Fuel Your Life: Formative Research for a Worksite Diabetes Prevention Program

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Fuel Your Life Formative Research for a Worksite
Diabetes Prevention Program

• Wilson, M.G., Davis, M., DeJoy, D.M., Bowen, H.,
  Baker, K., Bynum, B. Vandenberg, R.J.
• University of Georgia
• 2009 CDC Diabetes Translation Conference
• Long Beach, CA April 22, 2009

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Obesity Trends Among U.S. AdultsBRFSS, 1990,
1998, 2006
(BMI ?30, or about 30 lbs. overweight for 54
person)
1998
1990
2006
Source CDC Behavioral Risk Factor Surveillance
System
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Diabetes Prevention Program

• Initially developed to test the efficacy of using
  a lifestyle intervention to reduce the risk of
  developing diabetes through increased physical
  activity and decreased body weight
• Proven to be effective for managing weight
• By decreasing caloric intake and increasing
  energy expenditure in clinical and worksite
  studies
• Demonstrates reductions in weight of 4.9
  (clinical study) and 5.5 (worksite study) of
  initial body weight
• The program has not been adapted to be
  implemented on a large scale within the work
  setting

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Translation

• Three Phases
• Disseminate - to public health organizations with
  the intent to encourage them to adopt the
  intervention within their organization
• Implement - throughout the organization with
  fidelity to the core components with which it was
  tested to be efficacious or effective (with some
  adaptation)
• Institutionalize - the intervention and/or
  eventually abandon it as newer, effective
  interventions are introduced

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DPP Translation

• Purpose Examine the strategies that influence
  implementation of a weight management
  intervention in a worksite setting.
  Specifically, the following three strategies
• adaptation of the delivery
• modifications in the workplace environment
• modifications in the home environment

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DPP Core Components

• weight loss and physical activity goal-based
  behavioral intervention
• lifestyle coach delivery
• frequent contact
• individual tailoring of the intervention
• materials and strategies for an ethnically
  diverse population
• network support for the interventionists

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Purpose

• This presentation will share formative research
  process and data from Fuel Your Life, a worksite
  diabetes prevention program.

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Obesity at Union Pacific Railroad
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Cost of Injury Related to Overweight/Obesity
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Formative Research

• Interviews with key stakeholders (site managers,
  corporate managers for HP and safety,
  occupational nurse, union reps)
• Focus groups of employees
• Survey of employees

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Interviews

• Corporate
• Director of Health and Safety
• General Manager for Safety
• Site
• Safety coordinator
• Occupational health nurse
• Shop director
• Union representatives
• Employees

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Focus Groups

• Five focus group interviews
• 49 UPRR employees
• Focus group questions inquired about
• motivation to change health
• perception of taking healthy actions
• barriers to healthy eating and exercising
• supports for healthy eating and exercising

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Surveys

• Food intake
• Physical activity
• Sleep quality
• Social support
• Self-efficacy
• Anger and stress
• Medical history

• Job satisfaction
• Turnover
• Work attendance
• Work safety climate
• Accidents, injuries, work limitations

Survey of 68 participants (40)
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Study Population

• Average age - 44
• 81 male
• 79 white
• 70 married 49 children
• 31 high school / GED
• 39 some college
• 69 40K (37 60K)
• 12 administrative / management

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Results Interviews

• Railroad industry different than others
• Maintenance shops
• Unionized (7)
• Labor intensive / heavy equipment
• Very safety conscious
• Ongoing occupational health and safety programs

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Results Interviews (cont.)

• Daily safety meetings
• Workgroups organized by function
• 3 shifts
• Health personnel on site
• Lunch brought from home
• Railroad families

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Results Focus Groups

• Families / home life important influence
• Knowledge levels of what to eat and not to eat
  high follow thru lacking
• Work activity physical activity
• Proactive approach to weight loss
• Environmental supports at work
• Barriers time, lack of skills/strategies,
  families/home life, expense, shift work,
  convenience

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Workplace Trends

• Changing nature of work impact on home
• gt knowledge - lt action
• Confusion of work activity and physical activity

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Results - Survey

• Mean weight 219 lbs
• (138 378)
• Physical activity
• High 48
• Moderate 24
• Low 28

• Mean BMI 32.15
• (21.4 49.5)
• Diet
• 32 of calories from fat
• .56 servings of veggies a day
• .67 servings of fruit a day

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Results Survey (cont.)

• Diagnosed with
• 36 - high cholesterol
• 28 - high blood pressure
• 5 - diabetes
• 10 - depression

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Results Survey (cont.)

• Job satisfaction 3.8 (1-5 scale)
• Turnover intention 1.4 (1-5 scale)
• Absenteeism 1.4 (1-3 scale)
• Social support 2.7 (1-5 scale)

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Translation FUEL Your Life
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Workplace Supports

• Healthy vending
• Healthy catering
• Environmental prompts
• Worksite communication
• Peer support

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Home Supports

• Web site
• Support materials
• Program participation

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• Workplace Health Groupwww.uga.edu/publichealth/hp
  b/research/workplacemwilson_at_uga.edu