Background/Aims:
Behavioral nudges in the food environment increase healthy choices, but it is unknown if they improve diet and health. The ChooseWell 365 study will determine if an automated, personalized worksite intervention to nudge healthier choices improves overall diet and cardiometabolic health.
Design:
Randomized controlled trial of 602 hospital employees who regularly use on-site cafeterias and pay with an employee ID.
Intervention:
The intervention combines an environmental strategy (traffic-light labeling) with objective feedback and personalized nudges (health/lifestyle tips, social norms, incentives) to promote healthy food choices. The ChooseWell 365 software platform automatically generates personalized emails and letters that integrate employees’ weight goals with health, lifestyle, and cafeteria purchasing data. Over one year, the intervention group receives two weekly emails. One provides a log of daily purchases; the second provides personalized health/lifestyle tips. The intervention group receives monthly mailed letters with social norm comparisons and financial incentives for healthier purchases. The one-year intervention will be completed in February 2019; all follow-up will be completed March 2020.
Outcomes:
Weight, cardiometabolic risk factors, and dietary intake at one and two-year followup. Other outcomes include worksite food purchases by study participants and other non-participant employees who are socially connected (inferred from purchasing data) to participants.
Conclusions:
ChooseWell 365 tests a novel strategy to deliver a scalable worksite prevention program that is integrated into the workday. The intervention is personalized but automated and therefore does not require costlier individual counseling. In the future, this program could be applied broadly in other worksite settings.
Distress tolerance (DT) is considered an underlying facet of anxiety, depression and a number of other psychological disorders. Mindfulness may help to increase DT by fostering an attitude of acceptance non-judgment toward distressing experiences. Accordingly, the present study examined the effects of a brief mindfulness training on tolerance of different types of distress, and tested whether trait mindfulness moderates the effect of such training. Undergraduates (n = 107) naïve to mindfulness completed a measure of trait mindfulness and underwent a series of stress tasks (cold pressor, hyperventilation challenge, neutralization task) before and after completing a 15-minute mindfulness training or a no-instruction control in which participants listened to relaxing music. Participants in the mindfulness condition demonstrated greater task persistence on the hyperventilation task compared to the control group, as well as a decreased urge to neutralize the effects of writing an upsetting sentence. No effect on distress ratings during the tasks were found. Overall trait mindfulness did not significantly moderate task persistence, but those with lower scores on the act with awareness facet of mindfulness demonstrated greater relative benefit of mindfulness training on the hyperventilation challenge. Mediation analyses revealed significant indirect effects of mindfulness training on cold pressor task persistence and urges to neutralize through the use of the non-judge and non-react facets of mindfulness. These results suggest that a brief mindfulness training can increase DT without affecting the subjective experience of distress.
Introduction: Most Americans spend half their waking hours at work and consume food acquired there. The hypothesis was that the healthfulness of worksite food purchases was associated with employees' overall diet and health. Methods: Participants were 602 hospital employees who regularly used worksite cafeterias and enrolled in a health promotion study in 2016-2018. All cafeterias used traffic-light labels (green=healthy, yellow=less healthy, red=unhealthy). A Healthy Purchasing Score was calculated for each participant by summing weighted proportions of cafeteria items purchased over a 3month observation period (red=0, yellow=0.5, green=1, range, 0-1). Healthy Eating Index scores (range, 0-100) were calculated based on two 24-hour dietary recalls. BMI, blood pressure, and HbA1c were measured. Hypertension and prediabetes/diabetes diagnoses were determined by selfreported and clinical data. Regression analyses examined dietary quality and diagnoses by tertile of Healthy Purchasing Score (T1=least healthy purchases, T3=most healthy), adjusting for demographics. All data were collected prior to start of the intervention and were analyzed in 2018.
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