Department of Vascular Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
BMJ Open. 2013 Jan 24;3(1):e002125. doi: 10.1136/bmjopen-2012-002125.
To evaluate whether four types of low-cost interventions in the working environment can promote the small everyday lifestyle adaptations that can halt the epidemics of obesity and hypertension when maintained long term.
A single-blind uninterrupted time-series intervention study consisting of four study periods: run-in (2 weeks), baseline (2 weeks), intervention (2 weeks), and after intervention 2 weeks).
University Medical Centre with over 11 000 employees, over 1000 hospital beds and over 2000 customers visiting the hospital restaurant each day.
Hospital staff and visitors.
(1) Point-of-decision prompts on hospital elevator doors promoting stair use. (2) Point-of-purchase prompts in the hospital restaurant promoting reduced-salt soup. (3) Point-of-purchase prompts in the hospital restaurant promoting lean croissants. (4) Reversal of the accessibility and availability of diet margarine and butter in the hospital restaurant.
(1) Number of passages through 15 different parts of the hospital staircases. (2) Number and ratio of normal-salt and reduced-salt soup purchased. (3) Number and ratio of butter croissants and lean croissants purchased. (4) Number and ratio of diet margarine and butter purchased.
Elevator signs increased the mean 24-h number of stair passages per measurement site (baseline: 992 ± 479 on week days and 208 ± 116 on weekend days) by 11.2% (95% CI 8.7% to 13.7%). This effect was maintained at least 2 weeks after the point-of-decision prompts were removed. Point-of-purchase prompts promoting low-salt soup and lean croissants did not result in altered purchase behaviour. The ratio between the purchase of margarine and butter was changed sevenfold (p<0.01) by reversing the positions of these products in the hospital restaurant.
Healthy lifestyle adaptations in the working environment can be effectively promoted by making healthy choices easier than unhealthy ones. Educational prompts at points-of-decision moderately increase stair climbing, but do not affect healthy food choices.
Clinicaltrials.gov identifier number: NCT01574040.
评估在工作环境中实施四种低成本干预措施是否能促进日常生活中的小改变，这些改变若能长期坚持则可能阻止肥胖和高血压的流行。
一项单盲、不间断的时间序列干预研究，包括四个研究阶段：导入期（2 周）、基线期（2 周）、干预期（2 周）和干预后 2 周。
有 11000 多名员工、1000 多张病床和 2000 多名每天到医院餐厅就餐的顾客的大学医疗中心。
医院员工和访客。
（1）在医院电梯门处设置决策点提示，鼓励使用楼梯。（2）在医院餐厅的购买点设置提示，鼓励购买低盐汤。（3）在医院餐厅的购买点设置提示，鼓励购买低脂羊角面包。（4）改变医院餐厅中饮食用人造黄油和黄油的可及性和可得性。
（1）通过医院楼梯的 15 个不同部分的人数。（2）购买普通盐汤和低盐汤的数量和比例。（3）购买黄油羊角面包和低脂羊角面包的数量和比例。（4）购买饮食用人造黄油和黄油的数量和比例。
电梯提示使每个测量点的 24 小时平均楼梯通行次数增加了 11.2%（95%CI：8.7%~13.7%），基线期工作日为 992±479 次，周末为 208±116 次。这一效果至少在决策点提示去除后的 2 周内仍持续存在。在购买低盐汤和低脂羊角面包时，购买点提示并未导致购买行为的改变。通过改变医院餐厅中这些产品的位置，使人造黄油和黄油的购买比例发生了 7 倍的变化（p<0.01）。
通过使健康选择变得比不健康选择更容易，可有效促进工作环境中的健康生活方式改变。决策点处的教育提示适度增加爬楼梯的次数，但不会影响健康食物的选择。
Clinicaltrials.gov 注册号：NCT01574040。
