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Published in: BMC Public Health 1/2010

Open Access 01-12-2010 | Research article

Effects of worksite health promotion interventions on employee diets: a systematic review

Authors: Cliona Ni Mhurchu, Louise M Aston, Susan A Jebb

Published in: BMC Public Health | Issue 1/2010

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Abstract

Background

Public health strategies place increasing emphasis on opportunities to promote healthy behaviours within the workplace setting. Previous research has suggested worksite health promotion programmes have positive effects on physical activity and weight loss, yet little is known regarding their effects on dietary behaviour. The aim of this review was to assess the effects of worksite interventions on employee diets.

Methods

Electronic databases (MEDLINE, The Cochrane Library, PsycINFO, EMBASE, LexisNexis) were searched for relevant articles published between 1995 and April 2009. Studies were eligible for inclusion if they were peer-reviewed English language publications describing a worksite-based health promotion intervention with minimum study duration of eight weeks. All study designs were eligible. Studies had to report one or more diet-related outcome (energy, fat, fruit, or vegetable intakes). Methodological quality was assessed using a checklist that included randomisation methods, use of a control group, and study attrition rates.

Results

Sixteen studies were included in the review. Eight programmes focussed on employee education, and the remainder targeted change to the worksite environment, either alone or in combination with education. Study methodological quality was moderate. In general, worksite interventions led to positive changes in fruit, vegetable and total fat intake. However, reliance on self-reported methods of dietary assessment means there is a significant risk of bias. No study measured more robust outcomes such as absenteeism, productivity, or healthcare utilisation.

Conclusions

The findings of this review suggest that worksite health promotion programmes are associated with moderate improvement in dietary intake. The quality of studies to date has been frequently sub-optimal and further, well designed studies are needed in order to reliably determine effectiveness and cost-effectiveness. Future programmes to improve employee dietary habits should move beyond individual education and aim to intervene at multiple levels of the worksite environment.
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Literature
1.
go back to reference Ezzati MLA, Rodgers A, Hoorn Vander S, Murray CJL, the Comparative Risk Assessment Collaborative Group: Selected major risk factors and global and regional burden of disease. The Lancet. 2002, 360: 1347-1360. 10.1016/S0140-6736(02)11403-6.CrossRef Ezzati MLA, Rodgers A, Hoorn Vander S, Murray CJL, the Comparative Risk Assessment Collaborative Group: Selected major risk factors and global and regional burden of disease. The Lancet. 2002, 360: 1347-1360. 10.1016/S0140-6736(02)11403-6.CrossRef
2.
go back to reference Rayner M, Scarborough P: The burden of food related ill health in the UK. Journal of Epidemiology and Community Health. 2005, 59: 1054-1057. 10.1136/jech.2005.036491.CrossRefPubMedPubMedCentral Rayner M, Scarborough P: The burden of food related ill health in the UK. Journal of Epidemiology and Community Health. 2005, 59: 1054-1057. 10.1136/jech.2005.036491.CrossRefPubMedPubMedCentral
4.
go back to reference van Duijvenbode DC, Hoozemans MJM, van Poppel MNM, Proper KI: The relationship between overweight and obesity, and sick leave: a systematic review. International Journal of Obesity. 2009, 33: 807-816. 10.1038/ijo.2009.121.CrossRefPubMed van Duijvenbode DC, Hoozemans MJM, van Poppel MNM, Proper KI: The relationship between overweight and obesity, and sick leave: a systematic review. International Journal of Obesity. 2009, 33: 807-816. 10.1038/ijo.2009.121.CrossRefPubMed
5.
go back to reference ForeSight: Tackling Obesities: Future Choices. 2008, London: Government Office for Science ForeSight: Tackling Obesities: Future Choices. 2008, London: Government Office for Science
6.
go back to reference Black C: Working for a healthier tomorrow. Dame Carol Black's Review of the health of Britain's working age population. 2008, London: TSO Black C: Working for a healthier tomorrow. Dame Carol Black's Review of the health of Britain's working age population. 2008, London: TSO
7.
go back to reference Cabinet Office Strategy Unit: Food Matters: Towards a Strategy for the 21st Century. London. 2008 Cabinet Office Strategy Unit: Food Matters: Towards a Strategy for the 21st Century. London. 2008
8.
go back to reference Department of Health: Healthy weight, healthy lives: a toolkit for developing local strategies. London. 2008 Department of Health: Healthy weight, healthy lives: a toolkit for developing local strategies. London. 2008
9.
go back to reference Lock K, Pomerleau J, Causer L, Altmann DR, McKee M: The global burden of disease attributable to low consumption of fruit and vegetables: implications for the global strategy on diet. Bulletin of the World Health Organization. 2005, 83 (2): 100-108.PubMedPubMedCentral Lock K, Pomerleau J, Causer L, Altmann DR, McKee M: The global burden of disease attributable to low consumption of fruit and vegetables: implications for the global strategy on diet. Bulletin of the World Health Organization. 2005, 83 (2): 100-108.PubMedPubMedCentral
10.
go back to reference Murray CJL, Lauer JA, Hutubessy RCW, Niessen L, Tomijima N, Rodgers A, Lawes CMM, Evans DB: Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: A global and regional analysis on reduction of cardiovascular-disease risk. The Lancet. 2003, 361 (9359): 717-725. 10.1016/S0140-6736(03)12655-4.CrossRef Murray CJL, Lauer JA, Hutubessy RCW, Niessen L, Tomijima N, Rodgers A, Lawes CMM, Evans DB: Effectiveness and costs of interventions to lower systolic blood pressure and cholesterol: A global and regional analysis on reduction of cardiovascular-disease risk. The Lancet. 2003, 361 (9359): 717-725. 10.1016/S0140-6736(03)12655-4.CrossRef
11.
go back to reference Anderson LM, Quinn TA, Glanz K, Ramirez G, Kahwati LC, Johnson DB, Buchanan LR, Archer R, Chattopadhyay S, Kalra GP, et al: The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity. A systematic review. American Journal of Preventive Medicine. 2009, 37 (4): 340-357. 10.1016/j.amepre.2009.07.003.CrossRefPubMed Anderson LM, Quinn TA, Glanz K, Ramirez G, Kahwati LC, Johnson DB, Buchanan LR, Archer R, Chattopadhyay S, Kalra GP, et al: The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity. A systematic review. American Journal of Preventive Medicine. 2009, 37 (4): 340-357. 10.1016/j.amepre.2009.07.003.CrossRefPubMed
12.
go back to reference Benedict MA, Arterburn D: Worksite-based weight loss programs: A systematic review of recent literature. American Journal of Health Promotion. 2008, 22 (6): 408-416.CrossRefPubMed Benedict MA, Arterburn D: Worksite-based weight loss programs: A systematic review of recent literature. American Journal of Health Promotion. 2008, 22 (6): 408-416.CrossRefPubMed
13.
go back to reference Conn VS, Hafdahl AR, Cooper PS, Brown LM, Lusk SL: Meta-analysis of workplace physical activity interventions. American Journal of Preventive Medicine. 2009, 37 (4): 330-339. 10.1016/j.amepre.2009.06.008.CrossRefPubMedPubMedCentral Conn VS, Hafdahl AR, Cooper PS, Brown LM, Lusk SL: Meta-analysis of workplace physical activity interventions. American Journal of Preventive Medicine. 2009, 37 (4): 330-339. 10.1016/j.amepre.2009.06.008.CrossRefPubMedPubMedCentral
14.
go back to reference Dugdill L, Brettle A, Hulme C, McCluskey S, Long AF: Workplace physical activity interventions: A systematic review. International Journal of Workplace Health Management. 2008, 1 (1): 20-40. 10.1108/17538350810865578.CrossRef Dugdill L, Brettle A, Hulme C, McCluskey S, Long AF: Workplace physical activity interventions: A systematic review. International Journal of Workplace Health Management. 2008, 1 (1): 20-40. 10.1108/17538350810865578.CrossRef
15.
go back to reference National Institute for Health and Clinical Excellence: Workplace health promotion: how to encourage employees to be physically active. 2008, London: National Institute for Health and Clinical Excellence National Institute for Health and Clinical Excellence: Workplace health promotion: how to encourage employees to be physically active. 2008, London: National Institute for Health and Clinical Excellence
16.
go back to reference Pratt DS, Jandzio M, Tomlinson D, Kang X, Smith E: The 5-10-25 challenge: An observational study of a web-based wellness intervention for a global workforce. Disease Management. 2006, 9 (5): 284-290. 10.1089/dis.2006.9.284.CrossRefPubMed Pratt DS, Jandzio M, Tomlinson D, Kang X, Smith E: The 5-10-25 challenge: An observational study of a web-based wellness intervention for a global workforce. Disease Management. 2006, 9 (5): 284-290. 10.1089/dis.2006.9.284.CrossRefPubMed
17.
go back to reference Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Merrill RM, Ohmine S: The effects of a worksite chronic disease prevention program. Journal of Occupational and Environmental Medicine. 2005, 47 (6): 558-564. 10.1097/01.jom.0000165743.18570.66.CrossRefPubMed Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Merrill RM, Ohmine S: The effects of a worksite chronic disease prevention program. Journal of Occupational and Environmental Medicine. 2005, 47 (6): 558-564. 10.1097/01.jom.0000165743.18570.66.CrossRefPubMed
18.
go back to reference Block G, Block T, Wakimoto P, Block CH: Demonstration of an e-mailed worksite nutrition intervention program. Preventing Chronic Disease: Public Health Research, Practice, and Policy. 2004, 1 (4): 1-13. Block G, Block T, Wakimoto P, Block CH: Demonstration of an e-mailed worksite nutrition intervention program. Preventing Chronic Disease: Public Health Research, Practice, and Policy. 2004, 1 (4): 1-13.
19.
go back to reference Calderon KS, Smallwood C, Tipton DA: Kennedy space center cardiovascular disease risk reduction program evaluation. Vascular Health and Risk Management. 2008, 4 (2): 421-426.PubMedPubMedCentral Calderon KS, Smallwood C, Tipton DA: Kennedy space center cardiovascular disease risk reduction program evaluation. Vascular Health and Risk Management. 2008, 4 (2): 421-426.PubMedPubMedCentral
20.
go back to reference Campbell MK, Tessaro I, DeVellis B, Benedict S, Kelsey K, Belton L, Sanhueza A: Effects of a tailored health promotion program for female blue-collar workers: Health works for women. Preventive Medicine. 2002, 34: 313-323. 10.1006/pmed.2001.0988.CrossRefPubMed Campbell MK, Tessaro I, DeVellis B, Benedict S, Kelsey K, Belton L, Sanhueza A: Effects of a tailored health promotion program for female blue-collar workers: Health works for women. Preventive Medicine. 2002, 34: 313-323. 10.1006/pmed.2001.0988.CrossRefPubMed
21.
go back to reference Emmons KM, Linnan LA, Shadel WG, Marcus B, Abrams DB: The working healthy project: A worksite health-promotion trial targeting physical activity, diet and smoking. Journal of Occupational and Environmental Medicine. 1999, 41 (7): 545-555. 10.1097/00043764-199907000-00003.CrossRefPubMed Emmons KM, Linnan LA, Shadel WG, Marcus B, Abrams DB: The working healthy project: A worksite health-promotion trial targeting physical activity, diet and smoking. Journal of Occupational and Environmental Medicine. 1999, 41 (7): 545-555. 10.1097/00043764-199907000-00003.CrossRefPubMed
22.
go back to reference Sorensen G, Stoddard A, Dubowitz T, Barbeau EM, Bigby J, Emmons KM, Berkman LF, Peterson KE: The influence of social context on changes in fruit and vegetable consumption: Results of the healthy directions study. American Journal of Public Health. 2007, 97 (7): 1216-1227. 10.2105/AJPH.2006.088120.CrossRefPubMedPubMedCentral Sorensen G, Stoddard A, Dubowitz T, Barbeau EM, Bigby J, Emmons KM, Berkman LF, Peterson KE: The influence of social context on changes in fruit and vegetable consumption: Results of the healthy directions study. American Journal of Public Health. 2007, 97 (7): 1216-1227. 10.2105/AJPH.2006.088120.CrossRefPubMedPubMedCentral
23.
go back to reference Sorensen G, Stoddard A, Hunt MK, Herbert JR, Ockene JK, Avrunin JS, Himmelstein J, Hammond SK: The effects of a health promotion-health protection intervention on behavior change: The wellworks study. American Journal of Public Health. 1998, 88: 1685-1690. 10.2105/AJPH.88.11.1685.CrossRefPubMedPubMedCentral Sorensen G, Stoddard A, Hunt MK, Herbert JR, Ockene JK, Avrunin JS, Himmelstein J, Hammond SK: The effects of a health promotion-health protection intervention on behavior change: The wellworks study. American Journal of Public Health. 1998, 88: 1685-1690. 10.2105/AJPH.88.11.1685.CrossRefPubMedPubMedCentral
24.
go back to reference Sorensen G, Stoddard A, LaMontagne AD, Emmons K, Hunt MK, Youngstrom R, McLellan D, Christiani DC: A comprehensive worksite cancer prevention intervention: Behavior change results from a randomized controlled trial (United States). Journal of Public Health Policy. 2003, 24 (1): 5-25. 10.2307/3343174.CrossRefPubMed Sorensen G, Stoddard A, LaMontagne AD, Emmons K, Hunt MK, Youngstrom R, McLellan D, Christiani DC: A comprehensive worksite cancer prevention intervention: Behavior change results from a randomized controlled trial (United States). Journal of Public Health Policy. 2003, 24 (1): 5-25. 10.2307/3343174.CrossRefPubMed
25.
go back to reference Sorensen G, Stoddard A, Peterson K, Cohen N, Hunt MK, Stein E, Palombo R, Lederman R: Increasing fruit and vegetable consumption through worksites and families in the treatwell 5-a-day study. American Journal of Public Health. 1999, 89: 54-60.CrossRefPubMedPubMedCentral Sorensen G, Stoddard A, Peterson K, Cohen N, Hunt MK, Stein E, Palombo R, Lederman R: Increasing fruit and vegetable consumption through worksites and families in the treatwell 5-a-day study. American Journal of Public Health. 1999, 89: 54-60.CrossRefPubMedPubMedCentral
26.
go back to reference Braekman L, De Bacquer D, Maes L, De Backer G: Effects of a low-intensity worksite-based nutrition intervention. Occupational Medicine. 1999, 49 (8): 549-555. 10.1093/occmed/49.8.549.CrossRef Braekman L, De Bacquer D, Maes L, De Backer G: Effects of a low-intensity worksite-based nutrition intervention. Occupational Medicine. 1999, 49 (8): 549-555. 10.1093/occmed/49.8.549.CrossRef
27.
go back to reference De Bourdeaudhuij I, Stevens V, Vandelanotte C, Brug J: Evaluation of an interactive computer-tailored nutrition intervention in a real-life setting. Annals of Behavioral Medicine. 2007, 33 (1): 39-48. 10.1207/s15324796abm3301_5.CrossRefPubMed De Bourdeaudhuij I, Stevens V, Vandelanotte C, Brug J: Evaluation of an interactive computer-tailored nutrition intervention in a real-life setting. Annals of Behavioral Medicine. 2007, 33 (1): 39-48. 10.1207/s15324796abm3301_5.CrossRefPubMed
28.
go back to reference Holdsworth M, Haslam C, Raymond NT: An assessment of compliance with nutrition criteria and food purchasing trends in Heartbeat Award premises. Journal of Human Nutrition and Dietetics. 1999, 12: 327-335. 10.1046/j.1365-277x.1999.00169.x.CrossRef Holdsworth M, Haslam C, Raymond NT: An assessment of compliance with nutrition criteria and food purchasing trends in Heartbeat Award premises. Journal of Human Nutrition and Dietetics. 1999, 12: 327-335. 10.1046/j.1365-277x.1999.00169.x.CrossRef
29.
go back to reference Holdsworth M, Raymond NT, Haslam C: Does the heartbeat award scheme in England result in change in dietary behaviour in the workplace?. Health Promotion International. 2004, 19 (2): 197-204. 10.1093/heapro/dah207.CrossRefPubMed Holdsworth M, Raymond NT, Haslam C: Does the heartbeat award scheme in England result in change in dietary behaviour in the workplace?. Health Promotion International. 2004, 19 (2): 197-204. 10.1093/heapro/dah207.CrossRefPubMed
30.
go back to reference Lassen A, Thorsen AV, Trolle E, Elsig M, Ovesen L: Successful strategies to increase the consumption of fruits and vegetables: results from the Danish '6 a day' work-site canteen model study. Public Health Nutrition. 2003, 7 (2): 263-270. Lassen A, Thorsen AV, Trolle E, Elsig M, Ovesen L: Successful strategies to increase the consumption of fruits and vegetables: results from the Danish '6 a day' work-site canteen model study. Public Health Nutrition. 2003, 7 (2): 263-270.
31.
go back to reference Steenhuis IHM, Van Assema P, Glanz K: Strengthening environmental and educational nutrition programmes in worksite cafeterias and supermarkets in the Netherlands. Health Promotion International. 2001, 16 (1): 21-33. 10.1093/heapro/16.1.21.CrossRefPubMed Steenhuis IHM, Van Assema P, Glanz K: Strengthening environmental and educational nutrition programmes in worksite cafeterias and supermarkets in the Netherlands. Health Promotion International. 2001, 16 (1): 21-33. 10.1093/heapro/16.1.21.CrossRefPubMed
32.
go back to reference Garafolo K: Worksite wellness - rewarding healthy behaviors. AAOHN Journal. 1994, 42 (5): 236-240. Garafolo K: Worksite wellness - rewarding healthy behaviors. AAOHN Journal. 1994, 42 (5): 236-240.
33.
go back to reference Steenhuis I, Van Assema P, Van Breukelen G, Glanz K, Kok G, De Vries H: The impact of educational and environmental interventions in Dutch worksite cafeterias. Health Promotion International. 2004, 19 (3): 335-343. 10.1093/heapro/dah307.CrossRefPubMed Steenhuis I, Van Assema P, Van Breukelen G, Glanz K, Kok G, De Vries H: The impact of educational and environmental interventions in Dutch worksite cafeterias. Health Promotion International. 2004, 19 (3): 335-343. 10.1093/heapro/dah307.CrossRefPubMed
34.
go back to reference Engbers LH, van Poppel MNM, Chin A, Paw MJM, van Mechelen W: Worksite health promotion programs with environmental changes. A systematic review. American Journal of Preventive Medicine. 2005, 29 (1): 61-70. 10.1016/j.amepre.2005.03.001.CrossRefPubMed Engbers LH, van Poppel MNM, Chin A, Paw MJM, van Mechelen W: Worksite health promotion programs with environmental changes. A systematic review. American Journal of Preventive Medicine. 2005, 29 (1): 61-70. 10.1016/j.amepre.2005.03.001.CrossRefPubMed
35.
go back to reference Janer G, Kogevinas M: Health promotion trials at worksites and risk factors for cancer. Scandinavian Journal of Work Environment and Health. 2002, 28 (3): 141-157.CrossRef Janer G, Kogevinas M: Health promotion trials at worksites and risk factors for cancer. Scandinavian Journal of Work Environment and Health. 2002, 28 (3): 141-157.CrossRef
36.
go back to reference Rayner M, Scarborough P: The burden of food related ill health in the UK. Journal of Epidemiology & Community Health. 2005, 59: 1054-1057. 10.1136/jech.2005.036491.CrossRef Rayner M, Scarborough P: The burden of food related ill health in the UK. Journal of Epidemiology & Community Health. 2005, 59: 1054-1057. 10.1136/jech.2005.036491.CrossRef
37.
go back to reference ACE-Obesity Working Group: Assessing cost-effectiveness of obesity interventions in children and adolescents. 2006, Melbourne, Victoria: Victorian Government Department of Human Services ACE-Obesity Working Group: Assessing cost-effectiveness of obesity interventions in children and adolescents. 2006, Melbourne, Victoria: Victorian Government Department of Human Services
38.
go back to reference Swinburn B, Egger G, Raza F: Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Preventive Medicine. 1999, 29: 563-570. 10.1006/pmed.1999.0585.CrossRefPubMed Swinburn B, Egger G, Raza F: Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Preventive Medicine. 1999, 29: 563-570. 10.1006/pmed.1999.0585.CrossRefPubMed
39.
go back to reference Marteau TM, Ashcroft RE, Oliver A: Using financial incentives to achieve healthy behaviour. British Medical Journal. 2009, 338: b1415-10.1136/bmj.b1415.CrossRefPubMed Marteau TM, Ashcroft RE, Oliver A: Using financial incentives to achieve healthy behaviour. British Medical Journal. 2009, 338: b1415-10.1136/bmj.b1415.CrossRefPubMed
40.
go back to reference Wall J, Ni Mhurchu C, Blakely T, Rodgers A, Wilton J: Effectiveness of monetary incentives in modifying dietary behavior: A review of randomized, controlled trials. Nutrition Reviews. 2006, 64 (12): 518-531. 10.1111/j.1753-4887.2006.tb00185.x.CrossRefPubMed Wall J, Ni Mhurchu C, Blakely T, Rodgers A, Wilton J: Effectiveness of monetary incentives in modifying dietary behavior: A review of randomized, controlled trials. Nutrition Reviews. 2006, 64 (12): 518-531. 10.1111/j.1753-4887.2006.tb00185.x.CrossRefPubMed
41.
go back to reference Jeffery RW, French SA: Preventing weight gain in adults: the pound of prevention study. American Journal of Public Health. 1999, 89 (5): 747-751. 10.2105/AJPH.89.5.747.CrossRefPubMedPubMedCentral Jeffery RW, French SA: Preventing weight gain in adults: the pound of prevention study. American Journal of Public Health. 1999, 89 (5): 747-751. 10.2105/AJPH.89.5.747.CrossRefPubMedPubMedCentral
42.
go back to reference Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G: Financial incentive-based approaches for weight loss. Journal of the American Medical Association. 2008, 300 (22): 2631-2637. 10.1001/jama.2008.804.CrossRefPubMedPubMedCentral Volpp KG, John LK, Troxel AB, Norton L, Fassbender J, Loewenstein G: Financial incentive-based approaches for weight loss. Journal of the American Medical Association. 2008, 300 (22): 2631-2637. 10.1001/jama.2008.804.CrossRefPubMedPubMedCentral
43.
go back to reference French SA, Jeffery RW, Story M, Breitlow KK, Baxter JS, Hannan P, Snyder MP: Pricing and promotion effects on low-fat vending snack purchases: the CHIPS study. American Journal of Public Health. 2001, 91 (1): 112-117.CrossRefPubMedPubMedCentral French SA, Jeffery RW, Story M, Breitlow KK, Baxter JS, Hannan P, Snyder MP: Pricing and promotion effects on low-fat vending snack purchases: the CHIPS study. American Journal of Public Health. 2001, 91 (1): 112-117.CrossRefPubMedPubMedCentral
44.
go back to reference Anderson JV, Bybee DI, Brown RM, McLean DF, Garcia EM, Breer ML, Schillo BA: 5 a day fruit and vegetable intervention improves consumption in a low income population. Journal of the American Medical Association. 2001, 101 (2): 195-202. Anderson JV, Bybee DI, Brown RM, McLean DF, Garcia EM, Breer ML, Schillo BA: 5 a day fruit and vegetable intervention improves consumption in a low income population. Journal of the American Medical Association. 2001, 101 (2): 195-202.
45.
go back to reference Lewin S, Glenton C, Oxman AD: Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. British Medical Journal. 2009, 339: b3496-10.1136/bmj.b3496.CrossRefPubMedPubMedCentral Lewin S, Glenton C, Oxman AD: Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. British Medical Journal. 2009, 339: b3496-10.1136/bmj.b3496.CrossRefPubMedPubMedCentral
Metadata
Title
Effects of worksite health promotion interventions on employee diets: a systematic review
Authors
Cliona Ni Mhurchu
Louise M Aston
Susan A Jebb
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2010
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-10-62

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