The association between worksite physical environment and employee nutrition, and physical activity behavior and weight status

Changes in office workers' lived experiences of their own eating habits since working from home due to the COVID-19 pandemic: An interpretative phenomenological analysis

In response to the unprecedented circumstances of the COVID-19 pandemic, there has been little insight into how office workers perceived their own eating behaviour in relation to their new home working environment. The sedentary nature of office-based jobs means that it is crucial that workers in these occupations engage in health behaviours that are beneficial to them. The present study aimed to explore how office workers perceive changes to their own eating behaviour since the transition to working from home (WFH) as a consequence of the pandemic. Semi-structured interviews were conducted with six volunteer office workers who previously worked in an office environment and who are now WFH. Data were analysed using interpretative phenomenological analysis, allowing the researcher to explore each account and understand their lived experiences. There were five superordinate themes: Healthy eating; time constraints; escaping the office; social cognitions; and food indulgence. Increased snacking behaviour since WFH was a major challenge, which was particularly potent during times of elevated stress. Furthermore, quality of nutrition since WFH appeared to coincide with the participants' wellbeing, such that this was reported as being worst at times of low wellbeing. Future studies must focus on developing strategies to improve the eating behaviours and the general wellbeing of office workers as they continue to WFH. These findings can then be utilised for the development of health promoting behaviours.

Determinants of nutrition practice and food choice in UK construction workers

The workplace is considered an effective setting for health and wellbeing interventions, including programmes focusing on nutrition, and provides opportunities to tailor programmes to meet the specific needs of industry and employees. This study explored nutrition practices amongst construction workers and managers to inform the design of a nutrition intervention. Five focus groups were conducted on three construction sites: two with managers (n = 11) and three with workers (n = 27). Construction workers and managers identified several unhealthy nutrition-related behaviours, including high consumption of convenient and fast foods, excessive coffee, alcohol, energy drinks and low fruit and vegetable intake. These behaviours were often attributed to high workloads, long working hours and physically demanding jobs. Snacking and skipping meals were repeatedly reported, attributed to short breaks and poor accessibility to food outlets. The nutritional quality of meals differed between individuals (homemade vs fast food), depending on the type of sites (temporary vs permanent) and site location. Nutrition knowledge, establishing routines, meal planning and preparation were recognized as important in sustaining healthy nutrition habits. However, meal preparation depended on the facilities available, which differed between managers and workers, highlighting the complex relationship between the workplace context and eating behaviours. Construction workers were interested in learning about nutrition and improving their eating habits through nutrition intervention. However, they highlighted that better cooking and storage facilities on site, together with fewer job demands and longer break times, would enhance the sustainability of the intervention and their ability to make healthier food choices.

How supportive are workplace environments for sitting less and moving more? A descriptive study of Australian workplaces participating in the BeUpstanding program

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Workplaces varied in the number of activity-supportive characteristics present.

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Spatial characteristics were more common than resource or policy characteristics.

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Characteristics absent in most workplaces were likely to be modifiable or low cost (“easy wins”).

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Almost all workplaces had some room for improvement in terms of activity-supportive factors.

Desk-based workers are highly sedentary; this has been identified as an emerging work health and safety issue. To reduce workplace sitting time and promote physical activity it is important to understand what factors are already present within workplaces to inform future interventions. This cross-sectional study examined the prevalence of supportive environmental factors, prior to workplaces taking part in a ‘sit less, move more’ initiative (BeUpstanding). Participants were 291 Australian-based workplace champions (representing 230 organisations) who unlocked the BeUpstanding program’s online toolkit between September 2017 and mid-November 2020, and who completed surveys relating to champion characteristics, organisation and workplace characteristics, and the availability of environmental factors to support sitting less and moving more. Factors were characterized using descriptive statistics and compared across key sectors and factor categories (spatial; resources/initiatives; policy/cultural) using mixed logistic regression models. Of the 42 factors measured, only 11 were present in > 50% of workplaces. Spatial design factors were more likely to be present than resources/initiatives or policy/cultural factors. Centralised printers were the most commonly reported attribute (94%), while prompts to encourage stair use were the least common (4%). Most workplace factors with < 50% prevalence were modifiable and/or were considered modifiable with low cost. Organisations that were public sector, not small/medium, not regional/remote, and not blue-collar had higher odds of having supportive factors than their counterparts; however, workplaces varied considerably in the number of factors present. These findings can assist with developing and targeting initiatives and promoting feasible strategies for desk-based workers to sit less and move more.

Application of the theory of planned behavior in the design and implementation of a behavior-based safety plan in the workplace

BACKGROUND

Many accidents in industries occur due to unsafe practices and unsafe conditions. Occupational accidents endanger the health of workers and impose excessive costs on the employers. This study was designed and conducted to evaluate and implement a behavior-based safety approach in an industrial workplace based on the theory of planned behavior.

MATERIALS AND METHODS

The present study was a quasi-experimental study performed on 90 supervisors of an industrial workplace. Behavior-based safety interventions were performed based on the components of the theory of planned behavior using nine strategies of health education and health promotion, including skills training, participation, and social support. The data collection tool consisted of a researcher-made questionnaire that was answered by the supervisors before and 6 months after the intervention. The collected data were evaluated using SPSS 22 software. The significance level was considered 0.05.

RESULTS

The results showed that the constructs of subjective norms, attitude, and perceived control of behavior predict the safe behavior of supervisors. After behavior-based safety interventions, significant changes were observed in subjective norms, intention, attitude, and perceived control of behavior (P < 0.001) compared to before the intervention.

CONCLUSION

The results of this study showed the improvement of safe behavior of supervisors in the workplace due to behavioral-based safety interventions using the theory of planned behavior. Accordingly, this theory can be used as a suitable theoretical framework for designing and implementing interventions to promote safe behaviors of employees in the workplace.

Workplace neighbourhood built environment and workers' physically-active and sedentary behaviour: a systematic review of observational studies

Background

Many desk-based workers can spend more than half of their working hours sitting, with low levels of physical activity. Workplace neighbourhood built environment may influence workers’ physical activities and sedentary behaviours on workdays. We reviewed and synthesised evidence from observational studies on associations of workplace neighbourhood attributes with domain-specific physical activity and sedentary behaviour and suggested research priorities for improving the quality of future relevant studies.

Methods

Published studies were obtained from nine databases (PubMed, Web of Science, PsycINFO, Scopus, Transport Research International Documentation, MEDLINE, Cochrane, Embase, and CINAHL) and crosschecked by Google Scholar. Observational studies with quantitative analyses estimating associations between workplace neighbourhood built environment attributes and workers’ physical activity or sedentary behaviour were included. Studies were restricted to those published in English language peer-reviewed journals from 2000 to 2019.

Results

A total of 55 studies and 455 instances of estimated associations were included. Most instances of potential associations of workplace neighbourhood built environment attributes with total or domain-specific (occupational, transport, and recreational) physical activity were non-significant. However, destination-related attributes (i.e., longer distances from workplace to home and access to car parking) were positively associated with transport-related sedentary behaviour (i.e., car driving).

Conclusions

The findings reinforce the case for urban design policies on designing mixed-use neighbourhoods where there are opportunities to live closer to workplaces and have access to a higher density of shops, services, and recreational facilities. Studies strengthening correspondence between the neighbourhood built environment attributes and behaviours are needed to identify and clarify potential relationships.

Protocol registration

The protocol of this systematic review was registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 2 December 2019 (registration number: CRD42019137341).

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-020-01055-x.

Robust statistical methods for point of sale designs, the example of healthcare snack and drink vending

Purpose

The experiment introduces nutritional labelling, healthier products and product placement designs to the hospital vending machines, to promote healthy lifestyles.

Design/methodology/approach

The site where this experiment happens is a major London hospital, serving over a million patients every year. In the experiment, the hospital’s snack and drink vending machines are redesigned. The impact on product sales are then analysed using robust statistical methods.

Findings

Nutritional labelling has a statistically significant impact on product sales. Less of the unhealthiest products are sold. Healthier products and product placement designs have a larger impact but with less statistical significance. They require further testing.

Research limitations/implications

Experts in service operations can use this experiment’s regression modelling methods. The methods are ideal for measuring change over time in counting data sets in complex real world environments.

Practical implications

There are suggestions for practical vending service change in this research. They are in line and add a practical example to Government policy guidance.

Social implications

People using the redesigned vending machines have more opportunity for healthy lifestyle choices.

Originality/value

The experiment provides statistical evidence in support of catering for healthier lifestyles.

Objective Church Environment Audits and Attendee Perceptions of Healthy Eating and Physical Activity Supports within the Church Setting

Interventions in faith-based settings are increasingly popular, due to their effectiveness for improving attendee health outcomes and behaviors. Little past research has examined the important role of the church environment in individual-level outcomes using objective environmental audits. This study examined associations between the objectively measured physical church environment and attendees' perceptions of physical activity (PA) and healthy eating (HE) supports within the church environment, self-efficacy for PA and HE, and self-reported PA and HE behaviors. Data were collected via church audits and church attendee surveys in 54 churches in a rural, medically underserved county in South Carolina. Multi-level regression was used to analyze associations between the church environment and outcomes. Physical elements of churches were positively related to attendees' perceptions of church environment supports for PA (B = 0.03, 95% CI = 0.01, 0.05) and HE (B = 0.05, 95% CI = 0.01, 0.09) and there was a significant interaction between perceptions of HE supports and HE church environment. Self-efficacy and behaviors for PA and HE did not show an association with the church environment. Future research should establish a temporal relationship between the church environment and these important constructs for improving health. Future faith-based interventions should apply infrastructure changes to the church environment to influence important mediating constructs to health behavior.

Associations Between the Breakroom Built Environment, Worker Health Habits, and Worker Health Outcomes: A Pilot Study Among Public Transit Rail Operators

OBJECTIVE

To investigate the association between the breakroom built environment and worker health outcomes.

METHODS

We conducted this study in a mass transit organization (rail). We collected a user-reported breakroom quality score (worker survey), a worksite health promotion score (validated audit tool), and self-reported worker health outcomes (survey).

RESULTS

Among the 12 breakrooms audited and 127 rail operators surveyed, the average worksite health promotion score was 9.1 (out of 15) and the average user-reported breakroom quality was 3.1 (out of 7). After multivariable regression, breakrooms with higher worksite health promotion scores and user-reported breakroom quality were associated with lower odds of depression and fewer medical disability days.

CONCLUSIONS

This cross-sectional study demonstrates an association between the quality of the breakroom built environment and worker health, specifically depression and medical disability days.

Differences in pre-pregnancy diet quality by occupation among employed women

OBJECTIVE

Maternal risk factors for pregnancy outcomes are known to vary by employment status. We evaluated whether pre-pregnancy diet quality varies by occupation in a population-based sample.

DESIGN

We analysed interview data from 7341 mothers in a national case-control study of pregnancy outcomes. Self-reported job(s) held during the 3 months before pregnancy were classified using Standard Occupational Classification (SOC) codes. Usual diet in the year before conception was assessed with a semi-quantitative FFQ and evaluated using the Diet Quality Index for Pregnancy (DQI-P). Using logistic regression, we calculated adjusted OR and 95 % CI to estimate associations between low diet quality (defined as the lowest quartile of DQI-P scores) and occupation types.

SETTING

The National Birth Defects Prevention Study: Arkansas, California, Georgia, Iowa, Massachusetts, North Carolina, New Jersey, New York, Texas, Utah.

PARTICIPANTS

Employed mothers of infants born between 1997 and 2011.

RESULTS

No occupation was strongly associated with low diet quality. Moderate but relatively imprecise associations were observed for women employed in management (OR: 1·3; 95 % CI: 1·1, 1·7); arts, design, entertainment, sports and media (OR: 1·4; 95 % CI: 0·9, 2·1); protective service (OR 1·3; 95 % CI: 0·7, 2·5) and farming, fishing, and forestry occupations (OR: 0·5; 95 % CI: 0·2, 1·1).

CONCLUSIONS

Our analyses suggest that women in certain occupations may have lower diet quality in the months before pregnancy. Further research is needed to determine whether certain occupations could benefit from interventions to improve diet quality in the workplace for women of reproductive age.

[Nutritional composition of vending foods of public university and hospital buildings in Asturias]

OBJECTIVE

To evaluate the nutritional composition of food vending machines (VM) located in university public buildings and hospitals in Asturias.

DESIGN

Descriptive cross-sectional study.

LOCATION

The analysis was made of the contents of VMs located in public buildings, hospitals, and university teaching centres in the Principality of Asturias.

MAIN MEASUREMENTS

After the public buildings were mapped, each of them was visited to check for the presence of the VMs. A a photograph was then taken of the food contained in them. The variables analysed were the type of products and their nutritional composition.

RESULTS

The VMs of 19 buildings (12 university and 7 hospital), contained 215 foods that were grouped into 11 categories. The most frequent were "chocolates and chocolate bars" (30,2%), "cookies" (11.6%) and "chips" (11.6%). The Kcal average was 216 (SD=133.1). The mean fat, in grams was 12.52 (SD=11.21), saturated fat 4.48 (SD=3,83), sugars 11.88 (SD=31.13), fibre 1.9 (SD=2.47), proteins 3.38 (SD=3.62), and salt 0.3 (SD=0.62). A high excess of fat, saturated fat, and salt was observed, as well as a medium excess of sugars.

CONCLUSIONS

The nutritional quality of VM in hospitals and public university centres of the Principality of Asturias cannot be defined as healthy. Therefore, health promotion strategies could be developed with the aim of improving their nutritional composition or guiding the population/users towards the selection and consumption of healthier foods.

Association between time-related work factors and dietary behaviors: results from the Japan Environment and Children's Study (JECS)

Background

Few studies have examined the association of workhours and shift work (referred to here as “time-related work factors”) with dietary behaviors. We aimed to investigate this association, as well as the dietary behaviors among individuals with occupations characterized by time-related work factors.

Methods

A cross-sectional study was performed using data from the Japan Environment and Children’s Study. The study included 39,315 working men. Dietary behaviors (i.e., skipping breakfast, eating out, eating instant food, overeating, and eating fast) were assessed with a self-reported information from the Food Frequency Questionnaire. Logistic regression analysis was conducted to examine the associations of time-related work factors with dietary behaviors and dietary behavior tendencies among those in occupations characterized by long workhours and/or shift work.

Results

Long workhours were associated with high frequencies of skipping breakfast, eating out, eating instant food, overeating, and eating fast. The frequency of having shift work was associated with high frequencies of skipping breakfast, eating out, and eating instant food. Several occupations involving long workhours and/or shift work showed specific dietary behaviors; in some occupations, the level of significance changed after adjusting for time-related work factors in addition to other potential confounding factors.

Conclusions

Time-related work factors may help explain workers’ dietary behaviors. Long workhours and shift work may lead to poor dietary behaviors. Other factors influenced by occupation itself, such as food environment, may also influence workers’ dietary behaviors. Workhours and/or shift work, and these other work factors, should be given attention in workplace health promotion.

Evaluation of Worksite Wellness Nutrition and Physical Activity Programs and Their Subsequent Impact on Participants' Body Composition

Background

Adult obesity is globally recognized as a public health concern. As adults spend most of their weekdays at work, worksite wellness programs may include topics of nutrition education and physical activity to improve an employee's body composition. However, results are inconsistent with the impact they have on employees' body composition.

Objective

The purpose of this systematic review was to evaluate worksite wellness nutrition and physical activity programs and their subsequent impact on participants' body composition.

Methods

Extraction of articles was completed through 4 databases: PubMed, CINAHL, SCOPUS, and PsycINFO using keywords such as "nutrition and physical activity interventions/programs" and "weight." A 9-point inclusion criterion was established. Evaluation of the articles was assessed using the Academy of Nutrition and Dietetics Evidence-Based Manual.

Results

A total of 962 articles were identified. Twenty-three met the inclusion criterion. Seventeen studies resulted in a change in body composition (e.g., decreased BMI (kg/m2), waist circumference, and body fat percentage), and six studies did not show any changes. Programs that had professionals frequently interact with participants, regardless if the interactions were done daily, weekly, or monthly, led to a change in body composition. Additionally, programs that incorporated a motivation theory and provided content relevant to participants' needs resulted in a change in body composition.

Conclusion

Evidence supports that future worksite wellness programs that are designed using a motivational theory and content that is created relevant to participants' needs and that has frequent interactions with participants may result in a change in body composition.

Variation in Men's Dietary Intake Between Occupations, Based on Data From the Japan Environment and Children's Study

There has been increasing interest in dietary health promotion in the workplace. Although many previous studies have focused on dietary habits in specific occupations, variation between occupational groups requires clarification. The present study aimed to examine differences in food and nutrient intake between occupational groups, using detailed classification. A cross-sectional study was conducted using data from the Japan Environment and Children’s Study. The study included 38,721 employed Japanese expectant fathers aged between 20 and 65 years. Dietary intake was assessed using a food frequency questionnaire. Occupations were categorized into 11 categories according to the Japan Standard Occupational Classification. Analysis of variance and analysis of covariance were performed to compare dietary intake of occupational groups. Logistic regression analysis was performed to examine the differences in adherence to dietary recommendations across occupations. Dietary intake differed significantly between occupations. Specific dietary intake was observed in security and agricultural workers, who tended to exhibit higher consumption levels for numerous foods and nutrients. In addition, relative to other workers, security workers showed higher intake of dairy products and calcium, and agricultural workers consumed larger amounts of pickles and salt. The study categorized occupations into detailed categories using the Japan Standard Occupational Classification, which facilitated the clarification of overall dietary trends across occupations and identification of specific dietary characteristics in individual occupations. The findings could aid in workplace health promotion.

Associations among workplace environment, self-regulation, and domain-specific physical activities among white-collar workers: a multilevel longitudinal study

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.

Dietary Differences in Male Workers among Smaller Occupational Groups within Large Occupational Categories: Findings from the Japan Environment and Children's Study (JECS)

Studies examining workers' diet according to smaller occupational groups within "large occupational categories" are sparse. The aim of this study was to examine the potential differences in workers' diets based on the classification of workers into smaller occupational groups that comprise "large occupational categories". The subjects of this study were working fathers who had participated in the Japan Environment and Children's Study (N = 38,656). Energy and nutrient intake were calculated based on data collected from the Food Frequency Questionnaire. Occupations were classified according to the Japanese Standard Occupational Classification. Logistic regression analyses were performed to examine the adherence to current dietary recommendations within smaller occupational groups. In particular, significant differences were observed among the categorical groups of "professional and engineering workers", "service workers", and "agricultural, forestry, and fishery workers". In "professional and engineering workers", teachers showed higher odds of adherence to calcium intake recommendations compared with nurses (OR, 2.54; 95% CI, 2.02⁻3.14; p < 0.001). In "agricultural, forestry, and fishery workers", agriculture workers showed higher odds of adherence to calcium (OR, 2.15; 95% CI, 1.46⁻3.15; p < 0.001) and vitamin C (OR 1.90, 95% CI 1.31⁻2.74, p = 0.001) intake recommendations compared with forestry and fishery workers. These findings may be beneficial from a research perspective as well as in the development of more effective techniques to improve workers' diet and health.

Employee Health Behaviors, Self-Reported Health Status, and Association With Absenteeism: Comparison With the General Population

OBJECTIVES

To perform a comparison between health behaviors and health status of employees with those of the general population, to evaluate the association between employee health behaviors, health status, and absenteeism.

METHODS

Cross-sectional study enrolled 2433 employees from 16 Korean companies in 2014, and recruited 1000 general population randomly in 2012. The distribution of employee health behaviors, health status, and association with absenteeism were assessed.

RESULTS

Employees had significantly worse health status and low rates of health behaviors maintenance compared with the general population. Multiple logistic regression model revealed that regular exercise, smoking cessation, work life balance, proactive living, religious practice, and good physical health status were associated with lower absenteeism.

CONCLUSIONS

Maintaining health behaviors and having good health status were associated with less absenteeism. This study suggests investment of multidimensional health approach in workplace health and wellness (WHW) programs.

Does a grill menu redesign influence sales, nutrients purchased, and consumer acceptance in a worksite cafeteria?

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.

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Redesigning menus may improve nutrient content and promote sales.

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Consumers value variety even when well-liked offerings are available.

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Sodium use requires scrutiny when redesigning menu items.

Sociocultural Factors Influencing Eating Practices Among Office Workers in Urban South Korea

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.

A Quasi-Experiment to Assess the Impact of a Scalable, Community-Based Weight Loss Program: Combining Reach, Effectiveness, and Cost

BACKGROUND

Primary care addresses obesity through physician oversight of intensive lifestyle interventions or referral to external programs with demonstrated efficacy. However, limited information exists on community program reach, effectiveness, and costs across different groups of participants.

OBJECTIVE

To evaluate a scalable, community weight loss program using reach, effectiveness, and cost metrics.

DESIGN

Longitudinal pre-post quasi-experiment without control.

PARTICIPANTS

Enrolled participants in Weigh and Win (WAW), a community-based weight loss program.

INTERVENTION

A 12-month program with daily social cognitive theory-based email and/or text support, online access to health coaches, objective weight assessment through 83 community-based kiosks, and modest financial incentives to increase program reach.

MAIN MEASURES

Number of participants, representativeness, weight loss achievement (3%, 5% of initial weight lost), and cost of implementation.

KEY RESULTS

A total of 40,308 adults (79% women; 73% white; BMI = 32.3 ± 7.44, age = 43.9 ± 13.1 years) enrolled in WAW. Women were more likely than men to enroll in the program and continue engagement beyond an initial weigh-in (57% vs. 53%). Based on census data, African Americans were over-represented in the sample. Among participants who engaged in the program beyond an initial weigh-in (n = 19,029), 47% and 34% of participants lost 3% and 5% of their initial body weight, respectively. The average duration for those who achieved 5% weight loss was 1.7 ± 1.3 years. African American participants were more likely to achieve 5% weight loss and remain enrolled in the program longer compared to non-African American participants (2.0 ± 1.3 vs. 1.6 ± 1.2 years). Implementation costs were $2,822,698. Cost per clinically meaningful weight loss for African Americans ($257.97/3% loss; $335.96/5% loss) was lower than that for Hispanics ($318.62; $431.10) and Caucasians ($313.65; $441.87), due to the higher success rate of that subgroup of participants.

CONCLUSIONS

Weigh and Win is a scalable technology-supported and community-based weight loss program that reaches a large number of participants and may contribute to reducing health disparities.

Measures of the food environment: A systematic review of the field, 2007-2015

BACKGROUND

Many studies have examined the relationship between the food environment and health-related outcomes, but fewer consider the integrity of measures used to assess the food environment. The present review builds on and makes comparisons with a previous review examining food environment measures and expands the previous review to include a more in depth examination of reliability and validity of measures and study designs employed.

METHODS

We conducted a systematic review of studies measuring the food environment published between 2007 and 2015. We identified these articles through: PubMed, Embase, Web of Science, PsycINFO, and Global Health databases; tables of contents of relevant journals; and the National Cancer Institute's Measures of the Food Environment website. This search yielded 11,928 citations. We retained and abstracted data from 432 studies.

RESULTS

The most common methodology used to study the food environment was geographic analysis (65% of articles) and the domination of this methodology has persisted since the last review. Only 25.9% of studies in this review reported the reliability of measures and 28.2% reported validity, but this was an improvement as compared to the earlier review. Very few of the studies reported construct validity. Studies reporting measures of the school or worksite environment have decreased since the previous review. Only 13.9% of the studies used a longitudinal design.

CONCLUSIONS

To strengthen research examining the relationship between the food environment and population health, there is a need for robust and psychometrically-sound measures and more sophisticated study designs.

The Moderating Effect of Health-Improving Workplace Environment on Promoting Physical Activity in White-Collar Employees: A Multi-Site Longitudinal Study Using Multi-Level Structural Equation Modeling

OBJECTIVE

This longitudinal study aimed to investigate the moderating effect of health-improving workplace environment on relationships between physical activity, self-efficacy, and psychological distress.

METHODS

Data were collected from 16 worksites and 129 employees at two time-points. Health-improving workplace environment was measured using the Japanese version of the Environmental Assessment Tool. Physical activity, self-efficacy, and psychological distress were also measured. Multi-level structural equation modeling was used to investigate the moderating effect of health-improving workplace environment on relationships between psychological distress, self-efficacy, and physical activity.

RESULTS

Psychological distress was negatively associated with physical activity via low self-efficacy. Physical activity was negatively related to psychological distress. Physical activity/fitness facilities in the work environment exaggerated the positive relationship between self-efficacy and physical activity.

CONCLUSIONS

Physical activity/fitness facilities in the workplace may promote employees' physical activity.

Path Analysis of Campus Walkability/Bikeability and College Students' Physical Activity Attitudes, Behaviors, and Body Mass Index

PURPOSE

The purpose of this study was to assess the relationship between the walkability/bikeability of college campuses and students' body mass index (BMI) with student physical activity (PA) attitudes and behaviors as potential mediators.

DESIGN

Cross-sectional.

SETTING

Thirteen university campuses.

PARTICIPANTS

A total of 1384 student participants.

MEASURES

Walkability/bikeability environmental score (ES): 12-item audit assessed an average of 44 path segments per campus. Students were measured for height and weight and completed online surveys. Physical activity stage of change/behavior intentions were assessed using the transtheoretical model. The Cognitive Behavioral Physical Activity Questionnaire assessed outcome expectations, self-regulation, and personal barriers. International Physical Activity Questionnaire assessed walking-, moderate-, and vigorous-intensity PA.

ANALYSIS

Descriptive statistics, zero-order correlations, and path analysis with maximum likelihood estimation.

RESULTS

The overall model fit was good with χ² of 171.388 ( df = 18), P < .001, comparative fit index value of .95, and a root mean square of approximation of .079. After controlling for gender, there was a direct negative association between walkability/bikeability ES and BMI (β = -.085) and positive association between personal barriers and BMI (β = .134). Walkability/bikeability ES was positively associated with walking-intensity PA (β = .010). Self-regulation was positively associated with moderate-intensity PA (β = .213), which, in turn, was negatively associated with BMI (β = -.057).

CONCLUSIONS

The ease of walking and biking on a campus was related to college students' walking behavior and their BMI. Students' PA behavioral intentions were associated with moderate PA and lower BMI. These results provide evidence to focus on policies and structural supports for walkable/bikeable environments to supplement and enhance interventions encouraging individual behavior change for PA and weight management.

Assessing and understanding sedentary behaviour in office-based working adults: a mixed-method approach

Background

Sedentary behaviours (SB) can be characterized by low energy expenditure in a reclining position (e.g., sitting) often associated with work and transport. Prolonged SB is associated with increased risk for chronic conditions, and due to technological advances, the working population is in office settings with high occupational exposure to SB. This study aims to assess SB among office workers, as well as barriers and strategies towards reducing SB in the work setting.

Methods

Using a mixed-methods approach guided by the socio-ecological framework, non-academic office workers from a professional school in a large public university were recruited. Of 180 eligible office workers, 40 enrolled and completed all assessments. Self-reported and objectively measured SB and activity levels were captured. Focus group discussion (FGD) were conducted to further understand perceptions, barriers, and strategies to reducing workplace SB. Environmental factors were systematically evaluated by trained research staff using an adapted version of the Checklist for Health Promotion Environments at Worksites (CHEW). Thematic analysis of FGD was conducted and descriptive analysis of quantitative data was performed.

Results

The sample was mostly Chinese (n = 33, 80 %) with a total of 24 (60 %) female participants. Most participants worked five days a week for about 9.5(0.5) hrs/day. Accelerometer data show that participants spend the majority of their days in sedentary activities both on workdays (76.9 %) and non-workdays (69.5 %). Self-report data confirm these findings with median sitting time of 420(180) minutes at work. From qualitative analyses, major barriers to reducing SB emerged, including the following themes: workplace social and cultural norms, personal factors, job scope, and physical building/office infrastructure. CHEW results confirm a lack of support from the physical infrastructure and information environment to reducing SB.

Conclusions

There is high SB among office workers in this sample. We identified multiple levels of influence for prolonged occupational SB, with a particular emphasis on workplace norms and infrastructure as important barriers to reducing SB and increasing PA. A larger, representative sample of the Singaporean population is needed to confirm our findings but it seems that any intervention aimed at reducing SB in the workplace should target individual, environmental, and organizational levels.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3023-z) contains supplementary material, which is available to authorized users.

'When operating a cafeteria, sales come before nutrition' - finding barriers and facilitators to serving reduced-sodium meals in worksite cafeterias

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.