Abstract
BackgroundInsufficient PA has been shown to cluster with other CVD risk factors including insufficient fruit and vegetable intake, overweight, increased serum cholesterol concentrations and elevated blood pressure. This paper describes the development of Working on Wellness (WOW), a worksite intervention program incorporating motivational interviewing by wellness specialists, targeting employees at risk. In addition, we describe the evaluation the effectiveness of the intervention among employees at increased risk for cardiovascular disease.MethodsThe intervention mapping (IM) protocol was used in the planning and design of WOW. Focus group discussions and interviews with employees and managers identified the importance of addressing risk factors for CVD at the worksite. Based on the employees’ preference for individual counselling, and previous evidence of the effectiveness of this approach in the worksite setting, we decided to use motivational interviewing as part of the intervention strategy. Thus, as a cluster-randomised, controlled control trial, employees at increased risk for CVD (N = 928) will be assigned to a control or an intervention group, based on company random allocation. The sessions will include motivational interviewing techniques, comprised of two face-to-face and four telephonic sessions, with the primary aim to increase habitual levels of PA. Measures will take place at baseline, 6 and 12 months. Secondary outcomes include changes in nutritional habits, serum cholesterol and glucose concentrations, blood pressure and BMI. In addition, healthcare expenditure and absenteeism will be measured for the economic evaluation. Analysis of variance will be performed to determine whether there were significant changes in physical activity habits in the intervention and control groups at 6 and 12 months.DiscussionThe formative work on which this intervention is based suggests that the strategy of targeting employees at increased risk for CVD is preferred. Importantly, this study extends the work of a previous, similar study, Health Under Construction, in a different setting. Finally, this study will allow an economic evaluation of the intervention that will be an important outcome for health care funders, who ultimately will be responsible for implementation of such an intervention.Trial registrationUnited States Clinical Trails Register NCT 01494207
Highlights
Insufficient PA has been shown to cluster with other CVD risk factors including insufficient fruit and vegetable intake, overweight, increased serum cholesterol concentrations and elevated blood pressure
South African employees are at increased risk for cardiovascular disease with more than half not meeting recommended physical activity guidelines [3]
This paper describes the development of Working on Wellness (WOW), a worksite intervention program and the proposed methodology to evaluate the effectiveness among employees at increased risk for cardiovascular disease
Summary
Insufficient PA has been shown to cluster with other CVD risk factors including insufficient fruit and vegetable intake, overweight, increased serum cholesterol concentrations and elevated blood pressure. We describe the evaluation the effectiveness of the intervention among employees at increased risk for cardiovascular disease. In addition to the increasing prevalence of NCD mortality and morbidity, there is a concomitant increase in the prevalence of contributing risk factors such as inactivity and obesity [2]. South African employees are at increased risk for cardiovascular disease with more than half not meeting recommended physical activity guidelines [3]. 80% of the employees were categorised as being at risk for 2 behavioural risk factors (which included inactivity, overweight or obese, smoking, not managing stress effectively) while 18% had three behavioral risks [4]. The workplace has been identified as a setting that can potentially reach a large number of people simultaneously, and positively impact on the risk and health profile of individuals [5,6], and is an opportune setting for interventions targeting the adult population
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