Background: To develop an effective health education program to prevent\ncardiovascular disease in middle-aged residents after retirement in underpopulated\nareas, we explored the effects of a stress management program based\non the type A behavior pattern. Methods: This study was carried out in a rural\ncity in Japan recognized as underpopulated and participants were civil\nservants aged 45 - 64 who joined a stress management program offered as\npart of staff training. Learning materials for the program were developed\nbased on the type A behavior pattern. Measures for the impact evaluation\nwere Bloomâ??s learning domains and stage of change for stress management\npractice. Measures for the outcome evaluation were KGâ??s Daily Life Questionnaire\n(KG Questionnaire), the Hospital Anxiety and Depression Scale\n(HADS) and the Framingham 10-year cardiovascular risk score (CVD risk\nscore). We statistically analyzed changes in each item between time points.\nResults: Eighteen participants completed questionnaire surveys at pre-, post-,\nand 4 weeks post-program and eleven had complete blood pressure and\nweight measurements at pre- and post-program. In the impact evaluation, the\nFriedman test found significant differences between the three time points in\nall of Bloomâ??s learning domain scores and stage of change for stress management.\nIn the post hoc analysis, a significant increase was seen between preand\npost-program and between pre- and 4 weeks post-program in cognitive\ndomain score, psychomotor domain score and stage of change for stress\nmanagement. In the outcome evaluation, a significant decrease in systolic\nblood pressure was seen between pre- and post-program. Conclusion: The\npresent study suggested that a stress management program using learning materials based on type A behavior could promote stress management practices\nand reduce the risk of cardiovascular disease. This stress management\nprogram is expected to be useful as a health promotion activity for middle-\naged residents after retirement in underpopulated areas.
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