title: Step ahead a worksite obesity prevention trial among hospital employees.
abstract: BACKGROUND
  The worksite represents a promising venue in which to address the issue of obesity.
  
  
  METHODS
  Pair-matched, cluster-RCT. Data were collected from 2005 to 2008 and analyzed in 2008.
  
  
  METHODS
  A random sample of 806 employees was selected to represent the workforce of six hospitals in central Massachusetts.
  
  
  METHODS
  The 2-year ecologic intervention sought to prevent weight gain through changes in worksite weight-related norms using strategies targeted at the organization, interpersonal environment, and employees.
  
  
  METHODS
  The primary outcome was change in BMI at the 12- and 24-month follow-ups. Change in perceptions of organizational commitment to employee health and normative coworker behaviors were secondary outcomes.
  
  
  RESULTS
  There was no impact of the intervention on change in BMI from baseline to 12 (beta=0.272; 95% CI=-0.271, 0.782) or 24 months (beta=0.276; 95% CI=-0.338, 0.890) in intention-to-treat analysis. When intervention exposure (scale=0 to 100) was used as the independent variable, there was a decrease of 0.012 BMI units (95% CI=-0.025, 0.001) for each unit increase in intervention participation at the 24-month follow-up. Employees in intervention sites reported significantly greater improvements in perceptions of organizational commitment to employee health at 12 and 24 months compared to control sites, but there was no impact on perceptions of normative coworker behaviors.
  
  
  CONCLUSIONS
  The intervention had a dose-response relationship with BMI, with positive effects proportional to extent of participation. Although the intervention was able to change organizational perceptions, successfully improving changes in actual and perceived social norms may be needed to achieve population-level impact in complex worksite organizations.
authors.affiliation: University of Massachusetts Medical School, Worcester, 01655, USA. Stephenie.Lemon@umassmed.edu
authors.forename: Stephenie C
authors.initials: SC
authors.lastname: Lemon
authors.forename: Jane
authors.initials: J
authors.lastname: Zapka
authors.forename: Wenjun
authors.initials: W
authors.lastname: Li
authors.forename: Barbara
authors.initials: B
authors.lastname: Estabrook
authors.forename: Milagros
authors.initials: M
authors.lastname: Rosal
authors.forename: Robert
authors.initials: R
authors.lastname: Magner
authors.forename: Victoria
authors.initials: V
authors.lastname: Andersen
authors.forename: Amy
authors.initials: A
authors.lastname: Borg
authors.forename: Janet
authors.initials: J
authors.lastname: Hale
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D016000:Cluster Analysis; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control*; D016272:Occupational Health / Q000706:statistics & numerical data; D010564:Personnel, Hospital; D055815:Young Adult