Go!: results from a quasi-experimental obesity prevention trial with hospital employees

Abstract

BackgroundWorksite obesity prevention interventions using an ecological approach may hold promise for reducing typical weight gain. The purpose of this study was to examine the effectiveness of Go!, an innovative 12-month multi-component worksite obesity prevention intervention.MethodsA quasi-experimental non-equivalent control group design was utilized; 407 eligible hospital employees (intervention arm) and 93 eligible clinic employees (comparison arm) participated. The intervention involved pedometer distribution, labeling of all foods in the worksite cafeteria and vending machines (with calories, step equivalent, and a traffic light based on energy density signaling recommended portion), persuasive messaging throughout the hospital, and the integration of influential employees to reinforce healthy social norms. Changes in weight, BMI, waist circumference, physical activity, and dietary behavior after 6 months and 1 year were primary outcomes. Secondary outcomes included knowledge, perceptions of employer commitment to employee health, availability of information about diet, exercise, and weight loss, perceptions of coworker support and frequency of health discussions with coworkers. A process evaluation was conducted as part of the study.ResultsRepeated measures ANCOVA indicated that neither group showed significant increases in weight, BMI, or waist circumference over 12 months. The intervention group showed a modest increase in physical activity in the form of walking, but decreases in fruit and vegetable servings and fiber intake. They also reported significant increases in knowledge, information, perceptions of employer commitment, and health discussions with peers. Employees expressed positive attitudes towards all components of the Go! intervention.ConclusionsThis low-intensity intervention was well-received by employees but had little effect on their weight over the course of 12 months. Such results are consistent with other worksite obesity prevention studies using ecological approaches. Implementing low-impact physical activity (e.g., walking, stair use) may be more readily incorporated into the worksite setting than more challenging behaviors of altering dietary habits and increasing more vigorous forms of physical activity.Trial RegistrationThis study was registered with clinicaltrials.gov (NCT01585480) on April 24, 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2828-0) contains supplementary material, which is available to authorized users.

Obesity Prevention Worksite Wellness Interventions for Health Care Workers: A Narrative Review

“…Although the majority of the studies focused their intervention on modifying both dietary and physical activity behaviors, two studies (Pohjonen & Ranta, 2001; Yuan et al, 2009) focused only on physical activity behaviors. Half ( n = 6) of the studies reported some evidence/theoretical basis for the intervention, such as Theory of Planned Behavior (LaCaille et al, 2016), Transtheoretical Model (Long & Sheehan, 2010), Cognitive-Behavioral and Social Learning Theories (LaCaille et al, 2016; Tucker et al, 2011), Behavior-Change Health Practice (Yuan et al, 2009), Ecological Framework (LaCaille et al, 2016), and Experimental Learning and Bridges’ Model of Change (Shahar et al, 2009). The majority of the studies used a combination of behavioral/educational, environmental, and organizational support strategies to modify physical activity and/or dietary behaviors.…”

“…Follow-up from baseline ranged from 2 to 60 months, with only three studies (Long & Sheehan, 2010; Moy et al, 2006; Pohjonen & Ranta, 2001) reporting long-term (>12 months) weight outcomes. With regard to weight-related outcomes (Table 2), eight (73%) of the studies reported significant change in the weight outcomes favoring the intervention group as compared with the control group, whereas three (LaCaille et al, 2016; Long & Sheehan, 2010; Moy et al, 2006) reported no change in weight-related outcomes.…”

“…General ecological strategies (such as social marketing campaigns, annual counseling, nutritional labeling information, posters, signage to promote activity, access to wellness center) were not effective in improving weight outcomes or the perceptions about coworker support for healthy behaviors. However, interestingly, these strategies were effective in improving healthier habits (such as reduced smoking status, improved dietary intake, and physical activity) and employee’s perception of organizational commitment to their health (LaCaille et al, 2016; Lemon et al, 2010).…”

“…Overall, moderate-to-intense behavioral strategies (such as daily or weekly counseling/training session delivered by a trained professional) appeared to have fared better than less intensive strategies (such as only educational material, general ecological strategies, group or individual counseling 3-4 times a year, using activity monitor) in improving weight outcomes, indicating that intensity of the delivery matters (Aldana et al, 2005; Choy et al, 2017; Dekkers et al, 2011; LaCaille et al, 2016; Lemon et al, 2010; Moy et al, 2006; Pohjonen & Ranta, 2001; Tate et al, 2001; Thorndike et al, 2014; Thorndike, Sonnenberg, Riis, Barraclough, & Levy, 2012; Tucker et al, 2011; Van Wier et al, 2009; Yuan et al, 2009). However, one limitation is that information on dosage and fidelity of the intervention was not consistently reported across the studies, making it difficult to draw meaningful conclusion about dose–response relationship of various components of the interventions.…”

Crowdsourcing for self-monitoring: Using the Traffic Light Diet and crowdsourcing to provide dietary feedback

“…The TLD has been mainly used in assisting children with dietary self-monitoring to encourage the intake of lowenergy-dense foods and promote weight loss. 16,19 The TLD approach has also been widely used to assist adults with making healthier food point-of-purchase decisions, such as in cafeterias, 20,21 at concession stands, 22 and on food labels. 23 More recently, there has been an interest in using the TLD approach for self-monitoring with adults, as the TLD can be used with low-literacy populations.…”