Cheng J, Levy D E, McCurley J L, Rimm E B, Gelsomin E D, Thorndike A N
Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
Prev Med Rep. 2024 Apr 20;42:102736. doi: 10.1016/j.pmedr.2024.102736. eCollection 2024 Jun.
Whether employees' health status is associated with the effectiveness of workplace health promotion programs is unknown. The objective of this study was to determine if the effect of a workplace healthy eating intervention differed by baseline chronic disease status.
This was a secondary analysis of a randomized controlled trial conducted September 2016 to February 2018 among US hospital employees to test the effect of a 12-month behavioral intervention (personalized feedback, peer comparisons, and financial incentives) on diet and weight. Participants were classified as having chronic disease (yes/no) based on self-reported hypertension, hyperlipidemia, heart disease, stroke, pre-diabetes, diabetes, cancer or another serious illness. BMI was measured at study visits and calories purchased were measured from cafeteria sales data over 24 months. Mixed models with random effects assessed heterogeneity of treatment effects by chronic disease.
Participants (N = 548) were mostly female (79.7 %) and white (81.2 %); 224 (40.9 %) had chronic disease. Among those with chronic disease, intervention participants reduced caloric intake by 74.4 [22.3] kcal more than control, with a smaller difference between intervention and control (-1.9 [18.7] kcal) (three-way p-interaction = 0.02). The effect on BMI for those with chronic disease (0.47 [0.21] kg/m) indicated weight stability among intervention participants and weight gain among controls while the effect (-0.56 [0.18] kg/m) for those without chronic disease was the opposite (three-way p-interaction < 0.01).
Those with chronic diseases had greater reductions in calories purchased and gained less weight. Employers with limited resources for health promotion might consider tailoring programs to employees at highest risk.
员工的健康状况是否与工作场所健康促进项目的效果相关尚不清楚。本研究的目的是确定工作场所健康饮食干预的效果是否因基线慢性病状况而异。
这是一项对2016年9月至2018年2月在美国医院员工中进行的随机对照试验的二次分析，以测试一项为期12个月的行为干预（个性化反馈、同伴比较和经济激励）对饮食和体重的影响。根据自我报告的高血压、高脂血症、心脏病、中风、糖尿病前期、糖尿病、癌症或其他严重疾病，将参与者分类为患有慢性病（是/否）。在研究访视时测量体重指数（BMI），并根据24个月的自助餐厅销售数据测量购买的卡路里量。采用随机效应混合模型评估慢性病对治疗效果的异质性。
参与者（N = 548）大多为女性（79.7%）和白人（81.2%）；224人（40.9%）患有慢性病。在患有慢性病的人群中，干预组参与者的热量摄入比对照组减少了74.4[22.3]千卡，干预组与对照组之间的差异较小（-1.9[18.7]千卡）（三方p交互作用 = 0.02）。对患有慢性病的人群的BMI影响（0.47[0.21]kg/m²）表明干预组参与者体重稳定，而对照组体重增加，而对没有慢性病的人群的影响（-0.56[0.18]kg/m²）则相反（三方p交互作用<0.01）。
患有慢性病的人购买的卡路里减少更多，体重增加更少。健康促进资源有限的雇主可能会考虑为风险最高的员工量身定制项目。
