A Field Test of a Web-Based Workplace Health Promotion Program to Improve Dietary Practices, Reduce Stress, and Increase Physical Activity: Randomized Controlled Trial

Abstract

Background Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet.Objective The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity.Methods Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests.Results Retention rates were good for both groups—85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F1,415 = 7.104, P = .008) and Dietary Stage of Change (F1,408 = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F2,203 = 5.270, P = .003), Attitudes Toward a Healthful Diet (F2,204 = 2.585, P = .045), and Dietary Stage of Change (F2,200 = 4.627, P = .005). No significant differences were found between the two groups on measures of stress or physical activity, although t tests of pretest-posttest changes indicated that both groups improved on several of these measures. The Web-based group gave significantly higher ratings to the program materials than the print group on all health topics and in their overall evaluation (F1,410 = 9.808, P = .002).Conclusions The Web-based program was more effective than print materials in producing improvements in the areas of diet and nutrition but was not more effective in reducing stress or increasing physical activity. The higher ratings given to the Web-based program suggest that workers preferred it to the print materials. Both groups showed numerous pretest-posttest improvements in all health topics, although such improvements might be attributable in part to a Hawthorne effect. Results suggest that a multimedia Web-based program can be a promising means of delivering health promotion material to the workforce, particularly in the area of diet and nutrition.

Adaptive e-learning to improve dietary behaviour: a systematic review and cost-effectiveness analysis.

“…All e-learning interventions were delivered in high-income countries, and the majority of interventions were delivered in the USA [42][43][44][45][47][48][49][50][51][52][53]55,56,58,59,62,64,66,[70][71][72][73][74][75][80][81][82][83][84] research groups dedicated to e-learning and diet research; hence, the geographic clustering of studies. For example, a single large e-learning research group produced all eight RCTs set in the Netherlands and Belgium.…”

“…Twenty-four studies reported on actual use of intervention programs, either making use of automated logon or usage features within programs (16 studies 42,48,53,59,[62][63][64]66,69,71,74,77,79,80,82,84 ) or obtaining self-reported usage data from participants (three studies 52,58,60 ). Five studies 44,55,57,70,80 reported collecting usage data, but did not state how.…”

“…A majority of interventions involved the presentation of nutrition, health and lifestyle information (32 studies 43,44,[46][47][48][49][50][51][52][53][54]57,58,60,62,[65][66][67][68][69][70][71][72][73][75][76][77][79][80][81][82][83] ), the entering of food consumption data (25 studies 42,[45][46][47]49,50,[52][53][54][55]57,58,65,[67][68][69][72][73][74][75][76]…”

Internet- and mobile-based stress management for employees with adherence-focused guidance: efficacy and mechanism of change

“…A recent randomized trial found Ebert et al moderate effect sizes with regard to the reduction of depressive symptoms among stressed teachers (6,14), whereas another trial did not find beneficial effects of a problem-solving training on depression or work-related outcomes (15,16). So far, randomized controlled trials (RCT) on internet-based SMI show mixed results with some studies reporting significant results with moderate effects sizes on perceived stress (17)(18)(19) and others yielding non-significant outcomes (20,21). Our group recently conducted a RCT testing the efficacy of an internet-based stress management intervention (iSMI) among employees with heightened levels of perceived stress (22,23).…”

Capacidade para o trabalho e presenteísmo em trabalhadores de enfermagem; propostas de intervençôes gerenciais

“…(G2) Em estudo de revisão integrativa da literatura sobre os distúrbios osteomusculares relacionados ao trabalho em profissionais de enfermagem, Lelis et al (2012), recomendam investimentos em programas preventivos e educação em saúde. A utilização de recursos da internet tem apresentado resultados satisfatórios em programas de promoção da saúde com os temas de bem estar, gestão do estresse, alimentação saudável e controle de peso, bem como, fomentar a prática de atividade física com recursos que poderiam ser disponibilizados pela própria instituição (Cook et al, 2007).…”