Short-Term Effectiveness of a Lifestyle Intervention Program for Reducing Selected Chronic Disease Risk Factors in Individuals Living in Rural Appalachia: A Pilot Cohort Study
Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type 2 diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively. 1. Introduction Chronic diseases are on the rise, accounting for 84% of the current national healthcare expenditure [1]. Nearly 18% of the US Gross Domestic Product, or $2.7 trillion, is now being spent on healthcare. This is by far more than any other nation [2]. Many of these chronic diseases have lifestyle underpinnings and are responsive to lifestyle modification [3]. It is estimated that nearly 40% of all cancer deaths and 82% of cardiac deaths could be prevented. In addition, 71% of colon cancer, 71% of strokes, and 91% of the cases of diabetes could be avoided through appropriate lifestyle changes by adopting a simpler, healthier diet, by following a consistent activity program and by avoiding tobacco [4]. The Complete Health Improvement Program (CHIP) [5] is an intensive community-based lifestyle intervention that has been shown to offer significant benefits for the prevention, control, and even reversal of cardiovascular disease [6–8], type 2 diabetes (T2DM) [9, 10], and depression [11, 12]. This program is largely attractive to middle-class people who are generally employed, have the means to enroll, and have a level of education that facilitates the understanding, assimilation, and application of the healthy lifestyle principles presented in the program. In Appalachia, Athens County is struggling with the highest poverty level in Ohio at 35% [13], with nearly 18% of the population uninsured [14]. Many people in this region are struggling with issues related to poverty, such as
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