There is no conflict of interest.
Highlights
- The study's objective was to examine the impact of the Better Living program on health outcomes.
- The study used an interrupted time series design. Using health and survey data, the authors conducted statistical tests to compare the outcomes of employees before and after they participated in the Better Living program.
- The study found a significant relationship between program participation and increased health benefits.
- This study receives a low evidence rating. This means we are not confident that the estimated effects are attributable to the Better Living program; other factors are likely to have contributed.
Intervention Examined
Features of the Intervention
The Better Living program was created to promote wellness among employees in healthcare settings. The program encourages healthy lifestyle changes and offers peer support, acknowledging the long hours workers spend on the job. The Better Living program features nutritional and behavioral guidance for participants, facilitated through both individual and group meetings. During the 16-week program, participants have individual appointments each week to track their weight goals and also attend weekly group meetings for health education and support from peers.
Features of the Study
The study used an interrupted time series design to determine the impact of the Better Living program on overall employee health. The study took place in Omaha, Nebraska, with participating Methodist Health System employees. To participate in the program, employees needed to be at least 19 years old, classified as overweight or obese by CDC guidelines, enrolled in the company insurance plan, and not pregnant when the program began. Of the 114 eligible employees, 41 agreed to participate in the study. Data included metabolic health information as well as self-reported survey information on nutrition, physical activity, sleep, and depression. Data were gathered before and after the intervention, as well as at weekly intervals during individual appointments. Statistical tests that accounted for age, sex, education, smoking habits, and metabolic problems were used to compare the outcomes of participants before and after the intervention.
Findings
Health and safety
- The study found a significant relationship between program participation and improved health benefits including weight loss and decreased blood pressure and blood glucose levels.
- However, the study did not find any significant relationships between program participation and scores relating to improved nutrition, exercise, or sleep.
Considerations for Interpreting the Findings
The authors compared the outcomes of participants measured before and after they participated in the intervention. For these types of designs, the authors must observe outcomes for multiple periods before the intervention to rule out the possibility that participants had increasing or decreasing trends in the outcomes examined before enrollment in the program. That is, if participants who had recently increased their exercise time tended to enroll in the program, we would anticipate further increases over time, even if they did not participate in the program. Without knowing the trends before program enrollment, we cannot rule this out. Therefore, the study receives a low causal evidence rating.
Causal Evidence Rating
Research Guidelines
Review Protocol: Living Systematic Annual Search and Review Protocol
Review Guidelines: Causal Evidence Guidelines