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Diabetes Prevention and Control in the Workplace: A Pilot Project for County Employees

Barham, Kalleen MD; West, Susan RN; Trief, Paula PhD; Morrow, Cynthia MD, MPH; Wade, Michael MS; Weinstock, Ruth S. MD, PhD

Journal of Public Health Management and Practice: May/June 2011 - Volume 17 - Issue 3 - p 233–241
doi: 10.1097/PHH.0b013e3181fd4cf6
Original Article

Objectives: To improve nutrition and physical activity of county employees and promote weight loss.

Design: Random assignment to begin the program when first offered or after 3 months (“wait control” group).

Setting: Worksite.

Participants: Onondaga County employees (n = 45) at risk for diabetes (n = 35) or with diabetes (n = 10). Mean (±SD) age = 51.2 (± 8.0) years and body mass index (BMI) = 37.3 ± (6.8 kg/m2).

Intervention: Twelve weekly healthy lifestyle sessions based on the Diabetes Prevention Program curriculum, followed by monthly sessions for up to 12 months.

Outcomes: Medical: Weight, BMI, waist circumference, blood pressure, fasting glucose, lipid, and hemoglobin A1c levels. Psychosocial/behavioral: Health-related quality of life Short Form-12, Impact of Weight on Quality of Life Scale), physical activity (International Physical Activity Questionnaire), eating behavior (3-Factor Eating Questionnaire, National Cancer Institute Fat Screener), job satisfaction.

Results: The intervention group lost significant weight compared to the wait control group over the first 3 months (mean [95% CI], –2.23 kg [–3.5 to 0.97]) vs [+ 0.73 kg (+0.17 to +1.28)], with a decrease in BMI (P < .001) and waist circumference (P = .004), an increase in physical activity (International Physical Activity Questionnaire, P = .011) and lower dietary fat intake (P = .018). Over 12 months, 22.5% (9/40) lost more than 5% body weight and 12.5% (5/40) lost more than 7% body weight. After the first 3 months, there was gradual partial weight regain but reduction in waist circumference was maintained. The intervention group demonstrated significant improvement in Impact of Weight on Quality of Life Scale (P < .001), 3-Factor Eating (cognitive restraint P < .001, uncontrolled eating P = .003, and emotional eating P = .001), International Physical Activity Questionnaire (P = .011), and Short Form-12 Physical Component Summary (P = .048). No improvements were observed in blood pressure, lipid, hemoglobin A1c, or glucose levels. Job satisfaction was inversely related to BMI at baseline (P = .001) with a trend for improvement with the modest weight loss.

Conclusions: A worksite intervention program can help government employees adopt healthier lifestyles and achieve modest weight loss.

This study examines a worksite intervention program that can help government employees adopt healthier lifestyles and achieve modest weight loss.

Department of Medicine (Drs Barham, Trief, and Weinstock, Ms West), Public Health and Preventive Medicine (Mr Wade) and Psychiatry (Dr Trief), SUNY Upstate Medical University, Syracuse, New York; and Department of Veterans Affairs, Center for Integrated Healthcare (Drs Trief and Weinstock, and Mr Wade) and Onondaga County Department of Health (Dr Morrow), Syracuse, New York.

Correspondence: Ruth S. Weinstock, MD, PhD, SUNY Upstate Medical University, 750 E Adams St (CWB 353), Syracuse, NY 13210 (

This study is supported by Onondaga County, NY and the NYS Department of Health. There is no conflict of interest.

© 2011 Lippincott Williams & Wilkins, Inc.