Sudak Nancy L, Harry Melissa L
Office of Well-Being, Essentia Health, Duluth, MN.
Essentia Institute of Rural Health, Essentia Health, Duluth, MN.
Mayo Clin Proc Innov Qual Outcomes. 2024 Apr 4;8(3):201-212. doi: 10.1016/j.mayocpiqo.2024.03.001. eCollection 2024 Jun.
With the awareness that the Standard American Diet is a critical contributor to chronic diseases, this initiative aimed to assess the effects of a 28-day dietary challenge health care improvement project on health system employee energy level, sleep quality, gastrointestinal function, ability to concentrate, and aches/pains, including the impact of adherence level, during a period of restricted intake of gluten, dairy, and sugar offered annually from 2021 to 2023. A total of 754 employees completed the pre-challenge survey; analyses included 354 employees who completed both pre-challenge and post-challenge surveys in at least 1 year of this project. Wilcoxon signed rank tests compared presurvey and postsurvey responses to self-reported energy level, sleep quality, gastrointestinal function, ability to concentrate, and aches/pains. Analysis of variance with Tukey's honestly significant difference tests compared self-reported adherence level with change scores, with η representing effect size. In each challenge year, the mean rank levels of energy, sleep quality, gastrointestinal function, concentration, and aches/pains improved significantly between pre-surveys and post-surveys (all <.001). Although an association between significant positive change and diet adherence level was found for all items in at least 1 challenge year, those who mostly or completely adhered to the challenge diet restrictions reported significantly greater positive change in energy levels and gastrointestinal symptoms than those who did not or minimally adhered in all challenge years, with small to medium effect sizes. In conclusion, Essentia Health's employee challenge appeared to improve self-reported outcomes in 5 symptom domains, with energy levels and gastrointestinal symptoms correlating most favorably to adherence to the challenge. These findings have health and cost implications, which could be confirmed by formal research in employee and other populations.
鉴于美国标准饮食是导致慢性病的关键因素，该倡议旨在评估一项为期28天的饮食挑战医疗保健改善项目对医疗系统员工的能量水平、睡眠质量、胃肠功能、注意力集中能力和疼痛的影响，包括在2021年至2023年每年进行的麸质、乳制品和糖摄入量受限期间的依从水平的影响。共有754名员工完成了挑战前的调查；分析包括在该项目至少1年中完成了挑战前和挑战后调查的354名员工。Wilcoxon符号秩检验比较了调查前和调查后对自我报告的能量水平、睡眠质量、胃肠功能、注意力集中能力和疼痛的回答。采用方差分析和Tukey真实显著差异检验比较自我报告的依从水平与变化分数，η代表效应大小。在每个挑战年份，能量、睡眠质量、胃肠功能、注意力和疼痛的平均秩次水平在调查前和调查后之间均有显著改善（均P<0.001）。尽管在至少1个挑战年份中，所有项目的显著正向变化与饮食依从水平之间均存在关联，但在所有挑战年份中，大部分或完全遵守挑战饮食限制的员工在能量水平和胃肠道症状方面的正向变化显著大于未遵守或极少遵守的员工，效应大小为小到中等。总之，Essentia Health的员工挑战似乎改善了5个症状领域的自我报告结果，能量水平和胃肠道症状与挑战依从性的相关性最为有利。这些发现具有健康和成本方面的意义，可通过对员工和其他人群的正式研究加以证实。
