Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;75(12):1236-1243.
doi: 10.1136/jech-2021-216515. Epub 2021 Jul 28.

Behavioural interventions for CVD risk reduction for blue-collar workers: a systematic review

Melissa M Crane  1 , Shannon Halloway  2 , Zoe L Walts  3 , Kara L Gavin  4 , Angela Moss  2 , Jennifer C Westrick  5 , Bradley M Appelhans  6
Affiliations

Behavioural interventions for CVD risk reduction for blue-collar workers: a systematic review

Melissa M Crane et al. J Epidemiol Community Health. 2021 Dec.

Abstract

Objectives: Individuals working in blue-collar occupations experience high rates of cardiovascular disease (CVD). The purpose of this systematic review is to describe the characteristics and efficacy of behavioural interventions that have targeted CVD risk factors in this high-risk group.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched seven databases to find interventions focused on changing the following: blood pressure, cholesterol, diet, physical activity, smoking or weight. Eligible studies tested a behavioural intervention (not exclusively policy, environmental, or pharmaceutical), in individuals working in blue-collar occupations using a randomised study design. Study quality was evaluated using the National Heart, Lung, and Blood Institute's study quality assessment tool.

Results: 22 studies evaluating 31 interventions were included: 11 were rated as 'good' or 'fair' quality. Intervention intensity ranged from a single contact via a mailed letter to studies that included individual-level contacts at multiple time points between staff and participants. Studies that included at least some individual contact generally yielded the greatest effects. Interventions had the greatest observed effects on self-report changes in diet, regardless of intervention intensity. Four of the five higher quality studies that explicitly tailored the intervention to the occupational group were successful at reducing at least one risk factor.

Conclusions: Interventions that used individual contact and tailored the intervention to the occupational setting yielded the greatest effects on CVD risk-factor reduction in individuals working in blue-collar occupations. Generally, studies were low quality but showed promising effects for reaching this high-risk population. Future work should incorporate these promising findings in higher quality studies.

Prospero registration number: CRD42019136183.

Keywords: health promotion; occupational health; public health.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure.
Figure.
Flow chart of study screening and reasons for exclusion
See this image and copyright information in PMC

References

    1. Xu J, Murphy SL, Kockanek KD, Arias E. Mortality in the United States, 2018. NCHS Data Brief 2020:1–8. - PubMed
    1. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9 million participants. Lancet Glob Health 2018;6:e1077–e1086. - PubMed
    1. Lee-Kwan SH, Moore LV, Blanck HM, Harris DM, Galuska D. Disparities in state-specific adult fruit and vegetable consumption—United States, 2015. MMWR Morb Mortal Wkly Rep 2017;66:1241. - PMC - PubMed
    1. Ford ES, Bergmann MM, Boeing H, Li C, Capewell S. Healthy lifestyle behaviors and all-cause mortality among adults in the United States. Prev Med 2012;55:23–27. - PMC - PubMed
    1. Kvaavik E, Batty GD, Ursin G, Huxley R, Gale CR. Influence of individual and combined health behaviors on total and cause-specific mortality in men and women: the United Kingdom health and lifestyle survey. Arch Intern Med 2010;170:711–718. - PubMed

Publication types