The Effect of a Workplace Wellness Program for Primary School Teachers in Controlling Blood Pressure: A Before and After Study.

Background and objective: Hypertension is a major health issue worldwide, with primary schoolteachers possessing several lifestyle risks of the disease. There have not been any health promotion programs yet for primary school-teachers in Indonesia, especially for blood pressure control. A school-based model of workplace wellness program for teachers was developed. It focused on using screening as feedback in controlling blood pressure by eating a healthy diet, doing physical activity, and having regular checks. This study aimed to assess its clinical and behavioral effects.

Methods: This trial was a one group pre- and post-test study design without control. It was implemented purposively in three public primary school locations in Jakarta to 44 eligible teachers for approximately three months from January to March 2022. The workplace wellness program included on-site screening (blood pressure, body mass index/BMI, spot urine sodium-creatinine ratio), knowledge, motivation, and ongoing health behavior (physical activity and the dietary approach to stop hypertension/DASH), online education/training, consultation/counseling sessions with a family doctor, and self-monitoring. All screening measurements were repeated at the end of the program. A paired t-test or Wilcoxon analysis was performed using SPSS 20.0.

Results: Both systolic and diastolic blood pressure decreased by 5.05 mmHg (p = 0.018) and 6.41 mmHg (p < 0.001), respectively. The spot urine sodium-creatinine ratio and BMI decreased slightly but not significant (p = 0.707; p = 0.761). Knowledge and motivation increased slightly but not significant (p = 0.529; p = 0.175). The DASH behavior significantly increased by 25% (p < 0.001). Though the overall physical activity did not change, the walking activity increased twofold significantly (p = 0.006). This study also showed that the outcome would be achieved when the participant followed the recommendations obediently.

Conclusion: This school-based workplace wellness program was found to have a potential effect on controlling blood pressure by changing health behaviors. A randomized controlled trial is recommended to provide stronger evidence on its effectiveness before doing a large-scale implementation in primary schools in Indonesia.