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BMC Public Health
Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Study protocol

Design of the Balance@Work project: systematic development, evaluation and implementation of an occupational health guideline aimed at the prevention of weight gain among employees

Authors: Lisanne M Verweij, Karin I Proper, Andre NH Weel, Carel TJ Hulshof, Willem van Mechelen

Published in: BMC Public Health | Issue 1/2009

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Abstract

Background

Occupational health professionals may play an important role in preventive health promotion activities for employees. However, due to a lack of knowledge and evidence- and practice based methods and strategies, interventions are hardly being implemented by occupational physicians to date. The aim of the Balance@Work project is to develop, evaluate, and implement an occupational health guideline aimed at the prevention of weight gain among employees.

Methods

Following the guideline development protocol of the Netherlands Society of Occupational Medicine and the Intervention Mapping protocol, the guideline was developed based on literature, interviews with relevant stakeholders, and consensus among an expert group. The guideline consists of an individual and an environmental component. The individual component includes recommendations for occupational physicians on how to promote physical activity and healthy dietary behavior based on principles of motivational interviewing. The environmental component contains an obesogenic environment assessment tool. The guideline is evaluated in a randomised controlled trial among 20 occupational physicians. Occupational physicians in the intervention group apply the guideline to eligible workers during 6 months. Occupational physicians in the control group provide care as usual. Measurements take place at baseline and 6, 12, and 18 months thereafter. Primary outcome measures include waist circumference, daily physical activity and dietary behavior. Secondary outcome measures include sedentary behavior, determinants of behavior change, body weight and body mass index, cardiovascular disease risk profile, and quality of life. Additionally, productivity, absenteeism, and cost-effectiveness are assessed.

Discussion

Improving workers' daily physical activity and dietary behavior may prevent weight gain and subsequently improve workers' health, increase productivity, and reduce absenteeism. After an effect- and process evaluation the guideline will be adjusted and, after authorisation, published. Together with several implementation aids, the published guideline will be disseminated broadly by the Netherlands Society of Occupational Medicine.

Trial Registration

ISRCTN73545254/NTR1190
Appendix
Available only for authorised users
Literature
1.
Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003, 916: i-149. backcover.
2.
Proper KI, Hildebrandt VH: Overweight and obesity among Dutch workers: differences between occupational groups and sectors. Int Arch Occup Environ Health. 2009, Epub ahead of print
3.
Veerman JL, Barendregt JJ, van Beeck EF, Seidell JC, Mackenbach JP: Stemming the obesity epidemic: a tantalizing prospect. Obesity (Silver Spring). 2007, 15: 2365-2370. 10.1038/oby.2007.280.CrossRef
4.
Nooyens AC, Visscher TL, Verschuren WM, Schuit AJ, Boshuizen HC, van Mechelen W, et al: Age, period and cohort effects on body weight and body mass index in adults: The Doetinchem Cohort Study. Public Health Nutr. 2008, 1-9.
5.
Visscher TL, Kromhout D, Seidell JC: Long-term and recent time trends in the prevalence of obesity among Dutch men and women. Int J Obes Relat Metab Disord. 2002, 26: 1218-1224. 10.1038/sj.ijo.0802016.CrossRefPubMed
6.
Colditz GA, Willett WC, Stampfer MJ, Manson JE, Hennekens CH, Arky RA, et al: Weight as a risk factor for clinical diabetes in women. Am J Epidemiol. 1990, 132: 501-513.PubMed
7.
Neovius K, Johansson K, Kark M, Neovius M: Obesity status and sick leave: a systematic review. Obes Rev. 2009, 10: 17-27. 10.1111/j.1467-789X.2008.00521.x.CrossRefPubMed
8.
Pronk NP, Martinson B, Kessler RC, Beck AL, Simon GE, Wang P: The association between work performance and physical activity, cardiorespiratory fitness, and obesity. J Occup Environ Med. 2004, 46: 19-25. 10.1097/01.jom.0000105910.69449.b7.CrossRefPubMed
9.
van Duijvenbode DC, Hoozemans MJ, van Poppel MN, Proper KI: The relationship between overweight and obesity, and sick leave: a systematic review. Int J Obes (Lond). 2009, 33: 807-816. 10.1038/ijo.2009.121.CrossRef
10.
Garfinkel L: Overweight and mortality. Cancer. 1986, 58: 1826-1829. 10.1002/1097-0142(19861015)58:8+<1826::AID-CNCR2820581407>3.0.CO;2-6.CrossRefPubMed
11.
Schmier JK, Jones ML, Halpern MT: Cost of obesity in the workplace. Scand J Work Environ Health. 2006, 32: 5-11.CrossRefPubMed
12.
Peters JC, Wyatt HR, Donahoo WT, Hill JO: From instinct to intellect: the challenge of maintaining healthy weight in the modern world. Obes Rev. 2002, 3: 69-74. 10.1046/j.1467-789X.2002.00059.x.CrossRefPubMed
13.
Douketis JD, Macie C, Thabane L, Williamson DF: Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes (Lond). 2005, 29: 1153-1167. 10.1038/sj.ijo.0802982.CrossRef
14.
Tsai AG, Wadden TA: Systematic review: an evaluation of major commercial weight loss programs in the United States. Ann Intern Med. 2005, 142: 56-66.CrossRefPubMed
15.
Hill JO, Wyatt HR, Reed GW, Peters JC: Obesity and the environment: where do we go from here?. Science. 2003, 299: 853-855. 10.1126/science.1079857.CrossRefPubMed
16.
Hill JO: Can a small-changes approach help address the obesity epidemic? A report of the Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council. Am J Clin Nutr. 2009, 89: 477-484. 10.3945/ajcn.2008.26566.CrossRefPubMed
17.
Proper KI, Bakker I, van Overbeek K, Bergstra B, Verheijden MW, Hopman-Rock M, et al: Naar een gericht BRAVO beleid door bedrijfsartsen. 2005, Ref Type: Report
18.
Sackett DL, Richardson WS, Rosenberg W, Haynes RB: How to practice and teach evidence-based medicine. 1997, New York: Churchill Livingstone
19.
Hulshof CTJ: Introductie NVAB-Richtlijnen. Utrecht, Kwaliteitsbureau NVAB. 2009, Ref Type: Report
20.
Bartholomew LK, Parcel GS, Kok G, Gottlieb NH: Planning health promotion programs. An Intervention Mapping approach. 2006, San Francisco, CA: Jossey-Bass, 2
21.
22.
Westerterp KR: Pattern and intensity of physical activity. Nature. 2001, 410: 539-10.1038/35069142.CrossRefPubMed
23.
Troiano RP, Macera CA, Ballard-Barbash R: Be physically active each day. How can we know?. J Nutr. 2001, 131: 451S-460S.PubMed
24.
Owen N, Bauman A, Brown W: Too much sitting: a novel and important predictor of chronic disease risk?. Br J Sports Med. 2009, 43: 81-83. 10.1136/bjsm.2008.055269.CrossRefPubMed
25.
Suwazono Y, Dochi M, Sakata K, Okubo Y, Oishi M, Tanaka K, et al: A longitudinal study on the effect of shift work on weight gain in male Japanese workers. Obesity (Silver Spring). 2008, 16: 1887-1893. 10.1038/oby.2008.298.CrossRef
26.
Ishizaki M, Nakagawa H, Morikawa Y, Honda R, Yamada Y, Kawakami N: Influence of job strain on changes in body mass index and waist circumference--6-year longitudinal study. Scand J Work Environ Health. 2008, 34: 288-296.CrossRefPubMed
27.
Nakamura S, Nakamura K, Tanaka M: Increased risk of coronary heart disease in Japanese blue-collar workers. Occup Med (Lond). 2000, 50: 11-17.CrossRef
28.
Jans MP, Proper KI, Hildebrandt VH: Sedentary behavior in Dutch workers: differences between occupations and business sectors. Am J Prev Med. 2007, 33: 450-454. 10.1016/j.amepre.2007.07.033.CrossRefPubMed
29.
Schneider S, Becker S: Prevalence of physical activity among the working population and correlation with work-related factors: results from the first German National Health Survey. J Occup Health. 2005, 47: 414-423. 10.1539/joh.47.414.CrossRefPubMed
30.
Zhang Q, Wang Y: Trends in the association between obesity and socioeconomic status in U.S. adults: 1971 to 2000. Obes Res. 2004, 12: 1622-1632. 10.1038/oby.2004.202.CrossRefPubMed
31.
32.
Dubnov-Raz G, Pines A, Berry EM: Diet and lifestyle in managing postmenopausal obesity. Climacteric. 2007, 10 (Suppl 2): 38-41. 10.1080/13697130701586428.CrossRefPubMed
33.
Brown WJ, Bauman AE, Owen N: Stand up, sit down, keep moving: turning circles in physical activity research?. Br J Sports Med. 2009, 43: 86-88. 10.1136/bjsm.2008.055285.CrossRefPubMed
34.
35.
Gibson S: Sugar-sweetened soft drinks and obesity: a systematic review of the evidence from observational studies and interventions. Nutr Res Rev. 2008, 21: 134-147. 10.1017/S0954422408110976.CrossRefPubMed
36.
Shilts MK, Horowitz M, Townsend MS: Goal setting as a strategy for dietary and physical activity behavior change: a review of the literature. Am J Health Promot. 2004, 19: 81-93.CrossRefPubMed
37.
De Vet E, Oenema A, Sheeran P, Brug J: Should implementation intentions interventions be implemented in obesity prevention: the impact of if-then plans on daily physical activity in Dutch adults. Int J Behav Nutr Phys Act. 2009, 6: 11-10.1186/1479-5868-6-11.CrossRefPubMedPubMedCentral
38.
Ajzen I: The theory of planned behavior. Org Behav Hum Decis. 1991, 50: 179-211. 10.1016/0749-5978(91)90020-T.CrossRef
39.
Weinstein ND: The precaution adoption process. Health Psychol. 1988, 7: 355-386. 10.1037/0278-6133.7.4.355.CrossRefPubMed
40.
Kremers SP, de Bruijn GJ, Visscher TL, van Mechelen W, de Vries NK, Brug J: Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act. 2006, 3: 9-10.1186/1479-5868-3-9.CrossRefPubMedPubMedCentral
41.
Zimmermann BM: Attaining self-regulation. Handbook of selfregulation. Edited by: Boekaerts M PPaZM. 2000, San Diego: Academic Press, 13-39. full_text.
42.
Kremers SP, Visscher TL, Brug J, Chin A, Paw M, Schouten EG, Schuit AJ, et al: Netherlands research programme weight gain prevention (NHF-NRG): rationale, objectives and strategies. Eur J Clin Nutr. 2005, 59: 498-507. 10.1038/sj.ejcn.1602100.CrossRefPubMed
43.
Kwak L, Kremers SP, Werkman A, Visscher TL, van Baak MA, Brug J: The NHF-NRG In Balance-project: the application of Intervention Mapping in the development, implementation and evaluation of weight gain prevention at the worksite. Obes Rev. 2007, 8: 347-361. 10.1111/j.1467-789X.2006.00304.x.CrossRefPubMed
44.
Brug J, Conner M, Harre N, Kremers S, McKellar S, Whitelaw S: The Transtheoretical Model and stages of change: a critique: observations by five commentators on the paper by Adams, J. and White, M. (2004) why don't stage-based activity promotion interventions work?. Health Educ Res. 2005, 20: 244-258. 10.1093/her/cyh005.CrossRefPubMed
45.
Sheeran P: Intention-behaviour relations: A conceptual and empirical review. European Review of Social Psychology. Edited by: Hewstone M, Stroebe W. Wiley. 2002, 1-36. 10.1080/14792772143000003.
46.
de Bruijn GJ, Kremers SP, Singh A, Putte van den B, van Mechelen W: Adult active transportation: adding habit strength to the theory of planned behavior. Am J Prev Med. 2009, 36: 189-194. 10.1016/j.amepre.2008.10.019.CrossRefPubMed
47.
Adams J, White M: Why don't stage-based activity promotion interventions work?. Health Educ Res. 2005, 20: 237-243. 10.1093/her/cyg105.CrossRefPubMed
48.
Swinburn B, Gill T, Kumanyika S: Obesity prevention: a proposed framework for translating evidence into action. Obes Rev. 2005, 6: 23-33. 10.1111/j.1467-789X.2005.00184.x.CrossRefPubMed
49.
Hardeman W, Griffin S, Johnston M, Kinmonth AL, Wareham NJ: Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. Int J Obes Relat Metab Disord. 2000, 24: 131-143. 10.1038/sj.ijo.0801100.CrossRefPubMed
50.
Kok G, Schaalma H, Ruiter RA, van Empelen P, Brug J: Intervention mapping: protocol for applying health psychology theory to prevention programmes. J Health Psychol. 2004, 9: 85-98. 10.1177/1359105304038379.CrossRefPubMed
51.
Resnicow K, Jackson A, Wang T, De AK, McCarty F, Dudley WN, et al: A motivational interviewing intervention to increase fruit and vegetable intake through Black churches: results of the Eat for Life trial. Am J Public Health. 2001, 91: 1686-1693. 10.2105/AJPH.91.10.1686.CrossRefPubMedPubMedCentral
52.
Brug J, Spikmans F, Aartsen C, Breedveld B, Bes R, Fereira I: Training dietitians in basic motivational interviewing skills results in changes in their counseling style and in lower saturated fat intakes in their patients. J Nutr Educ Behav. 2007, 39: 8-12. 10.1016/j.jneb.2006.08.010.CrossRefPubMed
53.
Rollnick S, Allison J, Ballasiotes S, Barth T, Butler C, Rose G, et al: Variations on a theme: motivational interviewing and its adaptions. Motivational interviewing: preparing people for change. Edited by: Miller WR, Rollnick S. 2002, New York: Guilford, 251-269.
54.
Rollnick S, Butler CC, McCambridge J, Kinnersley P, Elwyn G, Resnicow K: Consultations about changing behaviour. BMJ. 2005, 331: 961-963. 10.1136/bmj.331.7522.961.CrossRefPubMedPubMedCentral
55.
Wammes B, Kremers S, Breedveld B, Brug J: Correlates of motivation to prevent weight gain: a cross sectional survey. Int J Behav Nutr Phys Act. 2005, 2: 1-10.1186/1479-5868-2-1.CrossRefPubMedPubMedCentral
56.
de Vries H, Kremers SP, Smeets T, Brug J, Eijmael K: The effectiveness of tailored feedback and action plans in an intervention addressing multiple health behaviors. Am J Health Promot. 2008, 22: 417-425.CrossRefPubMed
57.
Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al: Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007, 39: 1423-1434. 10.1249/mss.0b013e3180616b27.CrossRefPubMed
58.
Health Council Netherlands: Guideline Nutrition (available in Dutch). 2006/21. 2006, The Hague, Ref Type: Report
59.
60.
Quality Institute for Health Services Netherlands (Kwaliteitsinstituut voor de Gezondheidszorg CBO). Guideline Diagnostics and Treatment of Obesity in adults and children (available in Dutch). 1995, Ref Type: Report
61.
Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, et al: Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005, 366: 1640-1649. 10.1016/S0140-6736(05)67663-5.CrossRefPubMed
62.
Visscher TL, Snijder , Seidell JC: Epidemiology - definition and classification of obesity. Clinical Obesity. Edited by: Kopelman P, Caterson I, Dietz W. 2010, Wiley-Blackwell, 3-14.
63.
Wendel-Vos GC, Schuit AJ, Saris WH, Kromhout D: Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003, 56: 1163-1169. 10.1016/S0895-4356(03)00220-8.CrossRefPubMed
64.
Kemper HC, Ooijendijk WT, Stiggelbout M: Consensus over de Nederlandse Norm voor Gezond Bewegen. Tijdschr Soc Gezondheidsz. 2000, 78: 180-183.
65.
Van Assema P, Brug J, Ronda G, Steenhuis I, Oenema A: A short dutch questionnaire to measure fruit and vegetable intake: relative validity among adults and adolescents. Nutr Health. 2002, 16: 85-106.CrossRefPubMed
66.
Van Assema P, Brug J, Ronda G, Steenhuis I: The relative validity of a short Dutch questionnaire as a means to categorize adults and adolescents to total and saturated fat intake. J Hum Nutr Diet. 2001, 14: 377-390. 10.1046/j.1365-277X.2001.00310.x.CrossRefPubMed
67.
Clark BK, Sugiyama T, Healy GN, Salmon J, Dunstan DW, Owen N: Validity and reliability of measures of television viewing time and other non-occupational sedentary behaviour of adults: a review. Obes Rev. 2008, 10: 7-16. 10.1111/j.1467-789X.2008.00508.x.CrossRefPubMed
68.
Quality Institute for Health Services Netherlands (Kwaliteitsinstituut voor de Gezondheidszorg CBO). Cardiovasular Risk Management (available in Dutch). 2006, Ref Type: Report
69.
Conroy RM, Pyorala K, Fitzgerald AP, Sans S, Menotti A, De BackerG, et al: Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003, 24: 987-1003. 10.1016/S0195-668X(03)00114-3.CrossRefPubMed
70.
Hoeymans N, van Lindert H, Westert GP: The health status of the Dutch population as assessed by the EQ-6D. Qual Life Res. 2005, 14: 655-663. 10.1007/s11136-004-1214-z.CrossRefPubMed
71.
Bernaards CM, Proper KI, Hildebrandt VH: Physical activity, cardiorespiratory fitness, and body mass index in relationship to work productivity and sickness absence in computer workers with preexisting neck and upper limb symptoms. J Occup Environ Med. 2007, 49: 633-640. 10.1097/JOM.0b013e318058202c.CrossRefPubMed
72.
Kessler RC, Barber C, Beck A, Berglund P, Cleary PD, McKenas D, et al: The World Health Organization Health and Work Performance Questionnaire (HPQ). J Occup Environ Med. 2003, 45: 156-174. 10.1097/01.jom.0000052967.43131.51.CrossRefPubMed
73.
Kessler RC, Ames M, Hymel PA, Loeppke R, McKenas DK, Richling DE, et al: Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. J Occup Environ Med. 2004, 46: S23-S37. 10.1097/01.jom.0000126683.75201.c5.CrossRefPubMed
74.
Murta SG, Sanderson K, Oldenburg B: Process evaluation in occupational stress management programs: a systematic review. Am J Health Promot. 2007, 21: 248-254.CrossRefPubMed
75.
Verbeek JH, de Boer AG, Weide van der WE, Piirainen H, Anema JR, van Amstel RJ, et al: Patient satisfaction with occupational health physicians, development of a questionnaire. Occup Environ Med. 2005, 62: 119-123. 10.1136/oem.2004.016303.CrossRefPubMedPubMedCentral
76.
Lane C, Huws-Thomas M, Hood K, Rollnick S, Edwards K, Robling M: Measuring adaptations of motivational interviewing: the development and validation of the behavior change counseling index (BECCI). Patient Educ Couns. 2005, 56: 166-173. 10.1016/j.pec.2004.01.003.CrossRefPubMed
77.
Rogers EM: Diffusion of Innovations. 1995, New York: Free Press
Metadata
Title
Design of the Balance@Work project: systematic development, evaluation and implementation of an occupational health guideline aimed at the prevention of weight gain among employees
Authors
Lisanne M Verweij
Karin I Proper
Andre NH Weel
Carel TJ Hulshof
Willem van Mechelen
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-461

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