MECHANISMS IN MULTIPLE RISK FACTOR INTERVENTIONS - SMOKING, PHYSICAL-ACTIVITY, AND DIETARY-FAT INTAKE AMONG MANUFACTURING WORKERS

Background. Individuals who have multiple poor health behaviors accoun t for a disproportionately large percentage of the preventable U.S. he alth care cost burden. Understanding the relationships between multipl e risk factors is important for the design of both individual and publ ic health interventions. There have been few efforts to examine the co occurrence of psychosocial and motivational mechanisms that mediate sm oking, dietary fat intake, and physical activity in a defined populati on of blue collar workers. Methods. The sample comprised 1,559 manufac turing workers who participated in a self-help physical activity inter vention and who completed a computerized assessment battery about thei r smoking, dietary fat intake, physical activity, and demographic char acteristics. Results. Twenty-six percent of the sample were smokers, 5 1% did not exercise regularly, and 35% consumed more than an estimated 40% of calories per day from fat. Almost half of the sample was in th e later stages of readiness for physical activity and dietary fat inta ke, compared with only 3% for smoking. Only 12% of the smokers had smo king as their only risk factor. Smokers were significantly more likely to engage in poor dietary and physical activity behaviors, compared w ith nonsmokers. The relationship among smoking status and the other ri sk factors was apparent both in terms of dietary fat and physical acti vity behaviors, as well as mediators such as motivation for change. Lo wer dietary fat intake was associated with an absence of the other two risk factors. Conclusions. The results suggest that there are importa nt mediating mechanisms both within and among workers with one or more risk factors. Smokers are a particularly important target for health promotion interventions, and it may be possible to make initial contac t with them through other health programs at the worksite. The role of other lifestyle changes as a gateway to smoking cessation has not yet been explored, but may have potential for reaching smokers who are ve ry low in their motivational readiness to change. The implications of these findings for research and the design of multiple risk factor int erventions are discussed. (C) 1994 Academic Press, Inc.