A four week residential program for primary health care patients to control obesity and related heart risk factors: effective application of principles of learning and lifestyle change

Objective: To test the short and long-term effectiveness of a four week res idential program for primary health care patients to control obesity and re lated risk factors for cardio-vascular disease (CVD), especially blood pres sure (BP). Design: Prospective clinical study, with follow up after 1 and 5 y. Setting: Vindeln Patient Education Centre, Vindeln, and Department of Socia l Medicine, University of Umea, Sweden. Subjects: Approximately 2500 individuals, with two or more of the tradition al risk factors for CVD, participated in the program. This report describes a subsample of 100 consecutive patients, 52+/-9 y, 53 men, with obesity an d/or high BP. Intervention: Four week residential program with lectures and group discuss ions as well as practical sessions in smaller groups (meal preparations, ph ysical exercise, etc). The patients were followed-up medically in their hom e area. Outcome measures: Weight and blood pressure. Results: Dramatic reductions of weight and, especially, of blood pressure ( BP) occurred during the residential weeks, and the reductions were pronounc ed also after 1 y. After 5 y, the total mean weight among men with initial BMI greater than or equal to 30 kg/m(2) was still 5 kg lower, and diastolic and systolic BP among those with hypertension was 15 and 20 mm Hg lower, r espectively, than before the program. Conclusions: The full-time participation in the residential program and the enrollment and commitment of the patients may explain the clinical outcome . A level of predisposition greater than that required of most weight- and BP-control programs was confirmed and a great preventive or therapeutic pot ential was indicated. The study illustrates an effective application of the Precede-Proceed model of health promotion planning.