Workplace Interventions to Reduce Obesity and Cardiometabolic Risk
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The worksite is ideal for implementing interventions to reduce obesity and cardiometabolic risk factors. Although worksite health promotion is not new, employer-sponsored wellness programs have become more widespread due to the rising prevalence and high cost of obesity. Over the past two decades, employers and researchers focused efforts on individual-based programs to change employees’ nutrition and exercise behaviors, but more recently, the worksite environment has been targeted. Overall, there is good evidence that individual-based worksite programs can produce modest weight loss, but the evidence for effects on other risk factors and on long-term health outcomes and costs is inconsistent. There is less evidence for the benefit of environmental-based interventions, and more data will be needed to establish conclusions about the benefits of these types of interventions. A major challenge for employers and researchers in the future will be to find the balance between effectiveness and economic viability of worksite wellness programs.
KeywordsObesity Worksite intervention Physical activity Nutrition Environmental intervention Cardiovascular risk Cost-effectiveness
Anne Thorndike is supported by the grant 1 K23 HL93221-01 A1 from the National Institutes of Health.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 5.• Goetzel RZ, Roemer EC, Pei X, et al. Second-year results of an obesity prevention program at the Dow Chemical Company. J.Occup.Environ.Med. 2010, 52:291–302. This is one of the seven NHLBI-sponsored studies funded to evaluate worksite environmental interventions. The results suggested an effect of the intervention on weight, blood pressure, and cholesterol, but these results must be interpreted cautiously due to low participation and high attrition for measurement of outcomes.CrossRefPubMedGoogle Scholar
- 14.•• Anderson LM, Quinn TA, Glanz K, et al. 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. This is systematic review conducted by the Centers for Disease Control’s Task Force on Community Preventive Services that provides a comprehensive evaluation and a pooled estimate of the effectiveness of worksite interventions. It includes excellent discussion of the limitations of current research and questions that should be addressed in future studies.CrossRefPubMedGoogle Scholar
- 18.• Lemon SC, Zapka J, Li W, et al.: Step ahead a worksite obesity prevention trial among hospital employees. Am.J.Prev.Med. 2010, 38:27–38. This is one of the seven NHLBI-sponsored studies funded to evaluate worksite environmental interventions. It is a well-designed randomized controlled trial that found no difference in weight between the intervention and control sites at 2-year follow-up.CrossRefPubMedGoogle Scholar
- 19.• French SA, Hannan PJ, Harnack LJ, et al. Pricing and availability intervention in vending machines at four bus garages. J.Occup.Environ.Med. 2010, 52:S29–33. This is one of the 7 NHLBI-sponsored studies funded to evaluate worksite environmental interventions. Included was an innovative intervention to promote sales of healthy food and beverages at worksite vending machines. Results are of sales data only; there was no evaluation of employee weight at the 18-month follow-up.CrossRefPubMedGoogle Scholar
- 20.• Meenan RT, Vogt TM, Williams AE, et al. Economic evaluation of a worksite obesity prevention and intervention trial among hotel workers in Hawaii. J.Occup.Environ.Med. 2010, 52:S8–13. This is one of the seven NHLBI-sponsored studies funded to evaluate worksite environmental interventions. Employees at hotels in Hawaii were randomized to intensive environmental intervention to prevent obesity. Despite improvements in weight outcomes, intervention program costs far exceeded any cost savings resulting from reduced health care costs, absenteeism, or presenteeism.CrossRefPubMedGoogle Scholar
- 25.•• Soler RE, Leeks KD, Razi S, 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:S237–62. This is a comprehensive systematic review of worksite programs that utilize health risk assessments. The major conclusion is that this tool is not effective alone but should be used as part of a broader worksite health promotion program.CrossRefPubMedGoogle Scholar
- 31.• Sternfeld B, Block C, Quesenberry CP,Jr, et al. Improving diet and physical activity with ALIVE: a worksite randomized trial. Am.J.Prev.Med. 2009, 36:475–483. This is a randomized controlled trial of a tailored e-mail program to increase employees’ physical activity and improve nutritional behaviors. The intervention group had positive changes in self-reported behaviors. Weight outcomes were not measured.CrossRefPubMedGoogle Scholar
- 32.• Dishman RK, DeJoy DM, Wilson MG and Vandenberg RJ. Move to Improve: a randomized workplace trial to increase physical activity. Am.J.Prev.Med. 2009, 36:133–141. This is a group-randomized trial of an environmental physical activity intervention at 16 worksites. Employees at intervention sites had significant improvements in moderate-vigorous physical activity at the end of 12 weeks. Longer-term follow up was not performed.CrossRefPubMedGoogle Scholar
- 33.• Siegel JM, Prelip ML, Erausquin JT and Kim SA. A worksite obesity intervention: results from a group-randomized trial. Am.J.Public Health 2010, 100:327–333. This is a group-randomized trial at 16 schools of an environmental intervention to promote weight loss and physical activity among employees. Intervention sites had significant decrease in BMI, but outcomes were assessed at the school level and not the individual level.CrossRefPubMedGoogle Scholar