Does Successful Weight Loss in an Internet-Based Worksite Weight Loss Program Improve Employee Presenteeism and Absenteeism?

Measuring, Analyzing, and Presenting Work Productivity Loss in Randomized Controlled Trials: A Scoping Review

OBJECTIVES

This study aimed to conduct a scoping review of randomized controlled trials (RCTs) and investigate which work productivity loss outcomes were measured in these RCTs, how each outcome was measured and analyzed, and how the results for each outcome were presented.

METHODS

A systematic search was conducted from January 2010 to April 2020 from 2 databases: PubMed and Cochrane Central Register of Controlled Trials. Data on country, study population, disease focus, sample size, work productivity loss outcomes measured (absenteeism, presenteeism, employment status changes), and methods used to measure, report, and analyze each work productivity loss outcome were extracted and analyzed.

RESULTS

We found 435 studies measuring absenteeism or presenteeism, of which 155 studies (35.6%) measured both absenteeism and presenteeism and were included in our final review. Only 9 studies also measured employment status changes. The most used questionnaire was the Work Productivity and Activity Impairment Questionnaire. The analysis of absenteeism and presenteeism data was mostly done using regression models (n = 98, n = 98, respectively) for which a normal distribution was assumed (n = 77, n = 89, respectively). Absenteeism results were most often presented in time whereas presenteeism was commonly presented using a percent scale or score.

CONCLUSIONS

There is a lack of consensus on how to measure, analyze, and present work productivity loss outcomes in RCTs published in the past 10 years. The diversity of measurement, analysis, and presentation methods used in RCTs may make comparability challenging. There is a need for guidelines providing recommendations to standardize the comprehensiveness and the appropriateness of methods used to measure, analyze, and report work productivity loss in RCTs.

A systematic review of the effect of sleep interventions on presenteeism

Background

Sleep problems interfere with work performance. Decreased work productivity due to health problems is defined as presenteeism. Although empirical data on the improvement of presenteeism by sleep interventions have been published, a systematic review elucidating whether there is a difference in the improvement of presenteeism across various types of sleep interventions has not yet been published. This systematic review of studies aimed to clarify which sleep interventions are more likely to be effective in improving presenteeism.

Methods

The electronic databases PubMed, PsycINFO, and MEDLINE were used to perform a literature search (the start and end search dates were October 20, 2019, and March 11, 2020, respectively). A combination of terms such as “employee*,” “sleep,” “insomnia,” and “presenteeism” was used for the search. Both randomized and non-randomized control trials were included in this systematic review.

Results

Six types of sleep interventions were identified, including cognitive behavioral therapy for insomnia (CBT-I), sleep hygiene education, yoga, mindfulness, weight loss program, and changing the color temperature of fluorescent lights in the workplace. Only CBT-I improved both sleep problems and presenteeism compared with a control group. The results of this review also show that there is heterogeneity in the measurement of presenteeism.

Conclusions

The results of this systematic review suggested that CBT-I could be adapted for workers with sleep problems and presenteeism. We discussed whether CBT-I improved both sleep problems and presenteeism compared with other interventions. In addition, methods for measuring presenteeism in future research are proposed.

The future is now: a call for action for cardiac telerehabilitation in the COVID-19 pandemic from the secondary prevention and rehabilitation section of the European Association of Preventive Cardiology

The role of comprehensive cardiac rehabilitation is well established in the secondary prevention of cardiovascular diseases such as coronary artery disease and heart failure. Numerous trials have demonstrated both the effectiveness as well as the cost-effectiveness of comprehensive cardiac rehabilitation in improving exercise capacity and quality of life, and in reducing cardiovascular mortality and morbidity. However, the current COVID-19 pandemic has led to closure of many cardiac rehabilitation centres in Europe resulting in many eligible patients unable to participate in the optimisation of secondary prevention and physical performance. This elicits an even louder call for alternatives such as cardiac telerehabilitation to maintain the delivery of the core components of cardiac rehabilitation to cardiovascular disease patients. The present call for action paper gives an update of recent cardiac telerehabilitation studies and provides a practical guide for the setup of a comprehensive cardiac telerehabilitation intervention during the COVID-19 pandemic. This set up could also be relevant to any cardiovascular disease patient not able to visit cardiac rehabilitation centres regularly after the COVID-19 pandemic ceases.

Impact of a Structured Weight Management Program on Worker Productivity

OBJECTIVE

To determine the impact of an intensive behavioral weight management program on presenteeism and absenteeism in obese participants employed full-time.

METHODS

Participants were recruited from the University of Michigan Weight Management program (WMP), a multidisciplinary lifestyle program targeting 15% body weight loss. Absenteeism and presenteeism were assessed using the World Health Organization Health and Work Performance Questionnaire (HPQ) at baseline and 6 months.

RESULTS

One hundred forty-two participants, predominantly college-educated white-collar employees, were included in the study. After 6 months in the program, there was no significant change in absenteeism or presenteeism compared with baseline. There was a trend towards reduced absenteeism.

CONCLUSIONS

Participation in an intensive weight management program did not adversely impact worker productive time. Conversely, our findings should be reassuring to employer groups and to employees with obesity concerned about time spent away from work.

Impact of nutrition interventions and dietary nutrient density on productivity in the workplace

The global spread of diet-related noncommunicable diseases represents a threat to public health and national economies alike. The elimination of poverty and the eradication of hunger, two key United Nations Sustainable Development Goals, cannot be accomplished without a well-nourished labor force. Easy access to low-cost diets that are energy dense but nutrient poor has resulted in hidden hunger, in which micronutrient deficiencies coexist with obesity or overweight. Workplace interventions in low- and middle-income countries have addressed nutrient adequacy and micronutrient deficiencies, often using fortified foods. Workplace interventions in high-income countries have largely focused on weight loss, smoking cessation, stress reduction, and physical activity. Even though improvement of productivity may have been the ultimate goal, relatively few interventions in high-income countries have explored the likely impact of improved dietary nutrient density on workplace performance. Given that optimal nutrition benefits both physical and mental health, interventions to improve diet quality ought to have a measurable impact on the productivity of the labor force. The present review examines the evidence linking workplace dietary interventions with workplace productivity measures.

Obesity in the Workplace: Impact, Outcomes, and Recommendations

OBJECTIVE

To conduct a comprehensive literature review to develop recommendations for managing obesity among workers to improve health outcomes and to explore the impact of obesity on health costs to determine whether a case can be made for surgical interventions and insurance coverage.

METHODS

We searched PubMed from 2011 to 2016, and CINAHL, Scopus, and Cochrane Registry of Clinical Trials for interventions addressing obesity in the workplace.

RESULTS

A total of 1419 articles were screened, resulting in 275 articles being included. Several areas were identified that require more research and investigation.

CONCLUSIONS

Our findings support the use of both lifestyle modification and bariatric surgery to assist appropriate patients in losing weight.

Millennials: sickness presenteeism and its correlates: a cross-sectional online survey

OBJECTIVE

Sickness presenteeism (SP) is a well-documented phenomenon in the current workforce. However, little is known about the SP of future employees (Millennials). We investigated rate and propensity of presenteeism and health-related and work-related correlates in university students to obtain information about the relevance of SP in the future workforce. Sickness presenteeism (SP) refers to going towork while ill.¹ DESIGN AND SETTING: We administered a cross-sectional online survey in August 2018 involving self-assessments of health-related and work-related behaviour. As planned, we analysed rates, instances and propensities of presenteeism and absenteeism. The target population was Millennial university students.

RESULTS

749 German university students, average age 24.7±3.6 years, 49.5% women, mean academic progress 4.5±2.7 semesters, <1% without work experience, 15.4±10.3 mean weekly working hours. Presenteeism rates in the complete sample were 64% at school and 60.4% at work. For the subsample of participants who reported sickness, presenteeism rates were 87.9% at school and 87% at work. Presenteeism propensity among them was 0.67±0.34 at school and 0.68±0.35 at work. SP at school and at work was significantly correlated with subjective health (r=0.29, p=0.000 and r=0.25, p=0.000) and locus of control (r=-0.20, p=0.000 and r=-0.26, p=0.000). Age and sex adjusted multiple regression analysis showed that subjective health explained 9.7% of the variance in SP at school (B=0.049, p=0.000) and 8.1% of the variance in SP at work (B=0.037, p=0.000).

CONCLUSIONS

The SP rates of the future workforce were in line with previous research on older employees, whereas the presenteeism propensities we found here were higher. Across all analyses, subjective health proved to be associated with presenteeism. Thus, the relevance of SP will remain constant or might even increase with regard to the future workforce. Programmes offering health education should be implemented to sensitise this generation as early as possible.

Work ability and productivity in patients with diabetic foot

OBJECTIVE

To assess work ability and productivity in patients with diabetic foot.

METHODS

This investigation was a cross-sectional controlled study. A total of 117 individuals were selected from March to June 2014 and allocated to group A (patients without diabetes, n=43), group B (diabetes patients without foot ulcers, n=43), or group C (patients with diabetic foot, n=31). Two validated instruments, the Work Limitations Questionnaire (WLQ) and the Work Productivity and Activity Impairment Questionnaire General Health v2.0 (WPAI-GH), were used to assess work ability and productivity.

RESULTS

The groups were homogeneous regarding age and sex; however, patients in group C had a lower education level than the other participants (p=0.006). The median WLQ scores for groups A, B, and C were 0.0121, 0.0146, and 0.0852, respectively (p<0.0001). The WPAI-GH scores revealed a mean productivity loss of 20% for groups A and B and 100% for group C (p<0.0001).

CONCLUSIONS

Patients with diabetic foot showed decreased work ability and productivity.

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.

The Impact of Obesity in the Workplace: a Review of Contributing Factors, Consequences and Potential Solutions

This narrative review summarized findings from previous reviews and the most recently published studies, regarding the following: (1) the association between two occupational risk factors-shift work and sedentary work-and obesity, (2) the effects of obesity on workplace productivity and (3) the effectiveness of workplace interventions aimed at preventing or reducing obesity. Despite some inconsistencies in findings, there is convincing evidence that shift work increases the risk of obesity, while most studies did not show a significant association between sedentary work and obesity. Overweight and obesity were found to be associated with absenteeism, disability pension and overall work impairment, whilst evidence of their relationship with presenteeism, unemployment and early retirement was not consistent. Due to the vast heterogeneity in the types of workplace-based interventions to prevent or treat obesity, no sound conclusions can as yet be drawn about their overall effectiveness and best practice recommendations for their implementation.