ArticlePublisher preview available

Is Usage of a Wellness Center Associated with Improved Quality of Life?

American Journal of Health Promotion

May 2013
27(5):316-322

DOI:10.4278/ajhp.120213-QUAL-87

Source
PubMed

Authors:

Philip T Hagen

Mayo Foundation for Medical Education and Research

Show all 9 authorsHide

Purpose There is limited documentation regarding the potential quality of life (QOL) benefits associated with use of a worksite wellness center. Therefore, the aim of this study was to examine the relationship between potential QOL change and use of a worksite wellness center during a 12-month period. Design Analysis of an annual QOL wellness center member survey and wellness center use during a 12-month time period. Setting A worksite wellness center. Participants A total of 1151 employee wellness center members, average age of 39.5 years, 69.7% female, and 43.5% reported being overweight. Intervention Members of the worksite wellness center have access to a range of fitness options, including exercise classes, water aerobics, an indoor track, strength training, and aerobic conditioning equipment. Additionally, nutritional classes are offered, and there is a wellness café. For resiliency, members can participate in wellness coaching or a stress-reduction group program. Method Participants completed a baseline QOL survey and a second QOL survey 1 year later. An electronic entry system tracked use of the wellness center. Results Participants were divided into four wellness center use quartiles: low users (less than once every 2 weeks), below-average users, above-average users, and high users (two to three visits per week). High users reported experiencing improvements in their physical QOL (p < .0001) compared with the low users. Additionally, low users experienced a greater decline in their mental QOL (p = .05) compared with high users. Conclusion In a large sample of employees, use of a wellness center during a 12-month period was associated with benefits for physical QOL. QOL is an important domain of wellness; therefore, in addition to measuring physiologic changes, examining potential QOL changes may be another important outcome measure for wellness centers.

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Quality of Life; Culture Change/Supportive Environments; Worksite Wellness Programs

Is Usage of a Wellness Center Associated With

Improved Quality of Life?

Matthew M. Clark, PhD; Sarah M. Jenkins, MS; Katherine A. Limoges, MBA; Philip T. Hagen, MD;

Kandace A. Lackore, BS; Ann M. Harris, BA; Brooke L. Werneburg, BA; Beth A. Warren, MBA;

Kerry D. Olsen, MD

Abstract

Purpose. There is limited documentation regarding the potential quality of life (QOL) benefits associated

with use of a worksite wellness center. Therefore, the aim of this study was to examine the relationship between

potential QOL change and use of a worksite wellness center during a 12-month period.

Design. Analysis of an annual QOL wellness center member survey and wellness center use during a

12-month time period.

Setting. A worksite wellness center.

Participants. A total of 1151 employee wellness center members, average age of 39.5 years, 69.7%

female, and 43.5% reported being overweight.

Intervention. Members of the worksite wellness center have access to a range of fitness options, including

exercise classes, water aerobics, an indoor track, strength training, and aerobic conditioning equipment.

Additionally, nutritional classes are offered, and there is a wellness caf ´

e. For resiliency, members can

participate in wellness coaching or a stress-reduction group program.

Method. Participants completed a baseline QOL survey and a second QOL survey 1 year later. An

electronic entry system tracked use of the wellness center.

Results. Participants were divided into four wellness center use quartiles: low users (less than once every 2

weeks), below-average users, above-average users, and high users (two to three visits per week). High users

reported experiencing improvements in their physical QOL (p ,.0001) compared with the low users.

Additionally, low users experienced a greater decline in their mental QOL (p ¼.05) compared with high users.

Conclusion. In a large sample of employees, use of a wellness center during a 12-month period was

associated with benefits for physical QOL. QOL is an important domain of wellness; therefore, in addition to

measuring physiologic changes, examining potential QOL changes may be another important outcome

measure for wellness centers. (Am J Health Promot 2013;27[5]:316–322.)

Key Words: Quality of Life, Wellness Center, Usage, Prevention Research. Manuscript

format: research; Research purpose: program evaluation; Study design: nonexperimental

cohort; Outcome measure: cognitive; Setting: workplace; Health focus: social health;

Strategy: skill building/behavior change; Target population age: adults; Target population

circumstances: geographic location

PURPOSE

Many companies across the country

offer worksite wellness programs to

improve the health and wellness of

their employees. The beneﬁts of health

behavior–speciﬁc domains have been

well investigated.

For example, in a

meta-analysis, Verweij and colleagues

found that worksite weight loss inter-

ventions that combine physical activity

and nutrition reduce body weight by

about 1 kg, and that adding an

environmental component (such as

walking maps, team competitions, or

management commitment) improves

the effectiveness of these programs.

The beneﬁts of physical activity inter-

ventions,

stress-reduction programs,

4,5

and behavior change interventions

have all also been well documented

and provide outcome-based evidence

for the effectiveness of worksite well-

ness programs on speciﬁc health be-

haviors.

Quality of life (QOL) is an impor-

tant component of wellness and con-

sists of both physical and mental

domains. QOL is closely associated

with health status, health behaviors,

and wellness.

7–10

QOL can be deﬁned

as a hierarchical, multidimensional

construct that includes both physical

and mental health.

Physical health is

an important domain, but cognitive,

emotional, social, and spiritual func-

tioning are also important domains,

and all contribute to overall QOL.

12–15

The concept of wellness encompasses

QOL because both are more broadly

deﬁned than simply the absence of

disease or illness. To be well, individu-

als should report having a positive

QOL. Unfortunately, QOL is an often

overlooked domain in evaluating the

Matthew M. Clark, PhD, is with the Department of Psychiatry and Psychology, Mayo Clinic,

Rochester, Minnesota. Sarah M. Jenkins, MS, and Kandace A. Lackore, BS, are with the

Division of Biomedical Statistics and Informatics, Department of Health Sciences Research,

Mayo Clinic, Rochester, Minnesota. Katherine A. Limoges, MBA; Brooke L. Werneburg, BA;

and Beth A. Warren, MBA, are with the Dan Abraham Healthy Living Center, Mayo Clinic,

Rochester,Minnesota.PhilipT.Hagen,MD,iswith the Division of Preventive, Occupational,

and Aerospace Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

AnnM.Harris,BA,iswiththeSurveyResearchCenter,DivisionofHealthCarePolicy&

Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota. Kerry D.

Olsen, MD, is with the Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota.

Send reprint requests to Matthew M. Clark, PhD, Department of Psychiatry and Psychology, Mayo

Clinic, Rochester, MN 55905; clark.matthew@mayo.edu.

This manuscript was submitted February 13, 2012; revisions were requested May 18 and June 25, 2012; the manuscript was

accepted for publication July 20, 2012.

0890-1171/13/$5.00

DOI: 10.4278/ajhp.120213-QUAL-87

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Physical Activity and Fitness Level of Healthcare Workers in a Tertiary Teaching Hospital

Article

Full-text available

Nov 2024

Background and Objectives Physical activity (PA) and fitness level are considered key factors in public health promotion, and as such, healthcare workers (HCW) need to be physically well because they are not only responsible for themselves, but of their clients as well. Therefore, we aim to determine the PA and health-related fitness (HRF) level of HCW in a tertiary hospital, disaggregated to age, sex, work assignments, and job tenure. Methods A cross-sectional research design was utilized to assess HCW from the administrative, medical, nursing, and paramedical cohorts. ALPHA-FIT Test Battery was used to assess cardiorespiratory fitness, muscular strength, lower extremity power and strength, upper body muscle endurance, balance, and body composition. Results Our study concurred with the results of previous studies on HCW yielding lower PA levels compared with the general population. We tested 282 participants (administrative: 97; medical: 36; nursing: 55; paramedical: 94), mean age 37.4 years, 64.54% females, 52.13% perceived average health status. Ninety percent of the HCW had PA levels below the World Health Organization’s recommended levels. The ALPHA-FIT mean score per category revealed: one-legged stance, 2.67/3; figure-of-8 run, 2.45/3; shoulder-neck mobility, 4.58/5; modified push-up, 2.05/4; hand-grip strength, 2.5/5; jump and reach, 4/4; dynamic sit-up, 2.62/3; six-minute walk test, 475.38 meters covered. There were no significant differences in PA and HRF levels across cohorts except for modified sit-ups (p<0.001) and figure-of-8 run (p=0.012). The results showed significant inverse correlation between balance and shoulder-neck mobility and age (p<0.001), and modified push ups (p=0.004). Males had significantly higher sit-up scores (p<0.001), one-legged stance scores (p=0.001), and faster figure-of-8 run (p=0.011), while females had better jump and reach scores (p<0.001). Conclusion Physical activity levels of HCW did not meet the World Health Organization’s recommended PA levels. Healthcare professionals who are expected to be aware of the benefits of PA and HRF have shown low to midfit levels of grip strength, upper extremity endurance, core strength, and cardiorespiratory endurance. Information on PA and HRF may aid in policy making on employee wellness that could highly impact health service delivery.

"Workplace Physical Activity Program" (WOPAP) study protocol: a four-arm randomized controlled trial on preventing burnout and promoting vigor

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Mar 2019
BMC PUBLIC HEALTH

Background WOPAP is a theoretically-grounded workplace physical activity intervention that aims to reduce work-related burnout and to improve vigor at work and other work-related outcomes. Using a randomized controlled trial, we investigate whether a 10-week program including two Nordic walking sessions per week is effective in improving employee well-being at work, in comparison with another attractive leisure activity (Theatre condition) or a waiting list control condition. The design of the study makes it possible to test the effect on burnout and vigor of the instructor’s style during physical activity (i.e., traditional vs. need-supportive style). Finally, this study is also interested in several possible psychological (i.e., detachment, relaxation, mastery, control, relatedness, and positive affects experiences) and physiological (i.e., cardiorespiratory fitness) mechanisms through which the practice of physical activity in the intervention could influence burnout and vigor. Methods Employees of the authors’ University (N = 140) will be recruited via email, leaflets, and posters. Participants will be randomized to one of the four arms of the trial: (1) Physical Activity Traditional Style, (2) Physical Activity Need-Supportive Style, (3) Theatre condition, and (4) Waiting List Control. The experimental phase will last 10 weeks, followed by a six-month follow-up. During the ten weeks of the intervention, all groups – except the waiting list control – will carry out two activity sessions per week. Primary outcomes are burnout and vigor, secondary outcomes are work motivation, job satisfaction, work performance and work ability. These variables will be assessed before and after the intervention, and at three and six months after the end of the intervention. Moreover, burnout, vigor, needs satisfaction at work and psychological mediators will be assessed weekly throughout the intervention period. Discussion If effective, this study will provide evidence for the promotion of workplace physical activity interventions including a need-supportive climate to improve employee well-being. Results could be used to design new research protocols, but also to implement more efficient programs in the workplace. Trial registration ISRCTN12725337. Registered 21 March 2018. Registered retrospectively.

Negative mood is associated with sociobehavioral factors contributing to cardiovascular risk in an immigrant population

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Full-text available

Jul 2024
BMC PUBLIC HEALTH

Background After settling in the United States (US), immigrants often accumulate obesity and cardiovascular risk factors. As mood is often associated with health behaviors in the US population, mood may be an important mediating factor in immigrant populations. Methods The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention designed to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered “negative”, while ratings of good, very good, or excellent were considered “positive”. Results Hispanic/Latino (n = 268) and Somali (n = 181) adults enrolled in HIC completed baseline measures and were included in this analysis. Participants endorsing negative mood compared to positive mood had lower healthy eating scores (p = 0.02), lower physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood reported receiving less social support to eat healthy (p = < 0.001) and be physically active (p = 0.01). They also accessed community resources for healthy eating (p = 0.001) and physical activity (p = < 0.01) less frequently than participants endorsing positive mood. Conclusions On self-report, negative mood was associated with less healthy nutrition, lower confidence in eating healthy, sedentary lifestyle, and perceived lack of belonging to the community. Integrating mood management and self-efficacy strategies may enhance the effectiveness of lifestyle interventions to reduce obesity and cardiovascular risk among immigrants who report negative mood. Trial registration ClinicalTrials.gov registration: NCT05136339; April 23, 2022.

Negative Mood is Associated with Sociobehavioral Factors Contributing to Cardiovascular Risk in an Immigrant Population

Preprint

Full-text available

Feb 2024

Background Immigrants to the United States, on average, accumulate cardiovascular risk after resettlement, including obesity. There is a need to co-create interventions to address these disparities, and mood may be an important mediating factor. Methods The Healthy Immigrant Community (HIC) study, set in southeast Minnesota, enrolled 475 adult participants in a weight loss intervention to reduce cardiovascular risk. Baseline questionnaires assessed mood, nutrition, physical activity, self-efficacy for healthy eating and physical activity, social support, and cohesion. A single-item mood rating of poor or fair was considered “negative”, while ratings of good, very good, or excellent were considered “positive”. Results A total of 449 HIC participants (268 Hispanic/Latino and 181 Somali) with complete baseline measures and were included in this analysis. Participants endorsing negative mood compared to those endorsing positive mood had lower scores for healthy eating (p = 0.02) and physical activity levels (p = 0.03), lower confidence in eating a healthy diet (p = 0.001), and felt less of a sense of belonging to their community (p = 0.01). Those endorsing negative mood also reported receiving less social support from their family and friends to eat healthy (p = < 0.001) and be physically active (p = 0.01), and less often accessed community resources for healthy eating (p = 0.001) and physical activity (p = < 0.01) compared to participants reporting positive mood. Conclusions Negative mood was associated with less healthy nutrition, lower confidence in eating healthy, sedentary lifestyle, and perceived lack of belonging to the community. Integrating mood management and self-efficacy strategies may enhance the effectiveness of lifestyle interventions among immigrants who report negative mood. ClinicalTrials.gov registration: NCT05136339; April 23, 2022

Association between weight loss, change in physical activity, and change in quality of life following a corporately sponsored, online weight loss program

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Full-text available

Mar 2022
BMC PUBLIC HEALTH

Background The physiological benefits associated with corporately sponsored weight loss programs are increasingly well documented. However, less is known about how these programs affect employees’ quality of life (QoL). The purpose of the present analysis was to examine the association between weight loss, change in physical activity, and change in QoL following a corporately sponsored, online weight loss program. Methods We examined the relationship between weight loss, self-reported change in physical activity, and change in several QoL indices in 26,658 participants (79% women) after the initial 10 weeks of the online weight loss program. The trend in changes in each QoL index with increasing weight loss and change in physical activity was examined using logistic regression analysis. Results We observed greater improvements in each QoL index with increasing weight loss ( p -for-trend, < 0.001) as well as with progressive increases in physical activity ( p -for-trend, < 0.001). The combination of increasing weight loss and increases in physical activity were associated with the greatest improvements in each QoL index (additive effect). The percentage of employees reporting improvements in QoL (“improved” or “very much improved”) was 64% for energy, 63% for mood, 33% for sleep, 65% for self-confidence, 68% for indigestion, and 39% for musculoskeletal pain. Conclusions Among people, who engage with a commercial weight loss program, greater weight loss during the program was associated with greater improvements in QoL, and increases in physical activity further enhanced the QoL-related benefits.

The biopsychosocial barriers and enablers to being physically active following childbirth: a systematic literature review

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Phys Ther Rev

Background: Physical activity brings significant health benefits. Childbirth presents many physical, emotional and practical challenges to women and is known to disrupt engagement in regular physical activity. However, the specific barriers and enablers to physical activity in the postpartum period have not yet been systematically identified. Adequate understanding of these issues is crucial before effective interventions can be developed. Objectives: The primary objective was to identify the biopsychosocial barriers and enablers to physical activity following childbirth. Methods: A systematic literature review of qualitative research was conducted. Relevant literature was sourced using five online databases (CINAHL, Maternity and Infant Care, MEDLINE, PsycINFO and PubMed) and primary snowballing. Studies which met the pre-determined inclusion criteria were critically appraised independently by research team members and then collectively discussed to reach consensus. Results: A total of 391 potential records were identified. Following the application of eligibility criteria and removal of duplicates, six qualitative studies remained, all of which identified barriers and enablers to postpartum physical activity. Data demonstrated that lack of time and issues surrounding childcare were the most common barriers to physical activity, whilst a common enabler was social support. Reported benefits of physical activity in the postpartum period included improved mental well-being and weight loss. Conclusions: A number of specific barriers, enablers and benefits were identified. Future research should aim to develop and evaluate postpartum physical activity interventions. Outcomes should be collected prospectively at multiple time points and more diverse participant samples should be recruited.

Association Between Work‐Related Stress and Coronary Heart Disease: A Review of Prospective Studies Through the Job Strain, Effort‐Reward Balance, and Organizational Justice Models

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Participants’ Perspectives of a Worksite Wellness Program Using an Outcome-Based Contingency Approach

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The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women

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Full-text available

Apr 2018
ARCH WOMEN MENT HLTH

Few published studies have examined the relationship between exercise during pregnancy, quality of life (QOL), and postpartum depressive symptoms in healthy pregnant women. A prospective cohort of 578 healthy pregnant women were followed during their pregnancy through 6 months postpartum. Levels of self-reported exercise and QOL before, during, and following pregnancy were assessed using standardized questionnaires during each trimester of pregnancy and 6 months postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 28 weeks gestation and 6 weeks postpartum. Participants were classified as having "sufficient exercise" if they achieved at least 150 min of exercise per week. Sufficient exercisers reported significantly higher ratings on most domains of QOL during each trimester of pregnancy and in the postpartum follow-up, compared with insufficient exercisers. There were no significant between-group differences in depressive symptoms. In examining the impact of exercise during each trimester, active women who became sedentary during their third trimester demonstrated a decline in their QOL. Achieving recommended levels of exercise during pregnancy was associated with higher QOL during pregnancy and the postpartum in healthy pregnant women. Decreasing the amount of exercise during pregnancy was associated with reduced QOL. These results suggest that it may be important for health care professionals to counsel healthy pregnant women about both the benefits of being physically active during pregnancy, and to provide guidance on how to remain physically active during a healthy pregnancy.

Healthcare Systems and Healthcare Funding Supporting Healthy Aging

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Jan 2019

Paul Mulhausen

Historically healthcare systems have been built around and have emphasized the treatment of diseases. Health Systems in the United States (USA) have traditionally promoted service lines that are focused on disease, including cancer care, cardiovascula disease, and joint replacement programs. Only recently have healthcare systems begun to make efforts to promote good health and prevent disease and disability. In the USA, these changes are being promoted by the payers (especially Medicare) in the hope that more attention to preventing disease and disability will lead to lower healthcare costs. Efforts to provide and pay for health promotion and healthy aging should be based on the best available evidence and should include not only biomedical interventions but also psychosocial interventions, which in many circumstances are stronger determinants of good health. Effective health promotion requires ongoing engagement with patients and caregivers in a fashion that can’t be expected to succeed in a care model where prevention is an afterthought or infrequently addressed in care delivery. Healthcare systems and healthcare funders need to invest in services and solutions that address both the social and behavioral determinants of health while promoting healthy aging for both those who are younger now and will be older in the future and those who are already older but will be older still in the future.

Systematic review of the impact of worksite wellness programs

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To evaluate the process of a prevention program among construction workers. The program consisted of training sessions of a physical therapist and an empowerment trainer, and a Rest-Break Tool. Data on seven process items were collected by means of questionnaires and interviews. Recruiting construction companies to participate was difficult. The therapists and trainer largely provided the training sessions as intended, but the Rest-Break Tool was poorly implemented. Construction workers (n = 171) showed high reach (84%) and moderate attendance rates (three of four sessions). Sixty-four percent of the construction workers recommended the overall program to colleagues. Company size, economic recession, engagement of the management, and intervention year influenced dose delivered and satisfaction. The study showed a successful reach, dose and fidelity, and moderate satisfaction. Furthermore, contextual factors played an important role during the implementation.

Nurse-led health promotion interventions improve quality of life in frail older home care clients: Lessons learned from three randomized trials in Ontario, Canada

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J EVAL CLIN PRACT

Objective This paper explores the lessons learned from a series of three randomized controlled trials that included 498 community-living frail older adults (≥65 years) using home care services in Southern Ontario, Canada. Each study was designed to evaluate the effectiveness of different multi-component nurse-led health promotion and disease prevention (HPDP) interventions. Methods The nurse-led HPDP interventions were 6- or 12-month multi-component and evidence-based strategies targeting known risk factors for functional decline and frailty. Across the three studies, a common approach was used to measure the change in health-related quality of life (HRQOL) (SF-36) and the costs of use of health services (Health and Social Services Utilization Inventory) from baseline to the end of the intervention. Results The main lesson learned from the three studies is that nurse-led HPDP interventions for frail older home care clients provide greater improvements in HRQOL compared with usual home care. Such approaches are highly acceptable to this population and can be implemented using existing home care resources. Nurse-led HPDP interventions should include multiple home visits, multidimensional screening and assessment, multi-component evidence-based HPDP strategies, intensive case management, inter-professional collaboration, providers with geriatric training and experience, referral to and coordination of community services, and theory use. Conclusion The results of the three trials underscore the need to reinvest in nurse-led HPDP interventions in home care to optimize HRQOL and promote ageing in place in the target population of frail older adults. More studies are needed to evaluate the effectiveness of additional nurse-led HPDP interventions in other contexts and settings.

Stress Level, Health Behaviors, and Quality of Life in Employees Joining a Wellness Center

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Purpose Examine the relationship between stress level and quality of life at a worksite wellness center. Design A survey completed when joining the wellness center. Setting Employee wellness center. Subjects Survey that inquired about stress, health behaviors, and quality of life of more than 13,000 employees joining a wellness center. Measures A series of questions about current health status and health behaviors. Analysis Two-sample t-tests assuming unequal variances. Results A total of 2147 of these employees reported having high stress levels. Employees with high stress levels had statistically significant lower quality of life, more fatigue, and poorer health compared with employees with low stress levels. In terms of their ability and motivation to participate in wellness programs, the high-stress employees were also less active and had less healthy nutritional habits, less support, and less confidence in their ability to be active. They also reported having more health problems, including high blood pressure, high blood sugar, high cholesterol, and overweight. Conclusions It appears that employees with high stress levels—those who might most benefit from participation in wellness programs—may experience the greatest difficulty participating actively in wellness programs because of their lack of support, low confidence, and numerous health problems. Perhaps offering tailored stress reduction programs for these employees would be beneficial.

Exercise DVD Improves Exercise Expectations in Cardiovascular Outpatients

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Kristin S Vickers

Objective: To assess impact of exercise education intervention on exercise frequency and attitudes. Methods: Cardiovascular outpatients (N=509) were randomized to receive an education DVD or standard care. Outcome measures (baseline and 6 weeks) assessed exercise frequency and cognitive variables. Results: There was no difference between groups on exercise frequency change from baseline, but DVD group reported greater exercise outcome expectations than control group (P=0.01). There was a greater increase in relapse-prevention behavior in the DVD group, compared to control, for those with low relapse-prevention behavior at baseline (P=0.02). Conclusion: A minimal intervention improves outcome expectations for exercise.

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Kaiser's Measure of Sampling Adequacy (MSA) for factor-analytic correlation matrices is studied for several levels each of p, the number of variables, q, the number of factors, and rfl, the root-mean-square off-diagonal correlation. The major influence for MSA is p, in agreement with theory; the joint main effect influences of p, q, and rfl to the total SSs remains greater than 84% under various choices of the levels of p, q, and rfl.

Effectiveness of a Multidisciplinary Worksite Stress Reduction Programme for Women

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It has been well established that a high level of stress is associated with medical problems, mental health difficulties and absenteeism at the workplace. The aim of this single-arm study design was to examine the potential effectiveness of a 12-session multidisciplinary stress reduction programme on reducing perceived stress and improving health behaviours and quality of life. One hundred and four women participated in a programme that incorporated group support, skill building and cognitive behavioural and relaxation techniques. A series of Bonferroni corrected t-tests found that the participants reported having significantly (p < 0.001) lower levels of perceived stress, improved health behaviours (sleep, nutrition, physical activity) improved overall health and improved quality of life at the end of the 12 week programme and at 1-month follow-up. Although the effect sizes for improvement were all large, there was no control group, so regression to the mean or selection bias may have impacted the results. Therefore, these results provide initial support for the implementation of gender-based worksite stress reduction programmes and provide guidance in designing an effective worksite stress reduction programme. Further research using randomized controlled trials is warranted. Copyright © 2011 John Wiley & Sons, Ltd.

Workplace Weight Loss Program Impact on Quality of Life

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Dec 2011
J OCCUP ENVIRON MED

To determine the effectiveness of a 12-week workplace intervention program (WIP) focused on weight loss and reduction of cardiovascular risk factors on health-related quality of life (HRQOL) and the effect of delivery method on outcomes. A retrospective analysis of data collected in a 12-week trial comparing in-person (IP) and Internet-based (IB) intervention to identify the impact on HRQOL by utilizing the Centers for Disease Control and Prevention HRQOL-14 questionnaire. Repeated-measure analysis of variance indicated no significant intervention effect for HRQOL by group assignment. Within subjects, significant main effect was noted for improvement in Summative Index of unhealthy days, sleeplessness, and vitality days at weeks 12 and 26. At week 26, significant main effect was found for improved mentally unhealthy and depression days. Improvement in HRQOL following a 12-week university-based WIP can occur independent of method of delivery (IP vs IB).

The Chronic Care Model and Relationships to Patient Health Status and Health-Related Quality of Life

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Nov 2008

The chronic care model (CCM) is a system-level framework used to guide quality improvement efforts in health care. However, little is known about its relationship to patient-level health measures. This study describes the implementation of the CCM as adapted for prevention and health behavior counseling in primary care practices, and examines relationships between the CCM and patient health measures, including general health status and health-related quality of life (HRQOL). Baseline data from Round 2 of the Prescription for Health initiative (2005-2007) were used to assess CCM implementation in 57 practices located nationwide. Relationships between the CCM and three separate measures of health among 4735 patients were analyzed in 2007. A hierarchical generalized linear modeling approach to ordinal regression was used to estimate categories of general health status, unhealthy days, and activity-limiting days, adjusting for patient covariates and clustering effects. Outcome variances were significantly accounted for by differences in practice characteristics (p<0.001). Practices that used individual or group planned visits were more likely to see patients in lower health categories across all measures (OR=0.74-0.81, p<0.05). Practices that used patient registries, health promotion champions, evidence-based guidelines, publicly reported performance measures, and support for behavior change were associated with higher patient health levels (OR=1.28-1.98, p<0.05). A practice's implementation of the CCM was significantly related to patient health status and HRQOL. Adapting the CCM for prevention may serve to reorient care delivery toward more proactive behavior change and improvements in patient health outcomes.

Exercise DVD Improves Exercise Expectations in Cardiovascular Outpatients

Article

May 2011
AM J HEALTH BEHAV

To assess impact of exercise education intervention on exercise frequency and attitudes. Cardiovascular outpatients (N=509) were randomized to receive an education DVD or standard care. Outcome measures (baseline and 6 weeks) assessed exercise frequency and cognitive variables. There was no difference between groups on exercise frequency change from baseline, but DVD group reported greater exercise outcome expectations than control group (P=0.01). There was a greater increase in relapse-prevention behavior in the DVD group, compared to control, for those with low relapse-prevention behavior at baseline (P=0.02). A minimal intervention improves outcome expectations for exercise.