Environmental Approaches for Obesity Management at Dow

BACKGROUND:

More than half of all Americans are overweight or obese, and the prevalence of these risk factors has increased dramatically in the past decade. Obesity is a risk factor for several chronic illnesses, including type 2 diabetes and heart disease. The national medical cost that is attributed to obesity is estimated to be between $60 and $93 billion. Business leaders are becoming increasingly aware of the human and economic burden that poor health imposes on their workers. Many employers have invested in health promotion and disease prevention programs aimed at reducing the prevalence of obesity in the workplace through the encouragement of physical activity, maintaining a healthy diet, and improved management of health risk factors. Employers continue to seek innovative and evidence-based programs that can be implemented in the workplace to address a growing public health epidemic that also adversely affects worker productivity.

DESIGN NARRATIVE:

The primary objective of this study will be to evaluate the effect of introducing two levels of environmental programs, in addition to existing individualized programs, at reducing obesity in the workplace. Five outcomes will be evaluated: 1) body mass index and other weight-related biometric measures; 2) behavioral health risk factors; 3) weight-related health conditions; 4) health care utilization and medical expenditures; and 5) employee productivity measured in terms of reduced absenteeism and on-the-job presenteeism. The study will also include an assessment of costs and benefits of the two programs, including the medical, absenteeism, and productivity benefits, and an assessment of the impact of the programs on the worksite climate. Twelve Dow chemical companies will participate in the study. Participants will be randomly assigned to a moderate environmental program, an intensive environmental program, or a control group, which will receive individualized treatment only. The moderate program will include inexpensive environmental changes (e.g., prompts and reminders). In the high intensity program, senior managers will assist in the development of a worksite culture that is broadly supportive of improved weight and health management by employees. Annual health screening and biometrics data along with administrative medical claims, absence records, and productivity survey data will be analyzed to determine program impacts. Non-experimental statistical methods will be used to control the differences that remain across sites after randomization. The study will also produce extensive information about how employers can successfully implement environmental programs to reduce obesity at worksites.