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Hyun HS, Kim Y. Associations between working environment and weight control efforts among workers with obesity in Korea. J Int Med Res 2018; 46:2307-2316. [PMID: 29623760 PMCID: PMC6023066 DOI: 10.1177/0300060518764212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to investigate the relationship between working environment and weight control efforts among obese workers in Korea. Methods This study was based on the 2011 3rd Korean Working Conditions Survey, which was conducted on workers aged 15 years or older. A sample of 484 obese workers was included in the study. Multivariable logistic regression analysis was used to investigate the relationship between working environment and weight control efforts after controlling for individual variables. Adjusted odds ratios (ORs) and 95% confidence intervals were calculated. Results Of the participants, 63.4% reported that they made efforts to control their weight. After controlling for personal factors, the OR of weight control efforts for individuals working 40-49 hours per week was 2.4 times that for individuals working 60 hours or more per week. The OR of regular employment workers was 2.2 times that of non-regular workers. Conclusion We established that working hours and employment type were significantly related to weight control efforts. Therefore, we recommend that working conditions should be considered in designing effective workplace health promotion programs.
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Affiliation(s)
- Hye Sun Hyun
- Department of Nursing, Sangmyung University, Cheonan, Republic of Korea
| | - Yunyoung Kim
- Department of Nursing, Andong National University, Andong, Republic of Korea
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Watanabe K, Kawakami N, Otsuka Y, Inoue S. Associations among workplace environment, self-regulation, and domain-specific physical activities among white-collar workers: a multilevel longitudinal study. Int J Behav Nutr Phys Act 2018; 15:47. [PMID: 29855392 PMCID: PMC5984456 DOI: 10.1186/s12966-018-0681-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/20/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Psychological and environmental determinants have been discussed for promoting physical activity among workers. However, few studies have investigated effects of both workplace environment and psychological determinants on physical activity. It is also unknown which domains of physical activities are promoted by these determinants. This study aimed to investigate main and interaction effects of workplace environment and individual self-regulation for physical activity on domain-specific physical activities among white-collar workers. METHODS A multi-site longitudinal study was conducted at baseline and about 5-month follow-up. A total of 49 worksites and employees within the worksites were recruited. Inclusion criteria for the worksites (a) were located in the Kanto area, Japan and (b) employed two or more employees. Employee inclusion criteria were (a) employed by the worksites, (b) aged 18 years or older, and (c) white-collar workers. For outcomes, three domain-specific physical activities (occupational, transport-related, and leisure-time) at baseline and follow-up were measured. For independent variables, self-regulation for physical activity, workplace environments (parking/bike, signs/bulletin boards/advertisements, stairs/elevators, physical activity/fitness facilities, work rules, written policies, and health promotion programs), and covariates at baseline were measured. Hierarchical Linear Modeling was conducted to investigate multilevel associations. RESULTS Of the recruited worksites, 23 worksites and 562 employees, and 22 worksites and 459 employees completed the baseline and the follow-up surveys. As results of Hierarchical Linear Modeling, stairs/elevator (γ=3.80 [SE=1.80], p<0.05), physical activity/fitness facilities (γ=4.98 [SE=1.09], p<0.01), and written policies (γ=2.10 [SE=1.02], p<0.05) were significantly and positively associated with occupational physical activity. Self-regulation for physical activity was associated significantly with leisure-time physical activity (γ=0.09 [SE=0.04], p<0.05) but insignificantly with occupational and transport-related physical activity (γ=0.11 [SE=0.16] and γ=-0.00 [SE=0.06]). Significant interaction effects of workplace environments (physical activity/fitness facilities, work rules, and written policies) and self-regulation were observed on transport-related and leisure-time physical activity. CONCLUSIONS Workplace environments such as physical activity/fitness facilities, written policies, work rules, and signs for stair use at stairs and elevators; self-regulation for physical activity; and their interactions may be effective to promote three domain-specific physical activities. This study has practical implications for designing multi-component interventions that include both environmental and psychological approaches to increase effect sizes to promote overall physical activity.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Yasumasa Otsuka
- Faculty of Human Sciences, University of Tsukuba, 3-29-1, Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
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Maimone R, Guerini M, Dragoni M, Bailoni T, Eccher C. PerKApp: A general purpose persuasion architecture for healthy lifestyles. J Biomed Inform 2018; 82:70-87. [PMID: 29729482 DOI: 10.1016/j.jbi.2018.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 04/20/2018] [Accepted: 04/23/2018] [Indexed: 10/17/2022]
Abstract
Automatically monitoring and supporting healthy lifestyle is a recent research trend, fostered by the availability of low-cost monitoring devices, and it can significantly contribute to the prevention of chronic diseases deriving from incorrect diet and lack of physical activity. In this paper, we present a general purpose architecture for persuasion scenarios and behavioral change. The architecture is designed to be easily portable across languages and domains and has been implemented and evaluated in a specific system for Workplace Health Promotion (WHP) called PerKApp. PerKApp provides a fully fledged platform supporting the remote monitoring of workers lifestyle by providing real-time feedback through persuasive context-based messages when necessary.
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Rationale and design of a trial to personalize risk assessment in familial coronary artery disease. Am Heart J 2018; 199:22-30. [PMID: 29754662 DOI: 10.1016/j.ahj.2017.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/13/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND The lifetime risk of coronary artery disease (CAD) is doubled in people with a family history of premature disease, yet this risk is not captured in most 5- or 10-year risk assessment algorithms. Coronary artery calcium scoring (CCS) is a marker of subclinical CAD risk, which has been shown in observational studies to provide prognostic information that is incremental to clinical assessment; is relatively inexpensive; and is performed with a small radiation dose. However, the use of CCS in guiding prevention is not strongly supported by guidelines. Showing definitive evidence of the efficacy and cost-effectiveness of CCS is therefore of importance. STUDY DESIGN The proposed randomized controlled trial of the use of CCS will be targeted to 40- to 70-year-old first-degree relatives of patients with CAD onset <60 years old or second-degree relatives of patients with onset <50 years old. Control patients will undergo standard risk scoring and be blinded to CCS results. In the intervention group, primary prevention in patients undergoing CCS will be informed by this score. At 3 years, effectiveness will be assessed on change in plaque volume at computed tomography coronary angiography, the extent of which has been strongly linked to outcome. SUMMARY The CAUGHT-CAD trial will provide evidence to inform the guidelines regarding the place of CCS in decision making regarding primary prevention of patients with a family history of premature disease.
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Is More Always Better in Designing Workplace Wellness Programs?: A Comparison of Wellness Program Components Versus Outcomes. J Occup Environ Med 2018; 58:987-993. [PMID: 27513171 DOI: 10.1097/jom.0000000000000848] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Assess whether adding more components to a workplace wellness program is associated with better outcomes by measuring the relationship of program components to one another and to employee participation and perceptions of program effectiveness. METHODS Data came from a 2014 survey of 24,393 employees of 81 employers about services offered, leadership, incentives, and promotion. Logistic regressions were used to model the relationship between program characteristics and outcomes. RESULTS Components individually are related to better outcomes, but this relationship is weaker in the presence of other components and non-significant for incentives. Within components, a moderate level of services and work time participation opportunities are associated with higher participation and effectiveness. CONCLUSIONS The "more of everything" approach does not appear to be advisable for all programs. Programs should focus on providing ample opportunities for employees to participate and initiatives like results-based incentives.
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Burn N, Norton LH, Drummond C, Ian Norton K. Changes in Physical Activity Behaviour and Health Risk Factors Following a Randomised Controlled Pilot Workplace Exercise Intervention. AIMS Public Health 2018; 4:189-201. [PMID: 29546212 PMCID: PMC5689804 DOI: 10.3934/publichealth.2017.2.189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/08/2017] [Indexed: 11/18/2022] Open
Abstract
Background Declining physical activity (PA) and associated health risk factors are well established. Workplace strategies to increase PA may be beneficial to ameliorate extensive sedentary behavior. This study assessed the effectiveness of two PA interventions in workplace settings. Methods Interventions were conducted over 40 days targeting insufficiently active (<150 min/wk PA) and/or obese (BMI ≥ 30 kg/m2) adults; participants were randomly allocated to instructor-led exercise sessions either after-work (n = 25) or in-work (n = 23) with a 60 minPA/day common goal, or a wait-listed control group (n = 23). The programme commenced with low-moderate physical activities and progressed to high intensity game style activities by week six. Adherence and compliance were determined using both objective measures of daily PA time from HR monitors and self-report responses to PA questionnaires. Cardiovascular and metabolic risk factors were measured pre- and post-intervention. Changes across the study were analysed using Chi square and repeat-measures ANOVA. Results Adherence rates (completed pre and post-testing) were not different between groups (76.0 vs 65.2%). Compliance for the instructor-led sessions was higher for the after-work group (70.4% vs 26.4%, respectively). Increased total PA and aerobic fitness, and decreased weight in both intervention groups were found relative to controls. The after-work group undertook more vigorous PA, and had greater weight loss and fasting blood glucose improvement, relative to in-work participants and controls. Conclusions These workplace interventions resulted in rapid and dramatic increases in PA behaviour and important health benefits. Short, in-work PA sessions were less efficacious than longer after-work sessions.
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Affiliation(s)
- Naomi Burn
- Health and Social Care Institute, Teesside University, Middlesbrough Tees Valley, TS1 3BX, UK.,School of Health and Exercise Science, Faculty of Medicine, Nursing and Health Sciences, Flinders University of South Australia, Adelaide, South Australia, 5001
| | - Lynda Heather Norton
- School of Health and Exercise Science, Faculty of Medicine, Nursing and Health Sciences, Flinders University of South Australia, Adelaide, South Australia, 5001
| | - Claire Drummond
- School of Health and Exercise Science, Faculty of Medicine, Nursing and Health Sciences, Flinders University of South Australia, Adelaide, South Australia, 5001
| | - Kevin Ian Norton
- School of Health Sciences, University of South Australia, Adelaide, South Australia, 5001
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Velema E, Vyth EL, Hoekstra T, Steenhuis IHM. Nudging and social marketing techniques encourage employees to make healthier food choices: a randomized controlled trial in 30 worksite cafeterias in The Netherlands. Am J Clin Nutr 2018; 107:236-246. [PMID: 29474510 DOI: 10.1093/ajcn/nqx045] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/20/2017] [Indexed: 12/23/2022] Open
Abstract
Background Currently, many studies focus on how the environment can be changed to encourage healthier eating behavior, referred to as choice architecture or "nudging." However, to date, these strategies are not often investigated in real-life settings, such as worksite cafeterias, or are only done so on a short-term basis. Objective The objective of this study is to examine the effects of a healthy worksite cafeteria ["worksite cafeteria 2.0" (WC 2.0)] intervention on Dutch employees' purchase behavior over a 12-wk period. Design We conducted a randomized controlled trial in 30 worksite cafeterias. Worksite cafeterias were randomized to either the intervention or control group. The intervention aimed to encourage employees to make healthier food choices during their daily worksite cafeteria visits. The intervention consisted of 14 simultaneously executed strategies based on nudging and social marketing theories, involving product, price, placement, and promotion. Results Adjusted multilevel models showed significant positive effects of the intervention on purchases for 3 of the 7 studied product groups: healthier sandwiches, healthier cheese as a sandwich filling, and the inclusion of fruit. The increased sales of these healthier meal options were constant throughout the 12-wk intervention period. Conclusions This study shows that the way worksite cafeterias offer products affects purchase behavior. Situated nudging and social marketing-based strategies are effective in promoting healthier choices and aim to remain effective over time. Some product groups only indicated an upward trend in purchases. Such an intervention could ultimately help prevent and reduce obesity in the Dutch working population. This trial was registered at the Dutch Trial Register (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5372) as NTR5372.
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Affiliation(s)
- Elizabeth Velema
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
| | - Ellis L Vyth
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
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Risica PM, Gorham G, Dionne L, Nardi W, Ng D, Middler R, Mello J, Akpolat R, Gettens K, Gans KM. A multi-level intervention in worksites to increase fruit and vegetable access and intake: Rationale, design and methods of the 'Good to Go' cluster randomized trial. Contemp Clin Trials 2018; 65:87-98. [PMID: 29242108 PMCID: PMC5912165 DOI: 10.1016/j.cct.2017.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Fruit and vegetable (F&V) consumption is an important contributor to chronic disease prevention. However, most Americans do not eat adequate amounts. The worksite is an advantageous setting to reach large, diverse segments of the population with interventions to increase F&V intake, but research gaps exist. No studies have evaluated the implementation of mobile F&V markets at worksites nor compared the effectiveness of such markets with or without nutrition education. METHODS This paper describes the protocol for Good to Go (GTG), a cluster randomized trial to evaluate F&V intake change in employees from worksites randomized into three experimental arms: discount, fresh F&V markets (Access Only arm); markets plus educational components including campaigns, cooking demonstrations, videos, newsletters, and a web site (Access Plus arm); and an attention placebo comparison intervention on physical activity and stress reduction (Comparison). Secondary aims include: 1) Process evaluation to determine costs, reach, fidelity, and dose as well as the relationship of these variables with changes in F&V intake; 2) Applying a mediating variable framework to examine relationships of psychosocial factors/determinants with changes in F&V consumption; and 3) Cost effectiveness analysis of the different intervention arms. DISCUSSION The GTG study will fill important research gaps in the field by implementing a rigorous cluster randomized trial to evaluate the efficacy of an innovative environmental intervention providing access and availability to F&V at the worksite and whether this access intervention is further enhanced by accompanying educational interventions. GTG will provide an important contribution to public health research and practice. Trial registration number NCT02729675, ClinicalTrials.gov.
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Affiliation(s)
- Patricia M Risica
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA; Department of Epidemiology, Brown School of Public Health, Providence, RI 02912, USA.
| | - Gemma Gorham
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Laura Dionne
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - William Nardi
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Doug Ng
- Currently with Department of Surgery, Columbia University Medical Center, NY, New York 10032, USA
| | - Reese Middler
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Jennifer Mello
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA
| | - Rahmet Akpolat
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA
| | - Katelyn Gettens
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
| | - Kim M Gans
- Center for Health Equity Research, Brown School of Public Health, Providence, RI 02912, USA; Department of Behavioral and Social Sciences, Brown School of Public Health, Providence, RI 02912, USA; Department of Human Development and Family Studies, University of Connecticut, Storrs, CT 06269, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
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Stiehl E, Shivaprakash N, Thatcher E, Ornelas IJ, Kneipp S, Baron SL, Muramatsu N. Worksite Health Promotion for Low-Wage Workers: A Scoping Literature Review. Am J Health Promot 2018; 32:359-373. [PMID: 28893085 PMCID: PMC5770241 DOI: 10.1177/0890117117728607] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine: (1) What research has been done on health promotion interventions for low-wage workers and (2) what factors are associated with effective low-wage workers' health promotion programs. DATA SOURCE This review includes articles from PubMed and PsychINFO published in or before July 2016. Study Inclusion/Exclusion Criteria: The search yielded 130 unique articles, 35 met the inclusion criteria: (1) being conducted in the United States, (2) including an intervention or empirical data around health promotion among adult low-wage workers, and (3) measuring changes in low-wage worker health. DATA EXTRACTION Central features of the selected studies were extracted, including the theoretical foundation; study design; health promotion intervention content and delivery format; intervention-targeted outcomes; sample characteristics; and work, occupational, and industry characteristics. DATA ANALYSIS Consistent with a scoping review, we used a descriptive, content analysis approach to analyze extracted data. All authors agreed upon emergent themes and 2 authors independently coded data extracted from each article. RESULTS The results suggest that the research on low-wage workers' health promotion is limited, but increasing, and that low-wage workers have limited access to and utilization of worksite health promotion programs. CONCLUSION Workplace health promotion programs could have a positive effect on low-wage workers, but more work is needed to understand how to expand access, what drives participation, and which delivery mechanisms are most effective.
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Affiliation(s)
- Emily Stiehl
- 1 Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Namrata Shivaprakash
- 2 Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Esther Thatcher
- 3 University of Virginia Health System, University Medical Associates Clinic, Charlottesville, VA, USA
| | - India J Ornelas
- 4 Health Services, University of Washington, Seattle, WA, USA
| | - Shawn Kneipp
- 5 Health Care Environments Division, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sherry L Baron
- 6 Queens College, Barry Commoner Center for Health and the Environment, Flushing, NY, USA
| | - Naoko Muramatsu
- 7 School of Public Health and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Plant-Based Lunch at Work: Effects on Nutrient Intake, Environmental Impact and Tastiness—A Case Study. SUSTAINABILITY 2018. [DOI: 10.3390/su10010227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to determine the environmental impact, nutrient intake, appreciation and tastiness of three buffet-style lunches served at the workplace, consisting of (1) animal-based foods; (2) plant-based foods; and (3) both animal-based and plant-based foods. Employees of the National Institute for Public Health and the Environment in the Netherlands participated in the study. Participants scored the lunch for appreciation and tastiness (scores from 1 to 10). Greenhouse gas (GHG) emissions and land use associated with foods consumed were calculated using life cycle assessments. Nutrient intake was calculated using food composition data. The results show that both the plant-based and the combination lunch received higher scores for tastiness than the animal-based lunch. GHG emissions and land use were lowest for the plant-based lunch and highest for the animal-based lunch. The combination lunch was associated with increased fiber and decreased saturated fat intake compared to the animal-based lunch, but also lead to increased energy intake. The plant-based lunch did not increase energy intake, while increasing fiber intake and decreasing sodium (salt) and saturated fat intakes. These initial results show that plant-based lunches have the potential to improve nutrient intake and tastiness while reducing environmental impact. Additional research in this field is worthwhile.
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Shrestha A, Karmacharya BM, Khudyakov P, Weber MB, Spiegelman D. Dietary interventions to prevent and manage diabetes in worksite settings: a meta-analysis. J Occup Health 2017; 60:31-45. [PMID: 29187673 PMCID: PMC5799099 DOI: 10.1539/joh.17-0121-ra] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The translation of lifestyle intervention to improve glucose tolerance into the workplace has been rare. The objective of this meta-analysis is to summarize the evidence for the effectiveness of dietary interventions in worksite settings on lowering blood sugar levels. METHODS We searched for studies in PubMed, Embase, Econlit, Ovid, Cochrane, Web of Science, and Cumulative Index to Nursing and Allied Health Literature. Search terms were as follows: (1) Exposure-based: nutrition/diet/dietary intervention/health promotion/primary prevention/health behavior/health education/food /program evaluation; (2) Outcome-based: diabetes/hyperglycemia/glucose/HbA1c/glycated hemoglobin; and (3) Setting-based: workplace/worksite/occupational/industry/job/employee. We manually searched review articles and reference lists of articles identified from 1969 to December 2016. We tested for between-studies heterogeneity and calculated the pooled effect sizes for changes in HbA1c (%) and fasting glucose (mg/dl) using random effect models for meta-analysis in 2016. RESULTS A total of 17 articles out of 1663 initially selected articles were included in the meta-analysis. With a random-effects model, worksite dietary interventions led to a pooled -0.18% (95% CI, -0.29 to -0.06; P<0.001) difference in HbA1c. With the random-effects model, the interventions resulted in 2.60 mg/dl lower fasting glucose with borderline significance (95% CI: -5.27 to 0.08, P=0.06). In the multivariate meta-regression model, the interventions with high percent of female participants and that used the intervention directly delivered to individuals, rather the environment changes, were associated with more effective interventions. CONCLUSION Workplace dietary interventions can improve HbA1c. The effects were larger for the interventions with greater number of female participants and with individual-level interventions.
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Affiliation(s)
- Archana Shrestha
- Department of Epidemiology, Harvard T.H Chan School of Public Health
| | - Biraj Man Karmacharya
- Division of Cardiology, University of Washington.,Department of Community Medicine, Kathmandu University
| | - Polyna Khudyakov
- Department of Biostatistics, Harvard T.H Chan School of Public Health
| | - Mary Beth Weber
- Department of Global Health and Epidemiology, Rollins School of Public Health
| | - Donna Spiegelman
- Department of Epidemiology, Harvard T.H Chan School of Public Health.,Department of Biostatistics, Harvard T.H Chan School of Public Health.,Department of Nutrition, Harvard T.H Chan School of Public Health.,Department of Global Health and Population, Harvard T.H Chan School of Public Health
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Grivois-Shah R, Gonzalez JR, Khandekar SP, Howerter AL, O'Connor PA, Edwards BA. Impact of Healthy Vending Machine Options in a Large Community Health Organization. Am J Health Promot 2017; 32:1425-1430. [PMID: 29129109 DOI: 10.1177/0890117117734989] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To determine whether increasing the proportion of healthier options in vending machines decreases the amount of calories, fat, sugar, and sodium vended, while maintaining total sales revenue. DESIGN This study evaluated the impact of altering nutritious options to vending machines throughout the Banner Health organization by comparing vended items' sales and nutrition information over 6 months compared to the same 6 months of the previous year. SETTING Twenty-three locations including corporate and patient-care centers. INTERVENTION Changing vending machine composition toward more nutritious options. MEASURES Comparisons of monthly aggregates of sales, units vended, calories, fat, sodium, and sugar vended by site. ANALYSIS A pre-post analysis using paired t tests comparing 6 months before implementation to the equivalent 6 months postimplementation. RESULTS Significant average monthly decreases were seen for calories (16.7%, P = .002), fat (27.4%, P ≤ .0001), sodium (25.9%, P ≤ .0001), and sugar (11.8%, P = .045) vended from 2014 to 2015. Changes in revenue and units vended did not change from 2014 to 2015 ( P = .58 and P = .45, respectively). CONCLUSION Increasing the proportion of healthier options in vending machines from 20% to 80% significantly lowered the amount of calories, sodium, fat, and sugar vended, while not reducing units vended or having a negative financial impact.
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Affiliation(s)
- Ravi Grivois-Shah
- 1 Family and Community Medicine, Banner University Medical Group, University of Arizona College of Medicine, Tucson, AZ, USA
| | | | | | | | - Patrick A O'Connor
- 4 University of Arizona College of Public Health, Family and Community Medicine, Tucson, AZ, USA
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Watanabe K, Kawakami N. Effects of a multicomponent workplace intervention programme with environmental changes on physical activity among Japanese white collar employees: a protocol for a cluster randomised controlled trial. BMJ Open 2017; 7:e017688. [PMID: 29070639 PMCID: PMC5665227 DOI: 10.1136/bmjopen-2017-017688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Physical activity is one of the most important health behaviours as a determinant of physical and mental health. Although intervention strategies for promoting physical activity among workers are needed, evidence for the effectiveness of multilevel workplace interventions with environmental changes on the promotion of physical activity are still limited due to lack of cluster randomised controlled trials (RCTs). The aim of this study is to investigate effects of a 3-month workplace intervention programme with environmental changes on the improvement in physical activity among Japanese white collar employees. METHODS AND ANALYSIS This study will be a two-arm and parallel-group cluster (worksite) RCT. Japanese worksites and employees who are employed by the worksites will be recruited through health insurance associations and chambers of commerce. Worksites that meet the inclusion criteria will be randomly allocated to intervention or control groups. The intervention worksites will be offered the original intervention programme that consists of 13 contents with environmental changes. The control worksites will be able to get three times feedback of the assessment of the amount of physical activity and basic occupational health service in each worksite. The primary outcome will be the total amount of physical activity measured by the Global Physical Activity Questionnaire at baseline, 3 months and 6 months. Multilevel latent growth modelling will be conducted to examine the effectiveness of the intervention programme. ETHICS AND DISSEMINATION This study was ethically approved by the research ethics committee of the Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Japan (No. 11230). Results will be submitted and published in a scientific peer-reviewed journal. TRIAL REGISTRATION NUMBER UMIN000024069; Pre-results.
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Affiliation(s)
- Kazuhiro Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The Japan Society for the Promotion of Science, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Does a grill menu redesign influence sales, nutrients purchased, and consumer acceptance in a worksite cafeteria? Prev Med Rep 2017; 8:140-147. [PMID: 29034148 PMCID: PMC5635243 DOI: 10.1016/j.pmedr.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/26/2017] [Accepted: 09/01/2017] [Indexed: 12/05/2022] Open
Abstract
Worksite cafeterias are compelling venues to improve diet quality through environmental changes. We conducted a pre-post study to evaluate how a cafeteria-initiated grill menu redesign influenced sales, revenue, and nutrient content of foods purchased. Secondly, we evaluated consumer opinions about menu changes to inform practices for worksite environment interventions. Monthly sales data (2012–2015) were used to compute gross sales and revenue of entrées and side dishes pre-post menu changes. Alternative protein sources replaced red meat; nutrient composition and nutrients purchased were compared using Food Pro software. Consumer responses were queried using online surveys; open-ended responses were analyzed using NVivo. Differences in sales and nutrient content pre-post menu redesign were tested with Wilcoxon Rank Sum tests. Gross sales of entrées (61 vs. 222 servings/month; p = 0.01) and side dishes (120 vs. 365 servings/month; p = 0.001) increased more than three-fold post-menu changes. Revenue from entrées (312 vs. 1144 USD/month; p = 0.01) and side dishes (238 vs. 914 USD/month; p = 0.001) also increased; per entrée, consumers purchased significantly more unsaturated fat (5 g), and less saturated fat (3 g) and sodium (100 mg). For side dishes, they purchased fewer calories (48 kcal) and unsaturated fat (2.9 g), but more fiber (1.8 g), and sodium (260 mg). Four themes emerged from consumer responses: the importance of 1) variety, novelty, choice; 2) cost, affordability, value; 3) health; and 4) food quality, taste. Menu redesign can improve nutrient content, while also increasing sales and revenue. Multi-dimensional assessment of the nutritional, consumer, and retailer implications is desirable practice for enacting similar environmental changes. Redesigning menus may improve nutrient content and promote sales. Consumers value variety even when well-liked offerings are available. Sodium use requires scrutiny when redesigning menu items.
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Program Development and Effectiveness of Workplace Health Promotion Program for Preventing Metabolic Syndrome among Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080878. [PMID: 28777320 PMCID: PMC5580582 DOI: 10.3390/ijerph14080878] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 12/18/2022]
Abstract
This paper aims to develop and analyze the effects of a socio-ecological model-based intervention program for preventing metabolic syndrome (MetS) among office workers. The intervention program was developed using regular health examinations, a “health behavior and need” assessment survey among workers, and a focus group study. According to the type of intervention, subjects took part in three groups: health education via an intranet-based web magazine (Group 1), self-monitoring with the U-health system (Group 2), and the target population who received intensive intervention (Group 3). The intervention programs of Group 1 and Group 2, which relied on voluntary participation, did not show significant effects. In Group 3, which relied on targeted and proactive programs, showed a decrease in waist circumference and in fasting glucose (p < 0.001). The MetS score in both males (−0.61 ± 3.35 versus −2.32 ± 2.55, p = 0.001) and females (−3.99 ± 2.05 versus −5.50 ± 2.19, p = 0.028) also showed a statistically significant decrease. In light of the effectiveness of the intensive intervention strategy for metabolic syndrome prevention among workers used in this study, companies should establish targeted and proactive health care programs rather than providing a healthcare system that is dependent on an individual’s voluntary participation.
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Seppälä T, Hankonen N, Korkiakangas E, Ruusuvuori J, Laitinen J. National policies for the promotion of physical activity and healthy nutrition in the workplace context: a behaviour change wheel guided content analysis of policy papers in Finland. BMC Public Health 2017; 18:87. [PMID: 28764754 PMCID: PMC5540493 DOI: 10.1186/s12889-017-4574-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 07/06/2017] [Indexed: 11/15/2022] Open
Abstract
Background Health policy papers disseminate recommendations and guidelines for the development and implementation of health promotion interventions. Such documents have rarely been investigated with regard to their assumed mechanisms of action for changing behaviour. The Theoretical Domains Framework (TDF) and Behaviour Change Techniques (BCT) Taxonomy have been used to code behaviour change intervention descriptions, but to our knowledge such “retrofitting” of policy papers has not previously been reported. This study aims first to identify targets, mediators, and change strategies for physical activity (PA) and nutrition behaviour change in Finnish policy papers on workplace health promotion, and second to assess the suitability of the Behaviour Change Wheel (BCW) approach for this purpose. Method We searched all national-level health policy papers effectual in Finland in August 2016 focusing on the promotion of PA and/or healthy nutrition in the workplace context (n = 6). Policy recommendations targeting employees’ nutrition and PA including sedentary behaviour (SB) were coded using BCW, TDF, and BCT Taxonomy. Results A total of 125 recommendations were coded in the six policy papers, and in two additional documents referenced by them. Psychological capability, physical opportunity, and social opportunity were frequently identified (22%, 31%, and 24%, respectively), whereas physical capability was almost completely absent (1%). Three TDF domains (knowledge, skills, and social influence) were observed in all papers. Multiple intervention functions and BCTs were identified in all papers but several recommendations were too vague to be coded reliably. Influencing individuals (46%) and changing the physical environment (44%) were recommended more frequently than influencing the social environment (10%). Conclusions The BCW approach appeared to be useful for analysing the content of health policy papers. Paying more attention to underlying assumptions regarding behavioural change processes may help to identify neglected aspects in current policy, and to develop interventions based on recommendations, thus helping to increase the impact of policy papers. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4574-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tuija Seppälä
- Faculty of Social Sciences, University of Tampere, Linna, -33014, Tampere, FI, Finland.
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Tampere, Linna, -33014, Tampere, FI, Finland
| | | | - Johanna Ruusuvuori
- Faculty of Social Sciences, University of Tampere, Linna, -33014, Tampere, FI, Finland
| | - Jaana Laitinen
- Finnish Institute of Occupational Health, -00251, Helsinki, FI, Finland
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Largo-Wight E, Wlyudka PS, Merten JW, Cuvelier EA. Effectiveness and feasibility of a 10-minute employee stress intervention: Outdoor Booster Break. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2017. [DOI: 10.1080/15555240.2017.1335211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Erin Largo-Wight
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Peter S. Wlyudka
- Department of Mathematics and Statistics, University of North Florida, Jacksonville, Florida, USA
| | - Julie W. Merten
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
| | - Elizabeth A. Cuvelier
- Department of Public Health, University of North Florida, Jacksonville, Florida, USA
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Naughton P, McCarthy M, McCarthy S. Reducing consumption of confectionery foods: A post-hoc segmentation analysis using a social cognition approach. Appetite 2017; 117:168-178. [PMID: 28662906 DOI: 10.1016/j.appet.2017.06.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 05/29/2017] [Accepted: 06/25/2017] [Indexed: 01/13/2023]
Abstract
Considering confectionary consumption behaviour this cross-sectional study used social cognition variables to identify distinct segments in terms of their motivation and efforts to decrease their consumption of such foods with the aim of informing targeted social marketing campaigns. Using Latent Class analysis on a sample of 500 adults four segments were identified: unmotivated, triers, successful actors, and thrivers. The unmotivated and triers segments reported low levels of perceived need and perceived behavioural control (PBC) in addition to high levels of habit and hedonic hunger with regards their consumption of confectionery foods. Being a younger adult was associated with higher odds of being in the unmotivated and triers segments and being female was associated with higher odds of being in the triers and successful actors segments. The findings indicate that in the absence of strong commitment to eating low amounts of confectionery foods (i.e. perceived need) people will continue to overconsume free sugars regardless of motivation to change. It is therefore necessary to identify relevant messages or 'triggers' related to sugar consumption that resonate with young adults in particular. For those motivated to change, counteracting unhealthy eating habits and the effects of hedonic hunger may necessitate changes to food environments in order to make the healthy choice more appealing and accessible.
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Affiliation(s)
- Paul Naughton
- Teagasc Food Research Centre, Ashtown, Dublin 15, Ireland; Department of Food Business & Development, University College Cork, Ireland.
| | - Mary McCarthy
- HRB Centre for Diet and Health Research, CUBS, University College Cork, Ireland.
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Hipp JA, Dodson EA, Lee JA, Marx CM, Yang L, Tabak RG, Hoehner C, Marquet O, Brownson RC. Mixed methods analysis of eighteen worksite policies, programs, and environments for physical activity. Int J Behav Nutr Phys Act 2017; 14:79. [PMID: 28615024 PMCID: PMC5471708 DOI: 10.1186/s12966-017-0533-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 06/02/2017] [Indexed: 01/04/2023] Open
Abstract
Background This study examined whether specific worksite supports for physical activity (PA) were associated with total and domain-specific PA. Methods A cross-sectional, telephone-based study was conducted in four Missouri, USA, metropolitan areas in 2012 and 2013. Outcome variables included total PA and sub-domains (leisure, work, travel) measured using the International Physical Activity Questionnaire. Logistic regression determined odds of meeting PA recommendations, given access to and use of 18 unique PA worksite supports. A subsample of 119 participants also wore hip accelerometry for seven consecutive days and maintained a wear-time diary. Access to worksite supports were associated with odds of meeting objective moderate and vigorous (MV) PA above 150 min per week. Results Among 2013 survey participants, meeting PA recommendations while performing work-related tasks was significantly associated with several supports (e.g., walking maps, stair prompts), as was meeting recommendations during travel (e.g., flextime for PA, incentives for public transportation, walking/bicycling to work). Access to 11 worksite supports increased odds of meeting PA recommendations through leisure-time PA; five supports were associated with total PA. There were significant differences between access to and use of supports. Using objective MVPA, access to worksite challenges and bike storage were significantly associated with five and three times greater odds of meeting 150 min of MVPA per week, respectively. Conclusions Worksite wellness plans are increasing across the US and employers are eager for evidence-based supports for increasing PA. This study provides insights into the utility of multiple worksite supports for PA to increase odds that employees meet PA recommendations.
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Affiliation(s)
- J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, College of Natural Resources, and Fellow, Center for Human Health and the Environment, North Carolina State University, Campus Box 8004, Raleigh, NC, 27695, USA.
| | - Elizabeth A Dodson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Jung Ae Lee
- Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, AR, 72701, USA
| | - Christine M Marx
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO, 63110, USA
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1st Floor, 1090, Vienna, Austria
| | - Rachel G Tabak
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | | | - Oriol Marquet
- Department of Parks, Recreation, and Tourism Management and Center for Geospatial Analytics, College of Natural Resources, North Carolina State University, Campus Box 8000, Raleigh, NC, 27695, USA
| | - Ross C Brownson
- Prevention Research Center in St. Louis, Brown School, Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
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Park S, Sung E, Choi Y, Ryu S, Chang Y, Gittelsohn J. Sociocultural Factors Influencing Eating Practices Among Office Workers in Urban South Korea. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:466-474.e1. [PMID: 28363802 DOI: 10.1016/j.jneb.2017.02.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 02/08/2017] [Accepted: 02/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To understand the sociocultural factors affecting the eating behaviors of South Korean employees. DESIGN In-depth individual interviews. SETTING Two metropolitan areas of South Korea. PARTICIPANTS Thirteen male and 9 female office workers. PHENOMENON OF INTEREST The effects of sociocultural factors on office workers' eating behaviors. ANALYSIS The researchers transcribed and analyzed audio-recorded interviews using thematic analysis. RESULTS Among social and economic factors, participants with a family described a connection between female employment and lower frequency of home-cooked family meals. Working parents felt guilty about their need to depend on eating outside the home and eating processed foods because of their schedules. In addition, competitive and stressful working environments negatively affected workers' nutritional choices. Regarding cultural factors, given the powerful influences of collectivism and Confucianism on daily life, hierarchy and group harmony clearly had an important role in workers' everyday food choices. These included choosing menus that were most suitable for group meals and having to miss dinnertime while waiting until higher-position workers to leave work in the evening. CONCLUSIONS AND IMPLICATIONS In this sociocultural setting, targeting office workers and changing social norms for healthy eating may be more effective than providing individualized interventions. These findings may be transferable to other, similar Asian countries.
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Affiliation(s)
- Sohyun Park
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Eunju Sung
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Yuni Choi
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joel Gittelsohn
- Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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71
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Rhodes RE, Janssen I, Bredin SSD, Warburton DER, Bauman A. Physical activity: Health impact, prevalence, correlates and interventions. Psychol Health 2017; 32:942-975. [PMID: 28554222 DOI: 10.1080/08870446.2017.1325486] [Citation(s) in RCA: 359] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To provide a broad overview of the state of physical activity (PA) research in the form of (1) definitions of PA, (2) health benefits, (3) prevalence, (4) correlates and (5) interventions. DESIGN A high-level overview of published reviews of the literature. RESULTS Regular PA is an effective primary and secondary preventative strategy against at least 25 chronic medical conditions with risk reduction typically in the 20-30% range. While approximately 75% of adults meet recommended PA guidelines, the prevalence is slightly lower for women compared to men, and considerably lower for youth, older adults and those in higher income countries. Motivation, self-efficacy and self-regulation remain consistent correlates of PA. Interventions show PA changes in the small effect size range for adults and youth but the heterogeneity is considerable across studies. Only a few (aggregate of behavioural regulation strategies, supervision, high frequency of contact) reliable moderators of intervention success were identified across study quality, sample characteristics, theory/behaviour change techniques and delivery modes/settings. CONCLUSION PA research should continue to examine the mechanisms causing health outcomes, the dose that can lead to clinically relevant changes in health status, the scope and validity of PA surveillance and innovative behaviour change techniques, while improving the reach and duration of PA interventions.
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Affiliation(s)
- Ryan E Rhodes
- a Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , Canada
| | - Ian Janssen
- b School of Kinesiology and Health Studies , Queen's University , Kingston , Canada
| | - Shannon S D Bredin
- c School of Kinesiology , University of British Columbia , Vancouver , Canada
| | | | - Adrian Bauman
- d School of Public Health , University of Sydney , Sydney , Australia
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Buller DB, Walkosz BJ, Buller MK, Wallis A, Andersen PA, Scott MD, Eye R, Liu X, Cutter G. Results of a Randomized Trial on an Intervention Promoting Adoption of Occupational Sun Protection Policies. Am J Health Promot 2017; 32:1042-1053. [PMID: 28447466 DOI: 10.1177/0890117117704531] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate an intervention promoting adoption of occupational sun protection policies by employers in a randomized trial. DESIGN A randomized pretest-posttest controlled design with 2-year follow-up was conducted in 2010 to 2013. SETTING Local government organizations in Colorado who had outdoor workers in public works, public safety, and/or parks and recreation. PARTICIPANTS Ninety-eight local government organizations (n = 51 municipalities, 10 counties, and 37 special districts). INTERVENTION Organizations were randomly assigned to receive a policy and education intervention comprised of personal contacts and theory-based training and materials or to an attention control group. MEASURES Occupational policy documents were coded for sun safety content by a trained research assistant blind to condition. ANALYSIS Policy scores were analyzed with logistic and Poisson regression models using imputation. RESULTS At posttest, more organizations in the intervention group had a sun protection policy than in the control group (odds ratio [OR] = 4.91, P < .05; intent to treat: OR = 5.95, P < .05) and policies were more extensive (χ2 = 31.29, P < .01; intent to treat: χ2 =73.79, P < .01) and stronger (χ2 = 24.50, P < .01; intent to treat: χ2 = 51.95, P < .01). Policy adoption was higher when the number of contacts and trainings increased ( P < .05). CONCLUSION The intervention had a large effect on adoption of formal sun protection policies, perhaps because of its fit with legal requirements to maintain safe workplaces. Personal contacts with managers were influential on adoption of occupational policy even in this age of communication technology and social media.
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Affiliation(s)
| | | | | | - Allan Wallis
- 2 School of Public Affairs, University of Colorado Denver, Denver, CO, USA
| | - Peter A Andersen
- 3 School of Communication, San Diego State University, San Diego, CA, USA
| | - Michael D Scott
- 4 Department of Communication Arts and Sciences, California State University, Chico, CA, USA
| | | | - Xia Liu
- 1 Klein Buendel, Inc, Golden, CO, USA
| | - Gary Cutter
- 5 Department of Biostatistics, School of Public Health, University of Alabama, Birmingham, AL, USA
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Short-Term Efficacy of a “Sit Less, Walk More” Workplace Intervention on Improving Cardiometabolic Health and Work Productivity in Office Workers. J Occup Environ Med 2017; 59:327-334. [DOI: 10.1097/jom.0000000000000955] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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74
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Allan J, Querstret D, Banas K, de Bruin M. Environmental interventions for altering eating behaviours of employees in the workplace: a systematic review. Obes Rev 2017; 18:214-226. [PMID: 27860169 DOI: 10.1111/obr.12470] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/03/2016] [Accepted: 08/18/2016] [Indexed: 11/26/2022]
Abstract
Environmental, or 'choice-architecture', interventions aim to change behaviour by changing properties/contents of the environment and are commonly used in the workplace to promote healthy behaviours in employees. The present review aimed to evaluate and synthesize the evidence surrounding the effectiveness of environmental interventions targeting eating behaviour in the workplace. A systematic search identified 8157 articles, of which 22 were included in the current review. All included studies were coded according to risk of bias and reporting quality and were classified according to the emergent typology of choice-architecture interventions. More than half of included studies (13/22) reported significant changes in primary measures of eating behaviour (increased fruit/veg consumption, increased sales of healthy options and reduction in calories purchased). However, only one study produced a small significant improvement in weight/body mass index. Many studies had a high or unknown risk of bias; reporting of interventions was suboptimal; and the only trial to measure compensatory behaviours found that intervention participants who ate less during the intervention ate more out with the workplace later in the day. Hence, we conclude that more rigorous, well-reported studies that account for compensatory behaviours are needed to fully understand the impact of environmental interventions on diet and importantly on weight/body mass index outcomes.
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Affiliation(s)
- J Allan
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - D Querstret
- School of Psychology, University of Surrey, Guildford, UK.,Rowett Institute of Nutrition & Health, University of Aberdeen, Aberdeen, UK
| | - K Banas
- School of Philosophy, Psychology, Language Sciences, University of Edinburgh, Edinburgh, UK
| | - M de Bruin
- Health Psychology, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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75
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Effects of an Eight-Week Stepladder Exercise Protocol on Lower Limb Muscular Strength of Apparently Healthy Young Adults. HUMAN MOVEMENT 2017. [DOI: 10.1515/humo-2017-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractPurpose. Backward descent of stairs is associated with improved muscle strength and reduced joint stress, but the effect of backward ascent of stairs on lower limb muscle strength has not been reported. This study compared the effects of forward and backward stair climbing on lower limb muscle strength in apparently healthy young adults. Methods. The total of 31 young volunteers were allocated to either forward or backward stair climbing group (n = 16 and 15, respectively). Dynamic quadriceps and hamstring muscle strength was assessed in addition to thigh girth at baseline and at weeks 4 and 8 with the use of the repetitive maximum method and tape measure, respectively. Results. Between baseline and week 8, muscular strength in both groups (quadriceps: 14.4 ± 3.6 to 16.4 ± 3.4 kg; 14.0 ± 2.9 to 15.3 ± 2.7 kg; hamstring: 12.2 ± 3.2 to 13.4 ± 3.2; 11.7 ± 2.5 to 12.9 ± 2.7 kg) increased significantly (p < 0.05) while the increase in thigh girth was not significant (p > 0.05). The groups were comparable in all three measures post intervention. Conclusions. Forward and backward stair climbing protocols are effective for improving the dynamic strength of the hamstring and quadriceps muscles of apparently healthy young adults. Thus, either protocol could be used for the improvement of lower limbs dynamic muscle strength.
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76
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Aas RW, Raanaas RK, Shaw L. Unifying and diversifying workplace-based efforts for promoting health and preventing disability. Work 2017; 53:3-7. [PMID: 26684699 DOI: 10.3233/wor-152210] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Randi W Aas
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway.,Presenter, Stavanger, Norway.,University of Stavanger, Norway
| | | | - Lynn Shaw
- Pacific Coast University for Workplace Health Science, Port Alberni, British Columbia, Canada
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77
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Velema E, Vyth EL, Steenhuis IHM. Using nudging and social marketing techniques to create healthy worksite cafeterias in the Netherlands: intervention development and study design. BMC Public Health 2017; 17:63. [PMID: 28077114 PMCID: PMC5225653 DOI: 10.1186/s12889-016-3927-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 12/09/2016] [Indexed: 11/22/2022] Open
Abstract
Background The worksite cafeteria is a suitable setting for interventions focusing on changing eating behavior, because a lot of employees visit the worksite cafeteria regularly and a variety of interventions could be implemented there. The aim of this paper is to describe the intervention development and design of the evaluation of an intervention to make the purchase behavior of employees in the worksite cafeteria healthier. The developed intervention called “the worksite cafeteria 2.0” consists of a set of 19 strategies based on theory of nudging and social marketing (marketing mix). The intervention will be evaluated in a real-life setting, that is Dutch worksite cafeterias of different companies and with a number of contract catering organizations. Methods/design The study is a randomized controlled trial (RCT), with 34 Dutch worksite cafeterias randomly allocated to the 12-week intervention or to the control group. Primary outcomes are sales data of selected products groups like sandwiches, salads, snacks and bread topping. Secondary outcomes are satisfaction of employees with the cafeteria and vitality. Discussion When executed, the described RCT will provide better knowledge in the effect of the intervention “the worksite cafeteria 2.0” on the purchasing behavior of Dutch employees in worksite cafeterias. Trial registration Dutch Trial register: NTR5372.
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Affiliation(s)
- Elizabeth Velema
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
| | - Ellis L Vyth
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
| | - Ingrid H M Steenhuis
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands
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78
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Fitzgerald S, Kirby A, Murphy A, Geaney F, Perry IJ. A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions. BMC Public Health 2017; 17:49. [PMID: 28068975 PMCID: PMC5223559 DOI: 10.1186/s12889-016-3988-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 12/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The workplace has been identified as a priority setting to positively influence individuals' dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer's perspective. METHODS Cost data were obtained from a workplace dietary intervention trial, the Food Choice at Work Study. Micro-costing methods estimated costs associated with implementing and delivering the interventions for 1 year in four multinational manufacturing workplaces in Cork, Ireland. The workplaces were allocated to one of the following groups: control, nutrition education alone, environmental dietary modification alone and nutrition education and environmental dietary modification combined. A total of 850 employees were recruited across the four workplaces. For comparison purposes, total costs were standardised for 500 employees per workplace. RESULTS The combined intervention reported the highest total costs of €31,108. The nutrition education intervention reported total costs of €28,529. Total costs for the environmental dietary modification intervention were €3689. Total costs for the control workplace were zero. The average annual cost per employee was; combined intervention: €62, nutrition education: €57, environmental modification: €7 and control: €0. Nutritionist's time was the main cost contributor across all interventions, (ranging from 53 to 75% of total costs). CONCLUSIONS Within multi-component interventions, the relative cost of implementing and delivering nutrition education elements is high compared to environmental modification strategies. A workplace environmental modification strategy added marginal additional cost, relative to the control. Findings will inform employers and public health policy-makers regarding the economic feasibility of implementing and scaling dietary interventions. TRIAL REGISTRATION Current Controlled Trials: ISRCTN35108237 . Date of registration: The trial was retrospectively registered on 02/07/2013.
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Affiliation(s)
- Sarah Fitzgerald
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
| | - Ann Kirby
- Department of Economics, Aras na Laoi, University College Cork, Cork, Ireland
| | - Aileen Murphy
- Department of Economics, Aras na Laoi, University College Cork, Cork, Ireland
| | - Fiona Geaney
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Ivan J Perry
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
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79
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Affiliation(s)
- Paul E. Terry
- HERO: The Health Enhancement Research Organization
- Editor in Chief, American Journal of Health Promotion. Follow me on Twitter at:
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80
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Nicholls R, Perry L, Duffield C, Gallagher R, Pierce H. Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review. J Adv Nurs 2016; 73:1051-1065. [PMID: 27732741 DOI: 10.1111/jan.13185] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/28/2022]
Abstract
AIM The aim was to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses. BACKGROUND There is growing recognition of the influence of the workplace environment on the eating habits of the workforce, which in turn may contribute to increased overweight and obesity. Overweight and obesity exact enormous costs in terms of reduced well-being, worker productivity and increased risk of non-communicable diseases. The workplace is an ideal place to intervene and support healthy behaviours. This review aimed to identify barriers and facilitators to nurses' healthy eating in the workplace. DESIGN Integrative mixed method review. DATA SOURCES Five electronic databases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO. Reference lists were searched. Included papers were published in English between 2000-2016. Of 26 included papers, 21 were qualitative and five quantitative. REVIEW METHODS An integrative literature review was undertaken. Quality appraisal of included studies used standardized checklists. A social-ecological framework was used to examine workplace facilitators and constraints to healthy eating, derived from the literature. Emergent themes were identified by thematic analysis. RESULTS Review participants were Registered, Enrolled and/or Nurse Assistants primarily working in hospitals in middle or high income countries. The majority of studies reported barriers to healthy eating related to adverse work schedules, individual barriers, aspects of the physical workplace environment and social eating practices at work. Few facilitators were reported. Overall, studies found the workplace exerts a considerable negative influence on nurses' dietary intake. CONCLUSION Reorientation of the workplace to promote healthy eating among nurses is required.
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Affiliation(s)
- Rachel Nicholls
- Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Lin Perry
- Faculty of Health, University of Technology Sydney, New South Wales, Australia
| | - Christine Duffield
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, New South Wales, Australia.,Edith Cowan University, Perth, Western Australia
| | - Robyn Gallagher
- Charles Perkins Centre, Sydney Nursing School, University of Sydney, New South Wales, Australia
| | - Heather Pierce
- Faculty of Health, University of Technology Sydney, New South Wales, Australia
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A 3-Year Workplace-Based Intervention Program to Control Noncommunicable Disease Risk Factors in Sousse, Tunisia. J Occup Environ Med 2016; 57:e72-7. [PMID: 26147554 DOI: 10.1097/jom.0000000000000500] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effectiveness of a 3-year workplace-based intervention program on the control of the main noncommunicable disease risk factors (poor nutrition, physical inactivity, and tobacco use) among the employees of Sousse, Tunisia. METHODS We conducted a quasi-experimental study (pre- and postassessments with intervention and control groups) in six companies of the governorate of Sousse in Tunisia.The intervention program consisted of health education programs (eg, workshops, films and open sensitization days). We also scheduled free physical activity sessions and free smoking cessation consultations. RESULTS Our intervention program showed meaningful improvement among the employees toward dietary and physical activity behaviors but not for tobacco use. CONCLUSIONS Workplace is a crucial setting for health promotion, and future programs should consider a multisectoral approach to control the main noncommunicable disease risk factors.
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Abstract
Workplace dietary intervention studies in low- and middle-income countries using psychometrically sound measures are scarce. This study aimed to validate a nutrition knowledge questionnaire (NQ) and its utility in evaluating the changes in knowledge among participants of a Nutrition Education Program (NEP) conducted at the workplace. A NQ was tested for construct validity, internal consistency and discriminant validity. It was applied in a NEP conducted at six workplaces, in order to evaluate the effect of an interactive or a lecture-based education programme on nutrition knowledge. Four knowledge domains comprising twenty-three items were extracted in the final version of the NQ. Internal consistency of each domain was significant, with Kuder-Richardson formula values>0·60. These four domains presented a good fit in the confirmatory factor analysis. In the discriminant validity test, both the Expert and Lay groups scored>0·52, but the Expert group scores were significantly higher than those of the Lay group in all domains. When the NQ was applied in the NEP, the overall questionnaire scores increased significantly because of the NEP intervention, in both groups (P<0·001). However, the increase in NQ scores was significantly higher in the interactive group than in the lecture group, in the overall score (P=0·008) and in the healthy eating domain (P=0·009). The validated NQ is a short and useful tool to assess gain in nutrition knowledge among participants of NEP at the workplace. According to the NQ, an interactive nutrition education had a higher impact on nutrition knowledge than a lecture programme.
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83
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Prevalence of Physical Activity Policies and Environmental Strategies in Communities and Worksites: The Iowa Community Transformation Grant. J Occup Environ Med 2016; 58:e1-5. [PMID: 26716854 DOI: 10.1097/jom.0000000000000601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study describes results of community and worksite assessments of physical activity policies and environmental strategies in 26 Iowa counties. METHODS Community coalition members completed the Community Health Assessment and Group Evaluation tool. The study explored findings using descriptive statistics and examined rural-urban differences in two of the five assessed sectors: community and worksites. RESULTS Lower community scores (ie, needing improvement) were found for complete streets, bicycle use, and street calming. Higher scores (ie, identified strengths) were found for land use plans, maintain parks, and sidewalks Americans with Disabilities Act compliant. Worksites scored lower on promote stairwells, encourage non-motorized commuting, and implement activity breaks but higher on subsidize gym membership and provide area for physical activity. No rural-urban differences were found. CONCLUSIONS Results identify opportunities to enhance community and worksite policies and environmental strategies to increase physical activity.
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Formanoy MAG, Dusseldorp E, Coffeng JK, Van Mechelen I, Boot CRL, Hendriksen IJM, Tak ECPM. Physical activity and relaxation in the work setting to reduce the need for recovery: what works for whom? BMC Public Health 2016; 16:866. [PMID: 27557813 PMCID: PMC4997700 DOI: 10.1186/s12889-016-3457-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 08/05/2016] [Indexed: 11/10/2022] Open
Abstract
Background To recover from work stress, a worksite health program aimed at improving physical activity and relaxation may be valuable. However, not every program is effective for all participants, as would be expected within a “one size fits all” approach. The effectiveness of how the program is delivered may differ across individuals. The aim of this study was to identify subgroups for whom one intervention may be better suited than another by using a new method called QUalitative INteraction Trees (QUINT). Methods Data were used from the “Be Active & Relax” study, in which 329 office workers participated. Two delivery modes of a worksite health program were given, a social environmental intervention (group motivational interviewing delivered by team leaders) and a physical environmental intervention (environmental modifications). The main outcome was change in Need for Recovery (NFR) from baseline to 12 month follow-up. The QUINT method was used to identify subgroups that benefitted more from either type of delivery mode, by incorporating moderator variables concerning sociodemographic, health, home, and work-related characteristics of the participants. Results The mean improvement in NFR of younger office workers in the social environmental intervention group was significantly higher than younger office workers who did not receive the social environmental intervention (10.52; 95 % CI: 4.12, 16.92). Furthermore, the mean improvement in NFR of older office workers in the social environmental intervention group was significantly lower than older office workers who did not receive the social environmental intervention ( −10.65; 95 % CI: −19.35, −1.96). The results for the physical environmental intervention indicated that the mean improvement in NFR of office workers (regardless of age) who worked fewer hours overtime was significantly higher when they had received the physical environmental intervention than when they had not received this type of intervention (7.40; 95 % CI: 0.99, 13.81). Finally, for office workers who worked more hours overtime there was no effect of the physical environmental intervention. Conclusions The results suggest that a social environmental intervention might be more beneficial for younger workers, and a physical environmental intervention might be more beneficial for employees with a few hours overtime to reduce the NFR. Trial registration NTR2553
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Affiliation(s)
- Margriet A G Formanoy
- Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77, Leiden, The Netherlands
| | - Elise Dusseldorp
- Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77, Leiden, The Netherlands.,Department of Psychology, Catholic University of Leuven, Tiensestraat 102, Leuven, Belgium.,Methodology and Statistics, Institute of Psychology, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands
| | - Jennifer K Coffeng
- Department of Public and Occupational Health, the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Iven Van Mechelen
- Department of Psychology, Catholic University of Leuven, Tiensestraat 102, Leuven, Belgium
| | - Cecile R L Boot
- Department of Public and Occupational Health, the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Body@Work, Research Center Physical Activity, Work and Health, TNO- VU/VUmc, VU University Medical Center, Amsterdam, The Netherlands
| | - Ingrid J M Hendriksen
- Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77, Leiden, The Netherlands.,Body@Work, Research Center Physical Activity, Work and Health, TNO- VU/VUmc, VU University Medical Center, Amsterdam, The Netherlands
| | - Erwin C P M Tak
- Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77, Leiden, The Netherlands.
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85
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Dodson EA, Hipp JA, Gao M, Tabak RG, Yang L, Brownson RC. The Impact of Worksite Supports for Healthy Eating on Dietary Behaviors. J Occup Environ Med 2016; 58:e287-93. [PMID: 27414016 PMCID: PMC4980226 DOI: 10.1097/jom.0000000000000813] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the availability of worksite supports (WSS) for healthy eating and examine associations between existing supports and dietary behaviors. METHODS A cross-sectional, telephone-based study was conducted with 2013 participants in four metropolitan areas in 2012. Logistic regression was used to examine associations between dietary behaviors and the availability or use of WSS. RESULTS Those reporting the availability of a cafeteria/snack bar/food services at the worksite were more likely to consume fruits and vegetables more than twice/day, and less likely to consume fast food more than twice/week. CONCLUSIONS Study results highlight the utility of specific WSS to improve employee dietary behaviors while raising questions about why the presence of healthy foods at the worksite may not translate into employee consumption of such foods.
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Affiliation(s)
- Elizabeth Anne Dodson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, Missouri (Drs Dodson, Tabak); Department of Parks, Recreation, and Tourism Management, Center of Geospatial Analytics, College of Natural Resources, North Carolina State University, Raleigh (Dr Hipp); Maternal, Child and Family Health Coalition, Saint Louis, Missouri (Gao); Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria (Dr Yang); and Prevention Research Center in St. Louis, Brown School, Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, Missouri (Dr Brownson)
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86
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Newman L, Baum F, Javanparast S, O'Rourke K, Carlon L. Addressing social determinants of health inequities through settings: a rapid review. Health Promot Int 2016; 30 Suppl 2:ii126-43. [PMID: 26420808 DOI: 10.1093/heapro/dav054] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Changing settings to be more supportive of health and healthy choices is an optimum way to improve population health and health equity. This article uses the World Health Organisation's (1998) (WHO Health Promotion Glossary. WHO Collaborating Centre for Health Promotion, Department of Public Health and Community Medicine, University of Sydney, NSW) definition of settings approaches to health promotion as those focused on modifying settings' structure and nature. A rapid literature review was undertaken in the period June-August 2014, combining a systematically conducted search of two major databases with targeted searches. The review focused on identifying what works in settings approaches to address the social determinants of health inequities, using Fair Foundations: the VicHealth framework for health equity. This depicts the social determinants of health inequities as three layers of influence, and entry points for action to promote health equity. The evidence review identified work in 12 settings (cities; communities and neighbourhoods; educational; healthcare; online; faith-based; sports; workplaces; prisons; and nightlife, green and temporary settings), and work at the socioeconomic, political and cultural context layer of the Fair Foundations framework (governance, legislation, regulation and policy). It located a relatively small amount of evidence that settings themselves are being changed in ways which address the social determinants of health inequities. Rather, many initiatives focus on individual behaviour change within settings. There is considerable potential for health promotion professionals to focus settings work more upstream and so replace or integrate individual approaches with those addressing daily living conditions and higher level structures, and a significant need for programmes to be evaluated for differential equity impacts and published to provide a more solid evidence base.
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Affiliation(s)
- Lareen Newman
- Southgate Institute for Health Society & Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Fran Baum
- Southgate Institute for Health Society & Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Sara Javanparast
- Southgate Institute for Health Society & Equity, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
| | - Kerryn O'Rourke
- Victorian Health Promotion Foundation (VicHealth), 15-31 Pelham Street, Carlton, VIC 3053, Australia
| | - Leanne Carlon
- Victorian Health Promotion Foundation (VicHealth), 15-31 Pelham Street, Carlton, VIC 3053, Australia
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87
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Krug RDR, Del Duca GF, Silva KSD, Bertuol C, Nahas MV, Oliveira ESAD, Barros MVGD. Sociodemographic differences in walking for leisure and for commuting in Brazilian workers. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-6574201600020008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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88
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Van Hoye A, Heuzé JP, Larsen T, Sarrazin P. Comparison of coaches' perceptions and officials guidance towards health promotion in French sport clubs: a mixed method study. HEALTH EDUCATION RESEARCH 2016; 31:328-338. [PMID: 27060789 DOI: 10.1093/her/cyw015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 03/17/2016] [Indexed: 06/05/2023]
Abstract
Despite the call to improve health promotion (HP) in sport clubs in the existing literature, little is known about sport clubs' organizational capacity. Grounded within the setting-based framework, this study compares HP activities and guidance among 10 football clubs. At least three grassroots coaches from each club (n = 68) completed the Health Promoting Sports Clubs scale to assess their perceptions of HP; an official (n = 10) was interviewed about club's activities and official's guidance provided to coaches. A concurrent embedded design with quantitative results guiding the qualitative analysis was used. Despite no significant differences regarding coaches' perceptions of HP between the 10 sport clubs, except for the policy dimension, officials' interviews revealed some contradictions. Sport participation was recognized as automatically promoting HP, meaning that sport practice entails many benefits, without questioning the nature of the activities. HP was considered as a secondary aim in regard to sport performance, leading to the lack of written policies, partnerships and sporadic HP activities. Future interventions should consider: (i) the creation of required policy and long-term vision; (ii) the link between HP and sport performance; (iii) the rootedness of sport clubs within their community and (iv) guidelines towards HP from sport federations.
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Affiliation(s)
- A Van Hoye
- University of Grenoble Alpes, SENS, Grenoble, F-38000, France
| | - J-P Heuzé
- University of Grenoble Alpes, SENS, Grenoble, F-38000, France
| | - T Larsen
- Department of Health Promotion and Development, University of Bergen, Bergen, 5015, Norway
| | - P Sarrazin
- University of Grenoble Alpes, SENS, Grenoble, F-38000, France
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Does Worksite Culture of Health (CoH) Matter to Employees? Empirical Evidence Using Job-Related Metrics. J Occup Environ Med 2016; 58:448-54. [DOI: 10.1097/jom.0000000000000724] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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90
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Validating the plate mapping method: Comparing drawn foods and actual foods of university students in a cafeteria. Appetite 2016; 100:197-202. [DOI: 10.1016/j.appet.2016.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 01/24/2016] [Accepted: 02/11/2016] [Indexed: 11/17/2022]
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91
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Schölmerich VLN, Kawachi I. Translating the Social-Ecological Perspective Into Multilevel Interventions for Family Planning. HEALTH EDUCATION & BEHAVIOR 2016; 43:246-55. [DOI: 10.1177/1090198116629442] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Scholars and practitioners frequently make recommendations to develop family planning interventions that are “multilevel.” Such interventions take explicit account of the role of environments by incorporating multilevel or social-ecological frameworks into their design and implementation. However, research on how interventions have translated these concepts into practice in the field of family planning—and generally in public health—remains scarce. This article seeks to review the current definitions of multilevel interventions and their operationalization in the field of family planning. First, we highlight the divergent definitions of multilevel interventions and show the persistent ambiguity around this term. We argue that interventions involving activities at several levels but lacking targets (i.e., objectives) to create change on more than one level have not incorporated a social-ecological framework and should therefore not be considered as “multilevel.” In a second step, we assess the extent to which family planning interventions have successfully incorporated a social-ecological framework. To this end, the 63 studies featured in Mwaikambo et al.’s systematic review on family planning interventions were reexamined. This assessment indicates that the multilevel or social-ecological perspective has seldom been translated into interventions. Specifically, the majority of interventions involved some form of activity at the community and/or organizational level, yet targeted and measured intrapersonal change as opposed to explicitly targeting/measuring environmental modification.
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Affiliation(s)
- Vera L. N. Schölmerich
- Harvard School of Public Health, Boston, MA, USA
- University of Rotterdam, Rotterdam, Netherlands
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Fitzgerald S, Geaney F, Kelly C, McHugh S, Perry IJ. Barriers to and facilitators of implementing complex workplace dietary interventions: process evaluation results of a cluster controlled trial. BMC Health Serv Res 2016; 16:139. [PMID: 27102407 PMCID: PMC4840486 DOI: 10.1186/s12913-016-1413-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 04/19/2016] [Indexed: 11/16/2022] Open
Abstract
Background Ambiguity exists regarding the effectiveness of workplace dietary interventions. Rigorous process evaluation is vital to understand this uncertainty. This study was conducted as part of the Food Choice at Work trial which assessed the comparative effectiveness of a workplace environmental dietary modification intervention and an educational intervention both alone and in combination versus a control workplace. Effectiveness was assessed in terms of employees’ dietary intakes, nutrition knowledge and health status in four large manufacturing workplaces. The study aimed to examine barriers to and facilitators of implementing complex workplace interventions, from the perspectives of key workplace stakeholders and researchers involved in implementation. Methods A detailed process evaluation monitored and evaluated intervention implementation. Interviews were conducted at baseline (27 interviews) and at 7–9 month follow-up (27 interviews) with a purposive sample of workplace stakeholders (managers and participating employees). Topic guides explored factors which facilitated or impeded implementation. Researchers involved in recruitment and data collection participated in focus groups at baseline and at 7–9 month follow-up to explore their perceptions of intervention implementation. Data were imported into NVivo software and analysed using a thematic framework approach. Results Four major themes emerged; perceived benefits of participation, negotiation and flexibility of the implementation team, viability and intensity of interventions and workplace structures and cultures. The latter three themes either positively or negatively affected implementation, depending on context. The implementation team included managers involved in coordinating and delivering the interventions and the researchers who collected data and delivered intervention elements. Stakeholders’ perceptions of the benefits of participating, which facilitated implementation, included managers’ desire to improve company image and employees seeking health improvements. Other facilitators included stakeholder buy-in, organisational support and stakeholder cohesiveness with regards to the level of support provided to the intervention. Anticipation of employee resistance towards menu changes, workplace restructuring and target-driven workplace cultures impeded intervention implementation. Conclusions Contextual factors such as workplace structures and cultures need to be considered in the implementation of future workplace dietary interventions. Negotiation and flexibility of key workplace stakeholders plays an integral role in overcoming the barriers of workplace cultures, structures and resistance to change. Trial registration Current Controlled Trials: ISRCTN35108237. Date of registration: 02/07/2013 Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1413-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah Fitzgerald
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland.
| | - Fiona Geaney
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Clare Kelly
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Sheena McHugh
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
| | - Ivan J Perry
- Department of Epidemiology and Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland
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Rueff A, Logomarsino J. Increasing fruit and vegetable intake among manufacturing workers. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2016. [DOI: 10.1108/ijwhm-12-2014-0056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– Blue-collar manufacturing workers are more likely to have lifestyle risk factors, including a lower intake of fruit and vegetables, for the development of chronic diseases. The purpose of this paper is to assess the effects of worksite health-promotion interventions on fruit and vegetable intake among manufacturing workers.
Design/methodology/approach
– This paper reviews the evidence for the effectiveness of interventions and makes recommendations on best practices. Types of interventions and theoretical frameworks used in the workplace are reviewed, and findings are presented through research examples. Research for this paper was conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO.
Findings
– Positive results were found for the effectiveness of interventions to increase fruit and vegetable consumption. Multiple levels of intervention, an emphasis on employee participation in planning, higher self-efficacy, and social support were found to be effective.
Research limitations/implications
– Limitations of this review included self-reported data on fruit and vegetable intake. Also, determining if one intervention was more efficacious than another was difficult when multiple interventions were used within a study. Questions have been raised regarding the long-term impact of increased fruit and vegetable intake among employees.
Practical implications
– When planning programs, multiple levels of intervention will be needed to increase fruit and vegetable intake among workers. Also, employee participation should be emphasized when planning and implementing programs.
Originality/value
– The use of manufacturing companies should be considered as a platform for health-promotion programs. Increasing fruit and vegetable intake has the potential to impact numerous blue-collar workers to help reduce the risk of chronic disease.
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Seguin RA, Aggarwal A, Vermeylen F, Drewnowski A. Consumption Frequency of Foods Away from Home Linked with Higher Body Mass Index and Lower Fruit and Vegetable Intake among Adults: A Cross-Sectional Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2016; 2016:3074241. [PMID: 26925111 PMCID: PMC4746344 DOI: 10.1155/2016/3074241] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/07/2015] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Consumption of foods prepared away from home (FAFH) has grown steadily since the 1970s. We examined the relationship between FAFH and body mass index (BMI) and fruit and vegetable (FV) consumption. METHODS Frequency of FAFH, daily FV intake, height and weight, and sociodemographic data were collected using a telephone survey in 2008-2009. Participants included a representative sample of 2,001 adult men and women (mean age 54 ± 15 years) residing in King County, WA, with an analytical sample of 1,570. Frequency of FAFH was categorized as 0-1, 2-4, or 5+ times per week. BMI was calculated from self-reported height and weight. We examined the relationship between FAFH with FV consumption and BMI using multivariate models. RESULTS Higher frequency of FAFH was associated with higher BMI, after adjusting for age, income, education, race, smoking, marital status, and physical activity (women: p = 0.001; men: p = 0.003). There was a negative association between frequency of FAFH and FV consumption. FAFH frequency was significantly (p < 0.001) higher among males than females (43.1% versus 54.0% eating out 0-1 meal per week, resp.). Females reported eating significantly (p < 0.001) more FV than males. CONCLUSION Among adults, higher frequency of FAFH was related to higher BMI and less FV consumption.
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Affiliation(s)
- Rebecca A. Seguin
- Division of Nutritional Sciences, Cornell University, 412 Savage Hall, Ithaca, NY 14853, USA
| | - Anju Aggarwal
- Center for Public Health Nutrition, University of Washington, 330 Raitt Hall, Seattle, WA 98195, USA
| | - Francoise Vermeylen
- Division of Nutritional Sciences, Cornell University, B07 Savage Hall, Ithaca, NY 14853, USA
| | - Adam Drewnowski
- Nutritional Sciences, University of Washington, 305 Raitt Hall, Seattle, WA 98195, USA
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Hublet A, Maes L, Mommen J, Deforche B, De Bourdeaudhuij I. Health promotion interventions in social economy companies in Flanders (Belgium). BMC Public Health 2016; 16:11. [PMID: 26728132 PMCID: PMC4700726 DOI: 10.1186/s12889-015-2682-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/22/2015] [Indexed: 12/04/2022] Open
Abstract
Background Disadvantaged groups are often not reached by mainstream health promotion interventions. Implementing health promotion (HP) interventions in social economy companies, can be an opportunity to reach those people. The implementation of these interventions in social economy companies was studied. Factors that could be related to the implementation of HP and being supportive towards implementation in the future, were investigated. Methods An online, quantitative survey was sent to all 148 sheltered and social workshops in Flanders. In the questionnaire, the status of HP interventions and characteristics of the workshop were explored. Personal factors (such as attitudes towards HP, behavioural control, social norms and moral responsibility) were asked to the person responsible for implementation of HP interventions. Univariate and multivariate logistic regressions were performed. Results Respondents of 88 workshops completed the questionnaire. Almost 60 % of the workshops implemented environmental or policy interventions. Having a positive attitude towards HP, being more morally responsible, and having the subjective norm that employees are positive towards health promotion at work, were related to being more supportive towards the implementation of HP in the univariate analyses. Only attitude stayed significantly related to being more supportive towards the implementation of HP in the multivariate analyses. Conclusions Sheltered and social workshops are open to HP interventions, but more can be done to optimize the implementation. To persuade persons responsible for the implementation of HP to invest more in HP, changing attitudes concerning the benefits of health promotion for the employee and the company, is an important strategy.
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Affiliation(s)
- Anne Hublet
- Department of Public Health, Ghent University, De Pintelaan 185, 4K3, 9000, Ghent, Belgium.
| | - Lea Maes
- Department of Public Health, Ghent University, De Pintelaan 185, 4K3, 9000, Ghent, Belgium.
| | - Jasmine Mommen
- Department of Public Health, Ghent University, De Pintelaan 185, 4K3, 9000, Ghent, Belgium.
| | - Benedicte Deforche
- Department of Public Health, Ghent University, De Pintelaan 185, 4K3, 9000, Ghent, Belgium. .,Department of Human Biometry and Biomechanics, Vrije Universiteit Brussel, 1050, Brussels, Belgium.
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Walkosz BJ, Buller DB, Andersen PA, Wallis A, Buller MK, Scott MD. Factors Associated With Occupational Sun-Protection Policies in Local Government Organizations in Colorado. JAMA Dermatol 2015; 151:991-7. [PMID: 25993051 DOI: 10.1001/jamadermatol.2015.0575] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
IMPORTANCE Skin cancer prevention remains a national priority. Reducing chronic UV radiation exposure for outdoor workers through sun-safety practices is an important step to help reduce the incidence of skin cancer. OBJECTIVE To determine the presence of occupational sun-safety policies at local government organizations in a single state. DESIGN, SETTING, AND PARTICIPANTS Of 571 potentially eligible local government organizations of Colorado cities, counties, and special tax districts, we enrolled 98 in a randomized pretest-posttest controlled experiment starting August 15, 2010, that evaluated an intervention to promote the adoption of sun-safety policies. We used a policy-coding protocol to evaluate personal sun-protection practices, environmental and administrative controls, and policy directives for sun safety starting February 10, 2011. We report the baseline assessment of the occupational sun-protection policies of these organizations. MAIN OUTCOMES AND MEASURES The presence of an occupational sun-safety policy. RESULTS Overall, 85 local government organizations (87%) had policies that required personal sun-protection practices, including the use of eyewear, hats, and protective clothing. However, of the 98 responding organizations, only 8 hat policies (8%), 10 eyewear policies (10%), and 7 clothing policies (7%) mentioned sun protection as the intent of the policy. Only cosmopoliteness, operationalized as proximity to an urban area, was associated with the presence of a sun-safety policy (odds ratio, 0.99 [95% CI, 0.98-1.00]; P = .02). CONCLUSIONS AND RELEVANCE Outdoor workers are at increased risk for skin cancer because of long-term exposure to solar UV radiation. Although organizational policies have the potential to increase sun protection in occupational settings, occupational sun-safety policies were uncommon among local governments. Opportunities exist for dermatologists and other physicians to influence occupational sun-safety practices and policies, which are consistent with other safety procedures and could easily be integrated into existing workplace practices.
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Affiliation(s)
| | | | - Peter A Andersen
- School of Communication, San Diego State University, San Diego, California
| | - Allan Wallis
- School of Public Affairs, University of Colorado, Denver
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Kite J, Indig D, Mihrshahi S, Milat A, Bauman A. Assessing the usefulness of systematic reviews for policymakers in public health: A case study of overweight and obesity prevention interventions. Prev Med 2015; 81:99-107. [PMID: 26303371 DOI: 10.1016/j.ypmed.2015.08.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/12/2015] [Accepted: 08/13/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Systematic reviews (SRs) should include policy-relevant information in order to more readily inform policy and practice. We investigated whether SRs of overweight and obesity prevention interventions are framed in such a way that maximises their usefulness for policymakers. METHOD We conducted a systematic review of SRs of overweight and obesity prevention interventions published in 4 databases any time up to December 2014. We analysed the SRs for their usefulness to policymakers, using a coding frame developed based on literature around what policymakers want and need from systematic reviews. Systematic reviews were assessed for a) policy links and framing; b) quality assessment and conflict of interest statements: and c) discussion of policy implications. RESULTS Of the 153 SRs that met the inclusion criteria, very few (7%) had authors from policy-based organisations, 48% had funding from such organisations, and almost a third (31%) framed their introduction or aims around policy. Most (69%) discussed issues affecting generalisability of the SR findings but only a quarter (24%) discussed cost or cost-effectiveness of the intervention under investigation. Less than a third (29%) of SRs discussed the policy implications of their findings. SRs that were policy-framed were significantly more likely to discuss costs (PR=1.8, 95%CI 1.0-3.0) and policy implications (PR=2.5, 95%CI 1.5-4.0). CONCLUSION SRs should discuss the policy and practice implications of their findings to maximise the influence of SRs on policy making. It is recommended that SR guidelines are updated to include generalisability and discussion of policy and practice implications as a requirement.
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Affiliation(s)
- James Kite
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
| | - Devon Indig
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
| | - Seema Mihrshahi
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
| | - Andrew Milat
- NSW Ministry of Health, 73 Miller St, North Sydney, NSW, Australia.
| | - Adrian Bauman
- Prevention Research Collaboration, School of Public Health, University of Sydney, NSW, Australia.
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Acting to self-regulate unhealthy eating habits. An investigation into the effects of habit, hedonic hunger and self-regulation on sugar consumption from confectionery foods. Food Qual Prefer 2015. [DOI: 10.1016/j.foodqual.2015.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Roy R, Kelly B, Rangan A, Allman-Farinelli M. Food Environment Interventions to Improve the Dietary Behavior of Young Adults in Tertiary Education Settings: A Systematic Literature Review. J Acad Nutr Diet 2015; 115:1647-81.e1. [DOI: 10.1016/j.jand.2015.06.380] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 06/24/2015] [Indexed: 10/23/2022]
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100
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'When operating a cafeteria, sales come before nutrition' - finding barriers and facilitators to serving reduced-sodium meals in worksite cafeterias. Public Health Nutr 2015; 19:1506-16. [PMID: 26419495 DOI: 10.1017/s1368980015002827] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The present study was conducted to examine barriers to and facilitators of serving reduced-sodium meals (RSM) in worksite cafeterias. DESIGN We conducted in-depth interviews with key stakeholders in food catering companies. SETTING Food catering companies at various customer sites in South Korea. SUBJECTS A total of nineteen interviews with twenty-five participants from ten catering companies were conducted. Sixteen on-site dietitians and nine managers from the catering companies' headquarters participated in the interviews. RESULTS Four main themes emerged from the interviews. First, key stakeholders' psychosocial characteristics (perception, intention and knowledge) are important in serving RSM in worksite cafeterias. Second, skills and techniques related to measuring sodium content and preparing RSM were emphasized by the interviewees. Third, the lack of various delicious low-sodium menus is a barrier to serving RSM. Lastly, a number of environmental factors were addressed, which include social support for reduced-sodium diets (a facilitator) and pressure to maintain profit margins (a barrier), that contribute to serving meals with less salt. Based on these factors, various recommendations for future sodium reduction policies and programmes were suggested. CONCLUSIONS It is important to implement population-wide sodium reduction as a means of preventing CVD and stroke. The study provided important facilitators of and barriers to serving RSM in worksite cafeterias, which could be helpful in developing environmental interventions that promote low-sodium diets.
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