Suchergebnisse

Purpose. To evaluate minimal-contact and telephone-assisted weight-loss programs for overweight persons. Design. Participants were randomized to a minimal-contact group or one of two telephone-assisted weight-loss groups. All participants attended two group-based behavioral weight-loss classes and received written educational materials and diaries. For the subsequent 24 weeks, the minimal-contact group received no contact and the telephone-assisted group members received weekly calls to monitor their weight, food intake, and exercise. Setting. Baseline educational sessions and data collection were conducted at a university site. Subjects. Sixty-four healthy subjects (4 men) who were from 120% to 150% of ideal weight and were 25 to 55 years of age participated in the study. Measures. The major outcome of interest was change in measured weight over a 24-week period Data on calories expended in exercise, dietary intake, and demographics were also gathered at baseline and 24 weeks. Results. Weight loss did not differ significantly by treatment. Unexpectedly, the minimal-contact group lost almost twice as much weight as the telephone-assisted groups (12.7 vs 7.9 lb). Conclusions. There appears to be an audience for low-contact and telephone-assisted weight-loss programs, and such programs can be delivered easily. However, because the data show only modest weight-loss success, work should continue to identify the optimal content and design of such interventions.

Purpose. Published research on worksite weight-control programs is reviewed with the objective of assessing success in (1) reaching populations in need, (2) achieving sustained weight loss, and (3) improving employee health and productivity. Search method. Reviewed are 44 data-based articles published between 1968 and 1994. The initial search was part of a larger review on the health impact of worksite health promotion programs conducted by Centers for Disease Control and described in the introduction to this issue. We supplemented the resulting list with articles found in a search of our own reference files. Important findings. Methodologically the literature is relatively weak, consisting largely of uncontrolled case studies. Worksite interventions appear to be successful in reaching large numbers of people: the median participation rate among overweight employees was 39% in the six studies that provided this type of information. Worksite programs produced reasonable short-term weight loss: typically 1 to 2 pounds per week. Long-term weight loss, reductions in sitewide obesity prevalence, and health or productivity benefits have yet to be demonstrated. Major conclusions. Recommendations for future research include improved methods, more attention to recruitment and secondary outcomes, more direct comparison of different programs, and more creative use of worksites as environments and social units in designing programs.

This paper describes a study examining the feasibility of a worksite health promotion program that was repeated twice in one year. Weight control and smoking cessation classes, which included a supporting incentive component, were made available at a worksite of 485 white-collar employees continuously throughout one year. Identical education programs were offered twice at six-month intervals. Results suggest that this model of program implementation is attractive to employees. Total participation over 12 months included an estimated 53% of overweight employees in the weight program and 23 % of smokers in the smoking cessation program. The two series of classes, run back to back, generated similar participation. Thirty-nine percent of weight control participants and six percent of smoking cessation participants who enrolled in the first program also enrolled in the second. Weight losses and smoking cessation rates were comparable for the two cycles, with a mean weight loss of about seven pounds and a smoking cessation rate at six months of about 33%. Surveys of a random sample of employees at baseline and again at 12 months showed a 28% reduction in the prevalence of cigarette smoking, but no change in average weight or the prevalence of overweight. This study suggests that health promotion programs at worksites which offer repeated opportunities for employee participation are promising and deserve further study.

Objectives. Investigators planning studies employing group-randomized designs need good estimates of the extra variation introduced as a result of correlated observations within units of assignment. We report intraclass correlation coefficients (ICCs) for a wide range of outcomes commonly employed in worksite studies and demonstrate analysis methods that can limit their deleterious impact. Methods. A sample of 11, 711 employees of 24 firms recruited from the Minneapolis/St. Paul metropolitan area completed a mailed survey in the SUCCESS study, reporting on a broad array of outcomes. Applying mixed-model regression, we provide both crude and adjusted estimates of ICCs for 27 outcomes. Results. The crude ICCs were generally small, with a mean of .0163 and values ranging from 0 to .0650. Adjustment for demographics reduced the ICCs for 25 of the 27 outcomes, and adjustment for additional individual-level covariates further reduced the ICCs for 23 of the 27 outcomes. Conclusions. Our results suggest that worksite-level ICCs for a variety of outcomes are generally small and can generally be reduced by adjustment for individual-level characteristics. Incorporating this information in planning worksite studies can improve sample size calculations to avoid underpowered studies.

Purpose. This pilot study examined nutrition-related attitudes that may affect food choices at fast-food restaurants, including consumer attitudes toward nutrition labeling of fast foods and elimination of value size pricing. Methods. A convenience sample of 79 fast-food restaurant patrons aged 16 and above (78.5% white, 55% female, mean age 41.2 [17.1]) selected meals from fast-food restaurant menus that varied as to whether nutrition information was provided and value pricing included and completed a survey and interview on nutrition-related attitudes. Results. Only 57.9% of participants rated nutrition as important when buying fast food. Almost two thirds (62%) supported a law requiring nutrition labeling on restaurant menus. One third (34%) supported a law requiring restaurants to offer lower prices on smaller instead of bigger-sized portions. Conclusion. This convenience sample of fast-food patrons supported nutrition labels on menus. More research is needed with larger samples on whether point-of-purchase nutrition labeling at fast-food restaurants raises perceived importance of nutrition when eating out.

Purpose. The purpose of this study was to provide further information about preferences for types and formats (e.g., correspondence vs. face to face) of eating and exercise programs, actual participation rates in a variety of offered programs, and characteristics of program participants vs. nonparticipants. Design. Over a 3-year period, a large sample of community volunteers was given the opportunity to participate in various forms of diet and exercise programs as part of a weight gain prevention study. Setting. The study was conducted at a university and three local health department sites. Subjects. Subjects in the study were 616 individuals participating in the Pound of Prevention study (POP), a 3-year randomized evaluation of an intervention for preventing weight gain.1 Measures. The primary outcomes assessed were participation rates for each program offering. Program participants were also compared to those who did not participate on demographic characteristics, smoking, diet behavior, exercise behavior, and weight concern. Results. Survey results indicated that correspondence formats for delivery of health education programs were rated as more desirable than face-to-face formats. Participation for program offerings ranged from 0 to 16% of the study population. Participation data were consistent with survey results and showed participants' preference for correspondence formats even more strongly. Program offerings attracted health-conscious participants with higher education and income levels. Conclusions. These data suggest that some community members will get interested and take part in low-cost, minimal contact programs for exercise and weight control. Future research efforts should focus on investigating ways to increase participation in brief or minimal contact programs, particularly among groups that may be difficult to reach and at high risk for the development of obesity.