Stephen M. Weiss - Böcker

Cardiovascular disease continues to be the number ioral medicine" was developed and shaped into the one source of morbidity and mortality in our coun- following definition: try. Despite a 35% reduction since 1964, these Behavioral medicine is the interdisciplinary field con- diseases, particularly coronary heart disease cerned with the development and integration of behav- (CHD), claim nearly 1,000,000 lives each year in ioral and biomedical science knowledge and techniques the United States (Havlik & Feinleib, 1979). relevant to the understanding of health and illness and The Framingham study, among others, has iden- the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation. tified three major risk factors implicated in the de- (Schwartz & Weiss, 1978) velopment of CHD: smoking, elevated serum cho- lesterol, and high blood pressure (Castelli et at., This concept of "biobehavioral" collaboration 1986).Given that these factors account for less challenged scientists and clinicians of many disci- than 50% of the variance associated with CHD plines to consider how they might more effectively (Jenkins, 1976), it has become obvious that addi- develop diagnostic, treatment, and prevention tional risk factors must be identified if further pro- strategies by merging their perspectives to address gress is to be made in disease prevention and simultaneously, among others, behavioral, psy- control.

This book focuses on the major issues surrounding worksite health promotion programs. It identifies and discusses examples of the most intensively studied programs (such as Johnson and Johnson's "Live for Life," and AT&T's "TLC"), and considers the "state of science" for the four most frequently offered health-promotion program components: smoking cessation, weight control, exercise, and stress management. As is becoming increasingly evident, worksite health-promotion activities pose their own unique set of challenges -- challenges that are likely to have a significant impact on national health status and costs. Crucial areas addressed in this volume include program development and design, cost benefit/cost effectiveness, and legislative/policy issues.

This book focuses on the major issues surrounding worksite health promotion programs. It identifies and discusses examples of the most intensively studied programs (such as Johnson and Johnson's "Live for Life," and AT&T's "TLC"), and considers the "state of science" for the four most frequently offered health-promotion program components: smoking cessation, weight control, exercise, and stress management. As is becoming increasingly evident, worksite health-promotion activities pose their own unique set of challenges -- challenges that are likely to have a significant impact on national health status and costs. Crucial areas addressed in this volume include program development and design, cost benefit/cost effectiveness, and legislative/policy issues.

During the past decade, cardiovascular medicine has made significant strides in the diagnosis and treatment of coronary heart disease and related disorders as well as developing a better understanding of potential preventive, risk-reduc­ ing measures. Highly sophisticated diagnostic instrumentation, surgical pro­ cedures, and emergency medical care have undoubtedly contributed greatly to the trend of declining mortality from cardiovascular events. In the course of the extensive research efforts associated with this area, it has become increas­ ingly apparent that the identified coronary risk factors share the common ele­ ment of lifestyle as a major determiner of health behaviors associated with these factors. Further, it is suspected that behavioral and environmental factors may playa significant contributory role toward the etiology and progression of arteriosclerosis through their effects on the central and peripheral nervous sys­ tems and associated neurohormonal response. Considerable research effort has been devoted to identifying the risks asso­ ciated with smoking, elevated blood pressure, and serum cholesterol. Research development and modification is being vigorously pursued. Behavioral research exploring the role of psychological stress factors, social support networks, stressful life events, and the Type AlB behavior patterns has uncovered poten­ tially meaningful associations between behavioral factors and arteriosclerosis, as discussed in the succeeding chapters of this book.