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This prospective, quasi-experimental study consisted of a six-month company-based WHP intervention trial with a 6- and 12-month follow-up after the start of the intervention. IMSS' researchers promoted participation in this study among affiliated companies located in Mexico City and recruited 2,002 workers from seven different worksites, including a cooking utensils factory, a government public health services department, a metalworking company, a pharmaceutical company, a plastic factory, and a printing company. 1,011). Employers were presented with the intervention first and if they did not agree to participate, the option to enter the study as a control company was offered second. IMSS researchers met with the directors of each company to introduce the intervention program and obtain authorization to perform the activities. Nurses and social workers from the research team promoted the intervention throughout the company. As an incentive, they offered workers a complete and confidential physical examination, including blood tests such as glucose, cholesterol, and triglyceride levels for free.
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They remained in each of the companies for about a week to enroll as many participants as possible but no further efforts were made to reach workers on sick leave or disability. All participants provided written, informed consent before the onset of the study. Individual CVD risk factors were assessed via questionnaires, physical exams, and serologic tests. IMSS experts including occupational physicians, nurses, psychologists, nutritionists, and sports medicine specialists designed a health risk assessment questionnaire assessing socio-demographic and organizational characteristics, behavioral and biological risk factors for CVD, and personal history of diabetes, hypertension, CVD, and other self-reported doctors' diagnoses. The questionnaire was distributed among participants who completed it at home and submitted it to the research team on the day of their physical evaluation. The physical examination included anthropometric (height, weight, waist circumference, and skinfold measurements to assess body fat, muscle, and bone mass), physiological measurements (heart rate, BP, maximum oxygen intake), and a finger-stick cholesterol and glucose screening (see Supplementary Appendix 1). Assessors were not blind to intervention allocation. The WHP program lasted 6 months and included the following components: nutrition counseling, physical activity, [GlycoCares Blood Sugar Guideberberine blood sugar support](http://lieblingsmetropole.de/index.php?title=Type_2_Diabetes:_Best_Bread_To_Choose_If_You_Want_To_Lower_Blood_Sugar) and stress management. After initial screening for CVD risk factors through the health risk assessment survey, workers were invited to attend one or more intervention groups according to their specific individual health needs. Participation was voluntary. Prevention activities were offered both at the group and individual level during paid work hours. As a first step, workers were invited to participate in one of several offered 30-min information sessions (for maximal 25 participants each) to discuss the basic food groups.
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