Worksite Weight Loss Program Research Articles

Four worksite weight loss programs with high-stress occupations using a meal replacement product.

The objective was to evaluate the efficacy of worksite weight reduction programs at high-stress worksites. We employed a longitudinal study based on two meal replacements daily with subjects choosing a third 'sensible' meal. The subjects were 492 healthy, overweight men and women working in high-stress occupations (police, hospital health professionals, flight crew members, firefighters). The mean group ages ranged from 32.17 +/- 5.70 to 44.50 +/- 16.40 years; the mean group body mass indexes (BMIs) ranged from 27.40 +/- 2.54 to 32.90 +/- 3.39 kg/m(2). The completion rate for the 12 weeks was 79.8%. Reductions in mean weight and mean BMI were greater than in medically supervised clinical trials with non-worksite adults. Firefighters lost the most weight and medical personnel the least. Follow-up found considerable retention of weight loss. Men lost significantly more weight than women (p < 0.006). We conclude that employees in some high-stress settings may participate productively in worksite weight reduction and maintenance programs that use meal replacements.

Perfectionism, Stage of Change, and Self-Efficacy as Predictors of Weight Loss

This study evaluated the extent to which perfectionism, stage of change, and self-efficacy predicted weight loss in 46 participants who completed a 6-week behavioral worksite weight loss program. Measures included demographic information and pre-treatment height, weight, perfectionism, self-efficacy to resist overeating, and stages of change. Weight was also measured at post-treatment. The MAXR regression procedure was used to determine the overall ability of the variables to predict weight loss. The majority of the participants were married, Caucasian females. Mean age was 37.3 years. Average pre-treatment weight and height were 169.5 lb. And 64.8 in., respectively, with a mean weight loss of 4.6 lb. Over the 6-week period (range from 1.5 lb. weight gain to 18.5 lb. weight loss). The results indicated that a 3-vanable model (age, being in the maintenance stage of change, and being in the contemplation stage of change) accounted for the most variance in weight loss among study participants (i.e., 16.4%). These results suggest that weight control program participants may benefit from the inclusion of age-specific information and recommendations as part of the program protocol. In addition, it may be useful to tailor weight control interventions to the needs of specific groups according to stage of change.

Corrections

In the Letters to the Editor section of our July/ August 1993 issue, a word was omitted from a sentence of the letter written by Bruno Barmus. The sentence should have read, “This is obviously not based on breast cancer incidence and mortality statistics or surveys of mammography facilities but only on hearsay laudatory evidence.” We regret the omission. The article by Lando et al., which appeared on pages 22–24 of the September/October issue of the Journal, was incorrectly titled. The title should have read, “Factors Influencing Participation in Worksite Smoking Cessation and Weight Loss Programs: The Healthy Worker Project.” We sincerely regret the error. On page 60 of the article “A Review and Analysis of the Health and Cost-Effective Outcome Studies of Comprehensive Health Promotion and Disease Prevention Programs at the Worksite: 1991–1993 Update,” which appeared in the September/ October issue of the Journal, the findings reported for the Minneapolis/St. Paul Metropolitan Area61 should have been, “Among program participants, weight loss averaged 4.8 lbs. and 43% quit smoking. Significant net 2-year reductions in smoking prevalence in treatment vs. control sites were 4% and 2.1% in cross-section and cohort surveys, respectively; no significant treatment effects for weight; cost of smoking program was $1,500 for 2 years per site resulting in 8 to 16 extra quits. Thus, the cost of each quitter was $100 to $200.”

Worksite Wellness Programs: Incremental Comparison of Screening and Referral Alone, Health Education, Follow-up Counseling, and Plant Organization

Worksite wellness programs vary considerably in their design. This study tested four models to compare effectiveness at controlling high blood pressure, obesity, and cigarette smoking. Baseline screening was conducted in four manufacturing plants. Site 1 offered screening only, with referral recommendations for those found to have CVD risks. Site 2 also provided health education information and classes. Site 3 added routine follow-up counseling and a menu of intervention types, and Site 4 added social organization within the plant. Random samples of 400 to 500 employees were rescreened at the end of three years. Major improvements in risk levels were found with the addition of routine follow-up counseling and a menu of interventions (Sites 3 and 4, compared with Sites 1 and 2). More hypertensives entered treatment and showed greater reductions in blood pressure. Participation in worksite weight loss and smoking cessation programs was significantly increased, and those who participated showed significantly better maintenance of improvements where follow-up was provided. The program models that offered short-term interventions promoted through local media suffered in comparison with models that included personal outreach to people at risk, a variety of health improvement intervention modalities, and ongoing follow-up counseling to help people make decisions and sustain health improvements.

Promoting weight control at the worksite: A pilot program of self-motivation using payroll-based incentives

Thirty-six individuals participated in a worksite weight-loss program in which the central component was a self-motivation program of biweekly payroll deductions refunded contingent on meeting self-selected weight-loss goals. Half were assigned to early treatment and the remainder to a delayed treatment control group. Nine additional individuals also enrolled at the time of delayed treatment and were included in descriptive analyses of factors associated with weight loss. Results showed low program attrition over 6 months (6%) and mean weight losses (12.3 lb) that are competitive with those obtained in clinical settings. Although not different at baseline, participants in the delayed treatment group lost more than twice as much weight as those in the early treatment condition. This difference was interpreted as either a strong seasonal effect or a critical mass effect related to the proportion of employees at the worksite participating in the program. We conclude that self-motivation programs for health behavior change using the payroll system as an organization framework offer a promising new methodology for promoting healthful behaviors in work settings.

Participant characteristics as predictors of attrition in worksite weight loss

Attrition is a significant problem in worksite weight loss interventions, and differences in participants' motivational levels have been hypothesized to account for this high attrition rate. The present study examined characteristics of participants who completed a worksite weight loss program compared to those who dropped out, using a step-wise discriminant function analysis. The results indicate that a combination of motivational characteristics, expectations, and change in weight just prior to treatment significantly discriminated drop-outs from completers. The results of this investigation are discussed with respect to implications for developing cost-effective worksite treatment protocols and directions for future research.