Worksite nutrition and physical activity: assessing readiness for change among employees of a large manufacturing facility

1
Worksite nutrition and physical activity
assessing readiness for change among employees of
a large manufacturing facility

• Sharon Sugerman, MS, RD, FADA,
• Public Health Institute
• Cancer Prevention Nutrition Section
• October 23, 2001

2
Worksite - key channel for health promotion for
adults

• On workdays, spend more non-sleeping hours at
  work than at any other single place
• Eat 1-2 meals/day in or near the worksite
  environment
• Co-worker relationships reinforce social norms

3
Opportunities Afforded

• Exposure to worksite environment
• Provide a baseline
• fruit/vegetable consumption
• fruit/vegetable attitudes, beliefs/barriers
• physical activity
• Assess fruit/vegetable stage of change
• Provide direction for possible future
  intervention

4
The Survey (Q1)

• On average, how many servings of fruits and
  vegetables do you eat each day? Thats a
  combined total of both fruits and vegetables.
• 0 1 2 3 4 5 6 7 8 9 10

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The Survey (Q2)

• About how long have you been eating this number
  of fruits and vegetables?
• Less than 1 month
• 1-3 months
• 4-6 months
• Longer than 6 months

6
Intake and Stages of Change (Q3 and Q4)

• Are you seriously thinking about eating more
  servings of fruits and vegetables starting
  sometime in the next six months?
• Yes No
• Are you planning to eat more servings of fruits
  and vegetables during the next month?
• Yes No

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Algorithm for Stages of Change
Thompson, Byers, Kohlmeir. J Nutr. 124(11S),
2306-2308
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Physical Activity

• On average, how many times per week do you
  exercise?
• 0 1 2 3 4 5 or more
• On average, how many minutes per session do you
  exercise?
• 0-9 10-19 20-29
• 30-39 40-49 50 or more

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Demographics (1)

• N 733 (15 of workers)
• Race/ethnicity
• 43 White
• 23 African-American
• 16 Asian/Pacific Islander
• 15 Hispanic
• 3 Other

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Demographics (2)

• Gender
• 34 Female
• 66 Male
• Education Group
• 26
• High school or less
• 41
• Some college
• 33
• 4-year degree

• Age/Age Group
• Mean age 46
• 60 35-50
• 30 51-64
• Income Group
• 18 lt 50K
• 50 50K-65K
• 31 65K

11
Self-reported Fruit and Vegetable Consumption and
Belief About Amount Needed for Good Health
Percent of Workers
60
52
50
37
40
30
20
11
10
0
0-2
3-4
5
Servings FV Needed for Good Health
California Dept. of Health Services, 2000
12
Self-reported consumption of fruits and
vegetables, by age group
Mean servings of fruits and vegetables
5.5
5

4.1
4.5
4
3.1
3.1
3.1
3.5
3
2.5
2
1.5
1
0.5
0
Total
Age 35-50
Age 25-34
Age 51-64
p lt .01
California Dept. of Health Services, 2000
13
Stages of Change
Percent of Workers
100
90
80
68
70
60
50
40
30
15
20
11
3
10
2
0
Precontemplation
Preparation
Maintenance
Contemplation
Action
Stage of Change
California Dept. of Health Services, 2000
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Belief in Number of Servings Needed Was
Associated with Increased Consumption of Fruits
and Vegetables
15
Belief Was Highly Related to Stage of Change
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Physical Activity

• Adequate - 8
• Inadequate - 92
• Adequate Inadequate
• Age 25-34 - 20 80
• Age 35-50 - 7 93
• Age 51-64 - 7 93

p lt .01
17
Relationship Between Adequate Exercise and
Fruit/Vegetable Consumption

p lt .001 California Dept. of Health Services,
2000
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Most Significant Factors Related to Total Fruit
and Vegetable Consumption

• After controlling for demographics, two factors
  contributed unique components in terms of
  predicting the dependent variable
• Belief in number of servings for good health
• Adequate vs. inadequate exerciser
• The model accounts for 31.1 of the variance in
  fruit/vegetable intake

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Leading Reasons for Not Eating More Fruits and
Vegetables
California Dept. of Health Services, 2000
20
Leading Reasons for Not Eating More Fruits and
Vegetables by Amount Reported
p lt .001 California Dept. of Health Services,
2000
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Preferred source for health information

• Electronic and Print Media 30
• Doctors office 30
• At work 20
• Grocery store 10

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Using Stages of Change for Dietary Intervention
Preparation

• Key strategies
• Resolve ambivalence
• Develop firm commitment and specific action plan
• Treatment dos
• Encourage clients to set specific, achievable
  goals
• Reinforce small changes client may have already
  achieved

Adapted from Kristal et al. JADA 99 (6) 684
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Using Stages of Change for Dietary Intervention
Preparation

• Treatment donts
• Not using this as a time to recommend general
  behavior change, i.e. eat more fruits and
  vegetables
• Not downgrading small changes that have already
  been made

Adapted from Kristal et al. JADA 99 (6) 684
24
5 a Day Worksite CampaignNext Steps (1)

• Formative research
• Literature search
• successful programs
• gaps
• barriers
• potential partners
• Roundtables key informant interviews with
  gatekeepers/employers of large numbers of low and
  middle-income employees

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5 a Day Worksite CampaignNext Steps (2)

• Developmental Research
• Funding an individualized, on-line screening,
  assessment and delivery of tailored messages for
  increasing F/V and decreasing fat intake in
  worksite setting

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• Sharon B. Sugerman
• Public Health Institute
• PO Box 942732, MS-662
• Sacramento, CA 94234-7320
• 916-324-3059 (phone)
• 916-322-1532 (fax)
• ssugerma_at_dhs.ca.gov