Images of a Healthy Worksite: A Group-Randomized Trial for Worksite Weight Gain Prevention With Employee Participation in Intervention Design

The School Environment and Physical and Social-Emotional Well-Being: Implications for Students and School Employees

BACKGROUND

The school environment, consisting of the physical environment and social-emotional climate (SEC), plays a crucial role in both student and employee health; however, there is a lack of recent literature synthesizing school environment interventions in K-12 settings. We describe updated evidence about school environment interventions to support K-12 student and employee health in the United States.

METHODS

A 2-phase search included a review of reviews (2010-2018), followed by a search for individual articles (2010-2020) that targeted school physical environment and/or SEC to address physical activity (PA) and/or nutrition. We also investigated how nutrition and PA interventions with an SEC component improves social-emotional and/or mental health outcomes. Because research on dietary and PA behaviors for school employees is limited; we included studies on other worksites (eg, hospitals and offices) to provide insight for school employees.

FINDINGS

We identified 40 articles describing 40 unique studies and 45 interventions and grouped them by intervention type. Physical environment interventions demonstrated significant and positive nutrition and PA behavioral outcomes for students; outcomes among employees were mixed. Interventions with SEC components reported improvements in some mental health outcomes.

IMPLICATIONS

The school environment can affect dietary and PA behaviors as well as mental health for students and employees.

CONCLUSIONS

Establishing healthy school environments can support student and employee PA, dietary behaviors, and mental health.

Supporting School Staff: Insights From Employee Health and Well-Being Programs

BACKGROUND

The workplace is an important setting for health protection, health promotion, and disease prevention programs. In the school setting, employee health and well-being programs can address many physical and emotional concerns of school staff. This systematic review summarizes evidence-based approaches from employee health and well-being interventions supporting nutrition and physical activity (PA) in a variety of workplace settings.

METHODS

The 2-phase systematic review included a search for articles within systematic reviews that met our criteria (addressing employee health and well-being programs; published 2010-2018; Phase 1) and the identification of individual articles from additional searches (addressing school-based employee interventions; published 2010-2020; Phase 2). We included 35 articles.

FINDINGS

Across all studies and types of interventions and workplace settings, findings were mixed; however, multicomponent interventions appeared to improve health behaviors and health outcomes among employees.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Schools can apply this evidence from employee health and well-being programs in various workplace settings to implement coordinated and comprehensive employee health and well-being programs.

CONCLUSIONS

Employee health and well-being programs may be effective at supporting nutrition and PA. Schools can use findings from employee health and well-being programs in workplaces other than schools to support school staff.

Effectiveness of Multicomponent Interventions and Physical Activity in the Workplace to Reduce Obesity: A Systematic Review and Meta-Analysis

BACKGROUND

Overweight and obesity are public health problems that affects the workplace. This paper aims to analyse the effectiveness of workplace health promotion interventions in reducing Body Mass Index (BMI); Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, MEDLINE, and SCOPUS databases. The inverse variance statistical method was used for the meta-analysis with a random effects analysis model and standardised means. The results have been represented by Forest Plots and Funnel Plots graphs; Results: The multicomponent approach had the best results for reducing BMI (-0.14 [-0.24, -0.03], 95% CI; p = 0.009) compared to performing physical activity only (-0.09 [-0.39, 0.21], 95% CI; p = 0.56). However, both methods resulted in positive changes in reducing BMI in the general analysis (-0.12 [-0.22, -0.02], 95% CI; p = 0.01). The GRADE evaluation showed low certainty due to the high heterogeneity between interventions (I² = 59% for overall analysis).

CONCLUSIONS

The multicomponent approach could be an effective intervention to reduce obesity in the working population. However, workplace health promotion programs must be standardised to conduct quality analyses and highlight their importance to workers' well-being.

Influence of Nutrition, Food and Diet-Related Interventions in the Workplace: A Meta-Analysis with Meta-Regression

OBJECTIVE

To review the scientific literature on the influence of verified nutrition, food and diet interventions on occupational health.

METHOD

This study involved a critical analysis of articles retrieved from MEDLINE (via PubMed), Embase, Cochrane Library, PsycINFO, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS) and Medicina en Español (MEDES) using the descriptors "Diet, Food, and Nutrition" and "Occupational Health" and applying the filters "Clinical Trial", "Humans" and "Adult: 19+ years"; the search was conducted on 29 May 2021.

RESULTS

A total of 401 references were retrieved from the bibliographic databases, with an additional 16 identified through a secondary search; among the studies retrieved, 34 clinical trials were selected after applying the inclusion and exclusion criteria. The interventions were grouped into seven categories: (1) dietary interventions associated with exercise or educational programs; (2) individual environmental interventions or other educational actions; (3) educational interventions oriented toward lifestyle, dietetics, physical activity and stress management; (4) economic incentives; (5) multicomponent interventions (combination of mindfulness, e-coaching and the addition of fruits and vegetables); or dietary interventions (facilitating greater food supply in cafeterias); or interventions focused on physical exercise.

CONCLUSIONS

Given that most people spend a large part of their time in the workplace and, therefore, eat at least one of their daily meals there, well-planned interventions-preferably including several strategies-have been demonstrated, in general, as useful for combating overweight and obesity. From the meta-regression study, it was observed that the interventions give better results in people who presented high Body Mass Index (BMI) values (obesity). In contrast, intervention 2 (interventions related to workplace environment) would not give the expected results (it would increase the BMI).

Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis

Background

The workplace offers a unique opportunity for effective health promotion. We aimed to comprehensively study the effectiveness of multicomponent worksite wellness programmes for improving diet and cardiometabolic risk factors.

Methods

We did a systematic literature review and meta-analysis, following PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library, Web of Science, and Education Resources Information Center, from Jan 1, 1990, to June 30, 2020, for studies with controlled evaluation designs that assessed multicomponent workplace wellness programmes. Investigators independently appraised the evidence and extracted the data. Outcomes were dietary factors, anthropometric measures, and cardiometabolic risk factors. Pooled effects were calculated by inverse-variance random-effects meta-analysis. Potential sources of heterogeneity and study biases were evaluated.

Findings

From 10 169 abstracts reviewed, 121 studies (82 [68%] randomised controlled trials and 39 [32%] quasi-experimental interventions) met the eligibility criteria. Most studies were done in North America (57 [47%]), and Europe, Australia, or New Zealand (36 [30%]). The median number of participants was 413·0 (IQR 124·0–904·0), and median duration of intervention was 9·0 months (4·5–18·0). Workplace wellness programmes improved fruit and vegetable consumption (0·27 servings per day [95% CI 0·16 to 0·37]), fruit consumption (0·20 servings per day [0·11 to 0·28]), body-mass index (−0·22 kg/m² [−0·28 to −0·17]), waist circumference (−1·47 cm [−1·96 to −0·98]), systolic blood pressure (−2·03 mm Hg [−3·16 to −0·89]), and LDL cholesterol (−5·18 mg/dL [−7·83 to −2·53]), and to a lesser extent improved total fat intake (−1·18% of daily energy intake [−1·78 to −0·58]), saturated fat intake (−0·70% of daily energy [−1·22 to −0·18]), bodyweight (−0·92 kg [−1·11 to −0·72]), diastolic blood pressure (−1·11 mm Hg [−1·78 to −0·44]), fasting blood glucose (−1·81 mg/dL [−3·33 to −0·28]), HDL cholesterol (1·11 mg/dL [0·48 to 1·74]), and triglycerides (−5·38 mg/dL [−9·18 to −1·59]). No significant benefits were observed for intake of vegetables (0·03 servings per day [95% CI −0·04 to 0·10]), fibre (0·26 g per day [−0·15 to 0·67]), polyunsaturated fat (−0·23% of daily energy [−0·59 to 0·13]), or for body fat (−0·80% [−1·80 to 0·21]), waist-to-hip ratio (−0·00 ratio [−0·01 to 0·00]), or lean mass (1·01 kg [−0·82 to 2·83]). Heterogeneity values ranged from 46·9% to 91·5%. Between-study differences in outcomes were not significantly explained by study design, location, population, or similar factors in heterogeneity analyses.

Interpretation

Workplace wellness programmes are associated with improvements in specific dietary, anthropometric, and cardiometabolic risk indicators. The heterogeneity identified in study designs and results should be considered when using these programmes as strategies to improve cardiometabolic health.

Workplace cafeteria and other multicomponent interventions to promote healthy eating among adults: A systematic review

The objective of this review is to evaluate evidence for the effectiveness of workplace cafeteria and other supporting multicomponent interventions to promote healthy eating and reductions in health risks among adults. We conducted an electronic search in EMBASE, CINAHL, EconLit, Ovid, Cochrane, Web of Science and PubMed for English-language articles published from 1985 to July 2019. Studies were original articles reporting the results of workplace cafeteria interventions to promote healthy eating and reduction in health risks. Outcomes were classified as changes in fruit and vegetable intake, health risk indicators, dietary intake, and food sales. Interventions were categorized as interventions targeting food quality or quantity, targeting price, targeting food choice at point of purchase, targeting improved supply, targeting client's information, education or motivation and targeting organization policies. Behavioral change conditions used in interventions were identified using the COM-B system of behavioral change. Results were presented in a narrative summary. A total of 55 studies out of 6285 articles were identified for this review. Several studies used multicomponent interventions and the most featured interventions included interventions targeting food quality or quantity, targeting client's information, education or motivation and targeting food choice at point of purchase. There is evidence that workplace cafeteria and other supporting multicomponent interventions resulted in higher intake of fruit and vegetables, improved dietary intake, improved health outcomes and healthy food sales. The findings of this review have the potential to inform future cafeteria-based and other supporting multicomponent workplace health interventions. The review protocol was not registered in a repository.

Engagement as a Privilege and Disengagement as a Pathology

Employee engagement research to date has proliferated on the conceptualization that engagement is driven by mutable job design characteristics and related socioemotional resources. This essay explores concerns with that conceptualization. For instance, modern engagement research has defined a “work role” with an almost exclusive focus on employees occupying professional roles, largely ignoring broad swaths of population who hold blue- or pink-collar jobs. These concerns are set forth in a discussion of broadening the definition of engagement. We start by describing the key components of the construct of engagement, followed by a discussion of how changes in the modern work role restrict engagement in ways that do not comport with the traditional view. Next, this essay explores three assumptions inherent in engagement’s research stream: possibility, availability, and directionality. Finally, key research directions and questions are presented in an attempt to focus research attention on studying engagement from a more inclusive lens.

Effect of workplace physical activity interventions on the cardio-metabolic health of working adults: systematic review and meta-analysis

Background

Adults in urban areas spend almost 77% of their waking time being inactive at workplaces, which leaves little time for physical activity. The aim of this systematic review and meta-analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers (body weight, waist circumference, body mass index (BMI), blood pressure, lipids and blood glucose) among working adults.

Methods

All experimental studies up to March 2018, reporting cardio-metabolic worksite intervention outcomes among adult employees were identified from PUBMED, EMBASE, COCHRANE CENTRAL, CINAHL and PsycINFO. The Cochrane Risk of Bias tool was used to assess bias in studies. All studies were assessed qualitatively and meta-analysis was done where possible. Forest plots were generated for pooled estimates of each study outcome.

Results

A total of 33 studies met the eligibility criteria and 24 were included in the meta-analysis. Multi-component workplace interventions significantly reduced body weight (16 studies; mean diff: − 2.61 kg, 95% CI: − 3.89 to − 1.33) BMI (19 studies, mean diff: − 0.42 kg/m², 95% CI: − 0.69 to − 0.15) and waist circumference (13 studies; mean diff: − 1.92 cm, 95% CI: − 3.25 to − 0.60). Reduction in blood pressure, lipids and blood glucose was not statistically significant.

Conclusions

Workplace interventions significantly reduced body weight, BMI and waist circumference. Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies. Intervention acceptability and adherence, follow-up duration and exploring non-RCT designs are factors that need attention in future research.

Prospero registration number: CRD42018094436.

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.

Using the CDC's Worksite Health ScoreCard as a Framework to Examine Worksite Health Promotion and Physical Activity

Introduction

Worksite health promotion programs are emerging as an effective approach for addressing the adult obesity epidemic and improving the overall health of employees.

Methods

We conducted a scoping review to identify articles that described a physical activity component (eg, promoted increased physical or reduced sitting time) of a worksite health promotion intervention. Our search specified full-length articles published in English from January 2000 through July 2015. We used the Centers for Disease Control and Prevention’s Worksite Health ScoreCard, a validated tool, as a framework to summarize information on organizational supports strategies (18 questions) and physical activity strategies (9 questions) implemented by worksite health promotion programs. We also determined whether or not the included studies reported significant (P < .05) improvements in physical activity.

Results

We identified 18 worksite health promotion programs; 11 produced significant improvements in physical activity. Incentives, health risk assessments, health promotion committees, leadership support, marketing, and subsidies or discounts for use of exercise facilities were the most effective organizational supports strategies cited, and physical activity seminars, classes, and workshops were the most effective physical activity strategies cited.

Conclusion

The use of the Health ScoreCard allowed for a practical interpretation of our findings, which can inform next steps for the field. Future research should explore the relationships between components of worksite health promotion programs and their outcomes to further develop best practices that can improve worker health and promote physical activity.

A systematic review of the long-term effectiveness of work-based lifestyle interventions to tackle overweight and obesity

Obesity is one of the five leading global risks for mortality, accounting for 5% of deaths worldwide. Workplace health promotion programs have the potential to deliver population-level interventions combining physical activity and exercise. However, there is no recent critical review of trials on long-term effectiveness of multicomponent lifestyle interventions in the workplace targeting obesity. Good quality evidence is needed to develop optimal strategies to tackle adult obesity. 1035 studies were retrieved by literature search in MEDLINE, Embase, PSYCH INFO and Cochrane library from 2005 to September 2016. 11 studies were identified, which were critiqued using 2010 CONSORT guideline. Most of the studies were not high quality. Five studies reported positive findings. Many studies included environmental interventions, but only two showed significant Body Mass Index (BMI) reduction. Studies showing significant BMI reduction were of high intensity or included a specific motivational component. Although there is some evidence demonstrating long-term effectiveness of multicomponent lifestyle interventions in the workplace targeting obesity, more research is needed into the best methods of conducting these interventions. This study provides evidence that could be used as the basis for implementing similar programs.

Using Television-Viewing Hours and Total Hours Sitting as Interchangeable Measures of Sedentary Behavior

Sedentary behaviors, activities spent sitting, or lying down during waking hours, are of significant public health importance. Television-viewing (TV-viewing) hours and total hours sitting are common self-report measures of sedentary behaviors. Given the widespread usage of these measures, the study purpose was to measure the concordance between TV-viewing hours and total hours sitting to determine whether they can be used as interchangeable measures of time spent in sedentary behavior. Using a sample (n = 2687) of workers from a group-randomized control trial, the current study assessed the concordance between weekday total hours sitting and TV-viewing hours. Tertiles were created based on the distribution of total hours sitting and TV-viewing hours. Weighted Kappa (Kappa_w) statistics were calculated for the full sample and subgroups. Half of the sample reported 2 to 3 daily hours of TV-viewing hours and the most reported total hours sitting was 8 hours (14%). Kappa_w statistics for tertiles of total hours sitting and TV-viewing hours were 0.005 (95% CI = -0.02 to 0.03), indicating little agreement. Kappa_w statistics for subgroup analyses (body mass index categories, gender, and intervention assignment) showed poor agreement. Results do not support the use of total hours sitting and TV-viewing hours as interchangeable measures of sedentary behavior.