Tailoring Health Promotion Programs Increases Effectiveness, Work Productivity

A German study in the Journal of Medical Internet Research suggests that tailored, computer-based training and interventions can increase the effectiveness of health promotion programs for many workplaces.

Poor health choices, obesity, and obesity-related diseases contribute billions to healthcare spend worldwide and contribute to lost productivity in every workplace. But finding viable solutions to this widely known problem has proven elusive. Workplace promotion programs can be effective for some, but extending their utility and effectiveness would benefit both employers and employees.

Earlier studies have demonstrated that workplace health promotion programs can be effective at helping employees perform regular physical activity and eat healthier, making them less likely to exhibit a loss in productivity, even in cases in which those efforts don’t lead to direct losses in body mass index (BMI).

One of the key findings of the study is that considering the relative “motivational readiness” of employees enhances the reach and likelihood of success of programs that encourage preventive health, regular physical activity, and healthy nutrition. By categorizing employees as either “intenders” (those who have decided to adopt healthier behaviors) and “nonintenders” (those not obtaining goal behavior and not planning on doing so), and then tailoring communications efforts based on this categorization, interventions can be more effective.

The study was a randomized, controlled trial of employees in physically demanding careers, recruited during a routine medical examination. Two fully automated computer-based treatments were adopted based on employees readiness to adopt healthy behaviors. The tailored interventions out-performed controls in promoting healthy eating, exercise behavior, and overall healthy lifestyle.

According to the study authors, “Computer-based technology bears the advantage of having a better reach [than often-effective face-to-face interventions] and allows greater flexibility for employees... Computer- and Internet-based interventions offer options for tailoring interventions to the needs of the individuals. A substantial body of research has shown the efficacy of tailored programs administered via print, Internet, local computer/kiosk, and telephone.”

For “nonintenders,” the intervention was structured to rate their own health, picture the benefits of pursuing a healthier lifestyle, and then think about the potential positive outcomes of meeting a behavioral goal. Individuals were then asked to set behavioral goals for the next 3 weeks, with a focus on setting small goals with an eye toward reaching the larger goal of becoming more physically active during leisure time.

For “intenders,” the intervention stressed that a day has 1,440 minutes, and that 30 minutes per day could easily be allocated to volitional physical activity; and that one typically eats 3 meals and 1 or more snacks, which opens up ample opportunities to add or replace products by fruits and vegetables. Participants were then asked to name up to 3 personal behavioral goals to meet the target of being physically active 3 times a week for 30 minutes or longer as well as to eat 5 portions of fruits and vegetables each day and create their own action plan.

The active control condition contained general health information, for example, on the etiology of obesity and the inter-relation between physical activity, nutrition, and energy expenditure.

“Further testing the practical importance of the intervention on lifestyle revealed that employees receiving the stage-matched intervention were 2 times more likely to adopt a healthy lifestyle (the synthesis of nutrition and physical activity) than employees in the active control group,” the researchers concluded.