title: Environmental changes to control obesity: a randomized controlled trial in manufacturing companies.
abstract: OBJECTIVE
  To determine the effects of an environmental intervention on obesity, disease risk factors, and dietary intake in an employee population.
  
  
  METHODS
  Randomized controlled community trial.
  
  
  METHODS
  Eight manufacturing companies in Kentucky with ∼150 to 350 employees each.
  
  
  METHODS
  Randomly selected employees.
  
  
  METHODS
  Multicomponent environmental intervention that included employee advisory committees, point-of-decision prompts, walking paths, cafeteria/vending changes, and educational materials.
  
  
  METHODS
  Height; weight; body fat; blood pressure; fasting lipids, glucose and insulin; and dietary intake were assessed prior to and 3, 6, and 12 months after initiation of the intervention.
  
  
  METHODS
  Mixed-model repeat-measure analyses of covariance were used to analyze data collected over the study period. Categorical data were analyzed in contingency tables. A p value of .05 was used to judge statistical significance.
  
  
  RESULTS
  There were no intervention effects for outcome variables, with the exception of lower intake of saturated fat and dietary cholesterol in the intervention group compared to the control group. Over the course of the study, changes in anthropometry and biomeasures were similar in both groups.
  
  
  CONCLUSIONS
  Findings indicate that subtle environmental changes alone may not impact employees' weight and health; however, such institutional-level approaches may be essential to support healthy lifestyle habits that are initiated by more intensive efforts. Academic researchers should continue to partner with employers and practitioners to develop, implement, and evaluate innovative health promotion strategies including environmental interventions.
authors.affiliation: College of Nursing, University of Cincinnati, 3110 Vine Street, Cincinnati, OH 45221-0038, USA. bonnie.brehm@uc.edu
authors.forename: Bonnie J
authors.initials: BJ
authors.lastname: Brehm
authors.forename: Donna M
authors.initials: DM
authors.lastname: Gates
authors.forename: Mary
authors.initials: M
authors.lastname: Singler
authors.forename: Paul A
authors.initials: PA
authors.lastname: Succop
authors.forename: David A
authors.initials: DA
authors.lastname: D'Alessio
mesh_terms: D015992:Body Mass Index; D004777:Environment; D005247:Feeding Behavior; D005260:Female; D006266:Health Education; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007221:Industry; D007629:Kentucky; D008019:Life Style; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017132:Workplace