Zoellner Jamie, You Wen, Almeida Fabio, Blackman Kacie C A, Harden Samantha, Glasgow Russell E, Linnan Laura, Hill Jennie L, Estabrooks Paul A
Department of Human Nutrition, Foods and Exercise, Virginia Tech, Blacksburg, VA, USA
Department of Agricultural and Applied Economics, Virginia Tech, Blacksburg, VA, USA.
Am J Health Promot. 2016 Mar;30(4):279-82. doi: 10.1177/0890117116639558.
To examine if employee health literacy (HL) status moderated reach, retention, and weight outcomes in a worksite weight loss program.
The study was a two-group cluster randomized controlled weight loss trial.
The study was conducted in 28 worksites.
Subjects comprised 1460 employees with a body mass index >25 kg/m(2).
Two 12-month weight loss interventions targeted diet and physical activity behaviors: incentaHEALTH (INCENT; incentivized individually targeted Internet-based intervention) and Livin' My Weigh (LMW; less-intense quarterly newsletters).
A validated three-item HL screening measure was self-completed at baseline. Weight was objectively assessed with the Health Spot scale at baseline and 12-month follow-up.
The impact of HL on program effectiveness was assessed through fixed-effect parametric models that controlled for individual (i.e., age, gender, race, ethnicity, income, education) and worksite random effects.
Enrolled employees had significantly higher HL status [13.54 (1.68)] as compared to unenrolled [13.04 (2.17)] (p < .001). This finding was consistent in both interventions. Also, HL moderated weight loss effects (beta = .66; SE = 027; p = .014) and losing >5% weight (beta = -1.53; SE = .77; p < .047). For those with lower baseline HL, the INCENT intervention produced greater weight loss outcomes compared to LMW. The HL level of employees retained was not significantly different from those lost to follow-up.
HL influences reach and moderates weight effects. These findings underscore the need to integrate recruitment strategies and further evaluate programmatic approaches that attend to the needs of low-HL audiences.
探讨员工健康素养（HL）状况是否会调节工作场所减肥计划中的参与度、留存率和体重结果。
该研究为两组整群随机对照减肥试验。
研究在28个工作场所进行。
对象包括1460名体重指数>25kg/m²的员工。
两项为期12个月的减肥干预措施针对饮食和身体活动行为：激励健康计划（INCENT；基于互联网的个性化激励干预）和“活出我的体重”计划（LMW；强度较低的季度通讯）。
在基线时自行完成一项经过验证的三项HL筛查指标。在基线和12个月随访时使用健康秤客观评估体重。
通过固定效应参数模型评估HL对计划效果的影响，该模型控制了个体（即年龄、性别、种族、民族、收入、教育程度）和工作场所随机效应。
与未参与的员工[13.04（2.17）]相比，参与的员工HL状况显著更高[13.54（1.68）]（p<.001）。这一发现在两项干预措施中均一致。此外，HL调节了减肥效果（β=.66；标准误=.027；p=.014）以及体重减轻>5%的情况（β=-1.53；标准误=.77；p<.047）。对于基线HL较低的员工，与LMW相比，INCENT干预产生了更大的减肥效果。留存员工的HL水平与失访员工的HL水平无显著差异。
HL影响参与度并调节体重效果。这些发现强调了整合招募策略以及进一步评估满足低HL受众需求的计划方法的必要性。
