Obesity Prevention Worksite Wellness Interventions for Health Care Workers: A Narrative Review.

Abstract

Background: Health care workers face elevated risk of obesity due to their unique work requirements. The purpose of this systematic review was to present a narrative summary of the characteristics and effectiveness of worksite wellness programs focusing on preventing obesity among health care workers. Method: The databases Medline, CINAHL, Embase, PsycINFO, and PubMed were searched. Experimental and quasi-experimental studies published in English (between 2000 and 2018) that (a) were worksite interventions, (b) had intervention directed toward health care employees, and (c) reported weight-related outcomes were included. We excluded commercial weight loss studies. Two coders extracted data on the following: purpose, key study characteristics, design, type and dosage of intervention, outcome measure(s), attrition rate, and risk of bias. Results: Of the 51 studies included in this review, the majority (75%, n = 38) targeted diet and physical activity behaviors. The majority reported improved weight outcomes in favor of the intervention. Overall, moderate- to high-intensity behavioral strategies, using any mode of intervention delivery (phone, face-to-face, or Internet), delivered by a trained professional were effective in improving weight-related outcomes. Environmental strategies were effective in improving healthier habits. Self-directed strategies worked better for motivated employees. Discussion: Multicomponent interventions offered in health care settings may be successful in improving employee weight. Across study designs, several gaps in the reporting of intervention design, dosage, fidelity, and system-level outcomes were found. Conclusion/Applying research to practice: Occupational health professionals should continue to be creative in developing multicomponent interventions (combining behavioral/educational, environmental, and organizational support) and use evidence guidance frameworks/tools to design an intervention and report dosage outcomes.