The University of Texas Health Science Center at Houston.
Baylor College of Medicine.
Workplace Health Saf. 2020 Jan;68(1):32-49. doi: 10.1177/2165079919863082. Epub 2019 Aug 27.
Health care workers face elevated risk of obesity due to their unique work requirements. The purpose of this systematic review was to present a narrative summary of the characteristics and effectiveness of worksite wellness programs focusing on preventing obesity among health care workers. : The databases Medline, CINAHL, Embase, PsycINFO, and PubMed were searched. Experimental and quasi-experimental studies published in English (between 2000 and 2018) that (a) were worksite interventions, (b) had intervention directed toward health care employees, and (c) reported weight-related outcomes were included. We excluded commercial weight loss studies. Two coders extracted data on the following: purpose, key study characteristics, design, type and dosage of intervention, outcome measure(s), attrition rate, and risk of bias. : Of the 51 studies included in this review, the majority (75%, = 38) targeted diet and physical activity behaviors. The majority reported improved weight outcomes in favor of the intervention. Overall, moderate- to high-intensity behavioral strategies, using any mode of intervention delivery (phone, face-to-face, or Internet), delivered by a trained professional were effective in improving weight-related outcomes. Environmental strategies were effective in improving healthier habits. Self-directed strategies worked better for motivated employees. : Multicomponent interventions offered in health care settings may be successful in improving employee weight. Across study designs, several gaps in the reporting of intervention design, dosage, fidelity, and system-level outcomes were found. : Occupational health professionals should continue to be creative in developing multicomponent interventions (combining behavioral/educational, environmental, and organizational support) and use evidence guidance frameworks/tools to design an intervention and report dosage outcomes.
医疗工作者由于其独特的工作要求，面临着肥胖风险的增加。本系统综述的目的是对以预防医疗工作者肥胖为目标的工作场所健康促进计划的特征和效果进行叙述性总结。检索了 Medline、CINAHL、Embase、PsycINFO 和 PubMed 数据库。纳入了发表于 2000 年至 2018 年间的以英语撰写的、具有实验性或准实验性设计的、（a）为工作场所干预措施、（b）以医疗保健员工为干预对象、（c）报告体重相关结局的研究。我们排除了商业性减肥研究。两位编码员提取了以下数据：目的、研究特征要点、设计、干预类型和剂量、结局测量指标、失访率和偏倚风险。在本综述纳入的 51 项研究中，大多数（75%，n=38）针对饮食和身体活动行为。大多数研究报告称干预有利于改善体重结局。总体而言，采用任何干预方式（电话、面对面或互联网），由经过培训的专业人员实施的中高强度行为策略在改善体重相关结局方面是有效的。环境策略在改善更健康的习惯方面是有效的。自我指导策略对有积极性的员工效果更好。在医疗保健环境中提供的多组分干预措施可能有助于改善员工体重。在各种研究设计中，干预设计、剂量、保真度和系统层面结局报告方面存在一些差距。职业健康专业人员应继续创造性地开发多组分干预措施（结合行为/教育、环境和组织支持），并使用证据指导框架/工具来设计干预措施并报告剂量结局。
