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Nutrition and Physical Activity: Worksite Digital Health and Telephone Interventions to Increase Healthy Eating and Physical Activity

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What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of eight studies with 11 study arms (search period: January 2009-June 2020).

The systematic review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to nutrition, physical activity, and obesity prevention and control.

Context

Digital health interventions have the potential to reach a large number of people (Beleigoli et al., 2019). In the United States, 93% of adults use the internet (Pew Research Center, 2021a); 85% have access to a smartphone (Pew Research Center, 2021b); and 77% have home broadband (Pew Research Center, 2021a). Worksite health programs and policies provide opportunities to promote health and prevent disease. Effective worksite interventions have the potential to reduce health risks and improve the quality of life for more than 138 million workers in the United States (Centers for Disease Control and Prevention, 2018).

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement.

Physical Activity

  • Physical activity increased by a median of 38.5 minutes per week (2 studies with 4 study arms). Additional measures of physical activity demonstrated favorable findings (4 studies with 5 arms).

Dietary Behaviors

  • Fruit and vegetable intake increased by a median of 0.44 servings per day (2 studies with 4 study arms).
  • Fat intake decreased (3 studies with 4 study arms).

Weight-related

  • Body mass index results were mixed (4 studies with 5 arms); and weight decreased (2 studies with 2 arms).

Clinical

  • Clinical outcomes including systolic blood pressure, diastolic blood pressure, total cholesterol, high density lipoprotein, and glucose did not change (2 studies with 2 arms).

Summary of Economic Evidence

A systematic review of economic evidence has not been conducted.

Applicability

The CPSTF finding should be applicable to all working adults who are interested in improving these behaviors regardless of gender, income level, race, or ethnicity.

Evidence Gaps

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • How effective are interventions in worksites that are small (less than 100 employees) or medium sized (100 to less than 300 employees)?
  • Are these interventions effective in rural areas?
  • What are the long-term effects of digital health interventions among working adults?
  • What is the effect of interventions that last longer than 12 months?
  • What are the effects of incorporating wearable devices or trackers in the intervention?
  • What are the effects of adding social media to the intervention?
  • What is the ideal level of intensity for this type of intervention?

Study Characteristics

  • Included studies were conducted in the United States (6 studies), Denmark (1 study), and Germany (1 study). Only one study reported on population density, which was urban.
  • All included studies recruited participants from large worksites (>300 employees). Participants included social and healthcare workers in a nursing home (1 study), shift workers with physically demanding work (1 study), government workers (1 study), management and administrative personnel (3 studies), and a mix of management, clerical, and labor workers (2 studies).
  • Across all eight studies, participants had a mean age of 47.4 years. Studies reported higher proportions of females than males (on average, 70% were female). Intervention duration ranged from one month to 12 months, with a median duration of six months.
  • The six U.S. studies reported racial and ethnic distributions. Studies included participants self-identified as White (median 57.3%; 6 studies), Black or African American (median 7.1%; 5 studies), Hispanic or Latino (median 4.0%; 5 studies), Asian (median: 4.0%; 4 studies), or other race/ethnicity (median 3.6%; 5 studies).
  • Seven studies provided enough information to assess participants’ income. Participants represented populations considered to be lower income (1 study), higher income (3 studies), or a combination of higher, middle, and lower income (3 studies).