title: Enhancing workplace wellness efforts to reduce obesity: a qualitative study of low-wage workers in St Louis, Missouri, 2013-2014.
abstract: BACKGROUND
  The objective of this study was to examine workplace determinants of obesity and participation in employer-sponsored wellness programs among low-wage workers.
  
  
  METHODS
  We conducted key informant interviews and focus groups with 2 partner organizations: a health care employer and a union representing retail workers. Interviews and focus groups discussed worksite factors that support or constrain healthy eating and physical activity and barriers that reduce participation in workplace wellness programs. Focus group discussions were transcribed and coded to identify main themes related to healthy eating, physical activity, and workplace factors that affect health.
  
  
  RESULTS
  Although the union informants recognized the need for workplace wellness programs, very few programs were offered because informants did not know how to reach their widespread and diverse membership. Informants from the health care organization described various programs available to employees but noted several barriers to effective implementation. Workers discussed how their job characteristics contributed to their weight; irregular schedules, shift work, short breaks, physical job demands, and food options at work were among the most commonly discussed contributors to poor eating and exercise behaviors. Workers also described several general factors such as motivation, time, money, and conflicting responsibilities.
  
  
  CONCLUSIONS
  The workplace offers unique opportunities for obesity interventions that go beyond traditional approaches. Our results suggest that modifying the physical and social work environment by using participatory or integrated health and safety approaches may improve eating and physical activity behaviors. However, more research is needed about the methods best suited to the needs of low-wage workers.
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, 660 S Euclid Ave, Box 8005, St. Louis, MO 63110. Email: jstrickl@dom.wustl.edu.
authors.forename: Jaime R
authors.initials: JR
authors.lastname: Strickland
authors.affiliation: George Warren Brown School of Social Work, Washington University, St. Louis, Missouri.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Eyler
authors.affiliation: George Warren Brown School of Social Work, Washington University, St. Louis, Missouri.
authors.forename: Jason Q
authors.initials: JQ
authors.lastname: Purnell
authors.affiliation: Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Kinghorn
authors.affiliation: Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Herrick
authors.affiliation: Washington University School of Medicine, St. Louis, Missouri.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Evanoff
mesh_terms: D015444:Exercise; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods / Q000639:trends*; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007407:Interviews as Topic; D007750:Labor Unions; D008297:Male; D008923:Missouri; D009765:Obesity / Q000517:prevention & control*; D009786:Occupational Health Services / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling; D011203:Poverty; D015397:Program Evaluation; D036301:Qualitative Research; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016526:Workload; D017132:Workplace