A work-site weight management program to reinforce behavior

Promising Practices for the Prevention and Control of Obesity in the Worksite

Purpose.

To identify worksite practices that show promise for promoting employee weight loss.

Data Source.

The following electronic databases were searched from January 1, 1966, through December 31, 2005: CARL Uncover (via Ingenta), CDP, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Library, CRISP, Dissertation Abstracts, EMBASE, ERIC, Health Canada, INFORM (part of ABI/INFORM Proquest), LocatorPlus, New York Academy of Medicine, Ovid MEDLINE, SPORTDiscus, PapersFirst, PsycINFO, PubMed, and TRIP.

Study Inclusion and Exclusion Criteria.

Included studies were published in English, conducted at a worksite, designed for adults (aged ≥18 years), and reported weight-related outcomes.

Data Extraction.

Data were extracted using an online abstraction form.

Data Synthesis.

Studies were evaluated on the basis of study design suitability quality of execution, sample size, and effect size. Changes in weight-related outcomes were used to assess effectiveness.

Results.

The following six promising practices were identified: enhanced access to opportunities for physical activity combined with health education, exercise prescriptions alone, multicomponent educational practices, weight loss competitions and incentives, behavioral practices with incentives, and behavioral practices without incentives.

Conclusions.

These practices will help employers and employees select programs that show promise for controlling and preventing obesity. (Am J Health Promot 2011;25[3]:e12–e26.)

The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: a systematic review

This report presents the results of a systematic review of the effectiveness of worksite nutrition and physical activity programs to promote healthy weight among employees. These results form the basis for the recommendation by the Task Force on Community Preventive Services on the use of these interventions. Weight-related outcomes, including weight in pounds or kilograms, BMI, and percentage body fat were used to assess effectiveness of these programs. This review found that worksite nutrition and physical activity programs achieve modest improvements in employee weight status at the 6-12-month follow-up. A pooled effect estimate of -2.8 pounds (95% CI=-4.6, -1.0) was found based on nine RCTs, and a decrease in BMI of -0.5 (95% CI=-0.8, -0.2) was found based on six RCTs. The findings appear to be applicable to both male and female employees, across a range of worksite settings. Most of the studies combined informational and behavioral strategies to influence diet and physical activity; fewer studies modified the work environment (e.g., cafeteria, exercise facilities) to promote healthy choices. Information about other effects, barriers to implementation, cost and cost effectiveness of interventions, and research gaps are also presented in this article. The findings of this systematic review can help inform decisions of employers, planners, researchers, and other public health decision makers.

Grouping participants for tailored work-site weight loss programs: a signal detection approach

BACKGROUND

Although work-site obesity prevention programs have been widely promoted, they have a high rate of attrition and participants find it very difficult to maintain the decreased weight. It is necessary to develop effective work-site programs that match the type of intervention to the participants and offer the necessary support. To this end, higher-order interaction of the causal factors of obesity needs to be analyzed.

METHODS

The subjects were male, white-collar workers (20-64 years of age), in Osaka, Japan. Since conventional methods, such as regression analysis or analysis of variance, cannot deal with the interaction of many variables, signal detection analysis by Kraemer was used to identify the higher-order interaction of multiple predictors of obesity.

RESULTS

Out of 15 independent variables, a higher-order interaction consisting of 8 significant variables was identified. Consequently, the subjects were categorized into nine subgroups. It was revealed that the obesity of two groups of workers, 40 or more years old with a high degree of obesity, had different causes: one was related to working conditions, and one was related to smoking cessation. For the other terminal groups, further factors related to obesity were revealed.

CONCLUSION

Although the applicability of the findings is limited, the methodology using signal detection analysis might be applicable to other weight loss programs as a way of facilitating the matching of the type of intervention and the target group.

Case management and behavioral contracting. Components of rural substance abuse treatment

This article presents a model of case management with rural clients entering drug and alcohol treatment. As part of a larger treatment protocol called Structured Behavioral Outpatient Rural Therapy, behavioral contracting is combined with strengths perspective case management to help rural clients motivate themselves to engage and complete drug and alcohol treatment. This combined approach is designed to continually communicate and teach an "A-B-C" cognitive-behavioral approach to problem-solving and change. While not a panacea for addressing the myriad problems facing clients with drug use problems, such an approach promises to improve "treatment as usual" formats, which often ignore the formidable obstacles to human change experienced by rural clients and clinicians.

Worksite intervention for weight control: a review of the literature

PURPOSE

Published research on worksite weight-control programs is reviewed with the objective of assessing success in (1) reaching populations in need, (2) achieving sustained weight loss, and (3) improving employee health and productivity.

SEARCH METHOD

Reviewed are 44 data-based articles published between 1968 and 1994. The initial search was part of a larger review on the health impact of worksite health promotion programs conducted by Centers for Disease Control and described in the introduction to this issue. We supplemented the resulting list with articles found in a search of our own reference files.

IMPORTANT FINDINGS

Methodologically the literature is relatively weak, consisting largely of uncontrolled case studies. Worksite interventions appear to be successful in reaching large numbers of people: the median participation rate among overweight employees was 39% in the six studies that provided this type of information. Worksite programs produced reasonable short-term weight loss: typically 1 to 2 pounds per week. Long-term weight loss, reductions in sitewide obesity prevalence, and health or productivity benefits have yet to be demonstrated.

MAJOR CONCLUSIONS

Recommendations for future research include improved methods, more attention to recruitment and secondary outcomes, more direct comparison of different programs, and more creative use of worksites as environments and social units in designing programs.