title: Cost-effectiveness of a long-term Internet-delivered worksite health promotion programme on physical activity and nutrition: a cluster randomized controlled trial Images of a Healthy Worksite: A Group-Randomized Trial for Worksite Weight Gain Prevention With Employee Participation in Intervention Design. HealthWorks: results of a multi-component group-randomized worksite environmental intervention trial for weight gain prevention Long-term effects of a worksite health promotion program for firefighters. Weight gain prevention in the school worksite setting: results of a multi-level cluster randomized trial. Working on wellness (WOW): A worksite health promotion intervention programme Effectiveness of a Worksite-based Weight Loss Randomized Controlled Trial: The WORKSITE Study Weight loss among female health care workers- a 1-year workplace based randomized controlled trial in the FINALE-health study Diabetes prevention and control in the workplace: a pilot project for county employees. Obesity and Presenteeism: The Impact of Body Mass Index on Workplace Productivity Risk of chronic liver disease in post-menopausal women due to body mass index, alcohol and their interaction: a prospective nested cohort study within the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) Evaluation of a multicomponent workplace health promotion program conducted in Japan for improving employees' cardiovascular disease risk factors. Eight-Year Weight Losses with an Intensive Lifestyle Intervention: The Look AHEAD Study Effects of a tailored health promotion program for female blue-collar workers: health works for women. Comparison of strategies for sustaining weight loss: the weight loss maintenance randomized controlled trial. Worksite environment intervention to prevent obesity among metropolitan transit workers. Precision in Weighing: A Comparison of Scales Found in Physician Offices, Fitness Centers, and Weight Loss Centers Understanding how people process health information: a comparison of tailored and nontailored weight-loss materials. Quality of motivational interviewing matters: the effect on participation in health-promotion activities in a cluster randomized controlled trial. Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults Longitudinal Outcomes of a Comprehensive, Incentivized Worksite Wellness Program
abstract: This study aims to evaluate the cost-effectiveness of a long-term workplace health promotion programme on physical activity ( PA ) and nutrition . In total , 924 participants enrolled in a 2-year cluster r and omized controlled trial , with departments ( n = 74 ) within companies ( n = 6 ) as the unit of r and omization . The intervention was compared with a st and ard programme consisting of a physical health check with face-to-face advice and personal feedback on a website . The intervention consisted of several additional website functionalities : action-oriented feedback , self-monitoring , possibility to ask questions and monthly e-mail messages . Primary outcomes were meeting the guidelines for PA and fruit and vegetable intake . Secondary outcomes were self-perceived health , obesity , elevated blood pressure , elevated cholesterol level and maximum oxygen uptake . Direct and indirect costs were calculated from a societal perspective , and a process evaluation was performed . Of the 924 participants , 72 % participated in the first and 60 % in the second follow-up . No statistically significant differences were found on primary and secondary outcomes , nor on costs . Average direct costs per participant over the 2-year period were € 376 , and average indirect costs were € 9476 . In conclusion , no additional benefits were found in effects or cost savings . Therefore , the programme in its current form can not be recommended for implementation OBJECTIVES We assessed the effects of a  worksite multiple-component intervention addressing diet and physical activity on employees ' mean body mass index ( BMI ) and the percentage of employees who were overweight or obese . METHODS This group-r and omized trial ( n = 3799 ) was conducted at 10 worksites in the northeastern United States . Worksites were paired and allocated into intervention and control conditions . Within- and between-groups changes in mean BMI s and in the percentage of overweight or obese employees were examined in a volunteer sample . RESULTS Within-group mean BMI s decreased by 0.54 kilograms per meter squared ( P = .02 ) and 0.12 kilograms per meter squared ( P = .73 ) at the intervention and control worksites , respectively , result ing in a difference in differences ( DID ) decrease of 0.42 kilograms per meter squared ( P = .33 ) . The within-group percentage of overweight or obese employees decreased by 3.7 % ( P = .07 ) at the intervention worksites and increased by 4.9 % ( P = .1 ) at the control worksites , result ing in a DID decline of 8.6 % ( P = .02 ) . CONCLUSIONS Our findings support a worksite population strategy that might eventually reduce the prevalence of overweight and obesity by minimizing environmental exposures to calorically dense foods and increasing exposures to opportunities for energy expenditure within worksite setting Background U.S. adults are at unprecedented risk of becoming overweight or obese , and most scientists believe the primary cause is an obesogenic environment . Worksites provide an opportunity to shape the environments of adults to reduce obesity risk . The goal of this group-r and omized trial was to implement a four-component environmental intervention at the worksite level to positively influence weight gain among employees over a two-year period . Environmental components focused on food availability and price , physical activity promotion , scale access , and media enhancements . Methods Six worksites in a U.S. metropolitan area were recruited and r and omized in pairs at the worksite level to either a two-year intervention or a no-contact control . Evaluations at baseline and two years included : 1 ) measured height and weight ; 2 ) online surveys of individual dietary intake and physical activity behaviors ; and 3 ) detailed worksite environment assessment . Results Mean participant age was 42.9 years ( range 18 - 75 ) , 62.6 % were women , 68.5 % were married or cohabiting , 88.6 % were white , 2.1 % Hispanic . Mean  baseline BMI  was 28.5 kg/m2 ( range 16.9 - 61.2 kg/m2 ) . A majority of intervention components were successfully implemented . However , there were no differences between sites in the key outcome of weight change over the two-year study period ( p = .36 ) . Conclusions Body mass was not significantly affected by environmental changes implemented for the trial . Results raise questions about whether environmental change at worksites is sufficient for population weight gain prevention . Trial Registration Clinical Trials.gov : OBJECTIVE To describe effects of 2 worksite health promotion programs for firefighters , both immediate outcomes and the long-term consequences for 4 years following the interventions . METHODS At baseline , 599 firefighters were assessed , r and omized by fire station to control and 2 different intervention conditions , and reevaluated with 6 annual follow-up measurements . RESULTS Both a team-centered peer-taught curriculum and an individual motivational interviewing intervention demonstrated positive effects on BMI , with team effects on nutrition behavior and physical activity at one year . Most differences between intervention and control groups dissipated at later annual assessment s. However , the trajectory of behaviors across time generally was positive for all groups , consistent with lasting effects and diffusion of program benefits across experimental groups within the worksites . CONCLUSIONS Although one-year programmatic effects did not remain over time , the long-term pattern of behaviors suggested these worksites as a whole were healthier more than 3 years following the interventions OBJECTIVE To describe the effectiveness , reach and implementation of a weight  gain  prevention intervention among public school employees . METHOD A multi-level intervention was tested in a cluster r and omized trial among 782 employees in 12 central Massachusetts public high schools from 2009 to 2012 . The intervention targeted the nutrition and physical activity environment and policies , the social environment and individual knowledge , attitudes and skills . The intervention was compared to a material s only condition . The primary outcome measures were change in weight and body mass index ( BMI ) at 24-month follow-up . Implementation of physical environment , policy and social environment strategies at the school and interpersonal levels , and intervention participation at the individual level were assessed . RESULTS At 24-month follow-up , there was a net change ( difference of the difference ) of -3.03 pounds ( p=.04 ) and of -.48 BMI units ( p=.05 ) between intervention and comparison conditions . The majority of intervention strategies were successfully implemented by all intervention schools , although establishing formal policies was challenging . Employee participation in programs targeting the physical and social environment was maintained over time . CONCLUSION This study supports that a multi-level intervention integrated within the organizational culture can be successfully implemented and prevent weight gain in public high school employees Background Insufficient PA has been shown to cluster with other CVD risk factors including insufficient fruit and vegetable intake , overweight , increased serum cholesterol concentrations and elevated blood pressure . This paper describes the development of Working on Wellness ( WOW ) , a worksite intervention program incorporating motivational interviewing by wellness specialists , targeting employees at risk . In addition , we describe the evaluation the effectiveness of the intervention among employees at increased risk for cardiovascular disease . Methods The intervention mapping ( IM ) protocol was used in the planning and design of WOW . Focus group discussion s and interviews with employees and managers identified the importance of addressing risk factors for CVD at the worksite . Based on the employees ’ preference for individual counselling , and previous evidence of the effectiveness of this approach in the worksite setting , we decided to use motivational interviewing as part of the intervention strategy . Thus , as a cluster-r and omised , controlled control trial , employees at increased risk for CVD ( N = 928 ) will be assigned to a control or an intervention group , based on company r and om allocation . The sessions will include motivational interviewing techniques , comprised of two face-to-face and four telephonic sessions , with the primary aim to increase habitual levels of PA .  Measures will take place at baseline , 6 and 12 months . Secondary outcomes include changes in nutritional habits , serum cholesterol and glucose concentrations , blood pressure and BMI . In addition , healthcare expenditure and absenteeism will be measured for the economic evaluation . Analysis of variance will be performed to determine whether there were significant changes in physical activity habits in the intervention and control groups at 6 and 12 months . Discussion The formative work on which this intervention is based suggests that the strategy of targeting employees at increased risk for CVD is preferred . Importantly , this study extends the work of a previous , similar study , Health Under Construction , in a different setting . Finally , this study will allow an economic evaluation of the intervention that will be an important outcome for health care funders , who ultimately will be responsible for implementation of such an intervention . Trial registration United States Clinical Trails Register NCT Objective To determine the effectiveness of an individually-targeted Internet-based intervention with monetary incentives ( INCENT ) at reducing weight of overweight and obese employees when compared to a less-intensive intervention ( Livin ’ My Weigh [ LMW ] ) 6-months after program initiation . Design and Methods Twenty-eight worksites were r and omly assigned to either  INCENT  or LMW conditions . Both programs used evidence -based strategies to support weight loss . INCENT was delivered via daily e-mails over 12 months while LMW was delivered quarterly via both newsletters and onsite educational sessions . Generalized linear mixed models were conducted for weight change from baseline to 6-month post program and using an intention-to-treat ( ITT ) analysis to include all participants with baseline weight measurements . Results Across 28 worksites , 1,790 employees ( M=47 years of age ; 79 % Caucasian ; 74 % women ) participated . Participants lost an average of 2.27 lbs ( p<0.001 ) with a BMI decrease of 0.36 kg/m2 ( p<0.001 ) and 1.30 lbs ( p<0.01 ) and a BMI decrease of 0.20 kg/m2 ( p<0.01 ) in INCENT and LMW , respectively . The difference between INCENT and LMW group in weight loss and BMI reduction were not statistically significant . Conclusion The current study suggests that INCENT and a minimal intervention alternative may be effective approaches to help decrease the overall obesity burden within worksites Background Weight management constitutes a substantial problem particularly among groups of low socio-economic status . Interventions at work places may be a solution , but high quality worksite interventions documenting prolonged weight loss are lacking . This paper presents results of an intervention aim ed to achieve a 12 months weight loss among overweight health care workers . Methods Ninety-eight overweight female health care workers were r and omized into an intervention or a reference group . The intervention consisted of diet , physical exercise and cognitive behavioral training during working hours 1 hour/week . The reference group was offered monthly oral presentations . Several anthropometric measures , blood pressure , cardiorespiratory fitness , maximal muscle strength , and musculoskeletal pain were measured before and after the 12-months intervention period . Data were analyzed by intention-to-treat analysis . Results The intervention group significantly reduced body weight by 6 kg ( p < 0.001 ) , BMI by 2.2 ( p < 0.001 ) and body fat percentage by 2.8 ( p < 0.001 ) . There were no statistical reductions in the control group , result ing in significant differences between the two groups over time . Conclusions The intervention generated substantial reductions in body weight , BMI and body fat percentage among overweight female health care workers over 12 months . The positive results support the workplace as an efficient arena for weight loss among overweight females . Trial registration NCT01015716 OBJECTIVES To improve nutrition and physical activity of county employees and promote weight loss . DESIGN R and om assignment to begin the program when first offered or after 3 months ( " wait control " group ) . SETTING Worksite . PARTICIPANTS Onondaga County employees ( n = 45 ) at risk for diabetes ( n = 35 ) or with diabetes ( n = 10 ) . Mean ( ±SD ) age = 51.2 ( ± 8.0 ) years and body mass index ( BMI ) = 37.3 ± ( 6.8 kg/m ) . INTERVENTION Twelve weekly healthy lifestyle sessions based on the Diabetes Prevention Program curriculum , followed by monthly sessions for up to 12 months . OUTCOMES Medical : Weight , BMI , waist circumference , blood pressure , fasting glucose , lipid , and hemoglobin A1c levels . Psychosocial/behavioral : Health-related quality of life Short Form-12 , Impact of Weight on Quality of Life Scale ) , physical activity ( International Physical Activity Question naire ) , eating behavior ( 3-Factor Eating Question naire , National Cancer Institute Fat Screener ) , job satisfaction . RESULTS The intervention group lost significant weight compared to the wait control group over the first 3 months ( mean [ 95 % CI ] , -2.23 kg [ -3.5 to 0.97 ] ) vs [ + 0.73 kg ( + 0.17 to + 1.28 ) ] , with a decrease in BMI ( P < .001 ) and waist circumference ( P = .004 ) , an increase in physical activity ( International Physical Activity Question naire , P = .011 ) and lower dietary fat intake ( P = .018 ) . Over 12 months , 22.5 % ( 9/40 ) lost more than 5 % body weight and 12.5 % ( 5/40 ) lost more than 7 % body weight . After the first 3 months , there was gradual partial weight regain but reduction in waist circumference was maintained . The intervention group demonstrated significant improvement in Impact of Weight on Quality of Life Scale ( P < .001 ) , 3-Factor Eating ( cognitive restraint P < .001 , uncontrolled eating P = .003 , and emotional eating P = .001 ) , International Physical Activity Question naire ( P = .011 ) , and Short Form-12 Physical Component Summary ( P = .048 ) . No improvements were observed in blood pressure , lipid , hemoglobin A1c , or glucose levels . Job satisfaction was inversely related to BMI at baseline ( P = .001 ) with a trend for improvement with the modest weight loss . CONCLUSIONS A worksite intervention program can help government employees adopt healthier lifestyles and achieve modest weight loss Objective : To examine whether obesity is associated with increased presenteeism ( health-related limitations at work ) . Methods : R and omly selected manufacturing employees ( n = 341 ) were assessed via height and weight measures , demographic survey , wage data , and the Work Limitations Question naire . The Work Limitations Question naire measures productivity on four dimensions . Analyses of variance and analyses of covariance were computed to identify productivity differences based on body mass index ( BMI ) . Results : Moderately or extremely obese workers ( BMI ≥35 ) experienced the greatest health-related work limitations , specifically regarding time needed to complete tasks and ability to perform physical job dem and s. These workers experienced a 4.2 % health-related loss in productivity , 1.18 % more than all other employees , which equates to an additional $ 506 annually in lost productivity per worker . Conclusions : The relationship between BMI and presenteeism is characterized by a threshold effect , where extremely or moderately obese workers are significantly less productive than mildly obese workers Background We investigated the risk of  chronic liver disease ( CLD )  due to alcohol consumption and body mass index ( BMI ) and the effects of their interaction in a prospect i ve cohort study of women recruited to the UKCTOCS trial . Methods 95,126 post-menopausal women without documented CLD were stratified into 12 groups defined by combinations of BMI ( normal , overweight , obese ) and alcohol consumption ( none , < 1–15 , 16–20 and ≥21 units/week ) , and followed for an average of 5.1 years . Hazard ratios ( HR ) were calculated for incident liver-related events ( LRE ) . Results First LREs were reported in 325 ( 0.34 % ) participants . Compared to women with normal BMI , HR = 1.44 ( 95 % CI ; 1.10–1.87 ) in the overweight group and HR = 2.25 ( 95 % CI ; 1.70–2.97 ) in the obese group , adjusted for alcohol and potential confounders . Compared to those abstinent from alcohol , HR = 0.70 ( 95 % CI ; 0.55–0.88 ) for < 1–15 units/week , 0.93 ( 95 % CI ; 0.50–1.73 ) for 16–20 units/week and 1.82 ( 95 % CI ; 0.97–3.39 ) for ≥21 units/week adjusted for BMI and potential confounders . Compared to women with normal BMI drinking no alcohol , HR for LRE in obese women consuming ≥21 units/week was 2.86 ( 95 % CI ; 0.67–12.42 ) , 1.58 ( 95 % CI ; 0.96–2.61 ) for obese women drinking < 1–15 units/week and 1.93 ( 95 % CI ; 0.66–5.62 ) in those with normal BMI consuming ≥21 units/week after adjustment for potential confounders . We found no significant interaction between BMI and alcohol . Conclusion High BMI and alcohol consumption and abstinence are risk factors for CLD in post-menopausal women . However , BMI and alcohol do not demonstrate significant interaction in this group . Trial registration UKCTOCS is registered as an International St and ard R and omised Controlled Trial , number IS RCT N22488978 . Registered 06/04/2000 BACKGROUND The long-term effectiveness of multicomponent worksite health promotion programs targeting cardiovascular disease risk factors remains unclear in Japan . This study was conducted to evaluate the effectiveness of such a health promotion program consisting of a main program provided over 4 days and a follow-up program provided over 1 year . METHODS The subjects of this r and omized controlled trial were male employees working for a building maintenance company in Japan . The intervention group ( n = 152 ) and the control group ( n = 150 ) consisted of employees having abnormal findings in at least one of the following items at baseline health examination : body mass index ( BMI ) , systolic ( SBP )  or  diastolic blood pressure , total cholesterol , HDL cholesterol , triglycerides , and fasting blood glucose . Evaluation was conducted at 18 months after the main program . RESULTS BMI , SBP , total cholesterol , and triglycerides improved significantly in the intervention group compared with the control group ( P < 0.05 ) . When comparisons were limited to those who showed abnormality at baseline , BMI , total cholesterol , and triglycerides improved significantly in the intervention group ( P < 0.05 ) . CONCLUSIONS The multicomponent health promotion program provided to employees was shown to be effective in improving obesity , high blood pressure , and hyperlipidemia when evaluated 18 months after the main intervention program Objective To evaluate 8-year weight losses achieved with intensive lifestyle intervention ( ILI ) in the Look AHEAD ( Action for Health in Diabetes ) study . Design and Methods Look AHEAD assessed the effects of intentional weight loss on cardiovascular morbidity and mortality in 5,145 overweight/obese adults with type 2 diabetes , r and omly assigned to ILI or usual care ( i.e. , diabetes support and education [ DSE ] ) .  The ILI provided comprehensive behavioral weight loss counseling over 8 years ; DSE participants received periodic group education only . Results All participants had the opportunity to complete 8 years of intervention before Look AHEAD was halted in September 2012 ; ≥88 % of both groups completed the 8-year outcomes assessment . ILI  and DSE participants  lost ( mean±SE ) 4.7±0.2 % and 2.1±0.2 % of initial weight , respectively ( p<0.001 ) at year 8 ; 50.3 % and 35.7 % , respectively , lost ≥5 % ( p<0.001 ) , and 26.9 % and 17.2 % , respectively , lost ≥10 % ( p<0.001 ) . Across the 8 years ILI participants , compared with DSE , reported greater practice of several key weight-control behaviors . These behaviors also distinguished ILI participants who lost ≥10 % and kept it off from those who lost but regained . Conclusions Look AHEAD ’s ILI produced clinical ly meaningful weight loss ( ≥5 % ) at year 8 in 50 % of patients with type 2 diabetes and can be used to manage other obesity-related co-morbid conditions . Trial Registration clinical trials.gov Identifier : BACKGROUND This study assessed the effects of the Health Works for Women ( HWW ) intervention on improving multiple behaviors including nutrition and physical activity among rural female blue-collar employees in North Carolina . METHODS Nine small to mid-size workplaces were r and omly assigned to either intervention or delayed intervention conditions . After a baseline survey , an intervention consisting of two computer-tailored magazines and a natural helpers program was conducted over 18 months . Delayed worksites received one tailored magazine . Approximately 77 and 76 % of baseline respondents completed follow-up surveys at 6 and 18 months , respectively , and 538 women ( 63 % ) completed all three surveys . RESULTS At the 18-month follow-up , the intervention group had increased fruit and vegetable consumption by 0.7 daily servings compared to no change in the delayed group ( P < 0.05 ) . Significant differences in fat intake were observed at 6 months ( P < 0.05 ) but not at 18 months . The intervention group also demonstrated improvements in strengthening and flexibility exercise compared to the delayed group . The rates of smoking cessation and cancer screening did not differ between study groups . CONCLUSIONS The HWW project was a successful model for achieving certain health behavior changes among blue-collar women CONTEXT Behavioral weight loss interventions achieve short-term success , but re-gain is common . OBJECTIVE To compare 2 weight loss maintenance interventions with a self-directed control group . DESIGN , SETTING , AND PARTICIPANTS Two-phase trial in which 1032 overweight or obese adults ( 38 % African American , 63 % women ) with hypertension , dyslipidemia , or both who had lost at least 4 kg during a 6-month weight loss program ( phase 1 ) were r and omized to a weight-loss maintenance intervention ( phase 2 ) . Enrollment at 4 academic centers occurred August 2003-July 2004 and r and omization , February-December 2004 . Data collection was completed in June 2007 . INTERVENTIONS After the phase 1 weight-loss program , participants were r and omized to one of the following groups for 30 months : monthly personal contact , unlimited access to an interactive technology-based intervention , or self-directed control . Main Outcome Changes in weight from r and omization . RESULTS Mean entry weight was 96.7 kg . During the initial 6-month program , mean weight loss was 8.5 kg . After r and omization , weight regain occurred . Participants in the personal-contact group regained less weight ( 4.0 kg ) than those in the self-directed group ( 5.5 kg ; mean difference at 30 months , -1.5 kg ; 95 % confidence interval [ CI ] , -2.4 to -0.6 kg ; P = .001 ) . At 30 months , weight regain did not differ between the interactive technology-based ( 5.2 kg ) and self-directed groups ( 5.5 kg ; mean difference -0.3 kg ; 95 % CI , -1.2 to 0.6 kg ; P = .51 ) ; however , weight regain was lower in the interactive technology-based than in the self-directed group at 18 months ( mean difference , -1.1 kg ; 95 % CI , -1.9 to -0.4 kg ; P = .003 ) and at 24 months ( mean difference , -0.9 kg ; 95 % CI , -1.7 to -0.02 kg ; P = .04 ) . At 30 months , the difference between the personal-contact and interactive technology-based group was -1.2 kg ( 95 % CI -2.1 to -0.3 ; P = .008 ) . Effects did not differ significantly by sex , race , age , and body mass index subgroups . Overall , 71 % of study participants remained below entry weight . CONCLUSIONS The majority of individuals who successfully completed an initial behavioral weight loss program maintained a weight below their initial level . Monthly brief personal contact provided modest benefit in sustaining weight loss , whereas an interactive technology-based intervention provided early but transient benefit . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00054925 OBJECTIVE The results of an 18-month worksite intervention to prevent obesity among metropolitan transit workers are reported . METHODS Four garages in a major metropolitan area were r and omized to intervention or control groups . Data were collected during the fall of 2005 prior to the start of the intervention and during the fall of 2007 , after the intervention ended . Intervention program components at the garage included enhancement of the physical activity facilities , increased availability of and lower prices on healthy vending machine choices , and group behavioral programs . Mixed model estimates from cross-sectional and cohort sample s were pooled with weights inverse to the variance of their respective estimates of the intervention effects . RESULTS Measurement  participation rates were 78 % at baseline and 74 % at follow-up . The intervention effect on garage mean BMI change was not significant ( -0.14 kg/m(2 ) ) . Energy intake decreased significantly , and fruit and vegetable intake increased significantly in intervention garages compared to control garages . Physical activity change was not significant . CONCLUSION Worksite environmental interventions for nutrition and physical activity behavior change may have limited impact on BMI among transit workers who spend most of their workday outside the worksite Objective .  Weight assessment is a critical aid in patient care . It is particularly important in monitoring progression of pregnancies , heart failure status , and when adjusting medications . Although weight is generally determined using a scale , few studies have evaluated the precision of non-household scales . The objective of this study was to assess scale precision across a variety of setting s. Methods . An evaluation of scales from r and omly selected primary care clinics ( n=30 ) , diabetology/endocrinology clinics ( n=7 ) , weight loss facilities ( n=25 ) , and fitness centers ( n=30 ) was performed . Assessment s were completed on a total of 223 scales : 94 from primary care clinics , 32 from diabetology/endocrinology clinics , 39 from weight loss centers , and 58 from fitness centers . Scales were assessed for condition , location in facility , resting surface , commercial design ation , and calibration history . Scale precision was vali date d using 100 lb . ( 45.5 kg ) , 150 lb . ( 68.3 kg ) , 200 lb . ( 90.9 kg ) , and 250 lb . ( 113.6 kg ) certified weights . Results . Overall , scales demonstrated decreased precision with increased weight . At higher weights , more than 15 % of scales were off by more than 6 lbs . ( 2.3 kg ) , approximately 1 Body Mass Index ( BMI ) unit . While facility type was not significant , condition , location in facility , resting surface , commercial design ation , and calibration history were significant . Conclusions . This study demonstrates that many scales used to measure body weight are imprecise and that scales in health care setting s are no more precise than those in other facilities . Clinical decisions based on scales that are imprecise have the potential to cause iatrogenic complications in patient care Health information tailored to meet individuals ' unique needs has been shown to be more effective than generic information in promoting risk-reducing behavior changes . To explore mechanisms underlying tailoring 's effectiveness , this study r and omly assigned 198 overweight adults to receive  weight-loss material s that were ( a ) tailored to the individual , ( b ) in an American Heart Association ( AHA ) brochure , or ( c ) AHA-content formatted to look like tailored material s. Participants who received tailored material s had more positive thoughts about the material s , positive personal connections to the material s , positive self- assessment thoughts , and positive thoughts indicating behavioral intention than those who received either of the untailored material s. The tailoring of health information can significantly improve the chances the information will be thoughtfully considered and can stimulate prebehavioral changes such as self- assessment and intention Objectives This study aims to evaluate the effectiveness of a " blended " workplace health-promotion intervention , alongside identification of key components beneficial for future implementation strategies . Methods Within a cluster r and omized controlled trial , 491 employees at increased risk of cardiovascular disease were allocated to the limited ( N=217 ; 9 clusters ) or extensive ( N=274 ; 8 clusters ) intervention . The extensive intervention consisted of motivational interviewing ( MI ) within the framework of a web-based health risk assessment ( HRA ) , a blended care approach . The limited intervention received solely the web-based HRA .  Occupational health physicians ( N=21 ) within three organizations delivered the intervention . Implementation components investigated included : HRA ( reach and participation ) , newsletters ( percentage read ) , and MI sessions ( number and quality ) . MI quality was determined by scoring audiotaped MI sessions , using the MI treatment integrity code . After 6 and 12 months , effects on participation in health-promotion activities and its associations with components of implementation were determined by mixed-effects models . Results Over 80 % of employees participated in health-promotion activities , with an additional 8 % in the extensive compared to the limited group . In the extensive intervention , those with more or better quality MI sessions were more likely to participate in health-promotion activities . Increased MI quality was associated with sustained participation . Conclusions This study suggests that participation in health-promotion activities can be increased by adding MI to a web-based approach and improving the quality of the MI delivered . Interventions with MI should include optimized delivery and quality of MI sessions BACKGROUND Obesity causes frailty in older adults ; however , weight loss might accelerate age‐related loss of muscle and bone mass and result ant sarcopenia and osteopenia . METHODS In this clinical trial involving 160 obese older adults , we evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss . Participants were r and omly assigned to a weight‐management program plus one of three exercise programs — aerobic training , resistance training , or combined aerobic and resistance training — or to a control group ( no weight‐management or exercise program ) . The primary outcome was the change in Physical Performance Test score from baseline to 6 months ( scores range from 0 to 36 points ; higher scores indicate better performance ) . Secondary outcomes included changes in other frailty measures , body composition , bone mineral density , and physical functions . RESULTS A total of 141 participants completed the study .  The Physical Performance Test score increased more in the combination group than in the aerobic and resistance groups ( 27.9 to 33.4 points [ 21 % increase ] vs. 29.3 to 33.2 points [ 14 % increase ] and 28.8 to 32.7 points [ 14 % increase ] , respectively ; P=0.01 and P=0.02 after Bonferroni correction ) ; the scores increased more in all exercise groups than in the control group ( P<0.001 for between‐group comparisons ) . Peak oxygen consumption ( milliliters per kilogram of body weight per minute ) increased more in the combination and aerobic groups ( 17.2 to 20.3 [ 17 % increase ] and 17.6 to 20.9 [ 18 % increase ] , respectively ) than in the resistance group ( 17.0 to 18.3 [ 8 % increase ] ) ( P<0.001 for both comparisons ) . Strength increased more in the combination and resistance groups ( 272 to 320 kg [ 18 % increase ] and 288 to 337 kg [ 19 % increase ] , respectively ) than in the aerobic group ( 265 to 270 kg [ 4 % increase ] ) ( P<0.001 for both comparisons ) . Body weight decreased by 9 % in all exercise groups but did not change significantly in the control group . Lean mass decreased less in the combination and resistance groups than in the aerobic group ( 56.5 to 54.8 kg [ 3 % decrease ] and 58.1 to 57.1 kg [ 2 % decrease ] , respectively , vs. 55.0 to 52.3 kg [ 5 % decrease ] ) , as did bone mineral density at the total hip ( grams per square centimeter ; 1.010 to 0.996 [ 1 % decrease ] and 1.047 to 1.041 [ 0.5 % decrease ] , respectively , vs. 1.018 to 0.991 [ 3 % decrease ] ) ( P<0.05 for all comparisons ) . Exercise‐related adverse events included musculoskeletal injuries . CONCLUSIONS Of the methods tested , weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults . ( Funded by the National Institutes of Health ; LITOE Clinical Trials.gov number , NCT01065636 . This study evaluated health benefits of long-term participation in an employer-based wellness program  , focusing on selected chronic disease risk factors . A repeated measures longitudinal time-series study was conducted of 8 years of existing prospect ively collected annual data , including clinical measures of weight , blood pressure , cholesterol , and body fat percent . Participants were divided into their risk levels at baseline . Outcomes were compared to level of participation , for which annual points earned was a surrogate . Participants had lower increases in body mass index ( BMI ) than the general population had during the same time period . Greatest improvements in BMI , blood pressure , and cholesterol were seen in those at highest risk levels at baseline and in those whose physical activity increased over time . It was found that long-term participation in this program improved BMI , blood pressure , and cholesterol . Most benefits were found for those in high-risk groups . This program should recruit more employees in high health risk categories and emphasize retention and increased levels of participation
target: Programs that had professionals frequently interact with participants , regardless if the interactions were done daily , weekly , or monthly , led to a change in body composition .
  Additionally , programs that incorporated a motivation theory and provided content relevant to participants ' needs result ed in a change in body composition .
  Conclusion Evidence supports that future worksite wellness programs that are design ed using a motivational theory and content that is created relevant to participants ' needs and that has frequent interactions with participants may result in a change in body composition
background: Background Adult obesity is globally recognized as a public health concern .
  As adults spend most of their weekdays at work , worksite wellness programs may include topics of nutrition education and physical activity to improve an employee 's body composition .
  However , results are inconsistent with the impact they have on employees ' body composition .
  Objective The purpose of this systematic review was to evaluate  worksite wellness nutrition and physical activity programs and their subsequent impact on participants ' body composition .