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      How needs and preferences of employees influence participation in health promotion programs: a six-month follow-up study

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          Abstract

          Background

          Low participation in health promotion programs (HPPs) might hamper their effectiveness. A potential reason for low participation is disagreement between needs and preferences of potential participants and the actual HPPs offered. This study aimed to investigate employees’ need and preferences for HPPs, whether these are matched by what their employers provide, and whether a higher agreement enhanced participation.

          Methods

          Employees of two organizations participated in a six-month follow-up study (n = 738). At baseline, information was collected on employees’ needs and preferences for the topic of the HPP (i.e. physical activity, healthy nutrition, smoking cessation, stress management, general health), whether they favored a HPP via their employer or at their own discretion, and their preferred HPP regarding three components with each two alternatives: mode of delivery (individual vs. group), intensity (single vs. multiple meetings), and content (assignments vs. information). Participation in HPPs was assessed at six-month follow-up. In consultation with occupational health managers (n = 2), information was gathered on the HPPs the employers provided. The level of agreement between preferred and provided HPPs was calculated (range: 0–1) and its influence on participation was studied using logistic regression analyses.

          Results

          Most employees reported needing a HPP addressing physical activity (55%) and most employees preferred HPPs organized via their employer. The mean level of agreement between the preferred and offered HPPs ranged from 0.71 for mode of delivery to 0.84 for intensity, and was 0.47 for all three HPP components within a topic combined. Employees with a higher agreement on mode of delivery (OR: 1.72, 95% CI: 0.87-3.39) and all HPP components combined (OR: 2.36, 95% CI: 0.68-8.17) seemed to be more likely to participate in HPPs, but due to low participation these associations were not statistically significant.

          Conclusion

          HPPs aimed at physical activity were most needed by employees. The majority of employees favor HPPs organized via the employer above those at their own discretion, supporting the provision of HPPs at the workplace. This study provides some indications that a higher agreement between employees’ needs and preferences and HPPs made available by their employers will enhance participation.

          Electronic supplementary material

          The online version of this article (doi:10.1186/1471-2458-14-1277) contains supplementary material, which is available to authorized users.

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          Most cited references36

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          Meta-analysis of workplace physical activity interventions.

          Most adults do not achieve adequate physical activity levels. Despite the potential benefits of worksite health promotion, no previous comprehensive meta-analysis has summarized health and physical activity behavior outcomes from such programs. This comprehensive meta-analysis integrated the extant wide range of worksite physical activity intervention research. Extensive searching located published and unpublished intervention studies reported from 1969 through 2007. Results were coded from primary studies. Random-effects meta-analytic procedures, including moderator analyses, were completed in 2008. Effects on most variables were substantially heterogeneous because diverse studies were included. Standardized mean difference (d) effect sizes were synthesized across approximately 38,231 subjects. Significantly positive effects were observed for physical activity behavior (0.21); fitness (0.57); lipids (0.13); anthropometric measures (0.08); work attendance (0.19); and job stress (0.33). The significant effect size for diabetes risk (0.98) is less robust given small sample sizes. The mean effect size for fitness corresponds to a difference between treatment minus control subjects' means on VO2max of 3.5 mL/kg/min; for lipids, -0.2 on the ratio of total cholesterol to high-density lipoprotein; and for diabetes risk, -12.6 mg/dL on fasting glucose. These findings document that some workplace physical activity interventions can improve both health and important worksite outcomes. Effects were variable for most outcomes, reflecting the diversity of primary studies. Future primary research should compare interventions to confirm causal relationships and further explore heterogeneity.
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            Determinants of participation in worksite health promotion programmes: a systematic review

            Background The workplace has been identified as a promising setting for health promotion, and many worksite health promotion programmes have been implemented in the past years. Research has mainly focused on the effectiveness of these interventions. For implementation of interventions at a large scale however, information about (determinants of) participation in these programmes is essential. This systematic review investigates initial participation in worksite health promotion programmes, the underlying determinants of participation, and programme characteristics influencing participation levels. Methods Studies on characteristics of participants and non-participants in worksite health promotion programmes aimed at physical activity and/or nutrition published from 1988 to 2007 were identified through a structured search in PubMed and Web of Science. Studies were included if a primary preventive worksite health promotion programme on PA and/or nutrition was described, and if quantitative information was present on determinants of participation. Results In total, 23 studies were included with 10 studies on educational or counselling programmes, 6 fitness centre interventions, and 7 studies examining determinants of participation in multi-component programmes. Participation levels varied from 10% to 64%, with a median of 33% (95% CI 25–42%). In general, female workers had a higher participation than men (OR = 1.67; 95% CI 1.25–2.27]), but this difference was not observed for interventions consisting of access to fitness centre programmes. For the other demographic, health- and work-related characteristics no consistent effect on participation was found. Pooling of studies showed a higher participation level when an incentive was offered, when the programme consisted of multiple components, or when the programme was aimed at multiple behaviours. Conclusion In this systematic review, participation levels in health promotion interventions at the workplace were typically below 50%. Few studies evaluated the influence of health, lifestyle and work-related factors on participation, which hampers the insight in the underlying determinants of initial participation in worksite health promotion. Nevertheless, the present review does provide some strategies that can be adopted in order to increase participation levels. In addition, the review highlights that further insight is essential to develop intervention programmes with the ability to reach many employees, including those who need it most and to increase the generalizability across all workers.
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              A Systematic Review of Randomized Controlled Trials on the Effectiveness of Computer-Tailored Physical Activity and Dietary Behavior Promotion Programs: an Update

              Background A review update is necessary to document evidence regarding the effectiveness of computer-tailored physical activity and nutrition education. Purpose The purpose of this study was to summarize the latest evidence on the effectiveness of computer-tailored physical activity and nutrition education, and to compare the results to the 2006 review. Methods Databases were searched for randomized controlled trials evaluating computer-tailored physical activity and nutrition education aimed at primary prevention in adults, published from September 2004 through June 2011. Results Compared to the findings in 2006, a larger proportion of studies found positive effects for computer-tailored programs compared to generic or no information, including those for physical activity promotion. Effect sizes were small and generally at short- or medium-term follow-up. Conclusions The results of the 2006 review were confirmed and reinforced. Future interventions should focus on establishing larger effect sizes and sustained effects and include more generic health education control groups and objective measurements of dietary behavior. Electronic supplementary material The online version of this article (doi:10.1007/s12160-012-9384-3) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                a.rongen@erasmusmc.nl
                s.robroek@erasmusmc.nl
                wouter.vanginkel@tno.nl
                dennislindeboom@werkvannu.nl
                martinpet@lifeguard.nl
                a.burdorf@erasmusmc.nl
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                15 December 2014
                2014
                : 14
                : 1
                : 1277
                Affiliations
                [ ]Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands
                [ ]Werkgeversforum Kroon op het Werk, 2132 JJ Hoofddorp, the Netherlands
                [ ]WerkVanNu, 2726 VA Zoetermeer, the Netherlands
                [ ]Lifeguard B.V, 3508 AE Utrecht, the Netherlands
                Article
                7420
                10.1186/1471-2458-14-1277
                4301819
                25512055
                165e38f9-eb76-45bb-b13f-395dcb563ffc
                © Rongen et al.; licensee BioMed Central Ltd. 2014

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 August 2014
                : 11 December 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2014

                Public health
                workplace,health promotion,preferences,health behavior,participation
                Public health
                workplace, health promotion, preferences, health behavior, participation

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