Working on wellness (WOW): a worksite health promotion intervention programme

Tracy L Kolbe-Alexander, Karin I Proper, Estelle V Lambert, Marieke F van Wier, Julian D Pillay, Craig Nossel, Leegale Adonis, Willem Van Mechelen, Tracy L Kolbe-Alexander, Karin I Proper, Estelle V Lambert, Marieke F van Wier, Julian D Pillay, Craig Nossel, Leegale Adonis, Willem Van Mechelen

Abstract

Background: Insufficient PA has been shown to cluster with other CVD risk factors including insufficient fruit and vegetable intake, overweight, increased serum cholesterol concentrations and elevated blood pressure. This paper describes the development of Working on Wellness (WOW), a worksite intervention program incorporating motivational interviewing by wellness specialists, targeting employees at risk. In addition, we describe the evaluation the effectiveness of the intervention among employees at increased risk for cardiovascular disease.

Methods: The intervention mapping (IM) protocol was used in the planning and design of WOW. Focus group discussions and interviews with employees and managers identified the importance of addressing risk factors for CVD at the worksite. Based on the employees' preference for individual counselling, and previous evidence of the effectiveness of this approach in the worksite setting, we decided to use motivational interviewing as part of the intervention strategy. Thus, as a cluster-randomised, controlled control trial, employees at increased risk for CVD (N = 928) will be assigned to a control or an intervention group, based on company random allocation. The sessions will include motivational interviewing techniques, comprised of two face-to-face and four telephonic sessions, with the primary aim to increase habitual levels of PA. Measures will take place at baseline, 6 and 12 months. Secondary outcomes include changes in nutritional habits, serum cholesterol and glucose concentrations, blood pressure and BMI. In addition, healthcare expenditure and absenteeism will be measured for the economic evaluation. Analysis of variance will be performed to determine whether there were significant changes in physical activity habits in the intervention and control groups at 6 and 12 months.

Discussion: The formative work on which this intervention is based suggests that the strategy of targeting employees at increased risk for CVD is preferred. Importantly, this study extends the work of a previous, similar study, Health Under Construction, in a different setting. Finally, this study will allow an economic evaluation of the intervention that will be an important outcome for health care funders, who ultimately will be responsible for implementation of such an intervention.

Trial registration: United States Clinical Trails Register NCT 01494207.

Trial registration: ClinicalTrials.gov NCT01494207.

Figures

Figure 1
Figure 1
Flow diagram of participant recruitment.

References

    1. Bradshaw D, Groenewald P, Laubscher R, Nannan N, Nojilana B, Norman R, Pieterse D, Schneider M, Bourne DE, Timaeus IM. et al.Initial burden of disease estimates for South Africa, 2000. S Afr Med J. 2003;93(9):682–688.
    1. King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998;21(9):1414–1431. doi: 10.2337/diacare.21.9.1414.
    1. Kolbe-Alexander TL, Buckmaster C, Nossel C, Dreyer L, Bull F, Noakes TD, Lambert EV. Chronic disease risk factors, healthy days and medical claims in South African employees presenting for health risk screening. BMC Publ Health. 2008;8:228. doi: 10.1186/1471-2458-8-228.
    1. Prochaska JO, Butterworth S, Redding CA, Burden V, Perrin N, Leo M, Flaherty-Robb M, Prochaska JM. Initial efficacy of MI, TTM tailoring and HRI’s with multiplebehaviors for employee health promotion. Prev Med. 2008;46(3):226–231. doi: 10.1016/j.ypmed.2007.11.007.
    1. Dishman RK, Oldenburg B, O’Neal H, Shephard RJ. Worksite physical activityinterventions. Am J Prev Med. 1998;15(4):344–361. doi: 10.1016/S0749-3797(98)00077-4.
    1. Plotnikoff RC, McCargar LJ, Wilson PM, Loucaides CA. Efficacy of an E-mail intervention for the promotion of physical activity and nutrition behavior in the workplace context. Am J Health Promot. 2005;19(6):422–429. doi: 10.4278/0890-1171-19.6.422.
    1. Serxner SA, Gold DB, Grossmeier JJ, Anderson DR. The relationship between health promotion program participation and medical costs: a dose response. J Occup Environ Med. 2003;45(11):1196–1200. doi: 10.1097/01.jom.0000095002.12772.6a.
    1. Soler RE, Leeks KD, Razi S, Hopkins DP, Griffith M, Aten A, Chattopadhyay SK, Smith SC, Habarta N, Goetzel RZ. et al.A systematic review of selected interventions for worksite health promotion. The assessment of health risks with feedback. Am J Prev Med. 2010;38(2 Suppl):S237–S262.
    1. Goetzel RZ, Ozminkowski RJ, Bruno JA, Rutter KR, Isaac F, Wang S. The long-term impact of Johnson & Johnson’s Health & Wellness Program on employee health risks. J Occup Environ Med. 2002;44(5):417–424. doi: 10.1097/00043764-200205000-00010.
    1. Groeneveld IF, Proper KI, van der Beek AJ, Hildebrandt VH, van Mechelen W. Lifestyle-focused interventions at the workplace to reduce the risk of cardiovascular disease–a systematic review. Scand J Work Environ Health. 2010;36(3):202–215. doi: 10.5271/sjweh.2891.
    1. Pelletier KR. A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: update VI 2000–2004. J Occup Environ Med. 2005;47(10):1051–1058. doi: 10.1097/.
    1. Serxner S, Gold D, Anderson D, Williams D. The impact of a worksite health promotion program on short-term disability usage. J Occup Environ Med. 2001;43(1):25–29. doi: 10.1097/00043764-200101000-00006.
    1. Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Merrill RM, Ohmine S. The effects of aworksite chronic disease prevention program. J Occup Environ Med. 2005;47(6):558–564. doi: 10.1097/01.jom.0000165743.18570.66.
    1. Botes A, Otto M. Ethical dilemmas related to the HIV-positive person in the workplace. Nurs Ethics. 2003;10(3):281–294. doi: 10.1191/0969733003ne606oa.
    1. Day JH, Miyamura K, Grant AD, Leeuw A, Munsamy J, Baggaley R, Churchyard GJ. Attitudes to HIV voluntary counselling and testing among mineworkers in South Africa: will availability of antiretroviral therapy encourage testing? AIDS Care. 2003;15(5):665–672. doi: 10.1080/0954012030001595140.
    1. London L, Benjamin P. Voluntary HIV testing and counselling at the workplace–entirely compatible with the Employment Equity Act. S Afr Med J. 2003;93(11):804.
    1. Bartholomew L. Planning health promotion programs. 2. Jossey-Bass, A Wiley imprint, San Francisco, CA; 2006.
    1. Groeneveld IF, Proper KI, van der Beek AJ, van Duivenbooden C, van Mechelen W. Design of a RCT evaluating the (cost-) effectiveness of a lifestyle intervention for male construction workers at risk for cardiovascular disease: the health under construction study. BMC Publ Health. 2008;8:1. doi: 10.1186/1471-2458-8-1.
    1. Groeneveld IF, Proper KI, van der Beek AJ, van Mechelen W. Sustained body weight reduction by an individual-based lifestyle intervention for workers in the construction industry at risk for cardiovascular disease: results of a randomized controlled trial. Prev Med. 2010;51(3–4):240–246.
    1. Serxner SA, Gold DB, Bultman KK. The impact of behavioral health risks on worker absenteeism. J Occup Environ Med. 2001;43(4):347–354. doi: 10.1097/00043764-200104000-00010.
    1. Hallam JS, Petosa R. The long-term impact of a four-session work-site intervention on selected social cognitive theory variables linked to adult exercise adherence. Health Educ Behav. 2004;31(1):88–100. doi: 10.1177/1090198103259164.
    1. Proper KI, Hildebrandt VH, Van der Beek AJ, Twisk JW, Van Mechelen W. Effect of individual counseling on physical activity fitness and health: a randomized controlled trial in a workplace setting. Am J Prev Med. 2003;24(3):218–226. doi: 10.1016/S0749-3797(02)00645-1.
    1. Verweij LM, Coffeng J, van Mechelen W, Proper KI. Meta-analyses of workplace physical activity and dietary behaviour interventions on weight outcomes. Obes Rev. 2011;12(6):406–429. doi: 10.1111/j.1467-789X.2010.00765.x.
    1. Racette SB, Deusinger SS, Inman CL, Burlis TL, Highstein GR, Buskirk TD, Steger-May K, Peterson LR. Worksite Opportunities for Wellness (WOW): effects on cardiovascular disease risk factors after 1 year. Prev Med. 2009;49(2–3):108–114.
    1. Thorne S. Data analysis in qualitative research. Evid Based Nurs. 2000;3:3.
    1. Rollnick SMW. What is motivational interviewing? Behav Cogn Psychother. 1995;23:10.
    1. Miller WR, Rollnick S. Ten things that motivational interviewing is not. Behav Cogn Psychother. 2009;37(2):129–140. doi: 10.1017/S1352465809005128.
    1. Griffin-Blake CS, DeJoy DM. Evaluation of social-cognitive versus stage-matched, self-help physical activity interventions at the workplace. Am J Health Promot. 2006;20(3):200–209. doi: 10.4278/0890-1171-20.3.200.
    1. Kao YH, Lu CM, Huang YC. Impact of a transtheoretical model on the psychosocial factors affecting exercise among workers. J Nurs Res. 2002;10(4):303–310. doi: 10.1097/.
    1. Norcross JC, Krebs PM, Prochaska JO. Stages of change. J Clin Psychol. 2011;67(2):143–154. doi: 10.1002/jclp.20758.
    1. Armstrong TB. FC: Development of the World Health Organisation Global Physical Activity Questionnaire. J Public Health. 2006;14:5.
    1. Dobson AJ, Blijlevens R, Alexander HM, Croce N, Heller RF, Higginbotham N, Pike G, Plotnikoff R, Russell A, Walker R. Short fat questionnaire: a self-administered measure of fat-intake behaviour. Aust J Public Health. 1993;17(2):144–149.
    1. Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s Healthy Days Measures - population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37. doi: 10.1186/1477-7525-1-37.
    1. Black W. The CE plane: a graphic representation of cost-effectiveness. Med Decis Making. 1990;10:3.
    1. Fenwick E, Marshall DA, Levy AR, Nichol G. Using and interpreting cost-effectiveness acceptability curves: an example using data from a trial of management strategies for atrial fibrillation. BMC Health Serv Res. 2006;6:52. doi: 10.1186/1472-6963-6-52.
    1. Rothstein MA, Harrell HL. Health risk reduction programs in employer-sponsored health plans: Part I-efficacy. J Occup Environ Med. 2009;51(8):943–950. doi: 10.1097/JOM.0b013e3181b05421.
    1. Proper KI, Koning M, van der Beek AJ, Hildebrandt VH, Bosscher RJ, van Mechelen W. The effectiveness of worksite physical activity programs on physical activity, physical fitness, and health. Clin J Sport Med. 2003;13(2):106–117. doi: 10.1097/00042752-200303000-00008.

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe