Obesity/Overweight and the Role of Working Conditions

Nobrega, Suzanne; Champagne, Nicole; Abreu, Marlene; Goldstein-Gelb, Marcy; Montano, Mirna; Lopez, Isabel; Arevalo, Jonny; Bruce, Suezanne; Punnett, Laura

doi:10.1177/1524839915602439

Cited by 44 publications

(30 citation statements)

References 37 publications

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“…29–31 In 2009, NIH and the Centers for Disease Control and Prevention convened a multidisciplinary workshop to outline the conceptual framework and research needs addressing prevention through the integration of workplace health promotion and health protection (from occupational hazards), 32 which was adopted as a policy statement by AHA. 33 An important workshop theme corroborated by findings from this study is the disproportionate risk factor clustering of some groups of workers employed in the low wage service sector of the labor market, who are often employed by small firms 34 and accrue a disproportionate share of the costs attributed to workrelated fatal and non-fatal injuries and illnesses.…”

Section: Discussionmentioning

confidence: 99%

“…31,44 Correspondingly, population-level health policies should augment workplace-centered policies to advance the health of the most vulnerable segments of the workforce. Examples include food and beverage procurement policies, 45 universal smoke-free policies, 42 living wage legislation, 46,47 paid sick leave, 48 and restrictions on mandatory overtime.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

MacDonald

Bertke

Hein

et al. 2017

American Journal of Preventive Medicine

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Introduction Identification of groups with poor cardiovascular health (CVH) can inform where and how to target public health efforts. National prevalence estimates of CVH were derived for clinical (blood glucose, total cholesterol, blood pressure) and behavioral (BMI, diet quality, physical activity, smoking) factors among U.S. workers aged ≥45 years. Methods This cross-sectional analysis included 6,282 employed black and white men and women aged ≥45 years enrolled in the national population-based REasons for Geographic And Racial Differences in Stroke study from 2003 to 2007. Each CVH factor was scored as ideal (2), intermediate (1), or poor (0) according to American Heart Association criteria, and summed to define optimal composite scores: CVH (sum, 10–14), clinical (sum, 5–6), and behavioral (sum, 6–8) health. Occupational data were collected 2011–2013. Analyses were conducted in 2016. Results Only 14% met ideal criteria for all three clinical health factors, and none met ideal criteria for all four behavioral health factors. Sales and low status office workers had a low prevalence of optimal CVH. Service workers in protective services and the food preparation and serving occupations had a low prevalence of optimal clinical health; computer and healthcare support workers had a low prevalence of optimal behavioral health. Conclusions The prevalence of optimal CVH among middle-aged and older workers in the U.S. is low, but considerable differences exist by occupation. Targeted public health interventions may improve the CVH of at-risk older workers with different clinical and behavioral risk factor profiles employed in diverse occupational settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

MacDonald

Bertke

Hein

et al. 2017

American Journal of Preventive Medicine

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“…However, the workplaces and structures of many jobs have inherent health-diminishing aspects [6–8]. Factors such as psychosocial job strain, shift work, and excessive physical work load are related to worker behaviors such as smoking and lack of leisure-time exercise [9–12]. Thus the workplace environment itself should be designed to support these choices and to mitigate the stressors that counteract healthy behaviors [13].…”

Section: Introductionmentioning

confidence: 99%

“Working on Wellness:” protocol for a worksite health promotion capacity-building program for employers

Ryan¹,

Erck²,

McGovern

et al. 2019

BMC Public Health

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BackgroundIn the United States, worksite wellness programs are more often offered by larger employers. The Massachusetts Working on Wellness (WoW) program is an innovative, statewide capacity-building model designed to increase the number of smaller employers (200 or fewer workers) adopting health promotion initiatives. This article describes the WoW program design and approaches to recruitment, implementation, and evaluation.Methods/designWoW provides employer training, technical assistance and seed funding, utilizing a Wellness Program Development framework based on recognized good practices. For-profit employers with 200 employees or fewer are eligible for and encouraged to apply for a Massachusetts Small Business Wellness Tax Credit. During the phase described in this paper, employer organizations applied to the program and committed to designating a champion responsible for program implementation. Interventions were to include policy and environmental supports, as well as those targeting individual behavior change through raising awareness and education. Supports provided to employers included seed grants for qualifying activities (up to $10,000 with matching required), community linkages, data collection and organization-specific feedback tools, an on-line curriculum supplemented with technical assistance, and an expert webinar series. Data collection at multiple time points, from the initial application through program completion, provides information for evaluation of recruitment, planned and completed activities.DiscussionThis model is grounded in literature on good practices as well as in local knowledge about Massachusetts employers. It does not directly address the influence of working conditions, which can affect both worker participation and health behaviors. Implementation may be less successful with some organizations, such as those with many workers who are part-time or geographically distributed rather than in a centralized physical location. Program evaluation will assess the extent to which WoW achieves its goals. The data are expected to increase understanding of the needs of smaller employers and industries not traditionally implementing employee wellness programs.Electronic supplementary materialThe online version of this article (10.1186/s12889-019-6405-1) contains supplementary material, which is available to authorized users.

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“…Some workplace programs have shown positive effects on physical activity, fitness levels, weight, and/or diet [4,[75][76][77][78][79][80][81][82], but many studies are small, with non-randomized study designs, low rates of engagement and follow-up, and without intention-to-treat analyses [5,83,84]. In addition, despite evidence for the strong effect of the work environment in shaping health behaviors of work groups [5,68,75,[85][86][87], most worksite-based weightcontrol interventions have only focused on modifying the health behaviors of individual workers [88]. Furthermore, most of these programs have relied on a top-down approach, rather than a participatory approach based on employee involvement in the design of interventions [88,89].…”

Section: Discussionmentioning

confidence: 99%

Design of a randomized trial testing a multi-level weight-control intervention to reduce obesity and related health conditions in low-income workers

Stein

Strickland

Tabak

et al. 2019

Contemporary Clinical Trials

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Weight-control is a major public health focus for preventing multiple obesity-related health conditions. While clinic-based intensive lifestyle interventions are successful, low-socioeconomicstatus (SES) populations, which have a higher burden of obesity, are difficult to reach; thus, the workplace offers a useful setting to target low-SES workers. The current paper presents the design of a study testing a workplace intervention aimed at low-SES employees. Partnering with a large healthcare system and affiliated university, this project will test an innovative multi-level intervention ("Working for You") adapted from existing group-and individual-level intervention models to promote healthy weight among low-wage workers. The individual-level component is an interactive obesity treatment approach (iOTA) program that involves assessment of behavior risks, collaborative goal-setting with a health coach, and interactive SMS text-messages for ongoing support and self-monitoring. This mHealth intervention is embedded in the group-level component, a workplace participatory program that involves worker teams engaged in the design and implementation of interventions to change their workplace environments. These nested interventions are being tested in a group-randomized trial among 22 work groups (~1000 total workers, ~300 workers with obesity). The primary outcome will be program effects on weight at 2-year follow-up, compared to control, and the secondary outcomes will be effects on diet and physical activity; iOTA adherence, process measures, and work environment/support will also be examined. This pragmatic clinical trial will test scalable interventions that can be translated to other work settings to reduce obesity and related health risks among low-SES workers.

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Obesity/Overweight and the Role of Working Conditions

Cited by 44 publications

References 37 publications

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

“Working on Wellness:” protocol for a worksite health promotion capacity-building program for employers

Design of a randomized trial testing a multi-level weight-control intervention to reduce obesity and related health conditions in low-income workers

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