Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .
Impact of worksite wellness intervention on cardiac risk factors and one-year health care costs.
Cardiac rehabilitation and exercise training ( CRET ) provides health risk intervention in cardiac patients over a relatively short time frame . Worksite health programs offer a unique opportunity for health intervention , but these programs remain underused due to concerns over recouping the costs . We evaluated the clinical efficacy and cost-effectiveness of a 6-month worksite health intervention using staff from CRET .  Employees ( n = 308 ) and spouses ( n = 31 ) of a single employer were r and omized to active intervention ( n = 185 ) consisting of worksite health education , nutritional counseling , smoking cessation counseling , physical activity promotion , selected physician referral , and other health counseling versus usual care  ( n = 154 ) . Health risk status was assessed at baseline and after the 6-month intervention program , and total medical cl aim costs were obtained in all participants during the year before and the year after intervention . Significant improvements were demonstrated in quality -of-life scores ( + 10 % , p = 0.001 ) , behavioral symptoms ( depression -33 % , anxiety -32 % , somatization -33 % , and hostility -47 % , all p values < 0.001 ) , body fat ( -9 % , p = 0.001 ) , high-density lipoprotein cholesterol ( + 13 % , p = 0.0001 ) , diastolic blood pressure ( -2 % , p = 0.01 ) , health habits ( -60 % , p = 0.0001 ) , and total health risk ( -25 % , p = 0.0001 ) . Of employees categorized as high risk at baseline , 57 % were converted to low-risk status . Average employee annual cl aim costs decreased 48 % ( p = 0.002 ) for the 12 months after the intervention , whereas control employees ' costs remained unchanged ( -16 % , p = NS ) , thus creating a sixfold return on investment . In conclusion , worksite health intervention using CRET staff decreased total health risk and markedly decreased medical cl aim costs within 12 months
Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified , providing a set of specific evidence -based strategies that deserve close attention and prioritization for wider implementation .
Effective interventions included specific approaches in all 6 domains evaluated for improving diet , increasing activity , and reducing tobacco use .
The writing group also identified several specific interventions in each of these domains for which current evidence was less robust , as well as other inconsistencies and evidence gaps , informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies .
This systematic review identified and grade d the evidence for a range of population -based strategies to promote lifestyle change .
BACKGROUND Poor lifestyle behaviors , including suboptimal diet , physical inactivity , and tobacco use , are leading causes of preventable diseases globally .
Although even modest population shifts in risk substantially alter health outcomes , the optimal population -level approaches to improve lifestyle are not well established .