Worksite Health Promotion Programs with Environmental Changes
Open accessAbstract
Background It is now widely believed that health promotion strategies should go beyond education or communication to achieve significant behavioral changes among the target population. Environmental modifications are thought to be an important addition to a worksite health promotion program (WHPP). This review aimed to systematically assess the effectiveness of WHPPs with environmental modifications, on physical activity, dietary intake, and health risk indicators.Methods Online searches were performed for articles published up to January 2004 using the following inclusion criteria: (1) (randomized) controlled trial (RCT/CT); (2) intervention should include environmental modifications; (3) main outcome must include physical activity, dietary intake, and health risk indicators; and (4) healthy working population. Methodologic quality was assessed using a checklist derived from the methodologic guidelines for systematic reviews (Cochrane Back Review Group), and conclusions on the effectiveness were based on a rating system of five levels of evidence.Results Thirteen relevant, mostly multicenter, trials were included. All studies aimed to stimulate healthy dietary intake, and three trials focused on physical activity. Follow-up measurements of most studies took place after an average 1-year period. Methodologic quality of most included trials was rated as poor. However, strong evidence was found for an effect on dietary intake, inconclusive evidence for an effect on physical activity, and no evidence for an effect on health risk indicators.Conclusions It is difficult to draw general conclusions based on the small number of studies included in this review. However, evidence exists that WHPPs that include environmental modifications can influence dietary intake. More controlled studies of high methodologic quality need to be initiated that investigate the effects of environmental interventions on dietary intake and especially on physical activity in an occupational setting.
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In a systematic review of randomized controlled trials evaluating workplace interventions to improve lifestyle and health, 2 trials that provided fat and/or fiber information on foods in worksite vending machines or cafeterias demonstrated small increases in consumption of fiber or fruits and vegetables.
“In a systematic review of randomized controlled trials (RCTs) evaluating workplace interventions to improve lifestyle and health,121 2 trials that provided fat and/or fiber information on foods in worksite vending machines or cafeterias demonstrated small increases in consumption of fiber or fruits and vegetables.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [121]
In another trial, use of labeling (eg, posters, bulletin boards) to encourage use of stairs at a worksite did not significantly increase physical activity compared with controls.
“In another trial, use of labeling (eg, posters, bulletin boards) to encourage use of stairs at a worksite did not significantly increase physical activity compared with controls.121”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [121]
Overall, studies suggested that use of worksite cafeteria or vending machine labels or icons alone had little effect on improving diet, consistent with findings for labeling and consumer information approaches in other settings.
“Overall, these studies suggested that use of worksite cafeteria or vending machine labels or icons alone had little effect on improving diet, consistent with findings for labeling and consumer information approaches in other settings (Table 4).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [121]
Interpretation of worksite dietary interventions may be limited by weaknesses in methodology and reporting, such as self-reported outcome measures, undescribed randomization processes, or nonrandomized interventions.
“Although these worksite interventions appear promising, their interpretation may be limited by weaknesses in methodology and reporting; eg, outcome measures were often self-reported, randomization processes were not described, or interventions were nonrandomized.121,268”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [121]
In a randomized intervention, adding a new worksite fitness center or upgrading existing worksite fitness centers was associated with increased physical activity among employees.
“Consistent with these observational findings, in a randomized intervention, adding a new worksite fitness center or upgrading existing worksite fitness centers was associated with increased physical activity among employees.121”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [121]
Combination of labeling or other prompts together with additional environmental changes, such as types and locations of foods and beverages served, positively affected purchasing behaviors at worksites.
“In contrast, the combination of such labeling or other prompts together with additional environmental changes, such as types and locations of foods and beverages served, positively affected purchasing behaviors at worksites.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [121]
In another controlled trial, adding a worksite walking track did not significantly improve CVD risk factors.
“In contrast, in another controlled trial, adding a worksite walking track did not significantly improve CVD risk factors.121”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [121]
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- Authors
- Engbers, L. H., van Poppel, M. N. M., Chin A Paw, M. J. M., & van Mechelen, W.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2005-07
- Volume
- 29
- Issue
- 1
- Pages
- 61-70
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W2118757885
- Cited by
- 368
- References
- 43
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 9 · 2023: 5 · 2022: 10 · 2021: 9 · 2020: 15 · 2019: 20 · 2018: 19 · 2017: 23 · 2016: 25 · 2015: 33 · 2014: 18 · 2013: 23 · 2012: 35
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- green
- research.vumc.nl
- Licence
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety in Workplaces
- Keywords
- workplace health promotion, environmental modification, physical activity, dietary intake, health risk indicators, occupational health interventions, occupational health, behavior change
- MeSH terms
- Diet, Health Promotion, Humans, Netherlands, Occupational Health Services, Risk Factors, Exercise, Randomized Controlled Trials as Topic, Workplace, Risk Reduction Behavior
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