Reducing obesity in work organizations.
ABSTRACT The problem of overweight and obesity has been called an emerging "public health epidemic" of major proportions. In this issue of The Art of Health Promotion the focus is on the magnitude of the problem for employers and possible interventions that can help reduce obesity in working populations. Thirty-five possible intervention strategies from the "least invasive" to the "most invasive" are identified. Issues of cost, economic effectiveness and relative invasiveness are addressed in the ordering of the possible interventions. Finally a set of metrics are suggested for measuring the trends and effects of the use of multiple interventions targeted on obesity within a particular work force.
Article: Economics of diabetes mellitus[Show abstract] [Hide abstract]
ABSTRACT: The increasing prevalence of diabetes and prediabetes makes the cost of diabetes care a pressing concern. Nurses in all settings play a critical role in helping to reduce the cost of diabetes not only for individual patients but ultimately for the health care system. This article focuses on four main issues related to the economic impact of diabetes for patients and health systems: (1) overall estimates of the direct and indirect costs of diabetes and its associated complications, (2) the impact of cost on diabetes care and health outcomes, (3) the ways in which federal- and state-mandated insurance for persons with diabetes is being used to promote more cost-effective and high-quality diabetes care, and (4) the use of cost-effectiveness analysis to evaluate interventions designed to prevent diabetes or diabetes-related complications.Nursing Clinics of North America 01/2007; 41(4):499-511, v-vi. DOI:10.1016/j.cnur.2006.07.003 · 0.59 Impact Factor
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ABSTRACT: PHLAME's (Promoting Healthy Lifestyles: Alternative Models' Effects) objective was to assess and compare two means to promote healthy lifestyles. Prospective trial among 599 firefighters randomized by station to 1) team-centered curriculum, 2) one-on-one motivational interviewing (MI), and 3) controls. Assessment included dietary behavior, physical activity, weight, and general well-being at baseline and 12 months. Program effects were determined using an analysis of covariance (ANCOVA) based approach, and models for relationships were evaluated with path analysis. Both interventions were acceptable and delivered with high fidelity. The team and MI programs increased fruit and vegetable consumption (P < 0.01 and 0.05, respectively) and general well-being (P < 0.01). Significantly less weight gain occurred in both (P < 0.05). A cross-sectional model was consistent with mediation differing between interventions. Both a team-centered and individual-oriented intervention promoted healthy behaviors. The scripted team curriculum is innovative, exportable, and may enlist influences not accessed with individual formats.Journal of Occupational and Environmental Medicine 03/2007; 49(2):204-13. DOI:10.1097/JOM.0b013e3180329a8d · 1.80 Impact Factor
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ABSTRACT: Obese workers incur greater health care costs than normal weight workers. Possibly viewed by employers as an increased financial risk, they may be at a disadvantage in procuring employment that provides health insurance. This study aims to evaluate the association between body mass index [BMI, weight in kilograms divided by the square of height in meters] of employees and their likelihood of holding jobs that include employment-based health insurance [EBHI]. We used the 2004 Household Components of the nationally representative Medical Expenditure Panel Survey. We utilized logistic regression models with provision of EBHI as the dependent variable in this descriptive analysis. The key independent variable was BMI, with adjustments for the domains of demographics, social-economic status, workplace/job characteristics, and health behavior/status. BMI was classified as normal weight (18.5-24.9), overweight (25.0-29.9), or obese (> or = 30.0). There were 11,833 eligible respondents in the analysis. Among employed adults, obese workers [adjusted probability (AP) = 0.62, (0.60, 0.65)] (P = 0.005) were more likely to be employed in jobs with EBHI than their normal weight counterparts [AP = 0.57, (0.55, 0.60)]. Overweight workers were also more likely to hold jobs with EBHI than normal weight workers, but the difference did not reach statistical significance [AP = 0.61 (0.58, 0.63)] (P = 0.052). There were no interaction effects between BMI and gender or age. In this nationally representative sample, we detected an association between workers' increasing BMI and their likelihood of being employed in positions that include EBHI. These findings suggest that obese workers are more likely to have EBHI than other workers.BMC Health Services Research 02/2008; 8(1):101. DOI:10.1186/1472-6963-8-101 · 1.66 Impact Factor