Västerbotten Intervention Programme
Västerbotten intervention programme, VIP, is offered to all residents of the county’s municipalities. The aim is to motivate and support healthy lifestyle habits to decrease the risk of contracting cardiovascular disease and diabetes.
The health check is comprised of two visits to a healthcare centre. On the first visit, various samples and measures are taken. Additionally, the patient fills out a questionnaire regarding their lifestyle habits and social situation. On the second visit, the patient sits down with a specialized nurse to have a “health talk” based on the results of the check up and the questionnaire.
– The health talk is the core of the VIP. It provides the patient with support in forming healthy, long-term lifestyle habits, thereby reducing the risk of future disease, says Patrik Wennberg, VIP research coordinator.
This can mean increasing one’s physical activity, limiting alcohol consumption, quit using tobacco or developing healthier eating habits. Every patient is given their own ‘star profile’, where the points of the star represent different lifestyle habits and other results from the health check.
A sustainable, long-term programme
184,000 health checks were made between 1990 and 2018. VIP has been included in the regular primary care activities since 1996. All healthcare clinics in the county, those run by the region as well as by private entrepreneurs, invite their 40-, 50- and 60-year-old registered patients to partake. Around 6,000 health checks are conducted annually within the VIP framework.
– The residents of Västerbotten expect an invitation to a health check around their 40th, 50th and 60th birthday. Having people of the same age receive the invitation and partake in the health checks makes lifestyle habits and health common topics of conversation within the population, Patrik Wennberg reports.In the middle of the 1980s, when the work on regular health checks began in Västerbotten, the county had the highest mortality rate in the country for coronary artery disease. After studying knowledge gained from cardio-vascular projects in other countries in similar geographical locations, a preventative project was initiated in Norsjö, the community that was most affected by cardio-vascular disease. This project was the start of what would become Västerbotten intervention programme.
Decrease in mortality
In 2007, an evaluation of the health checks conducted between 1990 and 2006 showed a more rapid decrease in mortality in Västerbotten compared to the national average, both for those who had and those who had not participated in VIP. Furthermore, the mortality rate in Västerbotten was now around 10% lower than that of the country’s total population. This is equivalent to the prevention of 587 deaths. The overall mortality was even lower if only residents who had participated in VIP were included.
– VIP is a long-term effort to prevent disease and promote health. Providing support to a large number of people in forming healthier lifestyle habits has a great effect on public health, says Patrik Wennberg.
The health checks are also a way to identify people with a high risk of cardio-vascular disease and diabetes and who need medical treatment. Studies have shown that people whose diabetes was revealed through VIP have fewer complications and a higher survival rate than those who were discovered by ‘regular’ medical care. In addition, VIP participants with diabetes were diagnosed on average 4.6 years earlier that those diagnosed in connection to other healthcare visits.
A health-economic analysis from 2018 showed that the regular health checks are cost efficient. The years of life gained have meant a cost reduction for the health services which is around 50% greater than the cost of the health checks.
A resource for research
The database containing the results from the health checks in Västerbotten is a resource for research on health and disease in the population. Research is also conducted on blood samples donated by the participants for research purposes.
– Aside from studying the effects of VIP on public health, we are also able to study preventive measures, diagnostics and treatment of several of our most common public diseases. We are currently conducting an extensive study within the VIP framework on how image-based risk communication, in this case ultrasonography of the carotid arteries, may help furthering the prevention of cardio-vascular disease, says Patrik Wennberg.
The efforts made in Västerbotten have inspired others, and several regions in Sweden now use the health check model in some form.
– Several regions in Sweden are developing similar models for health checks, and we try to support them by contributing our accumulated experience from our persistent work with VIP.
Patrik Wennberg, general practitioner and Docent at the Public Health Unit, 073-832 88 19
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