Worksite Intervention Research Articles

Facilitators and barriers to healthy eating in a worksite cafeteria: a qualitative study from Nepal.

ObjectiveWorksite interventions can serve as a potential platform for translating existing knowledge of diabetes prevention and facilitate healthy food choices. The study explored perceptions about healthy eating as well as potential facilitators and barriers to healthy eating among employees in a wire manufacturing factory in Nepal.Methods and materialsWe conducted a cross-sectional exploratory qualitative study in a wire manufacturing industry in eastern Nepal. We conducted three focus group discussions (FGDs) with a total of 26 employees and four in-depth interviews (IDIs) with cafeteria operators/managers from a wire manufacturing factory in eastern Nepal. FGDs and IDIs were audio-recorded, transcribed verbatim and analysed using the thematic method.ResultsMost employees defined healthy eating as the consumption of food prepared and maintained using hygienic practices and fresh foods in general. Major barriers to healthy eating included unavailability of healthy foods, difficulty in changing eating habits, the preference for fried foods in Nepali culture and the high costs of some healthy foods. The most commonly reported facilitator of healthy eating was the availability of affordable healthy food options in worksite cafeterias.ConclusionAvailability of healthy food options at an affordable price could lead to healthier food choices in the worksite.

Does a grill menu redesign influence sales, nutrients purchased, and consumer acceptance in a worksite cafeteria?

Worksite cafeterias are compelling venues to improve diet quality through environmental changes.We conducted a pre-post study to evaluate how a cafeteria-initiated grill menu redesign influenced sales, revenue, and nutrient content of foods purchased. Secondly, we evaluated consumer opinions about menu changes to inform practices for worksite environment interventions. Monthly sales data (2012–2015) were used to compute gross sales and revenue of entrées and side dishes pre-post menu changes. Alternative protein sources replaced red meat; nutrient composition and nutrients purchased were compared using Food Pro software. Consumer responses were queried using online surveys; open-ended responses were analyzed using NVivo. Differences in sales and nutrient content pre-post menu redesign were tested with Wilcoxon Rank Sum tests. Gross sales of entrées (61 vs. 222 servings/month; p = 0.01) and side dishes (120 vs. 365 servings/month; p = 0.001) increased more than three-fold post-menu changes. Revenue from entrées (312 vs. 1144 USD/month; p = 0.01) and side dishes (238 vs. 914 USD/month; p = 0.001) also increased; per entrée, consumers purchased significantly more unsaturated fat (5 g), and less saturated fat (3 g) and sodium (100 mg). For side dishes, they purchased fewer calories (48 kcal) and unsaturated fat (2.9 g), but more fiber (1.8 g), and sodium (260 mg). Four themes emerged from consumer responses: the importance of 1) variety, novelty, choice; 2) cost, affordability, value; 3) health; and 4) food quality, taste. Menu redesign can improve nutrient content, while also increasing sales and revenue. Multi-dimensional assessment of the nutritional, consumer, and retailer implications is desirable practice for enacting similar environmental changes.

Promoting physical activity in worksite settings: results of a German pilot study of the online intervention Healingo fit

BackgroundWorldwide, one third of the adult population is insufficiently physically active. This fact has led to a strong demand for public health initiatives. Given the mixed evidence on the effectiveness of worksite interventions promoting physical activity (PA), a pedometer-based and gamified intervention, Healingo Fit, was developed and evaluated over a period of six weeks.MethodsThe effectiveness of Healingo Fit was evaluated as part of a randomized controlled trial (RCT) with two measurement points involving employees of an automobile manufacturer. Direct health promotion outcomes were assessed using self-developed items on PA knowledge, the HAPA brief scales and the exercise self-efficacy scale. IPAQ short version was used to assess different forms of PA behavior. Intervention effects were identified using a two-way analysis of variance (ANOVA) with repeated measurements.ResultsA total of 144 participants took part in the study (intervention group = 80, control group = 64). The results of the ANOVA show significant interaction effects (group x time) for health promotion outcomes (knowledge, intention, and self-efficacy), with medium to high effect sizes. In the health behavior related outcomes, there were significant improvements, with large effect sizes for low levels of PA, but not for moderate and high PA. Walking time increased by 125 min/week in the intervention group, corresponding to a percentage increase of 30% compared to baseline.ConclusionsPedometer-based interventions using gamification elements can have positive effects not only on health promotion parameters but can also lead to an increase in PA behavior. The online format of Healingo Fit is suitable for reaching large numbers of people and achieving population effects.Trial registrationGerman Clinical Trials Register (DRKS): DRKS00006105, date of registration: 2017–03-24.

The effect of effort-reward imbalance on the health of childcare workers in Hamburg: a longitudinal study

BackgroundThe prevalence of effort-reward imbalance (ERI) among qualified childcare workers in Germany is currently estimated at around 65%. High rates of burnout and musculoskeletal symptoms (MS) have also been reported for this group. Previous longitudinal studies show inconsistent results with regard to the association between ERI and MS. As yet, no longitudinal studies have been conducted to investigate the association between ERI and burnout or MS in childcare workers. This study aims to investigate the extent to which a relationship between ERI and MS or burnout can be observed in childcare workers in Germany on a longitudinal basis.MethodsIn 2014 childcare workers (N = 199, response rate: 57%) of a provider of facilities for children and youth in Hamburg were asked about stress and health effects in the workplace. Follow-up was completed one year later (N = 106, follow-up rate: 53%) For the baseline assessment, ERI was determined as the primary influencing factor. Data on MS was recorded using the Nordic questionnaire, and burnout using the personal burnout scale of the Copenhagen Burnout Inventory (CBI). The statistical analysis was carried out using multivariate linear and logistic regression.ResultsAt baseline ERI was present in 65% of the sample population. The mean burnout score at the time of follow-up was 53.7 (SD: 20.7); the prevalence of MS was between 19% and 62%. ERI was identified as a statistically significant factor for MS, after adjusting especially for physical stress (lower back: OR 4.2; 95% CI: 1.14 to 15.50, neck: OR 4.3; 95% CI: 1.25 to 15.0, total MS: OR 4.0; 95% CI: 1.20 to 13.49). With regard to burnout, a relative increase of 10% in the ERI ratio score increased the burnout score by 1.1 points (p = 0.034).ConclusionsERI was revealed to be a major factor in relation to MS and burnout in childcare workers. Based on this observation worksite interventions on the individual and organizational level should be introduced in order to prevent ERI.

Worksite weight management program

PurposeThis study aims to pilot test a new multi-component worksite intervention for weight loss in a primary healthcare setting.Design/methodology/approachThis randomized trial involved 88 participants (43, 45; intervention, control group). The intervention group enrolled in a 12-week lifestyle program that involved modification of dietary intake by community Registered Dietitian (RDs) and increasing high-intensity interval training (HITT) with motivational interviewing (MI) to support changes. The control group received traditional counselling and weekly aerobic exercise from Medical Officer and physiotherapist. The primary outcome measure was the changes in body weight. Secondary measures were changes in blood pressure, fasting blood glucose, fasting blood lipid and dietary changes. Assessments were repeated at a three-month interval.FindingsThere was a significant reduction in body weight and waist circumference within groups. Intervention group demonstrated a significant improvement in all cardiometabolic risk factors. This study showed that primary healthcare setting can be successful locations in promoting short-term health benefits. RDs were more successful and HITT appeared to be a favorable workout with MI in achieving drastic weight loss.Research limitations/implicationsThe short-term worksite intervention and not recording of body composition were the major drawbacks in this study.Originality/valueThe efficacy of multi-component worksite intervention (Diet–HITT–MI) in primary healthcare setting has not been clearly defined.

Systematic review of dietary salt reduction policies: Evidence for an effectiveness hierarchy?

BackgroundNon-communicable disease (NCD) prevention strategies now prioritise four major risk factors: food, tobacco, alcohol and physical activity. Dietary salt intake remains much higher than recommended, increasing blood pressure, cardiovascular disease and stomach cancer. Substantial reductions in salt intake are therefore urgently needed. However, the debate continues about the most effective approaches. To inform future prevention programmes, we systematically reviewed the evidence on the effectiveness of possible salt reduction interventions. We further compared “downstream, agentic” approaches targeting individuals with “upstream, structural” policy-based population strategies.MethodsWe searched six electronic databases (CDSR, CRD, MEDLINE, SCI, SCOPUS and the Campbell Library) using a pre-piloted search strategy focussing on the effectiveness of population interventions to reduce salt intake. Retrieved papers were independently screened, appraised and graded for quality by two researchers. To facilitate comparisons between the interventions, the extracted data were categorised using nine stages along the agentic/structural continuum, from “downstream”: dietary counselling (for individuals, worksites or communities), through media campaigns, nutrition labelling, voluntary and mandatory reformulation, to the most “upstream” regulatory and fiscal interventions, and comprehensive strategies involving multiple components.ResultsAfter screening 2,526 candidate papers, 70 were included in this systematic review (49 empirical studies and 21 modelling studies). Some papers described several interventions. Quality was variable. Multi-component strategies involving both upstream and downstream interventions, generally achieved the biggest reductions in salt consumption across an entire population, most notably 4g/day in Finland and Japan, 3g/day in Turkey and 1.3g/day recently in the UK. Mandatory reformulation alone could achieve a reduction of approximately 1.45g/day (three separate studies), followed by voluntary reformulation (-0.8g/day), school interventions (-0.7g/day), short term dietary advice (-0.6g/day) and nutrition labelling (-0.4g/day), but each with a wide range. Tax and community based counselling could, each typically reduce salt intake by 0.3g/day, whilst even smaller population benefits were derived from health education media campaigns (-0.1g/day). Worksite interventions achieved an increase in intake (+0.5g/day), however, with a very wide range. Long term dietary advice could achieve a -2g/day reduction under optimal research trial conditions; however, smaller reductions might be anticipated in unselected individuals.ConclusionsComprehensive strategies involving multiple components (reformulation, food labelling and media campaigns) and “upstream” population-wide policies such as mandatory reformulation generally appear to achieve larger reductions in population-wide salt consumption than “downstream”, individually focussed interventions. This ‘effectiveness hierarchy’ might deserve greater emphasis in future NCD prevention strategies.

Impact of worksite cafeteria interventions on fruit and vegetable consumption in adults

PurposeIncreasing obesity rates and health care costs have prompted worksites to investigate interventions to improve employee health. The purpose of this paper is to determine the effect of worksite cafeteria interventions on fruit and vegetable (F/V) consumption.Design/methodology/approachThis review was guided by the preferred reporting items for systematic reviews and meta-analyses method. After a thorough literature search and screening process, 18 studies were included in the review. Data were extracted, and a risk of bias assessment was created for the primary studies. An un-weighted average was used to determine the overall ranking for each study.FindingsThere appears to be a moderately strong association toward a positive impact of cafeteria interventions to increase F/V consumption. Of the 18 studies in the review, 13 reported a statistically significant increase, one reported a significant decrease, three reported mixed results, and one did not assess a change in consumption.Research limitations/implicationsMost of the data were self-reported and is subject to error. Furthermore, the heterogeneity of study design, method, and outcome measures among the studies warrants additional research with consistent methodology.Practical implicationsA positive impact on F/V consumption may be realized by the following techniques: price-point subsidies, point-of-purchase materials, and menu modification.Originality/valueThis new information on increasing F/V consumption in workplace cafeterias may improve employee health and reduce the risk of chronic disease.

Abstract P287: Systematic Review of Dietary Trans-fat Reduction Policies: Evidence for an Effectiveness Hierarchy?

Background: The four major risk factors prioritised in WHO non-communicable disease prevention strategies are tobacco, alcohol, physical inactivity and, crucially, poor diet. Trans-fatty acid intake in most countries still exceeds the WHO target of 2g/day, mainly reflecting consumption of industrial trans-fats in junk food. Furthermore, the most effective policies for reducing trans-fats remain unclear. We therefore systematically reviewed the evidence on trans-fat policy interventions to inform future prevention strategies. We also explicitly compared “upstream” interventions covering whole populations with “downstream” interventions targeting individuals. Methods: A pre-piloted search strategy was used to systematically search six electronic databases (Cinahl, CRD, CDSR, Medline, SCI and SCOPUS) for papers evaluating the effectiveness of trans-fat interventions, with intake (g/day) as the main outcome measure. Two researchers independently screened, extracted and graded the papers for quality. Each study was then categorised on a continuum ranging from “downstream” interventions targeting individuals (dietary counselling, media campaigns or nutrition labelling) to more “upstream” structural interventions covering the entire population - reformulation, regulation, fiscal policies and comprehensive strategies involving multiple policies. A narrative synthesis was used to summarise and compare the effectiveness of different interventions. Results: After screening 996 candidate papers, a total of 22 papers were included in this systematic review: 12 empirical studies and 10 modelling studies. Quality was variable. The largest trans-fat reductions occurred in Denmark. Multiple interventions decreased intake from 4.5g/day in 1976 to 1.5g/day in 1995 and then virtually zero after a legislative ban in 2005. The US now intends to emulate this approach. No studies quantifying tax interventions were identified. Voluntary reformulation reduced trans-fat intake by 1.5g/day followed by worksite interventions (1.2g/day) and food labelling (0.8g/day). Dietary counselling targeting individuals achieved the smallest reductions (0.8g/day). Conclusions: Multi-component interventions including a legislative ban to eliminate trans-fats from foods appear the most effective strategy to minimise intake, as achieved in Denmark, and ongoing in the US. However this approach remains underused. Reformulation and other multi-component interventions can also achieve useful reductions. By contrast, more “downstream” interventions targeting settings or individuals consistently achieve much smaller reductions. This “effectiveness hierarchy”, previously observed in tobacco and alcohol control, might perhaps be considered more often when planning future prevention strategies; for instance to control other harmful nutrients such as salt or sugar.

Effectiveness of a Worksite Intervention for Male Construction Workers on Dietary and Physical Activity Behaviors, Body Mass Index, and Health Outcomes: Results of a Randomized Controlled Trial.

To evaluate the effectiveness of an individually tailored intervention for improvement in lifestyle behavior, health indicators, and prevention and reduction of overweight among construction workers. Randomized controlled trial. Various blue-collar departments of a large construction company in the Netherlands. Blue-collar workers randomized to an intervention (n = 162) or a control group (n = 152). The intervention group received individual coaching sessions, tailored information, and materials to improve lifestyle behavior during a 6-month period, and the control group received usual care. Body weight, body mass index (BMI), waist circumference, physical activity (PA) levels, dietary behavior, blood pressure, and blood cholesterol were assessed. Effectiveness of the intervention on outcome measures at 6- and 12-month follow-up was assessed by using linear and logistic regression models adjusting for baseline levels. After 6 months, a statistically significant intervention effect was found on body weight ( B = -1.06, P = .010), BMI ( B = -0.32, P = .010), and waist circumference ( B = -1.38, P = .032). At 6 months, the percentage of those meeting public health guidelines for PA increased significantly in the intervention group compared to the control group ( B = 2.06, P = .032), and for sugar-sweetened beverages, an intervention effect was found at 6 months as well ( B = -2.82, P = .003). At 12 months, for weight-related outcomes, these differences were slightly smaller and no longer statistically significant. The intervention was not effective on the total amount of moderate to vigorous PA and other dietary and health outcomes. Intervention participants showed positive changes in vigorous PA and intake of sugar-sweetened beverages compared to controls, as well as effects on weight-related outcomes at 6 months. Long-term effects were still promising but not statistically significant.

Playing the Game of Health: Best Practices for Health Optimization Program in a Worksite Setting, with Case Study of a Real World Example

<p><em>While there have been multiple efforts to improve the health of the population, and simultaneously reducing the cost of healthcare and improving the quality of care, there is no single model for improving population health. Worksite health is a microcosm of the health of the nation and the results of been mixed. This paper considers the best practices associated with key worksite health. These best practices include the type of worksite intervention, attention to health literacy, engagement, onsite clinics, coaching and care plans, a digital platform, social support, population health, performance excellence, performance improvement, and an evaluation strategy. While each best practice is considered important, very few programs provide all of the components, and most emphasize one component over the other. A gap in the literature, therefore, is how these best practices can be combined into a single program. Following the review of literature of best practices, a case study, of the program design, of a comprehensive worksite program was conducted to demonstrate how these best practices are operationalized. The Game of Health, is a cognitive based program that focuses on stress management and behavior change in a program that provides onsite programs, a medical clinic, and a digital platform.</em><em></em></p>

The failure to increase social support: it just might be time to stop intervening (and start rigorously observing)

In 1986, Lichtenstein et al. (Behav Ther. 17(5):607–19, 1986) presented the results of five studies focused on enhancing social support for smoking cessation in community-based clinic and worksite interventions. The manuscript was titled Social Support in Smoking Cessation: In Search of Effective Interventions and its main conclusion was that "attempts to both increase social support and to enhance treatment effectiveness have not been successful." Thirty years later, the paper by Cutrona et al. (Transl Behav Med. 6(4):546–57, 2016) draws a similar conclusion from a study focused on providing social support through an online social network for smoking cessation. In reviewing these findings - and based on our knowledge of the extensive literature on social support interventions that has been published over the past 30+ years - we believe there is a need for a fundamental shift in research on social support. Our focus here is largely on smoking cessation, but our comments are applicable to other areas of behavior change.

Work-related self-efficacy as a moderator of the impact of a worksite stress management training intervention: Intrinsic work motivation as a higher order condition of effect.

Employees with low levels of work-related self-efficacy may stand to benefit more from a worksite stress management training (SMT) intervention. However, this low work-related self-efficacy/enhanced SMT benefits effect may be conditional on employees also having high levels of intrinsic work motivation. In the present study, we examined this proposition by testing three-way, or higher order, interaction effects. One hundred and fifty-three U.K. government employees were randomly assigned to a SMT intervention group (n = 68), or to a waiting list control group (n = 85). The SMT group received three half-day training sessions spread over two and a half months. Findings indicated that there were significant overall reductions in psychological strain, emotional exhaustion and depersonalization in the SMT group, in comparison to the control group. Furthermore, there were significant higher order Group (SMT vs. control) × Time 1 Work-Related Self-Efficacy × Time 1 Intrinsic Work Motivation interactions, such that reductions in emotional exhaustion and depersonalization at certain time points were experienced only by those who had low baseline levels of work-related self-efficacy and high baseline levels of intrinsic work motivation. Implications for work-related self-efficacy theory and research and SMT research and practice are discussed. (PsycINFO Database Record

Worksite Walkthrough Intervention: Data-driven Prevention of Workplace Violence on Hospital Units.

The aim of this study was to describe the implementation of a data-driven, unit-based walkthrough intervention shown to be effective in reducing the risk of workplace violence in hospitals. A structured worksite walkthrough was conducted on 21 hospital units. Unit-level workplace violence data were reviewed and a checklist of possible prevention strategies and an Action Plan form guided development of unit-specific intervention. Unit supervisor perceptions of the walkthrough and implemented prevention strategies were reported via questionnaires. Prevention strategies were categorized as environmental, behavioral, or administrative. A majority of units implemented strategies within 12 months' postintervention. Participants found the walkthrough useful, practical, and worthy of continued use. Structured worksite walkthroughs provide a feasible method for workplace violence reduction in hospitals. Core elements are standardized yet flexible, promoting fidelity and transferability of this intervention.

Testing an Intervention to Decrease Healthcare Workers’ Exposure to Antineoplastic Agents

To develop and test a worksite intervention that protects healthcare workers who handle antineoplastic drugs from work-related exposures. . Intervention study. . A university hospital in a large midwestern metropolitan area and its outpatient chemotherapy infusion clinic. . 163 staff (nurses, pharmacists, and pharmacy technicians) who work with antineoplastic agents. . A self-report survey measured workplace and individual factors to assess use of personal protective equipment (PPE). Wipe samples were tested for surface contamination. An intervention incorporating study findings and worker input was developed. . PPE use was the dependent variable, and the independent variables included knowledge of the hazard, perceived risk, perceived barriers, interpersonal influence, self-efficacy, conflict of interest, and workplace safety climate. . PPE use was lower than recommended and improved slightly postintervention. Self-efficacy and perceived risk increased on the post-test survey. Chemical residue was found in several areas. Awareness of safe-handling precautions improved postintervention. The unit where nurses worked was an important predictor of safety climate and PPE use on the pretest but less so following the intervention. . Involving staff in developing an intervention for safety ensures that changes made will be feasible. Units that implemented workflow changes had decreased contamination. . Worksite analysis identifies specific targets for interventions to improve antineoplastic drug handling safety.

Cost and culture: Factors influencing worksite physical activity across three universities.

Physical inactivity is a leading cause of morbidity and mortality. Worksites provide an ideal environment for physical activity (PA) interventions. Colleges and universities are a unique work venue, with institutions of higher education of varying scope within every state of the United States and worldwide. To explore the institutional influences on worksite PA across multiple universities. Employees from two large, universities (Midwestern and Southern) and a mid-size, university (Midwestern) participated in exploratory research in March/April 2010 and 2013. The Nominal Group Technique (NGT) methodology and the Health Belief Model (HBM) were used to assess perceived influences on employees' engagement in worksite PA. The findings demonstrate that university employees experienced similar factors that influence PA as employees across the different institutions. Specifically, there was an interesting relationship between opportunities for PA and lack of a supportive work culture to promote it. Emphasis on immediate perceived threats to PA inactivity may improve the utility of the HBM for interventions within this context. Further, campus worksite interventions for employees should address barriers such as cost of campus recreation centers and administrative support for engaging in worksite PA as possible cues to action.

Support for Food and Beverage Worksite Wellness Strategies and Sugar-Sweetened Beverage Intake Among Employed U.S. Adults.

Sugar-sweetened beverage (SSB) consumption is high among U.S. adults and is associated with obesity. Given that more than 100 million Americans consume food or beverages at work daily, the worksite may be a venue for interventions to reduce SSB consumption. However, the level of support for these interventions is unknown. We examined associations between workday SSB intake and employees' support for worksite wellness strategies (WWSs). We conducted a cross-sectional study using data from Web-based annual surveys that gather information on health-related attitudes and behaviors. Study setting was the United States. A total of 1924 employed adults (≥18 years) selected using probability-based sampling. The self-reported independent variable was workday SSB intake (0, <1 or ≥1 times per day), and dependent variables were employees' support (yes/no) for the following WWSs: (1) accessible free water, (2) affordable healthy food/drink, (3) available healthy options, and (4) less available SSB. Multivariable logistic regression was used to control for sociodemographic variables, employee size, and availability of cafeteria/vending machine. About half of employees supported accessible free water (54%), affordable healthy food/drink (49%), and available healthy options (46%), but only 28% supported less available SSB. Compared with non-SSB consumers, daily SSB consumers were significantly less supportive of accessible free water (adjusted odds ratio, .67; p < .05) or less available SSB (odds ratio, .49; p < .05). Almost half of employees supported increasing healthy options within worksites, although daily workday SSB consumers were less supportive of certain strategies. Lack of support could be a potential barrier to the successful implementation of certain worksite interventions.

Is frequency of fast food and sit-down restaurant eating occasions differentially associated with less healthful eating habits?

Studies have shown that frequency of fast food restaurant eating and sit-down restaurant eating is differentially associated with nutrient intakes and biometric outcomes. The objective of this study was to examine whether frequency of fast food and sit-down restaurant eating occasions was differentially associated with less healthful eating habits, independent of demographic characteristics. Data were collected from participants in 2015 enrolled in a worksite nutrition intervention trial (n = 388) in North Carolina who completed self-administered questionnaires at baseline. We used multiple logistic regressions to estimate associations between frequency of restaurant eating occasions and four less healthful eating habits, controlling for age, sex, race, education, marital status, and worksite. On average, participants in the highest tertile of fast food restaurant eating (vs. lowest tertile) had increased odds of usual intake of processed meat (OR = 3.00, 95% CI = 1.71, 5.28), red meat (OR = 2.30, 95% CI = 1.33, 4.00), refined grain bread (OR = 2.25, 95% CI = 1.23, 4.10), and sweet baked goods and candy (OR = 3.50, 95% CI = 2.00, 6.12). No associations were found between frequency of sit-down restaurant eating and less healthful eating habits. We conclude that greater frequency of fast food restaurant eating is associated with less healthful eating habits. Our findings suggest that taste preferences or other factors, independent of demographic characteristics, might explain the decision to eat at fast food or sit-down restaurants.

Work Site-Based Environmental Interventions to Reduce Sedentary Behavior: A Systematic Review.

The purpose of this investigation was to systematically review work site-based, environmental interventions to reduce sedentary behavior following preferred reporting items for systematic reviews and meta-analyses guidelines. Data were extracted from Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials, and Web of Science between January 2005 and December 2015. Inclusion criteria were work site interventions, published in peer-reviewed journals, employing environmental modalities, targeting sedentary behavior, and using any quantitative design. Exclusion criteria were noninterventions and non-English publications. Data extracted included study design, population, intervention dosage, intervention activities, evaluation measures, and intervention effects. Data were tabulated quantitatively and synthesized qualitatively. A total of 15 articles were identified for review and 14 reported statistically significant decreases in sedentary behavior. The majority of studies employed a randomized controlled trial design (n = 7), used inclinometers to measure sedentary behavior (n = 9), recruited predominantly female samples (n = 15), and utilized sit-to-stand desks as the primary intervention modality (n = 10). The mean methodological quality score was 6.2 out of 10. Environmental work site interventions to reduce sedentary behavior show promise because work sites often have more control over environmental factors. Limitations of this intervention stream include inconsistent measurement of sedentary behavior, absence of theoretical frameworks to guide program development, and absence of long-term evaluation. Future studies should include clear reporting of intervention strategies and explicit operationalization of theoretical constructs.

The Impact of a Worksite-Based Diabetes Prevention Intervention: A Pilot Study.

The purpose of this study was to assess the impact of a program to prevent the development of type 2 diabetes among participants with prediabetes. The program focused on a healthy eating style, behavior modification, daily physical activity, and achieving a healthy weight. This was a retrospective observational analysis of a pilot program designed to prevent diabetes among employees with prediabetes. This intervention involved 12-16 weeks of nutrition counseling with the registered dietitian and participation in physical activity of at least 150 min/week. The primary outcome for this study was the prevention of type 2 diabetes. Secondary outcome measures included changes in the following biometrics: body mass index (BMI), systolic blood pressure (SBP), diastolic blood press (DBP), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol, waist circumference, and triglyceride levels. The diabetes prevention intervention was associated with significant improvements in glucose (-6.6%), A1c (-2.9%), weight (-5.5%), BMI (-5.5%), SBP (-4.9%), DBP (-3.9%), total cholesterol (-5.0%), LDL-C (-7.0%), and triglycerides (-13.9%). After the 12-16-week intervention, the prevalence of prediabetes was reduced by 31% by fasting blood glucose or A1c levels. Baseline A1c, baseline glucose level, age, and number of sessions attended were all significant predictors of the odds of transitioning out of the prediabetes stage, controlling for all other covariates in the model. This pilot study suggests that the implementation of a worksite diabetes prevention intervention can help employees transition from a prediabetes status to no risk of diabetes.

Early Workplace Intervention to Improve the Work Ability of Employees with Musculoskeletal Disorders in a German University Hospital-Results of a Pilot Study.

Health promotion is becoming increasingly important in work life. Healthcare workers seem to be at special risk, experiencing musculoskeletal disorders (MSD); their situation is strongly influenced by demographic changes. The aim of this study is to evaluate the feasibility and outcome of a worksite intervention. In a one-group pretest-posttest design, 118 employees of a hospital were recruited from 2010 to 2011. The raised parameters were satisfaction with the program, work ability (Work Ability Index), and sickness absence (provided by human resource management). Patient-reported questionnaire data was raised at baseline (t1) and after three months (t2). Sickness leave was evaluated in the period six months prior to and six months after the intervention. Means, frequencies, standardized effect sizes (SES), analysis of variance, and regression analysis were carried out. Participants were found to be highly satisfied. Work ability increased with moderate effects (SES = 0.34; p < 0.001) and prognosis of gainful employment (SES = −0.19; p ≤ 0.047) with small effects. Days of MSD-related sickness absence were reduced by 38.5% after six months. The worksite intervention program is transferable to a hospital setting and integration in occupational health management is recommended. The use of a control group is necessary to demonstrate the effectiveness.