The impact of community-based health promotion on quality of life: The need to control for general health trends. The Northern Sweden MONICA Study in 2014
Abstract Background: The Västerbotten Intervention Programme (VIP) is a public health promotion programme in northern Sweden aimed at preventing cardiovascular diseases. Its positive effects on disease risk factors and on the risk of coronary heart disease itself have been reported, although the evidence is not unequivocal. Since only historical controls have been used, effects from sources other than the programme have largely been uncontrolled for and health-related quality of life (QoL) has not been evaluated.Methods: By using the neighbouring county of Norrbotten (NB) as a reference population, we compare QoL in Västerbotten (VB) and NB. In 2014, the World Health Organization’s Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Study was implemented in northern Sweden, where random samples from VB and NB were examined. In total, 1112 participants between the ages of 40 to 74 participated: 516 in VB, and 594 in NB. Their QoL was measured with the three-level EuroQol 5-dimension (EQ-5D-3L) questionnaire. Differences in mean QoL between VB and NB were analysed via the Student’s t-test and the Pearson chi-square test.Results: Average QoL measured by the EQ-5D index was 0.798 in VB and 0.811 in NB, i.e. a difference of 0.013 (p = 0.2; confidence interval/CI -0.009 to 0.036). For participants aged 45–54, the QoL was lower in VB than in NB, showing a difference of 0.048 (p = 0.041; CI 0.002 to 0.0094). In NB, QoL decreased with age – a pattern not seen in VB. Men had higher QoL than women, and participants with a university education had higher QoL than those without one. The vertical visual analogue scale (EQ VAS) showed similar results. Participants from NB and from VB did not differ regarding age, gender or level of education.Conclusions: We found similar levels of health-related QoL in VB and NB.Trial registration: Not applicable