Balance@Work - The (cost) effectiveness of an occupational health guideline to improve workers' physical activity and dietary behaviour in order to prevent weight gain.

The prevalence of overweight and obesity is high among the Dutch population and
is associated with an enormous public health impact as well as with an economic
burden. As it is expected that the prevalence of overweight will increase
further, there is an urgent need to intervene in order to prevent weight gain.
The Dutch government and the Netherlands Society of Occupational Medicine
(NVAB) recognise this urgency and are willing to intervene. To date, health
promotion in the occupational setting is mainly aimed at secondary prevention,
i.e. the treatment of sick listed workers. Among the few occupational
physicians (OP) who do implement primary prevention advice, the strategies vary
and information is neither up to date nor evidence based. Therefore, a need
exists to provide information to OPs on the prevention of weight gain.
Preceding this study, an extensive systematic literature research (the BRAVO
reviews) has been performed concluding that primary prevention lifestyle
interventions are feasible within the occupational health (OH) setting.
Moreover, lifestyle interventions aimed at primary prevention have shown to be
effective on the lifestyle behavior of concern as well as on certain
health-related outcomes, such as body weight and body composition. Now, a clear
cut guideline for OPs should be developed containing the acquired insights to
improve workers health.

The objective of this study is to evaluate the effectiveness of the
occupational guideline compared to usual care on the prevention of (further)
weight gain among workers.

This study will be performed using a randomised controlled design with two arms
in the workplace setting. Randomisation will take place at the OP level (n=30)
by a computer generated list. Before randomisation, OPs will be stratified by
business sector. OPs in the intervention group will apply the guideline
containing the lifestyle intervention to participating workers. OPs in the
control group will perform care as usual. During the inclusion period eligible
workers will be measured at baseline within an existing medical research, such
as the Preventive Medical Examination (PMO) of Risk Inventory and Evualiation
(RI&E). Participants will be measured at baseline, directly after the
intervention at 6 months, and at 12 months and 18 months after baseline.

Employees in the intervention group receive treatment according to the OP
guideline.
Target nutrition (1) and physical activity behaviours (2 and 3), derived from
the process of intervention mapping, are:
1. Replacing unhealthy snacks by healthy snacks, fruit and vegetables;
2. Reducing sedentary behaviour at work by replacing this behaviour by physical
activity of light or moderate intensity;
3. Reducing sedentary behaviour in leisure time by replacing this behaviour by
moderate or high intensity activities.
A minimum of three sessions are prescribed in which motivation, ambivalence,
barriers and benefits of the employee*s present behaviour and the desired
behaviour are discussed based on the principles of Motivational Interviewing.
Next, peronal target behavior are formulated, and tools (such as a pedometer
and nutrition diary) are given to achieve goals. Additionally, the employee*s
obesogenic work environment is assessed and discussed.

To our knowlegde, no risks are associated with participation.