Program Development and Effectiveness of Workplace Health Promotion Program for Preventing Metabolic Syndrome among Office Workers

Development and Evaluation of a Blended Self-Management Program for Metabolic Syndrome in Patients With Rheumatic Diseases

Rheumatic diseases are known to be associated with the development of metabolic syndrome, which increases mortality rates due to cardiovascular complications. Although a variety of self-management programs for rheumatic diseases have been developed, few have concentrated on metabolic syndrome. This study aimed to develop and verify a blended (a mixture of telephone and online interventions) metabolic syndrome self-management program. The program was developed in four stages: analysis to identify program contents, website design, website development, and validity testing. A quasi-experimental nonequivalent control group, pretest-posttest design was adopted to verify the program effectiveness in 54 patients with rheumatic disease. The program was initially implemented via telephone for 4 weeks and then self-administered via a web-based platform for 20 weeks. Indices of metabolic syndrome and self-management and quality of life scores were measured as outcome variables. Data were collected three times: before intervention, after 4 weeks of telephone interventions, and after 20 weeks of online self-interventions. The devised program had a significant overall effect on metabolic syndrome indices, metabolic syndrome-related self-management behaviors, and quality of life. Detailed analysis showed the program effectively reduced body mass index, waist circumference, systolic blood pressure, and blood glucose levels and improved metabolic syndrome self-management behaviors. Based on our findings, it can be expected that the use of this program may retard or prevent the progression of metabolic syndrome by improving some metabolic syndrome indices and metabolic syndrome-related self-management behaviors, which are key components of care in rheumatic disease patients with metabolic syndrome. This web-based program appears to be beneficial in public health care settings because it is cost-effective, readily available, and may provide long-term support.

Betriebliche Gesundheitsförderung (BGF) im Laufe der Zeit

Hintergrund

Zur Qualitätssicherung und Weiterentwicklung von BGF-Maßnahmen (betriebliche Gesundheitsförderung) ist es von Interesse, einen Überblick über wissenschaftlich untersuchte BGF-Maßnahmen in den letzten zwei Jahrzehnten zu erlangen.

Zielsetzung

Wissenschaftlich evaluierte BGF-Maßnahmen aus den Jahren 2000–2020 werden mithilfe der in der Praxis durch den GKV-Spitzenverband eingesetzten Themenfelder auf die thematischen Entwicklungen, den Nutzen, aber auch die Schwächen für die Übertragbarkeit in die Praxis hin analysiert.

Methode

Eine systematische Literaturrecherche für den Publikationszeitraum zwischen 2000 und 2020 wurde in zwei elektronischen Datenbanken durchgeführt.

Ergebnisse

Die Einschlusskriterien erfüllten 41 Artikel. Die meisten der in den Studien durchgeführten und evaluierten BGF-Maßnahmen waren keine Einzelmaßnahmen, sondern stellten Programme dar. In ihnen wurden mehrere Themenfelder gleichzeitig adressiert. Insgesamt zeigten sich die in den Studien untersuchten BGF-Maßnahmen sehr heterogen. Zum Ende des Untersuchungszeitraumes nahm die Anzahl an Publikationen zu.

Schlussfolgerung

Die im Leitfaden Prävention vorgegebenen BGF-Themenfelder sind bis auf ein Themenfeld ausgewogen vertreten. Die Studien zu den BGF-Maßnahmen sind bezogen auf die Verständlichkeit der angewendeten Didaktik und Methodik oft nur eingeschränkt nachvollziehbar und somit schwer in die organisationale Praxis übertragbar.

After Theranos: Using point-of-care testing to advance measures of health biomarkers in human biology research

OBJECTIVES

The rise and fall of the health technology startup Theranos is emblematic of the promise and peril of point-of-care testing (POCT). Instruments that deliver immediate results from minimally invasive samples at the location of collection can provide powerful tools to deliver health data in clinical and public health contexts. Yet, POCT availability is driven largely by market interests, which limits the development of inexpensive tests for diverse health conditions that can be used in resource-limited settings. These constraints, combined with complex regulatory hurdles and substantial ethical challenges, have contributed to the underutilization of POCT in human biology research.

METHODS

We evaluate current POCT capabilities and limitations, discuss promising applications for POCT devices in resource-limited settings, and discuss the future of POCT.

RESULTS

As evidenced by publication trends, POCT platforms have rapidly advanced in recent years, gaining traction among clinicians and health researchers. We highlight POCT devices of potential interest to population-based researchers and present specific examples of POCT applications in human biology research.

CONCLUSIONS

Several barriers can limit POCT applications, including cost, lack of regulatory approval for non-clinical use, requirements for expensive equipment, and the dearth of validation in remote field conditions. Despite these issues, we see immense potential for emerging POCT technology capable of analyzing new sample types and used in conjunction with increasingly common technology (e.g., smart phones). We argue that the fallout from Theranos may ultimately provide an opportunity to advance POCT, leading to more ethical data collection and novel opportunities in human biology research.

Relationship between Atherogenic Dyslipidaemia and Lipid Triad with Different Scales of Overweight and Obesity in 418,343 Spanish Workers

Obesity induces alterations in lipid biochemistry, evolving toward dyslipidaemia atherogenesis, a critical factor in the development of cardiovascular events. Two relevant forms of lipid abnormalities are atherogenic dyslipidaemia (AD) and lipid triad (LT), which involve alterations in triglyceride levels, HDL-c, and LDL-c. The aim of this study was to assess the linkage of atherogenic AD and LT with different scales of overweight and obesity. We carried out a cross-sectional study including 418,343 Spanish adult workers, recruited from workplace health assessments. Atherogenic dyslipidaemia was defined as triglyceride levels ≥ 150 mg/dL, HDL values < 40 mg/dL in men and <45 mg/dL in women, and normal LDL. Additionally, if LDL levels were >160 mg/dL, LT was considered. Subjects affected by AD and LT in the study exhibited significantly higher mean values than those without AD and LT in all overweight, obesity, and body fat related scales studied. VAI (visceral adiposity index) was the strongest predictor of AD (AUC = 0.934, 95% CI: 0.933 to 0.936) and LT (AUC = 0.926, 95% CI: 0.923 to 0.928). Atherogenic dyslipidaemia and LT positively correlate with different scales of overweight and obesity. Further studies should aim to identify other contributory factors. Our obtained data might be useful in laying the groundwork for future works on AD and LT.

Night shift work and the risk of metabolic syndrome: Findings from an 8-year hospital cohort

Objectives

Studies concerning the risk of metabolic syndrome associated with night work have shown inconsistent findings, due to imprecise working time data and cross-sectional design. We used register-based daily working time data to examine the risk of incident metabolic syndrome associated with night shift work.

Methods

Working time data collected between 2010 and 2018 of 5775 Taiwanese hospital workers were used to identify night shift workers and to calculate the number of night shifts. Metabolic syndrome was identified by annual occupational health examination results, which were linked to the working time data. Logistic regression models and generalized estimating equations were used to examine the association between night shift work and metabolic syndrome and the 5 components of metabolic syndrome.

Results

Night shift work is associated with a higher risk of developing metabolic syndrome (adjusted OR = 1.36, 95% CI = 1.04 to 1.78) and high waist circumference (adjusted OR = 1.27, 95% CI = 1.07 to 1.78) compared to day work. Among night shift workers, increased number of night shifts was associated with high blood pressure (adjusted OR = 1.15, 95% CI = 1.01 to 1.31).

Conclusions

Night shift work is associated with metabolic risk factors. Long-term effects of circadian rhythm disruption on metabolic disturbances needs to be further studied.

The Role of Physical Activity-Related Health Competence and Leisure-Time Physical Activity for Physical Health and Metabolic Syndrome: A Structural Equation Modeling Approach for German Office Workers

Office workers (OWs) are prone to insufficient physical activity (PA), which increases their risk of metabolic syndrome (MetS) and impaired physical health. The Physical Activity-related Health Competence (PAHCO) model holds the potential to facilitate a healthy physically active lifestyle. Therefore, in this study, we investigate the interplay between PAHCO, leisure-time PA, physical health, and MetS in OWs in Germany. In a cross-sectional study, OWs (N = 316, 25% female) completed self-report questionnaires along with an occupational health checkup to examine their Metabolic Syndrome Severity Score (MetSSS) values. Structural equation modeling indicated a strong positive association between PAHCO and leisure-time PA and a small positive association with physical health. PAHCO showed a considerable negative association with the MetSSS. Leisure-time PA was a positive mediator for the PAHCO-physical health association but was not a significant mediator for the association between PAHCO and the MetSSS. These findings underscore the importance of PAHCO in the context of leisure-time PA, physical health, and MetS in OWs. Furthermore, our findings highlight the health-enhancing value of the qualitative aspects of PA, such as motivational and volitional components in PA participation, with respect to physical health and MetS.

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.

Patterns of change in cardiovascular risks of Korean male workers: a 10-year cohort analysis using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) 2.0 database

OBJECTIVE

Health behaviour is one of the major determinants of cardiovascular diseases in working population. This study was tried to investigate the trend of cardiovascular health level, the relationship between continuous health behaviours, and changes in the risk of cardiovascular diseases of male workers by using a nationwide database.

DESIGN

This study is a retrospective cohort study.

SETTING AND PARTICIPANTS

The study analysed data of 57 837 male workers whose personal health examination data were continuously traced using Korea's National Health Insurance Service-National Sample Cohort 2.0 database.

PRIMARY OUTCOME MEASURES

A 10-year trend for all cardiovascular risks and change for the risks according to the consistent performance of healthy behaviours.

RESULTS

The results showed that the risk of being overweight (adjusted OR (aOR) 1.63, 95% CI 1.59 to 1.68) and obese (aOR 1.51, 95% CI 1.47 to 1.56) increased. The index of cardiovascular risk also increased for high fasting glucose (aOR 1.77, 95% CI 1.62 to 1.95) and high total cholesterol (aOR 1.68, 95% CI 1.60 to 1.76), respectively. The risks of high fasting glucose (aOR 2.09, 95% CI 1.40 to 3.13), high triglycerides (aOR 1.27, 95% CI 1.14 to 1.42) and high low-density lipoprotein cholesterol (aOR 1.38, 95% CI 1.14 to 1.66) were increased among high-risk smokers. Similarly, the risk of high total cholesterol (aOR 2.20, 95% CI 1.35 to 3.58) and high triglycerides (aOR 1.42, 95% CI 1.09 to 1.85) were increased among high-risk drinkers. In addition, the increase in the risk of being overweight (aOR 2.20, 95% CI 1.83 to 2.65) and obese (aOR 1.90, 95% CI 1.59 to 2.27) were analysed among who had not consistently exercised.

CONCLUSIONS

Since the pattern of change in the level of cardiovascular risk related to the continuous health behaviours of male workers was identified, the findings of the present study can be used as basic data to develop health promotion policies for the population.

Health promotion program for office workers with SEM based on the WHO’s healthy workplace framework

This study attempts to develop and verify the effectiveness of a health promotion program for office workers based on the social ecological model and the World Health Organization’s Healthy Workplace Framework. This study involved 272 office workers of a small and medium-sized enterprise in Korea. Data were analyzed through descriptive statistics, repeated measures analysis of variance (ANOVA) and Bonferroni correction using SPSS/WIN 23.0. Workplace environmental support was provided to all workers, while a 6-month intensive core program based on social support was implemented for the intensive management group. Based on the participation rate, individuals were divided into the core and dropout groups. In all office workers, there were negative changes in high-density lipoprotein cholesterol and job stress during the period. Meanwhile, the intensive group showed significant changes in body mass index and diastolic blood pressure. The study suggests that the organization’s support for a healthy environment and an individual’s continued participation based on social support are essential for the effectiveness of a health promotion program for office workers.

Participants' Experiences of a Workplace-Oriented Problem Gambling Prevention Program for Managers and HR Officers: A Qualitative Study

Workplace health promotion programs (WHPPs) refer to a set of health promotion and protection strategies implemented at a worksite and designed to meet the health and safety needs of employees. One important question for WHPPs is how middle management experience their participation in a WHPP. This study aims to explore this question further by applying a qualitative content analysis to interviews with thirteen managers and ten human resource officers participating in a WHPP focusing on problem gambling. The WHPP consisted of two components: policy implementation and skills-development training. The participants were interviewed about their experiences of these two components and the implementation process. The qualitative content analysis resulted in six themes: (1) Expectations of the skills-development training, (2) Experiences of and prior beliefs about problem gambling, (3) A good foundation, (4) The difficult conversation, (5) Appreciated aspects of the training sessions, and (6) Remaining obstacles. The results suggest that the presentation of cases, facts, and general knowledge was appreciated by most participants. However, participants also expressed that they would benefit from tailored interventions, more support in the policy implementation process, and following up on the results.

Association between Obesity and Carotid Intima-Media Thickness in Korean Office Workers: The Mediating Effect of Physical Activity

Background

Obesity and physical inactivity are associated with higher prevalence of cardiovascular disease (CVD).

Objective

This study investigated the association between obesity and carotid intima-media thickness (CIMT) stratified by physical activity (PA) in Korean office workers.

Methods

Data obtained from 914 office workers aged 21-60 years (347 women) were used. Resting blood pressures, body mass index (BMI), and waist-to-height ratio (WHtR) were measured. PA was assessed using the international physical activity questionnaire. CIMT was assessed with a carotid artery ultrasonography. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence interval (CI) of obesity stratified by weekly PA for an abnormally increased CIMT.

Results

Logistic regression analyses showed that those who were overall obese (OR=2.50, 95% CI=1.60-3.91, P<0.001) or central obese (OR=2.08, 95% CI=1.29-3.40, P=0.003) had significantly higher estimated risks of having an abnormally increased CIMT even after adjustments for age, sex, smoking, alcohol consumption, resting blood pressures, and history of hypertension, diabetes, and hyperlipidemia, as compared with those who were not overall or central obese (OR=1). A multivariate linear regression suggested that age (P<0.001), sex (P=0.002), hypertension (P=0.014), smoking (P=0.054), BMI (P<0.001), and physical activity (P=0.011) were important determinants of abnormally elevated CIMT in this study population.

Conclusion

The current findings suggest that the risk of obesity for an abnormally increased CIMT is significantly modulated by demographics as well as lifestyle-related risk factors including smoking and physical inactivity in Korean office workers.

Novel App- and Web-Supported Diabetes Prevention Program to Promote Weight Reduction, Physical Activity, and a Healthier Lifestyle: Observation of the Clinical Application

BACKGROUND

The increasing incidence of type 2 diabetes mellitus presents as a tsunami of health problems and health care costs. Preventing this development needs to target the underlying rise in metabolic syndrome cases through obesity and unhealthy lifestyle. Obesity is frequently perceived as a social issue with implicit psychological strain; health apps/weight-reduction programs are mushrooming from this side. The present program intends to bring weight reduction into the hands of HCPs by utilizing advanced digital technology.

METHODS

The prospective observational study analyzed 166 patients with metabolic syndrome as treated for weight reduction in 23 medical practices in Germany. Two approaches were observed: usual care (UC; n = 57) and a personalized health management program (PHM; n = 109). Key for PHM was the interaction between HCP and patient: reinforcing lifestyle changes through personalized goals and HCP-feedback via app- and web-based communication. Comparing PHM/UC was based on a time-to-success (5% weight reduction) analysis by Cox regression. Further exploratory analyses addressed the comparison of achievers and nonachievers.

RESULTS

Cox regression adjusted for sex, age, and BMI revealed a chance ratio for weight reduction of 6.2 (2.4-16.2, p = .0003) favoring PHM. Expected success rates were 44.8% for PHM, 11.5% for UC. PHM achievers reduced their weight by 8.0% and lowered their BMI by 2.7 points. Motivation for lifestyle changes represented a key for success.

CONCLUSIONS

The approach of enhanced interaction of HCPs and patients via app- and web-based communication was a clear success and delivered favorable responder rates. Treating obesity from a medical viewpoint will help to deepen the motivation for changing lifestyles. The study represents a cornerstone for a wider scoped application of these novel digital health approaches.

Factors associated with healthy and unhealthy workplace eating behaviours in individuals with overweight/obesity with and without binge eating disorder

Objective

Most Americans spend an average of 8 hours per day in the workplace. Current understanding of eating behaviours in the workplace and their association with overweight, obesity and binge eating disorder (BED) is limited. Workplace eating behaviours and weight‐related self‐efficacy were examined in a sample of 98 individuals with overweight or obesity, with or without BED.

Design

Participants completed the Weight Efficacy Lifestyle Questionnaire, Work and Social Adjustment Scale, Worker's Perception of Environmental Factors, and a Workplace Questionnaire.

Results

Eating unplanned food occurred on average 2.43 times per week (SD = 3.37), and eating unplanned food even when meals were brought from home occurred on average 1.28 times per week (SD = 1.84). Individuals with BED purchased lunch even when they brought food from home significantly more frequently than did individuals without BED. Those with BED also reported significantly poorer work and social adjustment related to binge eating as compared with those without BED. The most significant barriers to healthy eating in the workplace were coworker influence, eating more food in general and more junk food in response to stress, eating unplanned food at work and time constraints.

Conclusions

These factors may be important to target in weight‐loss treatment to increase individuals' weight loss success. As individuals with BED may be the most vulnerable to eating unplanned foods, clinicians may want to focus on this potential barrier in BED treatment.