Weight gain prevention in the school worksite setting: Results of a multi-level cluster randomized trial

Abstract

Objective To describe the effectiveness, reach and implementation of a weight gain prevention intervention among public school employees. Method A multi-level intervention was tested in a cluster randomized trial among 782 employees in 12 central Massachusetts public high schools from 2009 to 2012. The intervention targeted the nutrition and physical activity environment and policies, the social environment and individual knowledge, attitudes and skills. The intervention was compared to a materials only condition. The primary outcome measures were change in weight and body mass index (BMI) at 24-month follow-up. Implementation of physical environment, policy and social environment strategies at the school and interpersonal levels, and intervention participation at the individual level were assessed. Results At 24-month follow-up, there was a net change (difference of the difference) of −3.03 pounds (p=.04) and of −.48 BMI units (p=.05) between intervention and comparison conditions. The majority of intervention strategies were successfully implemented by all intervention schools, although establishing formal policies was challenging. Employee participation in programs targeting the physical and social environment was maintained over time. Conclusion This study supports that a multi-level intervention integrated within the organizational culture can be successfully implemented and prevent weight gain in public high school employees.

Influence of family, friend and coworker social support and social undermining on weight gain prevention among adults

“…While the modest weight change observed in the current study is not clinically significant, small shifts in population weight may result in large population benefit . The worksite‐based intervention specifically targeted worksite support ; thus, increases in perceived coworker support for physical activity were seen among intervention participants over time as hypothesized, with no significant changes in family, friend, or coworker support observed for the overall study sample. These findings suggest that strategies to help individuals: 1) solicit support (either from existing members of their social network and/or from new members) among those reporting low support for healthy eating and physical activity; and 2) navigate social undermining of healthy eating and physical activity among those reporting frequent social undermining may be key intervention targets for clinicians, practitioners, and investigators.…”

Randomized Trials of Nurse-Delivered Interventions in Weight Management Research: A Systematic Review

“…The length of the interventions ranged from six weeks to two years. Nine studies had outcome assessments at follow-up times ranging from six months to 3 years (Fulkerson et al, 2015; Hesselink et al, 2015; Kokkvoll, Grimsgaard, Steinsbekk, Flaegstad, & Njolstad, 2015; Lemon et al, 2014; ter Bogt et al, 2011; Valve et al, 2013; Vermunt et al, 2012; Wilson et al, 2016; Wright et al, 2013). Furthermore, nine studies reported nurses delivering interventions within multidisciplinary teams (Andryukhin, Frolova, Vaes, & Degryse, 2010; Brown et al, 2011; Brown, Goetz, Hamera, & Gajewski, 2014; Fulkerson et al, 2015; Gallagher et al, 2012; Kokkvoll et al, 2015; Lemon et al, 2014; Vermunt et al, 2012; Wilson et al, 2016; Wright et al, 2013).…”

Impact of School Staff Health on Work Productivity in Secondary Schools in Massachusetts

“…Of the 782 participants enrolled, 80.6% completed follow‐up through 24 months (n = 630). Additional details regarding intervention conditions, recruitment, and retention procedures have been previously described …”

“…This study sought to address this research gap by assessing the impact of school employees' health risk factors on their work productivity and absenteeism, analyzing data from a school employee weight maintenance intervention in 12 secondary schools in central Massachusetts . Specifically, this study examined 3 common health risk factors—obesity, depressive symptoms, and smoking—that have been shown to impact employee productivity and are potentially modifiable/treatable.…”

“…10,11 This study sought to address this research gap by assessing the impact of school employees' health risk factors on their work productivity and absenteeism, analyzing data from a school employee weight maintenance intervention in 12 secondary schools in central Massachusetts. 12 Specifically, this study examined 3 common health risk factors-obesity, depressive symptoms, and smoking-that have been shown to impact employee productivity and are potentially modifiable/treatable. Specific aims of this study were to (1) examine the frequency of 3 common health risk factors (obesity, depressive symptoms, and smoking) in secondary school employees; (2) evaluate on-thejob productivity of secondary school employees; and (3) examine differences in work productivity among employees with and without health risk factors.…”