The Risk Reduction Program is a structured and supervised program designed to assist individuals with lifestyle diseases (e.g. Coronary artery disease – (CAD); Diabetes – (DM); High blood pressure – (HBP); or Obesity) enhance their quality of life. The program is also appropriate for individuals with stable cardiovascular disease who have not previously participated in a cardiac rehabilitation program or other individuals with medical conditions that require structure and clinical supervision. The program is a one year program (with an intensive ~ 100 day “kick-start”) that provides education and group support in the areas of cardiovascular risk factors, physical activity / exercise, yoga and stress management, healthy eating, and health responsibility. The group structure combined with ongoing feedback and guidance from a case manager / health coordinator is designed to enhance knowledge and build skills for lifelong changes. An interdisciplinary team including exercise physiologists, a registered dietitian, a health educator and an experienced yoga instructor are utilized throughout the program to assist with goal setting, provide individual counseling and ongoing support and reinforcement.

“PHASE I”
Week 1
• Written medical history form
• Blood work (lipids and glucose)
• Physical assessment – lung function, body composition
• Stress test

Week 2 – 15
• Review baseline medical tests, discuss basis of exercise prescription. Establish initial physical activity goals.
• Participate in group support and yoga / stress management classes.
• Goal setting with a case manager, who will review your needs, review your exercise program and individualize a plan to meet your goals.
• Participate in assisted exercise. ( 3 days/week for about 1hr-1.5 hrs)
• Hours suggested to exercise for participants initially (to benefit from our RRP personal trainers) Monday, Wednesday and Friday 6:00 – 8:00 am; 11:00 – 1:00 pm; 4:30 – 6:30 pm.

After you are familiar with your exercise prescription & exercise progression protocol you are encouraged to exercise at any time our WellWorks facility is open (i.e. 5:45 am -10:00 pm Monday - Friday & 9:00 am – 6:00 pm Saturday & Sunday).

Weeks 2 – 15
• Monday 5:30 – 6:30 Facilitated Group Support
• Monday 6:30 – 7:30 Yoga / Stress management
• Thursday 4:30 – 5:30 Yoga / Stress management
• Thursday 5:30 – 6:30 Nutrition counseling (see calendar for dates)

Week 15
• Written medical history form
• Blood work (lipids and glucose)
• Physical assessment – lung function, body composition
• Stress test

AFTER THE 100 Days…
“PHASE II”
Months 3-6
• Continue with lifestyle changes: Yoga (may participate for 1 additional quarter), exercise, physical activity, healthy eating.
o Meet with trainer 1 day/week
• Group support – monthly get-togethers with cohort and group leaders.
• Periodic check-ins with case manager, exercise physiologists, registered dietitian.
o Meet with Case Manager/Dietitian 1 x/month
• Scheduled physiologic re-tests for BodPod, waist circumference and blood lipids/glucose
• Reset goals for next 90 days.

“PHASE III”
Months 6-9
• Continue with lifestyle changes independently!
• Group support – encouraged to continue led by cohort members.
• Periodic check-ins with case manager, exercise physiologists, registered dietitian.
o Meet with Case Manager/Dietitian 1 x/month
• Scheduled physiologic re-tests for BodPod, waist circumference and blood lipids/glucose
• Reset goals for next 90 days.

“PHASE IV”
Months 9-12
• Continue with lifestyle changes independently!
• Group support – encouraged to continue led by cohort members.
• Periodic check-ins with case manager, exercise physiologists, registered dietitian.
o Meet with Case Manager/Dietitian 1 x/month
• 1 year testing including:
o Written medical history form
o Blood work (lipids and glucose)
o Physical assessment – lung function, body composition
o Stress test

RISK REDUCTION PROGRAM
Expected Outcomes
• Abstain from tobacco
• Optimize lipids LDL < 130 (prevention); 70-100 (known CVD); TC/HDL-C ratio < 5.0 (<4.0with CVD); Triglycerides <150
• Optimize BP < 120/80
• Optimize Diabetes control (Hgb AIc<: 7%)
• Achieve and maintain ideal body weight (BMI < 25; Waist circumference < 40 inches (male); < 35 inches (female)
• Achieve and maintain regular exercise. (Exercise capacity >7 METS)
• Achieve and maintain healthy eating
**** <20 - 25 % calories from fat, <10% saturated fat, <150 mg cholesterol per day, >25 grams of fiber per day, >5 servings of fruits and vegetables per day, < 2400 mg sodium per day
• Improve interpersonal relationships, ability to manage stress, and enhance spiritual growth
• Decrease psychological distress
• Experienced Yoga practitioner
• Practice relaxation response 10 - 20 minutes per day
• Increase or maintain self-efficacy to meet individual goals
• Improve or maintain health responsibility

Outcome Measures:
• Lipid profile and glucose
• Hgb Alc (if diabetic or risk factors for diabetes)
• Blood pressure measurement
• Graded exercise tolerance test
• Lung function measurements
• Body composition measurements
• Participant attendance
• Health care utilization / claims

Entry Criteria:
Participants may be referred by their Primary Care Physician.
Any Ohio University employee (& eligible dependent) with cardiovascular risk factors and / or significant lifestyle disease is eligible to participate. Cardiovascular risk factors include diabetes, hypertension, dyslipidemia, cigarette smoking, stress, obesity, or sedentary behavior. Individuals with stable cardiovascular disease who meet entry criteria may also be appropriate for this program. Participants with cardiovascular disease or uncontrolled risk factors will exercise during specified times to assure the availability or clinical staff on site.