Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1993 Mar;83(3):395–401. doi: 10.2105/ajph.83.3.395

The Healthy Worker Project: a work-site intervention for weight control and smoking cessation.

R W Jeffery 1, J L Forster 1, S A French 1, S H Kelder 1, H A Lando 1, P G McGovern 1, D R Jacobs Jr 1, J E Baxter 1
PMCID: PMC1694637  PMID: 8438979

Abstract

OBJECTIVES. A randomized trial was conducted to evaluate the effectiveness of a work-site health promotion program in reducing obesity and the prevalence of cigarette smoking. METHODS. Thirty-two work sites were randomized to treatment or no treatment for 2 years. Treatment consisted of health education classes combined with a payroll-based incentive system. Evaluation was based on cohort and cross-sectional surveys. RESULTS. Of 10,000 total employees in treatment work sites, 2041 and 270 participated in weight control and smoking cessation programs, respectively. Weight losses averaged 4.8 lbs, and 43% of smoking participants quit. Net 2-year reductions in smoking prevalence in treatment vs control work sites were 4.0% and 2.1% in cross-sectional and cohort surveys, respectively. No treatment effect was found for weight. Treatment effects for smoking prevalence and weight were both positively correlated with participation rates in the intervention programs (r = .45 for smoking and r = .55 for weight). CONCLUSIONS. This work-site health promotion program was effective in reducing smoking prevalence at a cost that is believed to make the investment worthwhile.

Full text

PDF
395

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abraham S., Johnson C. L., Najjar M. F. Weight and height of adults 18-74 years of age. United States, 1971-74. Vital Health Stat 11. 1979 May;(211):1–49. [PubMed] [Google Scholar]
  2. Alderman M. H., Madhavan S., Davis T. Reduction of cardiovascular disease events by worksite hypertension treatment. Hypertension. 1983 Nov-Dec;5(6 Pt 3):V138–V143. doi: 10.1161/01.hyp.5.6_pt_3.v138. [DOI] [PubMed] [Google Scholar]
  3. Becker D. M., Conner H. F., Waranch H. R., Stillman F., Pennington L., Lees P. S., Oski F. The impact of a total ban on smoking in the Johns Hopkins Children's Center. JAMA. 1989 Aug 11;262(6):799–802. [PubMed] [Google Scholar]
  4. Bennett D., Levy B. S. Smoking policies and smoking cessation programs of large employers in Massachusetts. Am J Public Health. 1980 Jun;70(6):629–631. doi: 10.2105/ajph.70.6.629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Brownell K. D., Cohen R. Y., Stunkard A. J., Felix M. R., Cooley N. B. Weight loss competitions at the work site: impact on weight, morale and cost-effectiveness. Am J Public Health. 1984 Nov;74(11):1283–1285. doi: 10.2105/ajph.74.11.1283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brownell K. D., Cohen R. Y., Stunkard A. J., Felix M. R., Cooley N. B. Weight loss competitions at the work site: impact on weight, morale and cost-effectiveness. Am J Public Health. 1984 Nov;74(11):1283–1285. doi: 10.2105/ajph.74.11.1283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Erfurt J. C., Foote A., Heirich M. A. Worksite wellness programs: incremental comparison of screening and referral alone, health education, follow-up counseling, and plant organization. Am J Health Promot. 1991 Jul-Aug;5(6):438–448. doi: 10.4278/0890-1171-5.6.438. [DOI] [PubMed] [Google Scholar]
  8. Fielding J. E. Effectiveness of employee health improvement programs. J Occup Med. 1982 Nov;24(11):907–916. [PubMed] [Google Scholar]
  9. Fielding J. E. Health promotion and disease prevention at the worksite. Annu Rev Public Health. 1984;5:237–265. doi: 10.1146/annurev.pu.05.050184.001321. [DOI] [PubMed] [Google Scholar]
  10. Fielding J. E., Piserchia P. V. Frequency of worksite health promotion activities. Am J Public Health. 1989 Jan;79(1):16–20. doi: 10.2105/ajph.79.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Follick M. J., Fowler J. L., Brown R. A. Attrition in worksite weight-loss interventions: the effects of an incentive procedure. J Consult Clin Psychol. 1984 Feb;52(1):139–140. doi: 10.1037//0022-006x.52.1.139. [DOI] [PubMed] [Google Scholar]
  12. Forster J. L., Jeffery R. W., Sullivan S., Snell M. K. A work-site weight control program using financial incentives collected through payroll deduction. J Occup Med. 1985 Nov;27(11):804–808. doi: 10.1097/00043764-198511000-00011. [DOI] [PubMed] [Google Scholar]
  13. Glasgow R. E., Klesges R. C., Godding P. R., Vasey M. W., O'Neill H. K. Evaluation of a worksite-controlled smoking program. J Consult Clin Psychol. 1984 Feb;52(1):137–138. doi: 10.1037//0022-006x.52.1.137. [DOI] [PubMed] [Google Scholar]
  14. Glasgow R. E., Terborg J. R. Occupational health promotion programs to reduce cardiovascular risk. J Consult Clin Psychol. 1988 Jun;56(3):365–373. doi: 10.1037//0022-006x.56.3.365. [DOI] [PubMed] [Google Scholar]
  15. Jeffery R. W., Adlis S. A., Forster J. L. Prevalence of dieting among working men and women: the healthy worker project. Health Psychol. 1991;10(4):274–281. doi: 10.1037//0278-6133.10.4.274. [DOI] [PubMed] [Google Scholar]
  16. Jeffery R. W., Folsom A. R., Luepker R. V., Jacobs D. R., Jr, Gillum R. F., Taylor H. L., Blackburn H. Prevalence of overweight and weight loss behavior in a metropolitan adult population: the Minnesota Heart Survey experience. Am J Public Health. 1984 Apr;74(4):349–352. doi: 10.2105/ajph.74.4.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Jeffery R. W., Forster J. L., Snell M. K. Promoting weight control at the worksite: a pilot program of self-motivation using payroll-based incentives. Prev Med. 1985 Mar;14(2):187–194. doi: 10.1016/0091-7435(85)90034-9. [DOI] [PubMed] [Google Scholar]
  18. Jeffery R. W., Pheley A. M., Forster J. L., Kramer F. M., Snell M. K. Payroll contracting for smoking cessation: a worksite pilot study. Am J Prev Med. 1988 Mar-Apr;4(2):83–86. [PubMed] [Google Scholar]
  19. Kent D. C., Cenci L. Smoking and the workplace: tobacco smoke health hazards to the involuntary smoker. J Occup Med. 1982 Jun;24(6):469–472. [PubMed] [Google Scholar]
  20. Klesges R. C., Vasey M. M., Glasgow R. E. A worksite smoking modification competition: potential for public health impact. Am J Public Health. 1986 Feb;76(2):198–200. doi: 10.2105/ajph.76.2.198. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Kristein M. M. How much can business expect to profit from smoking cessation? Prev Med. 1983 Mar;12(2):358–381. doi: 10.1016/0091-7435(83)90245-1. [DOI] [PubMed] [Google Scholar]
  22. Kronenfeld J. J., Jackson K., Blair S. N., Davis K., Gimarc J. D., Salisbury Z., Maysey D., McGee J. G. Evaluating health promotion: a longitudinal quasi-experimental design. Health Educ Q. 1987 Summer;14(2):123–139. doi: 10.1177/109019818701400201. [DOI] [PubMed] [Google Scholar]
  23. Lando H. A., McGovern P. G., Barrios F. X., Etringer B. D. Comparative evaluation of American Cancer Society and American Lung Association smoking cessation clinics. Am J Public Health. 1990 May;80(5):554–559. doi: 10.2105/ajph.80.5.554. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Lando H. A., McGovern P. G., Kelder S. H., Jeffery R. W., Forster J. L. Use of carbon monoxide breath validation in assessing exposure to cigarette smoke in a worksite population. Health Psychol. 1991;10(4):296–301. doi: 10.1037//0278-6133.10.4.296. [DOI] [PubMed] [Google Scholar]
  25. Orleans C. S., Shipley R. H. Worksite smoking cessation initiatives: review and recommendations. Addict Behav. 1982;7(1):1–16. doi: 10.1016/0306-4603(82)90019-3. [DOI] [PubMed] [Google Scholar]
  26. Petersen L. R., Helgerson S. D., Gibbons C. M., Calhoun C. R., Ciacco K. H., Pitchford K. C. Employee smoking behavior changes and attitudes following a restrictive policy on worksite smoking in a large company. Public Health Rep. 1988 Mar-Apr;103(2):115–120. [PMC free article] [PubMed] [Google Scholar]
  27. Pirie P., Jacobs D., Jeffery R., Hannan P. Distortion in self-reported height and weight data. J Am Diet Assoc. 1981 Jun;78(6):601–606. [PubMed] [Google Scholar]
  28. Rosen G. M., Lichtenstein E. An employee incentive program to reduce cigarette smoking. J Consult Clin Psychol. 1977 Oct;45(5):957–957. [PubMed] [Google Scholar]
  29. Rosenstock I. M., Stergachis A., Heaney C. Evaluation of smoking prohibition policy in a health maintenance organization. Am J Public Health. 1986 Aug;76(8):1014–1015. doi: 10.2105/ajph.76.8.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Schmid T. L., Jeffery R. W., Hellerstedt W. L. Direct mail recruitment to home-based smoking and weight control programs: a comparison of strategies. Prev Med. 1989 Jul;18(4):503–517. doi: 10.1016/0091-7435(89)90009-1. [DOI] [PubMed] [Google Scholar]
  31. Shipley R. H., Orleans C. T., Wilbur C. S., Piserchia P. V., McFadden D. W. Effect of the Johnson & Johnson Live for Life program on employee smoking. Prev Med. 1988 Jan;17(1):25–34. doi: 10.1016/0091-7435(88)90069-2. [DOI] [PubMed] [Google Scholar]
  32. Sorsensen G., Rigotti N., Rosen A., Pinney J., Prible R. Effects of a worksite nonsmoking policy: evidence for increased cessation. Am J Public Health. 1991 Feb;81(2):202–204. doi: 10.2105/ajph.81.2.202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Stunkard A. J., Albaum J. M. The accuracy of self-reported weights. Am J Clin Nutr. 1981 Aug;34(8):1593–1599. doi: 10.1093/ajcn/34.8.1593. [DOI] [PubMed] [Google Scholar]
  34. Stunkard A. J., Cohen R. Y., Felix M. R. Weight loss competitions at the worksite: how they work and how well. Prev Med. 1989 Jul;18(4):460–474. doi: 10.1016/0091-7435(89)90006-6. [DOI] [PubMed] [Google Scholar]
  35. Tell G. S., Jeffery R. W., Kramer F. M., Snell M. K. Can self-reported body weight be used to evaluate long-term follow-up of a weight-loss program? J Am Diet Assoc. 1987 Sep;87(9):1198–1201. [PubMed] [Google Scholar]
  36. Velicer W. F., Prochaska J. O., Rossi J. S., Snow M. G. Assessing outcome in smoking cessation studies. Psychol Bull. 1992 Jan;111(1):23–41. doi: 10.1037/0033-2909.111.1.23. [DOI] [PubMed] [Google Scholar]
  37. Weissfeld J. L., Holloway J. J., Kirscht J. P. Effects of deceptive self-reports of quitting on the results of treatment trials for smoking: a quantitative assessment. J Clin Epidemiol. 1989;42(3):231–243. doi: 10.1016/0895-4356(89)90059-0. [DOI] [PubMed] [Google Scholar]
  38. Wilbur C. S. The Johnson & Johnson program. Prev Med. 1983 Sep;12(5):672–681. doi: 10.1016/0091-7435(83)90225-6. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES