HealthWorks: results of a multi-component group-randomized worksite environmental intervention trial for weight gain prevention

Jennifer A Linde, Katherine E Nygaard, Richard F MacLehose, Nathan R Mitchell, Lisa J Harnack, Julie M Cousins, Daniel J Graham, Robert W Jeffery, Jennifer A Linde, Katherine E Nygaard, Richard F MacLehose, Nathan R Mitchell, Lisa J Harnack, Julie M Cousins, Daniel J Graham, Robert W Jeffery

Abstract

Background: U.S. adults are at unprecedented risk of becoming overweight or obese, and most scientists believe the primary cause is an obesogenic environment. Worksites provide an opportunity to shape the environments of adults to reduce obesity risk. The goal of this group-randomized trial was to implement a four-component environmental intervention at the worksite level to positively influence weight gain among employees over a two-year period. Environmental components focused on food availability and price, physical activity promotion, scale access, and media enhancements.

Methods: Six worksites in a U.S. metropolitan area were recruited and randomized in pairs at the worksite level to either a two-year intervention or a no-contact control. Evaluations at baseline and two years included: 1) measured height and weight; 2) online surveys of individual dietary intake and physical activity behaviors; and 3) detailed worksite environment assessment.

Results: Mean participant age was 42.9 years (range 18-75), 62.6% were women, 68.5% were married or cohabiting, 88.6% were white, 2.1% Hispanic. Mean baseline BMI was 28.5 kg/m(2) (range 16.9-61.2 kg/m(2)). A majority of intervention components were successfully implemented. However, there were no differences between sites in the key outcome of weight change over the two-year study period (p = .36).

Conclusions: Body mass was not significantly affected by environmental changes implemented for the trial. Results raise questions about whether environmental change at worksites is sufficient for population weight gain prevention.

Trial registration: ClinicalTrials.gov: NCT00708461.

Figures

Figure 1
Figure 1
Individual participant recruitment flow diagram.

References

    1. Bureau of Labor Statistics. Economic news release: employment status of the civilian population by sex and age. Accessed at [ ] on April 7, 2011.
    1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999-2008. JAMA. 2010;303:235–241. doi: 10.1001/jama.2009.2014.
    1. Hill JO, Wyatt HR, Reed GW, Peters JC. Obesity and the environment: where do we go from here? Science. 2003;299:853–855. doi: 10.1126/science.1079857.
    1. Caban AJ, Lee DJ, Fleming LE, Gomez-Marin O, LeBlanc W, Pitman T. Obesity in US workers: the national health interview survey, 1986-2002. Am J Public Health. 2005;95:1614–1622. doi: 10.2105/AJPH.2004.050112.
    1. Bungum T, Satterwhite M, Jackson AW, Morrow JR Jr. The relationship of body mass index, medical costs, and job absenteeism. Am J Health Behav. 2003;27:456–462. doi: 10.5993/AJHB.27.4.17.
    1. Neovius K, Johansson K, Kark M, Neovius M. Obesity status and sick leave: a systematic review. Obes Reviews. 2009;10:17–27. doi: 10.1111/j.1467-789X.2008.00521.x.
    1. Chau N, Bhattacherjee A, Kunar BM. Lorhandicap Group. Relationship between job, lifestyle, age and occupational injuries. Occup Med (Lond) 2009;59:114–119. doi: 10.1093/occmed/kqp002.
    1. Neovius K, Johansson K, Rössner S, Neovius M. Disability pension, employment, and obesity status: a systematic review. Obes Reviews. 2008;9:572–581. doi: 10.1111/j.1467-789X.2008.00502.x.
    1. Bureau of Labor Statistics. Economic news release: American time use survey summary. Accessed at [ ] on April 7, 2011.
    1. Samuel TW, Raleigh SG, Hower JM, Schwartz RW. The next stage in the health care economy: aligning the interests of patients, providers, and third-party payers through consumer-driven health care plans. Am J Surgery. 2003;186:117–124. doi: 10.1016/S0002-9610(03)00189-2.
    1. French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Annu Rev Public Health. 2001;22:309–335. doi: 10.1146/annurev.publhealth.22.1.309.
    1. Jeffery RW, French SA, Raether C, Baxter JE. An environmental intervention to increase fruit and salad purchases in a cafeteria. Prev Med. 1994;23:788–792. doi: 10.1006/pmed.1994.1135.
    1. French SA, Jeffery RW, Story M, Breitlow KK, Baxter JS, Hannan P, Snyder MP. Pricing and promotion effects on low-fat vending snack purchases: the CHIPS study. Am J Public Health. 2001;91:112–117.
    1. Chan CB, Ryan DA, Tudor-Locke C. Health benefits of a pedometer-based physical activity intervention in sedentary workers. Prev Med. 2004;39:1215–1222. doi: 10.1016/j.ypmed.2004.04.053.
    1. Kerr NA, Yore MM, Ham SA, Dietz WH. Increasing stair use in a worksite through environmental changes. Am J Health Promot. 2004;18:312–315. doi: 10.4278/0890-1171-18.4.312.
    1. Anderson LM, Quinn TA, Glanz K, Ramirez G, Kahwati LC, Johnson DB, Buchanan LR, Archer WR, Chattopadhyay S, Kalra GP, Katz DL. Task Force on Community Preventive Services. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: a systematic review. Am J Prev Med. 2009;37:340–357. doi: 10.1016/j.amepre.2009.07.003.
    1. Jeffery RW, Forster JL, French SA, Kelder SH, Lando HA, McGovern PG, Jacobs DR Jr, Baxter JE. The healthy worker project: a work-site intervention for weight control and smoking cessation. Am J Public Health. 1993;83:395–401. doi: 10.2105/AJPH.83.3.395.
    1. Schmitz MK, Jeffery RW. Public health interventions for the prevention and treatment of obesity. Med Clin North Am. 2000;84:491–512. doi: 10.1016/S0025-7125(05)70233-9.
    1. Jeffery RW, French SA. Preventing weight gain in adults: the pound of prevention study. Am J Public Health. 1999;89:747–751. doi: 10.2105/AJPH.89.5.747.
    1. Sherwood NE, Jeffery RW, French SA, Hannan PJ, Murray DM. Predictors of weight gain in the pound of prevention study. Int J Obes. 2000;24:395–403. doi: 10.1038/sj.ijo.0801169.
    1. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall; 1986.
    1. Stokols D. Establishing and maintaining healthy environments: toward a social ecology of health promotion. Am Psychol. 1992;47:6–22.
    1. Engbers LH, van Poppel MN, Chin A, Paw MJ, van Mechelen W. Worksite health promotion programs with environmental change: a systematic review. Am J Prev Med. 2005;29:61–70. doi: 10.1016/j.amepre.2005.03.001.
    1. Goetzel RZ, Roemer EC, Pei X, Short ME, Tabrizi MJ, Wilson MG, Dejoy DM, Craun BA, Tully KJ, White JM, Baase CM. Second-year results of an obesity prevention program at the Dow Chemical Company. J Occup Environ Med. 2010;52:291–302. doi: 10.1097/JOM.0b013e3181d46f0b.
    1. Lemon SC, Zapka J, Li W, Estabrook B, Rosal M, Magner R, Andersen V, Borg A, Hale J. Step ahead: a worksite obesity prevention trial among hospital employees. Am J Prev Med. 2010;38:27–38. doi: 10.1016/j.amepre.2009.08.028.
    1. French SA, Story M, Fulkerson JA, Hannan P. An environmental intervention to promote lower fat food choices in secondary schools: outcomes of the TACOS study (Trying Alternative Cafeteria Options in Schools) Am J Public Health. 2004;94:1507–1512. doi: 10.2105/AJPH.94.9.1507.
    1. French SA, Harnack LJ, Hannan PJ, Mitchell NR, Gerlach AF, Toomey TL. Worksite environment intervention to prevent obesity among metropolitan transit workers. Prev Med. 2010;50:180–185. doi: 10.1016/j.ypmed.2010.01.002.
    1. Murray DM, Hannan PJ, Wilfinger RD, Baker WL, Dwyer JH. Analysis of data from group-randomized trials with repeat observations on the same groups. Stat Med. 1998;17:1581–1600. doi: 10.1002/(SICI)1097-0258(19980730)17:14<1581::AID-SIM864>;2-N.
    1. Wolfe BL, Smith JE. Different strokes for different folks: why overweight men do not seek weight loss treatment. Eat Disord. 2002;10:115–124. doi: 10.1080/10640260290081687.
    1. Minneapolis Saint Paul Regional Economic Development Partnership. Workforce. Accessed at [ ] on November 3, 2011.
    1. Minnesota Adult Tobacco Survey. Tobacco use in Minnesota: 2010 update. Accessed at [ ] on November 3, 2011.
    1. Jeffery RW, Baxter J, McGuire M, Linde J. Are fast food restaurants an environmental risk factor for obesity? Int J Beh Nutr Phys Act. 2006;3:2. doi: 10.1186/1479-5868-3-2.
    1. Neville BH, Merrill RM, Kumpfer KL. Longitudinal outcomes of a comprehensive, incentivized worksite wellness program. Eval Health Prof. 2011;34:103–123. doi: 10.1177/0163278710379222.
    1. Sorensen G, Hunt MK, Cohen N, Stoddard A, Stein E, Phillips J, Baker F, Combe C, Hebert J, Palombo R. Worksite and family education for dietary change: the Treatwell 5-a-day program. Health Educ Res. 1999;13:577–591.

Source: PubMed

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