In 2006, The Dow Chemical Company introduced a series of environmental interventions at the workplace aimed at reducing obesity rates among its workers. fter one year, the company reported favorable results related to employees’ weight, blood pressure, and tobacco use, as well as early signs of improvements in employee absenteeism rates.
Program Description
Narrative Description of Program
NHLBI funded Dow to study the effects of environmental and ecological interventions to reduce and manage overweight and obesity as well as financial outcomes. Study goals include: 1) test the multifaceted hypothesis: relative to individual interventions, environmental interventions reduce the prevalence of obesity and overweight, reduce the prevalence of other weight-related risk factors, improve health, reduce healthcare utilization and expenditures, and improve other indicators known to be related to employee productivity 2) test whether savings outweigh program expenses, thus producing a positive ROI.
Two intervention levels were implemented. Moderate interventionsincluded healthy choices in vending machines and cafeterias (25% healthy food option requirement), healthy choices at company-sponsored meetings (50% of items required to meet healthy food criteria), on-site marked walking paths, targeted messages to encourage healthy eating and physical activity, and a recognition program for employees engaging in health improvement initiatives and/or who changed their behavior. These interventions supplemented an individual behavior change program encouraging weight loss and increased physical activity. Additionally, the worksite was saturated with healthy eating and physical activity messages; point-of purchase messages on vending machines and in cafeterias and signs marking the walking paths were included. A concerted communication campaign including signs, posters, table tents, e-mails, messages in meetings, and information on Dow’s intranet site was also developed to create awareness and foster participation.
In addition to the moderate strategies, intense-level interventions included: site level goals aligned with the site’s management plan, leadership training, site progress reports to senior leadership, established employee champions at the work group level (Healthy Culture FocalPoints), and leadership recognition. These interventions were designed to garner leadership support, integrate the interventions into company processes, and recognize individuals for progress toward health achievement goals. The chosen intense interventions were designed to make them part of the company culture.
Contact Summary
| General Information | |
|---|---|
| Program Name | The LightenUP Study |
| Company Name and Address | The Dow Chemical Company Employee Development Center Midland, MI 48674 |
| Contact Person | Karen Tully |
| Program Information | |
| Program Category | Worksite-based |
| Year begun | 2004 |
| Total number of individual participants | 6,646 |
| Number of currently actively enrolled | 3,229 |
| Access to Program | Approximately 10,000 Dow employees at 12 sites in the US. Sites were randomized into various intensity levels: Five sites (n=~6,600) received "intense" environmental/ecologic interventions, four sites (n=~1,400) received "moderate" environometal/ecological interventions and three sites (n=~2,300 were control sites. |
| Program targeted at Healthy People 2000 and/or Healthy People 2010 goals | Yes |
| Program goals (in priority order) | (1) Test the multifaceted hypothesis that, relative to individual interventions, environmental interventionsa) reduce the prevalence of obesity and overweight b) reduce the prevalence of other weight-related risk factors, c) improve health, and reduce healthcare utilization and expenditures, and d) improve an array of indicators known to be related to employee productivity(2) Test wether savings outweights program expenses, thus producing a positive return on investment |
Evaluation Summary
Narrative Description of Evaluation Results
Time 1 results include:
- When comparing intervention to control sites, initial results show that the interventions produced favorable changes in weight, BMI, blood pressure, tobacco use and alcohol use.
- At intense sites, decreases in percent prevalence of persons at high risk for poor nutrition (-3.7%), tobacco use (-1.3%), and poor physical activity (-1.4%) from Time 1 to Time 2 was significant.
- Only moderate sites showed a significant decrease in percent prevalence for poor nutrition (-3.9%).
- Comparing changes in biometric risk factors of the moderate versus control sites showed a significant difference in prevalence of high blood pressure (-4.0%) and high cholesterol (-6.7%).
- Moderate sites demonstrate significant decreases in percent prevalence of people with high blood pressure by 3.5% and high blood glucose by 1.5%.
- Intense sites demonstrate a significant decrease in percent of unproductive time spent at work, by 0.2% for a savings of $161.70 per participant.
- Moderate sites had a significant decrease in absenteeism (-1.7 days, savings $522.93 per participant) and percent of unproductive time spent at work (-0.3%, savings $250.00 per participant).
- Comparing differences in the changes of moderate versus control sites showed only a significant difference in absenteeism (-2.1 days, savings $629.09 per participant).
- Intense and moderate sites showed improvement from Time 1 to Time 2 in the perception of cultural support at Dow to promote health (0.1 point increase).
- Control sites participants felt the cultural support for health at Dow significantly decreased from Time 1 to Time 2 (0.1 point).
- Intense and moderate sites show improvement in the perception of cultural support for adopting and encouraging healthy lifestyles and environmental support for healthy eating (e.g., healthy vending, cafeteria and catering options) significantly improved.
- Increased employee awareness of communications encouraging healthy eating and physical activity.
- Increased site leadership support for health promotion.
Evaluation Methods
To evaluate the impact of environmental interventions on health risks, a quasi-experimental, pre/post design was used with three data points: baseline, year 1 and year 2. Intervention sites were matched, and then randomly assigned to moderate or high intensity. The study included 12 sites: 3 control and 9 intervention (4 moderate, 5 intense). Additionally, other Dow sites in the US (N=~7,500) provided benchmark/comparison data (administrative and health risk). Behavioral risk data was measured with HRA responses and biometric measurements. Outcome measures included height/weight (body mass index), blood pressure, cholesterol (total/HDL), blood glucose, diet/nutrition, exercise/physical activity, smoking, stress, alcohol, health care utilization and costs (self report and insurance claims data), absenteeism (self report and administrative data), and presenteeism (Work Limitations Questionnaire).
Analysis and evaluation requires coordination with Dow and their research partners: National Business Group on Health, Emory University, Thomson Reuters, and University of Georgia. The evaluation team is a well-qualified group with a variety of advanced degrees and experience in research methodology and data analysis. Research protocol is reviewed and approved by Institutional Review Boards at Dow and Emory University. Additional review is provided by a Data Safety Monitoring Board.
Evaluation Documentation
- Lighten up estimating roi
- dow_lighten_up_presentations_publications
- dow lighten up environmental assessment tool
- dow lighten up committed to health
- dow lighten up design obesity
- dow lighten up chronic health condition assessment
- dow lighten up assessing management support
- dow lighten up abstracts
- dow_lighten_up_abstracts
Critique
The following are verbatim remarks made by the reviewers:
A
- Moderate interventions include healthy vending and cafeteria, healthy food at meetings, walking paths, targeted messaging, and recognition.
- Intense interventions include all moderate plus site goals, leadership training, employee champions
- Excellent communication campaign
- Favorable changes in weight, BMI, BP, tobacco, and alcohol use were demonstrated
- Multiple publications
- 4% decrease in health care costs from 2006-2007
- Very impressive program
B
- Very well-developed, comprehensive, evidence-based cultural and environmental strategy
- Randomization of sites to two treatment arms and a control condition
- Administrative cost measures as well as self-report used in evaluation
- Rigorous evaluation methods with validated instrumentation
C
- Substantial commitment to research and evaluation
- Formal test of ecological approach
- Large scale programming effort
- Extensive organizational commitment
- Multiple measures used
D
- Pre-post evaluations
- 3 Control sites
- Publications, mostly process
- One good ROI but with modest savings only
E
- Conflict
F
- Good program.
G
- 3 year study with a pre-post design – 66% participation There was an intense intervention, moderate intervention and controls The study was to test for the impact of environmental and ecological interventions on obesity and overweight and assess risk change, biometrics, absenteeism, presenteeism and financials.
- This project led to the development of the EAT survey as well as the Leading by Example survey. (contribution to the field as issues of obesity need to be addressed.)
H
- Conflict
I
- Strong evaluation design and metrics
- ecological intervention approach
- significant outcomes