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

Linde, Nygaard, Maclehose, Mitchell, Harnack, Cousins, Graham, Jeffery

Description

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

Sujets

• Obesity
• Adult
• Environment

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 10
• Langue: English

Extrait

Lindeet al.International Journal of Behavioral Nutrition and Physical Activity2012,9:14 http://www.ijbnpa.org/content/9/1/14

R E S E A R C HOpen Access HealthWorks: results of a multicomponent grouprandomized worksite environmental intervention trial for weight gain prevention 1,4* 11,2 11 Jennifer A Linde, Katherine E Nygaard , Richard F MacLehose, Nathan R Mitchell , Lisa J Harnack , 3 11 Julie M Cousins , Daniel J Grahamand 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, 2 2 88.6% were white, 2.1% Hispanic. Mean baseline BMI was 28.5 kg/m (range 16.961.2 kg/m ). 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 Keywords:Obesity, Worksites, Adults, Environment, Weight gain prevention

Background Approximately 140 million U.S. adults (60% of the free living population) are employed [1]. Recent statistics indicate that 68% of U.S. adults are overweight, with 33% classified as obese [2]. Adults are at continued risk for weight gain over time, with average increases of two pounds per year [3]. Obesity is rising across all employ ment groups, with no differences in increases by race/ ethnicity or sex [4]. Obesity is associated with negative

* Correspondence: [e-mail] 1 Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA Full list of author information is available at the end of the article

consequences in working populations, including more frequent absenteeism, sick leave [5,6] or workplace injury and disability pension claims [7,8], and greater health care costs [5]. As employed adults spend approximately half of wak ing time at work [9], worksites provide a logical setting in which the environment might be reshaped to pro mote healthier behaviors and improve weight control. Employers may be motivated to make changes due to concerns about quality or cost of employee health care [10], and worksites may be in a unique position to lever age resources (e.g. food service, communication net works, Human Resources departments) and promote

© 2012 Linde et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.