guidelines for the prevention of obesity at the … · program on food aid and promotion of ......

Guidelines for the Prevention of Obesity at the Workplace

Pania Karnaki ENWHP Meeting 12th June 2012

The GPOW Project

  The GPOW project   The conceptual framework   Main outcomes

–  Best practice recommendations –  Guidelines – specific sector examples

Contents of Presentation

Project Details

DG SANCO, Public Health Program 2003-2008 Duration: 24 months - 01.05.07 to 30.04.09 -

GPOW Partnership

  Lead partner: Greece: Institute of Preventive Medicine Occupational and Environmental Health - PROLEPSIS

GPOW Partnership

  Cyprus: Cyprus International Institute for the Environment and Public Health in association with Harvard University - CII

  Czech Republic: Charles University of Prague - UCPRA   Finland: Finnish Institute of Occupational Health – FIOH   Germany: - Technical University of Dresden – TUD   Hungary: Medical and Educational Development Ltd –

INNOVAMED

GPOW Partnership

  Italy: Aso San Giovanni Battista Di Torino – CPO   Lithuania: State Environmental Center (SEHC)   Poland: Institute of Occupational Medicine – Nofer   Romania: Fundatia Romtens

Prolepsis – Institute of Preventive Medicine Environmental and Occupational Health

  non-profit organization, since 1991

 active in the field of medical research, health promotion, environmental and occupational health.

 human resources comprises a multi-disciplinary team of physicians, public health & health promotion specialists, statisticians, economists, sociologists and psychologists.

www.prolepsis.gr

Recent experience

  Promotion of vaccination among migrant populations and Health Care Workers in Europe

  Educational seminars for physicians & health professionals on medical writing, epidemiology, health reporting, etc.

  Program on Food Aid and promotion of Healthy Nutrition for students of underprivileged schools in Athens and Thessaloniki

  Development of national nutritional guidelines

Recent experience

  Development of health promotion tools for various groups, e.g. farmers on health and safety, women for promotion of health at the workplace, the elderly on various health issues, hard to reach populations (cervical cancer), alcohol in the workplace

  Workplace Mental Health, development of tools for the prevention of occupational stress among employees of the petroleum industry in Greece

Current EU projects Co-ordinator:

  DG SANCO:   euFAQT   PROMOVAX   HPROIMMUNE

  DG Education, Audiovisual & Culture Agency:   HeaRT

Associate partner: AURORA, CROSSING BRIDGES, SUNIA GEEL, EWA, IROHLA (FP7), DRIVERS (FP7)

GPOW - Main Objective

To provide up-to-date information and useful tools for the prevention of obesity in the workplace

Specific Objectives -  Identify and assess policies, good practices,

and interventions targeting obesity at the workplace

-  Develop a set of guidelines for adopting counter obesity strategies taking into consideration different sectors, locations, sizes

 Lifestyle behaviors are only one of the causes of obesity  A person’s lifestyle practices are influenced and/or altered by his/her workplace and work conditions

GPOW Conceptual Framework

 Many factors within a workplace influence

weight gain

•  Workplace Environment •  Work Organization •  Workplace Conditions •  Policy


 Workplaces are not viewed only as a

convenient setting TO DO counter obesity health promotion activities

 Work and workplaces are considered

determinants of weight outcomes


Workplace Obesogenic factors

Obese employees

Not addressing certain OHS

issues

Lifestyle behaviors

Organizational/Environmental factors

GPOW Evaluation of Policies and Best

Practices

Best Practice

Evaluation - through a purpose made evaluation tool - interventions targeting obesity at the workplace

The evaluation tool

Based on:

extensive review of European and international health promotion assessment tools q u a l i t y i n d i c a t o r s a n d e l e m e n t s o f comprehensive workplace health promotion

The evaluation tool

Design –  Needs assessment –  Measurable goals and objectives –  Intervention aim(s) –  Ecologic/Holistic Approach –  Participatory – empowerment strategies –  Theoretical framework underpinning the

intervention –  Study design applied

The evaluation tool

Intervention

–  Duration of the intervention –  Upper level management commitment –  Participatory approach –  Methods addessing various determinants

The evaluation tool

Evaluation –  Participation rates –  Attrition rates –  Extent to which the objectives and goals set

were met –  Cost effectiveness of the program evaluated –  Follow up conducted

Method

  114 papers were ident i f ied descr ib ing interventions for the prevention of obesity at the workplace

  13 were excluded as they were systematic review

papers

Method

  From the remaining identified practices 58 were not suitable for evaluation as these were:

–  ongoing projects –  projects which were not evaluated and thus could not be

recommended as good practices –  did not have as a stated objective the prevention of obesity –  the sample size was too small

Method

  45 practices were evaluated and those which received from both partners a score over 10 were chosen as best practices

Best practice recommendations

Recommendation 1: Conduct careful and

extensive needs assessment Recommendation 2: Apply theoretically driven, multicomponent interventions Social cognitive theory/social support principles/stages of change model

Recommendations for interventions targeting obesity at the workplace

Recommendation 3: Combine physical activity and nutrition methods such as:

  Information sessions: individual counseling and group training in

diet, exercise and behavior modification   Provide personalized tailored information and counseling   Use audiovisual materials   Provide dietary assessment and behavioral feedback   Provide self-help manuals and tailored written materials


Recommendation 4: Include environmental changes as part of the intervention plan

  Activities in company cafeterias such as food labeling, seasonal

themes, market stands, and tasting healthy products   Improving shower/change facilities, improve bike sheds, and

organize lunch walking groups onsite   Consider employee fitness centers and physical activity classes


Recommendation 5: Include organizational changes as part of the intervention plan

  Evaluate and change company policy on overtime, working hours,

business trips, lunch breaks

Recommendation 6: Carry out the intervention during work hours


Recommendation 7: Intervention period extending over one year

Recommendation 8: Allow participants to self

monitor progress   Use pedometers to monitor physical activity progress   Use dietary cards to measure food intake   Provide personalized feedback and input


Recommendation 9: Emphasize employee participation   Establish a committee comprising employees to monitor and guide

planning and implementation of the intervention   Seek feedback from employees during implementation   Monitor participation and investigate reasons for drop out


Recommendation 10: Use simple easy to read language, visuals or research alternative methods such as PCs and mobile phones for employees with low literacy skills or migrants


Recommendation 11: Establish incentives for both employees to increase participation as well as employers to encourage commitment to workplace health promotion activities

Guidelines for the Prevention of

Obesity

Guidelines for the prevention of obesity at the workplace

  Literature review   Identification of

Workplace Obesogenic factors by experts

  Evaluation of

workplace obesity interventions

Guidelines for the Prevention of obesity at the workplace


  Presents the health problem of obesity and its consequences

  Explains why obesity should be addressed at the workplace – how can employers and employees benefit from workplace obesity programs

  Identifies the most important workplace obesogenic factors

  Offers recommendations for successful workplace obesity interventions


  Outlines and provides per work sector obesogenic factors and practical recommendations on specific evidence-based strategies: –  Office workers: secretaries, clerks and senior

managers, lawyers, executives –  Transportation employees, truck drivers, taxi drivers –  Firefighters and police officers –  Health care personnel, nurses, doctors –  Blue collar workers: industrial employees,

construction workers

Office workers – secretaries, clerks and senior managers, lawyers, executives

•  Work overload • Unplanned and

frequent overtime • Long uninterrupted

working hours

• Less time for breaks during work

• Less energy and time for

physical activity • Higher consumption of fast

food and ready prepared food


Disruption of Work – Life balance

Consequences for the entire family


Interventions

• Monitor overtime and distribute workload avoiding piling work on only few employees

• Notify employees ahead if extra work or unavoidable

overtime is foreseen • Consider alternative management style if overtime

and work overload become too frequent


•  Cramped working spaces • Lack of food storing and preparation facilities • Unhealthy food choices in workplace canteens

• Frequent business lunches and dinners • Frequent business trips

•  Allocate lunch break areas •  Provide water fountains •  Provide fridge and microwave facilities •  Promote the use of stairs


Interventions

•  Provide guidelines for healthy eating during business meetings

•  Provide healthy food options in canteens or

cooperate with nearby restaurants – food coupons/ticket restaurants


  Long hours of sedentary type of work   No physical activity opportunities along the

transportation routes   Limited access to healthy nutrition in

transportation or truck terminals   Shift work

Preventing obesity among transportation employees, truck drivers, taxi drivers

  Occupational stress   Lack of adequate rest areas   Lack of scheduled breaks or meals

  Organizational factors such as work overload and excess demand leading to psychological strain

Transportation employees, truck drivers,

taxi drivers

Obesity CVD (strokes etc), sleeping apnea syndrome

Public safety hazard

Occupational Health Safety issue

Transportation employees, truck drivers, taxi drivers

Occupational Health & Safety related activities

  Employees need to take their scheduled breaks   Conduct periodic health checks among all employees   Monitor and regulate work shifts according to OHS

legislation   Monitor and regulate days off according to OHS

legislation


Statutory bodies such as:   unions   associations   employee representative organizations   statutory OHS bodies

Involved in counter obesity interventions


i.e. Employee and employer associations could

establish a feedback system to identify possible problems and suggest solutions.


  Install fridges in all trucks   Agreements with specific road side restaurants

could be reached to include special menus with healthy options for truck drivers


  Install vending machines with healthy food options in bus stations

  Reorganizing working hours, run times, rest days,

breaks


Industry workers, construction workers

  Personal beliefs and attitudes towards physical activity and proper nutrition

  Occupational environmental factors: Lack of healthy

food options in canteen or lack of a canteen, lack of onsite physical activity facilities, limited availability of nearby (and safe) recreational areas, green spaces, parks, sports grounds etc


  Lack of a workplace health promotion policy   Lack of staff to implement workplace health

promotion activities   Inadequate legislation concerning eating areas and

work cafeterias   Easy access to fast food, takeaways, street food

Health threatening lifestyle behaviors

Address attitudes and beliefs about nutrition and

physical activity through workplace health promotion campaigns

Large scale and over a long period of time


Comprehensive Workplace Health promotion approach

1.  Seek and secure management support and commitment

2.  Establish a coordinating body/committee which should include representatives from all sectors and levels of the workplace


3. Conduct a needs assessment in order to establish potential health risks and stimulate interest in the program

4. Develop an action plan based on the prioritized

needs and problems


5. Implement the plan with active participation from the workers

6. Evaluate the process and outcome to establish the

success and problems and to obtain recommendations for improvement of the program

Thank you for your attention

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