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Objectives: Our goal in this study to investigate the impacts of using safe delivery kits, along with education on their appropriate use, has on preventing newborn and maternal infection. Design: A cross-sectional study. Setting: Participants, and Interventions: we conducted the study on 23 sites across a rural district in Oromia Region, Ethiopia. Safe delivery kits were distributed by health extension workers. Participants comprised 534 mothers between the ages of 17 and 45 years, who were given a safe delivery kit at 7 months' pregnancy for use during their subsequent delivery. Data collection was performed by the trained interviewers in rural Ethiopian communities. Results: Multiple logistic regression analyses showed an independent association between using the cord tie provided in the kits and decreased newborn infection. Specifically, newborns whose mothers used the cord tie were 30 times less likely to develop cord infection than those not using the cord tie in the kits. Further, mothers who received education regarding safe delivery kit use had lower rates of puerperal infection. Conclusion: Single-use delivery kits, when combined with education regarding the appropriate means of using the kit, can decrease the likelihood of maternal infection. Implications for nursing: Nurses and health extension workers in low and middle-income countries should educate mothers on safe delivery kits by providing information regarding their usefulness and the importance of correct and consistent use. Implications for Health Policy: our findings emphasize the need for further interventions in vulnerable countries designed to increase the rate of hygienic birthing practices for deliveries outside health-care facilities.
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Parto Obstétrico , Población Rural , Humanos , Etiopía , Estudios Transversales , Femenino , Adulto , Población Rural/estadística & datos numéricos , Recién Nacido , Embarazo , Adolescente , Parto Obstétrico/estadística & datos numéricos , Adulto Joven , Persona de Mediana EdadRESUMEN
BACKGROUND: As the number of COVID-19 patients rises, there has been a notable increase in the workload for nurses. However, medium-sized hospitals lacked standardized protocols or consistent approaches to address the specific working conditions of nurses. Furthermore, concerns about patient care have heightened as the issue of nursing shortages coincides with the expansion of the comprehensive nursing care services project. PURPOSE: This study aimed to investigate the factors that influence patient safety management activities, such as calling, organizational commitment, job stress, and nursing work environment, among comprehensive nursing care service unit nurses during the COVID-19 pandemic. METHODS: A conceptual framework based on the Job Demand-Resource model and literature review of patient safety management activities was used to develop structured questionnaires that were distributed to 206 participants working in 7 comprehensive nursing care service units of small and medium-sized hospitals with at least 300 beds in the S and K provinces. Data analysis was conducted using descriptive statistics, chi-squared tests, t-tests, ANOVA, and hierarchical regression with the SPSS/WIN 23.0 program. RESULTS: The results showed that calling (ß =.383, p<.001) and job stress (ß= -.187, p=.029) significantly influenced patient safety nursing activities in comprehensive care service ward nurses. The explanatory power of the model was 26.0% (F= 6.098, p<.001). CONCLUSIONS: Our findings suggest that comprehensive care service ward nurses' career, income, COVID-19 patient nursing anxiety, calling, and job stress were important factors that influence patient safety nursing activities. Therefore, it was essential to develop calling education programs and improve the nursing work system and establish a fair compensation system during the pandemic situation.
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BACKGROUND: Disaster nursing deploys professional nursing knowledge and skills systematically to reduce disaster-related risks to life and health. Disaster nursing education requires providing simulations using standardized patients. PURPOSE: The purpose of this study was to develop, based on the International Council of Nurses' Framework of Disaster Nursing Competencies, a simulation-based disaster nursing education program for nursing students that employed standardized patients. METHODS: A nonequivalent, control group, pretest-and-posttest design was used. Participants were senior nursing students from two universities, with 70 assigned to the experimental group, 35 assigned to the comparison group, and 35 assigned to the control group. Data were collected from January 25 to April 3, 2019. The simulation-based disaster nursing education program consisted of a 60-minute theoretical lecture on disaster management and two scenarios. The effectiveness of the simulation-based disaster nursing education program was measured using levels of disaster nursing competencies, disaster triage competency, disaster preparedness, critical thinking disposition, and confidence in disaster nursing. RESULTS: Significant differences were found between the experimental and comparison/control groups in terms of disaster nursing competencies ( F = 20.06, p < .001), nursing triage ( F = 17.35, p < .001), disaster preparedness ( F = 60.37, p < .001), critical thinking disposition ( F = 19.63, p < .001), and confidence in disaster nursing ( F = 20.24, p < .001). CONCLUSIONS: Simulation-based disaster nursing education programs using standardized patients can be useful in disaster nursing education. They can contribute to future changes in nursing education and practice by improving the disaster nursing capabilities and preparedness of students.
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Enfermería en Desastre , Estudiantes de Enfermería , Humanos , Escolaridad , Pensamiento , PacientesRESUMEN
PURPOSE: We aimed to investigate the association between dry eye disease (DED) symptoms and mental health among Korean adults in the community. METHODS: A cross-sectional study analyzed the data of 152 participants using mobile-phone applications for recording mental health. We defined individuals with DED symptoms as those who experienced a sense of irritation or dryness of the eye (either constantly or often). Mental health (perceived stress, depression, and anxiety) was assessed using the Perceived Stress Scale, Patient Health Questionnaire-9, and General Anxiety Disorder-7, in this order. Multiple logistic regression analysis was conducted to examine the association between DED symptoms and mental health. We also adjusted for possible covariates. We investigated sex differences in mental health status in relation to DED. RESULTS: We found that 41.4% of the participants (48.4% female and 30.5% male) showed DED symptoms, and its prevalence was higher in female than in male. The average perceived stress and anxiety symptoms in the female with DED (24.69±4.73 and 6.56±5.09, respectively) were significantly higher than those without DED (21.38±4.68 and 4.54±4.03) (p = 0.020 and 0.038, respectively). Even after adjusting for possible covariates, female who had DED showed higher risks of perceived stress (OR = 1.28), depression (OR = 2.64), and anxiety (OR = 5.81). CONCLUSIONS: Clinicians and nurses should therefore be aware of the possibility of mental health problems among female with DED.
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Síndromes de Ojo Seco , Salud Mental , Humanos , Adulto , Masculino , Femenino , Encuestas y Cuestionarios , Factores Sexuales , Estudios Transversales , Caracteres Sexuales , Síndromes de Ojo Seco/diagnóstico , Prevalencia , Factores de RiesgoRESUMEN
It has become important for nurses to implement self-leadership and exercise critical thinking in problem-solving to address the health issues of patients. This has led to a need for nursing education programs in which nursing students learn to embrace self-leadership and self-evaluation approaches to develop their skills. Within 260 nursing undergraduates with experience in simulation practice as study subjects, a self-reporting survey was conducted on self-leadership, goal commitment, critical thinking, and problem-solving skills. An analysis was conducted using the SPSS/WIN 21.0 program. t-test and ANOVA were conducted to validate the difference between problem-solving abilities. Multiple regression was conducted to examine the impact of these variables on problem-solving skills. The variables of religion, satisfaction with major, goal commitment, and critical thinking were found to have a significant impact on problem-solving abilities. The results were as follows: critical thinking (ß = 0.36, p < 0.05), goal commitment (ß = 0.28, p < 0.05), and explanatory power of 41%. To improve the nursing undergraduates' problem-solving abilities through simulation practice, there needs to be a method that supports them in setting goals with self-leadership and enhance goal commitment. The method also needs to support the development of their critical thinking and curiosity for questions deriving from experiencing diverse programs in order to deliver effective outcomes.
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Educación en Enfermería , Estudiantes de Enfermería , Educación en Enfermería/métodos , Humanos , Aprendizaje , Solución de Problemas , PensamientoRESUMEN
Public health plays a pivotal role in society [...].
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Promoción de la Salud , Salud PúblicaRESUMEN
Although health apps have been developed and utilized in many countries, there is no baseline study about what percentage of Korean workers use these types of health apps. Therefore, the purpose of this study was to describe the work-related stress, health status, and utilization of health apps of Korean adult workers. This descriptive study included 95 adults in South Korea. Demographic variables, work-related stress, health status, and utilization of health apps were obtained using an online self-reported survey. Descriptive analyses were used to explore prevalence of each variable. This study found that almost 65% of the participants fell into the higher work-related stress group. About 41.6% of the participants in this sample evaluated their general health status as fair to poor with 26.8% being overweight to obese and 11.6% having hypertension. However, only about 33.7% of the sample have used health apps. Therefore, utilization of health apps as health and stress management tools should be encouraged at a public health level.
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Aplicaciones Móviles , Estrés Laboral , Adulto , Estado de Salud , Humanos , República de Corea/epidemiología , Encuestas y CuestionariosRESUMEN
AIMS: This study constructed and tested a structural equation model on clinical nurses' emotional labor, job satisfaction, and job performance based on Grandey's emotion regulation model. DESIGN: We performed a correlational study to predict the relationship between the following variables: emotional labor (surface and deep acting), job satisfaction, job performance, self-efficacy, emotional intelligence, display rules, job autonomy, social support, and job stress. METHODS: Our hypothetical model was based on Grandey's emotional regulation model and on a literature review of emotional labor, job satisfaction, and job performance. Structured questionnaires were distributed to participants who worked in seven general hospitals with no less than 300 beds in a province, South Korea. We analyzed 424 questionnaires and used AMOS 23 to explore the relationships between the constructs. RESULTS: Our model fit the data well (χ2 = 96.420, GFI = 0.966, CFI = 0.956, RMSEA = 0.084). Display rules, self-efficacy, job autonomy, and job stress accounted for 20.5% of variance in surface acting. Self-efficacy, emotional intelligence, job autonomy, and job stress accounted for 23.3% of variance in deep acting. Job stress, self-efficacy, job autonomy, surface acting, and deep acting accounted for 45.0% of variance in job satisfaction. Self-efficacy, job autonomy, emotional intelligence, and deep acting accounted for 43.3% of variance in job performance. CONCLUSION: We confirmed that display rules, emotional intelligence, job stress, self-efficacy, and job autonomy are important factors that could decrease nurses' emotional labor and increase their job satisfaction and performance. These findings support the development and application of various interventions to decrease emotional labor and increase job satisfaction and job performance among nurses. IMPLEMENTATION: This study filled the need for an integrated structural equation model of emotional labor. With this model, we found that emotional labor operates differently in nursing practice than in other service fields. As such, this model can help hospital management to adjust their customer service guidelines to improve nurses' job satisfaction and performance.
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Regulación Emocional , Enfermeras y Enfermeros , Personal de Enfermería en Hospital , Rendimiento Laboral , Humanos , Satisfacción en el Trabajo , Personal de Enfermería en Hospital/psicologíaRESUMEN
This study examined the determinants of perceived accessibility of maternity leave and childcare leave in South Korea. Although maternity leave and childcare leave are mandated in Korea, many employees are hesitant to use the policies. The purpose of this study was to empirically examine why some women are more likely than others to perceive the policies as inaccessible and to identify what those women's characteristics are. The results revealed that nonregular workers were significantly less likely than regular workers with secure contracts to perceive the policies as accessible even though they were eligible for them. In addition, workers who worked in the private sector, did not belong to a labor union, worked in small firms, or worked long hours were significantly less likely to perceive the policies as accessible than those who worked in the public sector, belonged to a labor union, worked in large firms, or worked short hours. Further, workers with low salaries were significantly less likely than workers with high salaries to perceive the policies as accessible. The study underscores that accessibility of leave policies in Korea is significantly correlated with women's employment status and wage level in the labor market.
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Empleo , Permiso Parental , Niño , Cuidado del Niño , Femenino , Humanos , Embarazo , República de Corea , Salarios y BeneficiosRESUMEN
BACKGROUND: Scoping reviews of the literature on the development and application of mental health apps based on theoretical suggestions are lacking. This study systematically examines studies on the effects and results of mental health mobile apps for the general adult population. METHODS: Following PICOs (population, intervention, comparison, outcome, study design), a general form of scoping review was adopted. From January 2010 to December 2019, we selected the effects of mental health-related apps and intervention programs provided by mobile to the general adult population over the age of 18. Additionally, evaluation of methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) checklist. RESULTS: Fourteen studies were analyzed of 1205 that were identified; duplicate and matching studies were excluded. One was a descriptive study and 13 were experimental, of which randomized control trials (RCTs) accounted for 71.4%. Four of the mobile apps were developed based on cognitive behavior theory, one based on stress theory, and one on ecological instant intervention theory. These apps included breathing training, meditation, and music therapy. Stress, depression, and anxiety decreased using these apps, and some were effective for well-being. CONCLUSION: With the rapid development of technology related to mental health, many mobile apps are developed, but apps based on theoretical knowledge and well-designed research are lacking. Further research and practices should be conducted to develop, test, and disseminate evidence-based mHealth for mental health promotion. RCT studies are needed to expand the application to mental health services to various populations.
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Servicios de Salud Mental , Aplicaciones Móviles , Telemedicina , Adulto , Ansiedad , Humanos , Salud Mental , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
PURPOSE: There has been a recent surge in interest in mental health and how to improve individuals' health-related quality of life. Mental health management using mobile apps can be a useful intervention method. The development and application of verified and highly efficient apps for mental health and stress management are needed. We developed healing programs and verified their effectiveness based on apps designed to promote adult mental health. METHODS: We conducted a one-group pretest-posttest study in which 85 participants used the app for 12 weeks. We assessed its effects on participants' stress (perceived stress scale, effort-reward imbalance, and photoplethysmogram (PPG)), anxiety, depression, emotional labor, and well-being. RESULTS: The stress survey results post-intervention increased or stayed the same; however, the PPG results decreased (p = 0.002) after using the app. Depression (p = 0.043) and anxiety (p = 0.003) also decreased; however, emotional labor and well-being remained unchanged. The awareness of, knowledge of, and attitude toward mental health management all increased post-intervention. DISCUSSION: The developed mobile app was an efficient and highly accessible way to promote mental health. However, the app requires modification and supplementation for continual use. Additionally, ongoing research concerning the study, evaluation, and integration of mobile apps is required.
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Aplicaciones Móviles , Adulto , Trastornos de Ansiedad , Cognición , Humanos , Salud Mental , Calidad de VidaRESUMEN
Wellness in adult workers is intimately associated with better quality of life in individuals, as well as in the family, community, workplace, and country. This study aimed to examine the status of wellness in adult workers and to identify the factors that influence wellness. A descriptive survey was conducted with 260 adult workers. T- test and one-way ANOVA with post-hoc Scheffe test were used to analyze the data. Multiple regression analysis was performed on stress, depression, anxiety, well-being, self-efficacy, and perceived health status. The regression model for wellness in adult workers was significant (F = 42.21, p < 0.001), with an explanatory power of 0.558. Depression (ß = -0.306) was identified as the most influential factor for wellness in adult workers, followed by self-efficacy (ß = 0.280) and well-being (ß = 0.264). Depression, stress, and anxiety negatively influenced wellness, whereas self-efficacy, well-being, and perceived health status positively influenced wellness. Study findings suggest the need to develop intervention programs for workers that decrease stress, depression, and anxiety, and incorporate self-efficacy strategies.
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Salud Mental , Adulto , Ansiedad , Humanos , Calidad de Vida , Lugar de TrabajoRESUMEN
PURPOSE: This study aimed to develop an emerging infectious disease (COVID-19) simulation module for nursing students and verify its effectiveness. METHODS: A one-group pretest-posttest quasi-experimental study was conducted with 78 under-graduate nursing students. A simulation module was developed based on the Jeffries simulation model. It consisted of pre-simulation lectures on disaster nursing including infectious disease pandemics, practice, and debriefings with serial tests. The scenarios contained pre-hospital settings, home visits, arrival to the emergency department, and follow-up home visits for rehabilitation. RESULTS: Disaster preparedness showed a statistically significant improvement, as did competencies in disaster nursing. Confidence in disaster nursing increased, as did willingness to participate in disaster response. However, critical thinking did not show significant differences between time points, and neither did triage scores. CONCLUSION: The developed simulation program targeting an infectious disease disaster positively impacts disaster preparedness, disaster nursing competency, and confidence in disaster nursing, among nursing students. Further studies are required to develop a high-fidelity module for nursing students and medical personnel. Based on the current pandemic, we suggest developing more scenarios with virtual reality simulations, as disaster simulation nursing education is required now more than ever.
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COVID-19 , Enfermedades Transmisibles , Desastres , Estudiantes de Enfermería , Humanos , SARS-CoV-2RESUMEN
(1) Background: This study aims to investigate the impact of emotional labor and workplace violence on sleep disturbance, depression, and health status in workers. (2) Methods: Data from 34,742 participants of the 2011-2014 Korean Working Conditions Survey were included in this study. We compared the incidence of sleep disturbance, depression, and health status according to emotional labor and workplace violence and used logistic regression to analyze factors that affect health status. (3) Results: Emotional laborers were more likely to experience sleep disturbance, depression and anxiety, and muscle pain. Workers who have experienced workplace violence were more likely to experience depression and anxiety, abdominal pain, and sleep disturbance. (4) Conclusion: Emotional labor and workplace violence have a grave impact on physical and mental health, with particularly greater effects on mental health. In addition, workplace violence has a greater health impact than emotional labor. The findings of this study suggest the need to implement programs that stabilize and heal workers who have experienced emotional labor and to enforce regulations and policies to protect workers from verbal and physical abuse.
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Emociones , Violencia Laboral , Lugar de Trabajo , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Encuestas y Cuestionarios , Recursos Humanos , Adulto JovenRESUMEN
This study examined the health promotion model (HPM) as a framework for assessing perceptions and health-related behaviors related to cardiovascular disease (CVD) risk among blue-collar workers. This was done with the aim of providing time-sensitive educational and training materials for workers while on the job or functioning in their communities. The revised HPM was evaluated in the above context using specific criteria developed by Chinn and Kramer (2008) and scoping literature review. Specifically, we assessed the model based on five criteria such as its clarity, simplicity, generality, accessibility, and importance. The revised HPM showed strengths in both accessibility and generality. That is, it applied to all populations and chronic illnesses through clearly defined and specified major concepts. However, there were several weaknesses in areas of clarity and consistency; the model included three new concepts (i.e., activity-related affect, commitment to a plan of action, and immediate competing demands and preference) that actually decreased these elements. In this context, situational influences require adequately reflected external variables. Nevertheless, the revised HPM showed predictive power among this study's target population. The HPM was modified to address deficiencies in regard to the concept of risk perception. Work-related situational influences were also restructured based on individual and environmental characteristics. The modified framework can be used to clarify health-related behaviors among blue-collar workers.
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Purpose: With globalization, the importance of global health is being stressed. Although nurses are indispensable healthcare professionals, programs to develop nurses with global health competencies and relevant studies are rare. Accordingly, this study was designed to develop a program to increase global health competencies and global leadership in nursing students and test its effect. Methods: A single group pre- and post-test study design was used. A 13-weeks program was developed and implemented with 204 students. Data were analyzed using paired t-test. The program to promote global health competencies was designed to improve nursing students' knowledge of global health, global leadership, global health competencies, critical thinking ability, and student-student partnership. Results: Global health competencies (t = -19.96, p < 0.001), self-assessed global leadership (t = -7.67, p < 0.001), and critical thinking ability (t = -7.67, p < 0.001) all significantly increased. Discussion: The study findings of increased global health competencies and global leadership in nursing students after participation in the program indicated ways in which global health competencies of nurses need to be developed. Therefore, the following aspects should be considered. First, nursing educators should understand the need and importance of global health education and accordingly, current nursing curriculums should be revised to include courses about global health. A systematic course of studies about global health should be developed and implemented based on discussions among experts and researchers. Second, as future health care professionals, nursing students should take an interest in global health problems and recognize various issues that need to be solved beyond borders between countries. To develop global health competencies, various efforts and systematic curriculum revisions are necessary.
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Competencia Clínica , Curriculum , Bachillerato en Enfermería , Salud Global , Estudiantes de Enfermería , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , UniversidadesRESUMEN
Contextual factors are associated with risks of cardiovascular disease (CVD) perceived by personnel employed in small-medium-sized workplaces. In an ecological model, data collection and analysis were undertaken, stratified by intrapersonal, interpersonal, and organizational contexts of blue-collar workers. Data were collected in face-to-face (n = 36) and focus group (n = 4) interviews and subjected to qualitative content analysis, to generate three main themes, 10 generic categories and 18 sub-categories. At the intrapersonal level, "physical burden", "burn out due to overtime work", "no time to take care of health because of family responsibility", and "lack of recognition and knowledge of CVD risks" were derived from the individual interviews. At the interpersonal level, "stress of possible job losses", "dislike of stigmatization of unhealthy persons", "smoking and drinking to reduce relationship stress", and "unhealthy work environment" differed by level of risk perception. "Preferred economic value" and "lack of understanding about importance of CVD management of an employer" emerged at the organizational level. Factors that influence CVD risks among workers in small-medium-sized business were present at the multiple levels. Therefore, healthcare providers in the field of occupational health should consider CVD risks in the context of blue-collar workers and organizational level for health-promotion programs.
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Enfermedades Cardiovasculares , Salud Laboral , Adulto , Actitud Frente a la Salud , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Empleo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Lugar de Trabajo , Adulto JovenRESUMEN
This study examined the effect of lifestyle interventions on cardiovascular disease risk factors among workers. The study comprised a systematic review and meta-analysis of controlled trials. Relevant controlled trials were searched, with selections based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN). Of 1174 identified publications, one low-quality study was excluded. Finally, 10 were analyzed. The effect sizes were analyzed for heterogeneity, and random effect models (Hedge's g) were used. A subgroup analysis was performed on the follow-up point of intervention (≤ 12 months vs. > 12 months). Publication bias was also analyzed. Interventions were effective for systolic (g = 0.66, 95% CI: 0.27-1.60) and diastolic blood pressure (g = 0.63, 95% CI: 0.21-1.06), and BMI (g = 0.71, 95% CI: 0.15-1.11). Interventions were ineffective for weight (g = 0.18, 95% CI: -0.04, 0.40) and LDL-cholesterol (g = 0.46, 95% CI: -0.02, 0.93). There was high heterogeneity between studies (I2 =78.45 to I2 = 94.61). There was no statistically significant publication bias, except for systolic blood pressure. Interventions to reduce risk of cardiovascular disease risk might be effective in improving physical outcomes, but additional high-quality trials are needed in the future.
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Enfermedades Cardiovasculares , Estilo de Vida , Adulto , Presión Sanguínea , Peso Corporal , Enfermedades Cardiovasculares/prevención & control , LDL-Colesterol , Humanos , OcupacionesRESUMEN
Purpose: Developing and evaluating a simulation scenario for community nursing practicum students.Design: One group, pretest posttest design with 87 nursing students.Methods: Data were collected through questionnaires. The simulation was based on Jeffries' simulation model and used a standardized patient.Findings: Self-efficacy and critical thinking increased with the developed simulation. Positive correlations were identified among critical thinking, learning effectiveness, and self-efficacy.Conclusions: The home-visit simulation scenario was effective in providing students with a problem-solving experience in conditions similar to reality.Clinical Evidence: Further research is needed to develop various types of community simulation scenarios to enhance competency for community health practice.
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Diabetes Mellitus/enfermería , Visita Domiciliaria , Enfermeros de Salud Comunitaria/educación , Simulación de Paciente , Anciano , Competencia Clínica , Diabetes Mellitus/terapia , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Autoeficacia , Persona Soltera , Encuestas y Cuestionarios , Adulto JovenRESUMEN
This study developed and evaluated a health management program based on the participant-centered concept of action research to reduce cardiovascular disease (CVD) risk factors among blue collar workers. Data from structured questionnaires completed by 32 workers in a small-to-medium sized workplace from September 2015 to October 2016 as well as participants' anthropometrical (weight and waist) and biological (blood pressure, glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol) data were analyzed using paired t-test and Fisher's exact test. To examine the longitudinal effect of the intervention, survival analysis and linear mixed model (LMM) were used. There was an improvement in participants' self-regulation in maintaining health-promoting behaviors, body weight, blood pressure, and HDL cholesterol following the intervention. Furthermore, the effects of the health management program continued even after the program ended. These findings suggest that the health management program developed in this study could be effective in reducing CVD risk factors among workers in small-to-medium sized workplaces and should be applied to other small-to-medium sized workplaces to foster health-promoting behaviors.