means and SDs and using paired t tests to compare differences in variables.

Results: After the CHIP intervention, 110 participants with baseline elevated FBG levels showed notable reductions in FBG levels, total cholesterol, low-density lipoprotein cholesterol, body mass index, and systolic blood pressure (all P values <.001). Likewise, participants in the subsample with T2DM experienced reductions in all CVD risk factors (all P values <.05).

Conclusion: The CHIP lifestyle intervention was effective in reducing CVD risk factors in this Appalachian population with elevated FBG levels or with T2DM.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Appalachian Region / epidemiology
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control*
  • Female
  • Follow-Up Studies
  • Health Promotion*
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Morbidity / trends
  • Ohio / epidemiology
  • Program Evaluation*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Risk Reduction Behavior*