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Ben Nathan C, Ben Nathan J, Chou YT, Joshi SM, Gallagher C, Chao AM. Benefits managers' attitudes toward obesity treatment coverage. Obes Res Clin Pract 2024; 18:94-100. [PMID: 38637266 DOI: 10.1016/j.orcp.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 03/09/2024] [Accepted: 04/05/2024] [Indexed: 04/20/2024]
Abstract
Despite the existence of effective treatments, obesity continues to present a severe public health crisis. Limited access to treatments works against efforts to reduce obesity prevalence. A major barrier to treatment access is a lack of insurance coverage. This study focused on an important population of stakeholders: benefits managers. The purpose of this study was to explore the relationships between attitudes about insurance coverage of obesity treatments and obesity stigma. Benefits managers have the ability to advocate for insurance coverage of medical interventions. We assessed whether attitudes toward covering obesity benefits for employees could be modified by receiving targeted information or were associated with particular factors. We recruited participants from Dun & Bradstreet's employer database using emails. Participants were randomized to one of three conditions that provided written information about: (1) prevalence of obesity (control), (2) prevalence + financial implications of obesity, and (3) prevalence + physiology of obesity. Questionnaires were self-administered online. The response rate was 4.8%, with 404 participants meeting eligibility criteria. While attitudes toward coverage of obesity interventions did not differ significantly based on condition (p > 0.05), gender, history of previous obesity treatment, and an individual's likelihood to attribute obesity to biological and environmental factors showed significant associations with supporting coverage of obesity treatment (p < 0.05). Findings suggest that understanding obesity as a condition caused by biological factors as opposed to personal responsibility and behavior is associated with greater support for coverage of all its treatments.
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Affiliation(s)
- Caroline Ben Nathan
- Marketing Department, The Wharton School, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jennifer Ben Nathan
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yung-Tang Chou
- Department of Computer and Information Science, School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sukanya M Joshi
- Department of Computer and Information Science, School of Engineering & Applied Sciences, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christine Gallagher
- Milken Institute School of Public Health, The George Washington University, Washington DC 20052, USA
| | - Ariana M Chao
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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2
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Braun A, Portner J, Xu M, Weaver L, Pratt K, Darragh A, Spees CK. Preliminary Support for the Use of Motivational Interviewing to Improve Parent/Adult Caregiver Behavior for Obesity and Cancer Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4726. [PMID: 36981636 PMCID: PMC10048747 DOI: 10.3390/ijerph20064726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Motivational interviewing (MI) is a promising behavioral intervention for improving parent and adult caregiver (PAC) health behavior for obesity and cancer prevention. This study explored the preliminary effects of MI from a registered dietitian (RDMI) within an obesity prevention intervention to promote PAC behavior change and positive proxy effects on children and the home environment. N = 36 PAC/child dyads from low-resource communities were enrolled in a randomized trial testing a 10-week obesity prevention intervention. Intervention dyads were offered RDMI sessions. Data were collected at baseline and post-intervention (PAC diet quality (Healthy Eating Index (HEI)), child skin carotenoids, home environment, and PAC ambivalence regarding improving diet). Results show that for every RDMI dose, PAC HEI scores increased (0.571 points, p = 0.530), child skin carotenoid scores improved (1.315%, p = 0.592), and the home food environment improved (3.559%, p = 0.026). There was a significant positive relationship between RDMI dose and change in ambivalence (ρ = 0.533, p = 0.007). Higher baseline ambivalence was associated with greater dose (ρ = -0.287, p = 0.173). Thus, RDMI for PACs may improve diets among PACs who are otherwise ambivalent, with potential effects on the diets of their children and the home food environment. Such intervention strategies have the potential for greater effect, strengthening behavioral interventions targeting obesity and cancer.
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Affiliation(s)
- Ashlea Braun
- Department of Nutritional Sciences, College of Education and Human Sciences, Oklahoma State University, Stillwater, OK 74078, USA
| | - James Portner
- College of Social Work, The Ohio State University, Columbus, OH 43210, USA
| | - Menglin Xu
- The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Lindy Weaver
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Keeley Pratt
- Human Development and Family Science Program, Department of Human Sciences, College of Education and Human Ecology, The Ohio State University, Columbus, OH 43210, USA
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Amy Darragh
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Colleen K. Spees
- Division of Medical Dietetics, School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
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Nehme PA, Marot LP, Nogueira LFR, Marqueze EC, Crispim CA, Moreno CRC. A Nutritional Counseling Program Prevents an Increase in Workers' Dietary Intake and Body Weight During the COVID-19 Pandemic. Front Physiol 2021; 12:703862. [PMID: 34366892 PMCID: PMC8335487 DOI: 10.3389/fphys.2021.703862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/17/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic caused thousands of deaths and changed lives all over the world. Daily life has also altered people's eating habits, mainly among those who stayed working at home. However, changes in the eating habits of workers who remained working during the pandemic are still unknown. The aim of this study was to evaluate the impact of the COVID-19 pandemic on the dietary habits of day and shift workers from a condominium management company, as well as to measure adherence to a nutritional counseling program and its effect on workers' food intake and body weight. One hundred and fifty-one workers (77.5% of day workers and 22.5% of shift workers) were followed up in the pre-pandemic period and during the pandemic. Data on anthropometry, food consumption, and adherence to nutritional counseling were collected during nutritional meetings, which focused on qualitative modification of food intake and control of energy consumption. The rate of adherence to the program did not differ between shifts. The pandemic significantly increased the intake of calories, macronutrients, and several micronutrients in workers of both shifts. Adherence to the nutritional counseling program had an impact on the consumption of proteins and some micronutrients, and also promoted a reduction in body weight and body mass index of workers of both shifts. Evening/night shift workers overall ate their meals later than day workers and also presented an earlier afternoon snack during the pandemic when compared with the pre-pandemic period. In conclusion, the pandemic seems to contribute to the increase in food intake of workers, regardless of the work shift. Those who joined a nutritional counseling program managed their food intake and lost weight.
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Affiliation(s)
- Patricia A Nehme
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Luisa P Marot
- Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Elaine C Marqueze
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil.,Public Health Graduate Program, Catholic University of Santos, Santos, Brazil
| | | | - Claudia R C Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil.,Psychology Department, Stockholm University, Stockholm, Sweden
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JaKa MM, Dinh JM, Rivard RL, Herrmann SD, Spoonheim J, Pronk NP, Ziegenfuss JY. Pragmatic Evaluation of a Health System-Based Employee Weight Management Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5901. [PMID: 34072841 PMCID: PMC8199381 DOI: 10.3390/ijerph18115901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022]
Abstract
Objective: We aimed to evaluate the fidelity and estimate the effectiveness of a novel health system employee weight-management program. Methods: Employees participating in a weight loss program consisting of self-monitoring, health coaching and meal replacements optionally enrolled in the 12-month study. Longitudinal, single-arm analyses were conducted evaluating change over time via survey, claims and programmatic data. Token participation incentives were offered for survey completion. Results: In total, 140 participants enrolled (51.2 ± 9.8 years; BMI = 33.2 ± 6.5 kg/m2; 89.3% female). During 1 year, participants attended 18.0 ± 12.2 coaching appointments and self-reported significant improvements in weight (-8.2 ± 10.5% body weight), BMI (-3.9 ± 6.5 kg/m2), fruit/vegetable intake, home food preparation, added sugar, sugar sweetened beverages and life satisfaction (all p < 0.05). No significant changes were reported in physical activity, weight-related social support, self-efficacy or healthcare utilization (all p > 0.05). Conclusions: The findings from this evaluation establish implementation fidelity. Clinically significant self-reported weight loss, coupled with improvements in many weight-related behaviors, suggest the program is an effective weight management tool when offered as an employee well-being program.
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Affiliation(s)
- Meghan M. JaKa
- HealthPartners Institute, Bloomington, MN 55425, USA; (M.M.J.); (R.L.R.); (N.P.P.); (J.Y.Z.)
| | - Jennifer M. Dinh
- HealthPartners Institute, Bloomington, MN 55425, USA; (M.M.J.); (R.L.R.); (N.P.P.); (J.Y.Z.)
| | - Rachael L. Rivard
- HealthPartners Institute, Bloomington, MN 55425, USA; (M.M.J.); (R.L.R.); (N.P.P.); (J.Y.Z.)
| | - Stephen D. Herrmann
- Sanford Research, Sioux Falls, SD 57104, USA;
- Sanford Health, Sioux Falls, SD 57117, USA
| | | | - Nicolaas P. Pronk
- HealthPartners Institute, Bloomington, MN 55425, USA; (M.M.J.); (R.L.R.); (N.P.P.); (J.Y.Z.)
- HealthPartners, Bloomington, MN 55425, USA;
| | - Jeanette Y. Ziegenfuss
- HealthPartners Institute, Bloomington, MN 55425, USA; (M.M.J.); (R.L.R.); (N.P.P.); (J.Y.Z.)
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Stein RI, Strickland JR, Tabak RG, Dale AM, Colditz GA, Evanoff BA. Design of a randomized trial testing a multi-level weight-control intervention to reduce obesity and related health conditions in low-income workers. Contemp Clin Trials 2019; 79:89-97. [PMID: 30664943 PMCID: PMC6521952 DOI: 10.1016/j.cct.2019.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 12/13/2022]
Abstract
Weight-control is a major public health focus for preventing multiple obesity-related health conditions. While clinic-based intensive lifestyle interventions are successful, low-socioeconomic-status (SES) populations, which have a higher burden of obesity, are difficult to reach; thus, the workplace offers a useful setting to target low-SES workers. The current paper presents the design of a study testing a workplace intervention aimed at low-SES employees. Partnering with a large healthcare system and affiliated university, this project will test an innovative multi-level intervention ("Working for You") adapted from existing group- and individual-level intervention models to promote healthy weight among low-wage workers. The individual-level component is an interactive obesity treatment approach (iOTA) program that involves assessment of behavior risks, collaborative goal-setting with a health coach, and interactive SMS text-messages for ongoing support and self-monitoring. This mHealth intervention is embedded in the group-level component, a workplace participatory program that involves worker teams engaged in the design and implementation of interventions to change their workplace environments. These nested interventions are being tested in a group-randomized trial among 22 work groups (~1000 total workers, ~300 workers with obesity). The primary outcome will be program effects on weight at 2-year follow-up, compared to control, and the secondary outcomes will be effects on diet and physical activity; iOTA adherence, process measures, and work environment/support will also be examined. This pragmatic clinical trial will test scalable interventions that can be translated to other work settings to reduce obesity and related health risks among low-SES workers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02934113.
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Affiliation(s)
- Richard I Stein
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States.
| | - Jaime R Strickland
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Rachel G Tabak
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Ann Marie Dale
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Graham A Colditz
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Bradley A Evanoff
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
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Demou E, MacLean A, Cheripelli LJ, Hunt K, Gray CM. Group-based healthy lifestyle workplace interventions for shift workers: a systematic review. Scand J Work Environ Health 2018; 44:568-584. [PMID: 30196312 PMCID: PMC6716979 DOI: 10.5271/sjweh.3763] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Shift work is a risk factor for many chronic diseases and has been associated with unhealthy lifestyle behaviors. Workplaces have great potential for promoting and supporting behavior change. We conducted a systematic review of group-based lifestyle workplace interventions for shift workers to (i) identify adaptations and intervention components that accommodate shift working and (ii) assess their impact on weight, physical activity, sedentary behavior and healthy eating. Methods A systematic search was conducted in Scopus, Web of Knowledge, EBSCO and Ovid databases. Using pre-established criteria, independent pairs of researchers conducted the study selection, quality appraisal and data extraction. Results In total, 22 studies on group-based workplace interventions for shift workers were included. Many demonstrated organizational level adaptations, such as flexible delivery times and paying employees’ time for their involvement. Delivery locations near the workplace and management support were other key features. Common intervention components included competitive group activities, individualized goal setting, self-monitoring and feedback, staff involvement in intervention delivery, and incentives. There was moderate evidence for effectiveness on weight and physical activity outcomes, but insufficient evidence for healthy eating outcomes. No interventions focusing on sedentary behavior among shift workers were found. Conclusion Current evidence demonstrates that group-based workplace interventions can be effective for supporting shift workers to lose weight and increase physical activity, while further research is needed to change healthy eating and sedentary behaviors. Our findings offer decision support on organizational-level adaptations and intervention components that are important to make interventions that promote healthy lifestyles more accessible to shift workers.
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Affiliation(s)
- Evangelia Demou
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3AX, UK.
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7
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McQueen A, Kreuter M, Loughran M, Thompson T, Poor T. Perceptions of Health Coaching for Behavior Change Among Medicaid and Commercially Insured Adults. Health Promot Pract 2018; 21:288-297. [PMID: 30064265 DOI: 10.1177/1524839918790936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Use of health coaching to help individuals make and sustain changes in health behavior and disease management is increasing, and early evidence about its effects is promising. However, few studies assess participants' preferences and expectations about health coaches, the use of the term health coach, and the coaching relationship. To help inform the design of future health coaching programs, we conducted qualitative interviews with 50 U.S. adults (25 with Medicaid, 25 commercially insured) to assess their (1) sources of health information; (2) familiarity with, preferences for, and associations with 32 terms that could describe "someone who uses experience and one-on-one communication to help others change behaviors to improve their health;" and (3) perceptions of how well different terms apply across different health behaviors and for nonhealth concerns (e.g., financial, career). Results showed wide variability in preferences for different coaching terms and mental models of coaching that differed by insurance type. Commercially insured participants made a distinction between experts and supporters as different categories of coaches. Medicaid participants associated coach with sports and viewed the term as less professional. All participants preferred terms such as advisor and specialist, and all wanted content experts who could also appreciate the broader context of their life.
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Affiliation(s)
- Amy McQueen
- Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Tess Thompson
- Washington University in St. Louis, St. Louis, MO, USA
| | - Tim Poor
- Washington University in St. Louis, St. Louis, MO, USA
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8
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Gomero R, Murguía L, Calizaya L, Mejia CR, Sánchez-B A. Association between the Increase in Body Mass Index and Medical Absenteeism in a Peruvian Mining Population. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2018; 9:129-136. [PMID: 29995018 PMCID: PMC6466975 DOI: 10.15171/ijoem.2018.1201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/24/2018] [Indexed: 11/15/2022]
Abstract
Background:
Obesity and overweight are associated with work absenteeism of medical cause. However, there is little knowledge on the relationship between incremental body mass index (BMI) and absenteeism.
Objective:
To assess the effect of annual increase in BMI on amount of prolonged absenteeism.
Methods:
Data from a longitudinal historical cohort of workers of a mining camp in Peru between 2006 and 2014 were used for the analysis. Prolonged absenteeism of 30 days or more in one year was chosen as the dependent variable; annual increase in BMI was considered as the explanatory variable. Regression analysis with generalized estimating equation was used to determine the relative risk adjusted for age, sex and type of work.
Results:
There were 1347 cases of medical leave reported with a median of 6 days. Of all cases of medical leave, 11% of those who had an annual increase in BMI and 6% of those who maintained their BMI were cases of prolonged absenteeism. Prolonged absenteeism significantly increased in workers who had an annual increment in BMI (adj RR 1.16, 95% CI 1.05 to 1.29).
Conclusion:
The annual increase in BMI was marginally associated with prolonged absenteeism. Temporal increment in BMI, regardless of the baseline BMI, may be an independent determinant of the work absenteeism of medical cause.
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Affiliation(s)
- Raúl Gomero
- Environmental and Occupational Medicine, Faculty of Medicine, Cayetano Heredia University, Lima, Peru
| | - Ludy Murguía
- Faculty of Medicine, Cayetano Heredia University, Lima, Peru
| | - Livia Calizaya
- Faculty of Medicine, Peruvian University of Applied Science, Lima, Peru
| | - Christian R Mejia
- Occupational Health and Epidemiology Program, Faculty of Medicine, Continental University, Huancayo, Peru
| | - Arnaldo Sánchez-B
- Faculty of Medicine, University of British Columbia, British Columbia, Canada.
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Meng L, Wolff MB, Mattick KA, DeJoy DM, Wilson MG, Smith ML. Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases. Saf Health Work 2017; 8:117-129. [PMID: 28593067 PMCID: PMC5447415 DOI: 10.1016/j.shaw.2016.11.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 10/20/2016] [Accepted: 11/07/2016] [Indexed: 10/27/2022] Open
Abstract
Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13), cardiovascular diseases (n = 8), and diabetes (n = 6). Intervention strategies included instructional education/counseling (n = 20), workplace environmental change (n = 6), physical activity (n = 10), use of technology (n = 10), and incentives (n = 13). Self-reported data (n = 21), anthropometric measurements (n = 17), and laboratory tests (n = 14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.
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Affiliation(s)
- Lu Meng
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Marilyn B. Wolff
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Kelly A. Mattick
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - David M. DeJoy
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Mark G. Wilson
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
| | - Matthew Lee Smith
- Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, USA
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, College Station, TX, USA
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Richardson CR, Goodrich DE, Larkin AR, Ronis D, Holleman RG, Damschroder LJ, Lowery JC. A Comparative Effectiveness Trial of Three Walking Self-monitoring Strategies. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2017; 1:133-142. [PMID: 28529971 PMCID: PMC5435380 DOI: 10.1249/tjx.0000000000000017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Walking programs improve health outcomes in adults at risk for cardiovascular disease (CVD), and self-monitoring strategies can improve adherence to such programs. The objective of this study was to determine whether a 6-month Internet-based walking program using Web-enhanced pedometers results in more weight loss than walking programs based on time or simple pedometer step count goals in adults with or at risk for CVD. This was a multisite, randomized controlled trial of 255 male veterans who were ambulatory, insufficiently active, and with body mass index (BMI) ≥28, and who reported CVD risk factors ≥1 risk factors. Participants were randomized to one of three self-monitoring strategies to increase walking: 1) time-based walking goals; 2) simple pedometer-based walking goals; and 3) Web-enhanced pedometer feedback goals with Internet-mediated feedback. All participants also attended five individual weight loss sessions with a dietitian. The main outcome measure was change in weight at 6 months (kg), and the secondary outcomes were change in accelerometer-measured physical activity (min) and change in health-related quality of life at 6 months. The 255 participants had a mean age of 56.3 yr (SD = 10.0), BMI = 36.3 (SD = 5.3), with a mean value of 5.2 (SD = 2.3) medical comorbidities. Dropouts were distributed evenly across the three groups, and 72% of participants completed the program. At 6 months, participants in the Web-enhanced pedometer arm lost significantly more weight (−1.9 kg, 95% CI, −2.7 to −1.1) than those in the time-based group (−0.7 kg, 95% CI, −1.5 to 0.0; P = 0.04) and simple pedometer group (−0.6 kg, 95% CI, −1.4 to 0.2; P = 0.02). In conclusion, Internet-enhanced pedometers result in greater weight loss in veterans than in walking programs using time-based walking goals or simple pedometers.
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Affiliation(s)
- Caroline R Richardson
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI.,The Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI
| | - David E Goodrich
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Angela R Larkin
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - David Ronis
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Robert G Holleman
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Laura J Damschroder
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Julie C Lowery
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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11
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Wilson ER, Kyle TK, Nadglowski JF, Stanford FC. Obesity coverage gap: Consumers perceive low coverage for obesity treatments even when workplace wellness programs target BMI. Obesity (Silver Spring) 2017; 25:370-377. [PMID: 28063213 PMCID: PMC6100791 DOI: 10.1002/oby.21746] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/18/2016] [Accepted: 11/21/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Evidence-based obesity treatments, such as bariatric surgery, are not considered essential health benefits under the Affordable Care Act. Employer-sponsored wellness programs with incentives based on biometric outcomes are allowed and often used despite mixed evidence regarding their effectiveness. This study examines consumers' perceptions of their coverage for obesity treatments and exposure to workplace wellness programs. METHODS A total of 7,378 participants completed an online survey during 2015-2016. Respondents answered questions regarding their health coverage for seven medical services and exposure to employer wellness programs that target weight or body mass index (BMI). Using χ2 tests, associations between perceptions of exposure to employer wellness programs and coverage for medical services were examined. Differences between survey years were also assessed. RESULTS Most respondents reported they did not have health coverage for obesity treatments, but more of the respondents with employer wellness programs reported having coverage. Neither the perception of coverage for obesity treatments nor exposure to wellness programs increased between 2015 and 2016. CONCLUSIONS Even when consumers have exposure to employer wellness programs that target BMI, their health insurance often excludes obesity treatments. Given the clinical and cost-effectiveness of such treatments, reducing that coverage gap may mitigate obesity's individual- and population-level effects.
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Affiliation(s)
| | - Theodore K. Kyle
- ConscienHealth, Pittsburgh, Pennsylvania, USA
- Obesity Action Coalition, Tampa, Florida, USA
| | | | - Fatima Cody Stanford
- Massachusetts General Hospital-Department of Medicine-Gastroenterology, MGH Weight Center, Harvard Medical School, Boston, Massachusetts, USA. Correspondence: Fatima Cody Stanford ()
- Department of Pediatrics-Endocrinology, MGH Weight Center, Harvard Medical School, Boston, Massachusetts, USA
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Impact of a Workplace Health Promotion Program on Employees' Blood Pressure in a Public University. PLoS One 2016; 11:e0148307. [PMID: 26840508 PMCID: PMC4739732 DOI: 10.1371/journal.pone.0148307] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 01/15/2016] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Workplace health promotion is important in the prevention of non-communicable diseases among employees. Previous workplace health programs have shown benefits such as lowered disease prevalence, reduced medical costs and improved productivity. This study aims to evaluate the impact of a 6-year workplace health promotion program on employees' blood pressure in a public university. METHODS In this prospective cohort study, we included 1,365 employees enrolled in the university's workplace health promotion program, a program conducted since 2008 and using data from the 2008-2013 follow-up period. Participants were permanent employees aged 35 years and above, with at least one follow up measurements and no change in antihypertensive medication during the study period. Baseline socio-demographic information was collected using a questionnaire while anthropometry measurements and resting blood pressure were collected during annual health screening. Changes in blood pressure over time were analyzed using a linear mixed model. RESULTS The systolic blood pressure in the hypertension subgroup decreased 2.36 mmHg per year (p<0.0001). There was also significant improvement in systolic blood pressure among the participants who were at risk of hypertension (-0.75 mmHg, p<0.001). The diastolic blood pressure among the hypertensive and at risk subgroups improved 1.76 mmHg/year (p<0.001) and 0.56 mmHg/year (p<0.001), respectively. However, there was no change in both systolic and diastolic blood pressure among participants in the healthy subgroup over the 6-year period. CONCLUSION This study shows that continuing participation in workplace health promotion program has the potential to improve blood pressure levels among employees.
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