Physiological and Behavioral Correlates of Baseline Stages of Change in the Health Plus Challenge

Program.Robert C. Lowe, MA

Polk County School Board, Winter Haven, Florida

The prevalence of both diabetes and cardiovascular disease in our Polk County School District (PCSD) population is higher than the national averages. The health care costs for these employees, retirees, and dependents are substantially higher than for the balance of the insured. The Health Plus Challenge program (HPC) was developed in response to double-digit inflation in health care costs for the (PCSD) employees. A two-year pilot project demonstrated a reduction in the health care costs related to diabetes and cardiovascular disease (Lowe, 2005). Increased body mass index (BMI) may lead to increased risk for both diabetes and cardiovascular disease. Therefore, a primary goal of the HPC program was to decrease the risk for these diseases through reduction in BMI through screenings, counseling, and education.

We hypothesized that BMI would be correlated to Stages of Change for Weight Management as well as other physiological and behavioral factors at baseline.

Introduction

Purpose

Methods

Biometric and Health Risk Appraisal (HRA) data was collected on 1532 HPC participants (mean age 47±12 years and mean BMI of 32±6). Pearson correlation coefficients were generated for each variable. Multiple regression was utilized to develop the best subset of variables related to the prediction of Stages of Change for Weight Management. Significance was set at the p < 0.05 level.

Conclusions

These results suggest that no meaningful relationship between BMI and Stage of Change for Weight Management is present in our obese population of PCSB employees. Stage of Change for Weight Management is weakly related to exercise frequency and HRA total score. Stage of Change for Weight Management is, however, moderately related to other Stages of Change for Diet and Nutrition, Exercise, and Stress. Biometric and HRA scores were poor predictors of Stages of Change for Weight Management. Taken together these results suggest that other measures such as one-on-one counseling, risk factor modification education, print and electronic mailings, and PCSB district-wide programs may play an important role in determining body composition.

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For further information please contact:Robert Lowe, M.A., FAACVPR

robert.lowe@polk-fl.net

ABCs of Health

Results

•The resulting correlation matrix revealed that Stage of Change for Weight Management was significantly correlated to frequency of exercise; Stages of Change for Diet & Nutrition, Exercise, and Stress; and the total HRA score (all p≤0.05; Table 1).

•All other biometrics, including BMI and Body Fat, failed to reach a meaningful level of correlation ( see Table 1).

•Stepwise multiple regression of the biometric and HRA variables produced a very poor fit (Adjusted R2 =8.8%) but the overall relationship was significant with the subset of exercise score, gender, total HRA score, and nutrition score (F 4,1343 = 33.53, p < 0.05).

1348134813481171130713041348 N

0.000.050.000.000.000.000.00p (2-tailed)

-0.17-0.050.190.550.690.760.24

Pearson Correlation

Stage of Change - Weight Management

Body FatBMIHRA total score

Stage of Change - Stress

Stage of Change - Exercise

Stage of Change - Diet & Nutrition

Exercise Frequency per weekTable 1