Worksite nutrition and physical activity: assessing readiness for change among employees of a large manufacturing facili

1. Worksite nutrition and physical activity: assessing readiness for change among employees of a large manufacturing facility Sharon Sugerman, MS, RD, FADA, Public Health Institute Cancer Prevention & Nutrition Section October 23, 2001

2. Worksite - key channel for health promotion for adults • On workdays, spend more non-sleeping hours at work than at any other single place • Eat 1-2 meals/day in or near the worksite environment • Co-worker relationships reinforce social norms

3. Opportunities Afforded • Exposure to worksite environment • Provide a baseline • fruit/vegetable consumption • fruit/vegetable attitudes, beliefs/barriers • physical activity • Assess fruit/vegetable stage of change • Provide direction for possible future intervention

4. The Survey (Q1) • On average, how many servings of fruits and vegetables do you eat each day? That’s a combined total of both fruits and vegetables. 0 1 2 3 4 5 6 7 8 9 10+

5. The Survey (Q2) • About how long have you been eating this number of fruits and vegetables? • Less than 1 month • 1-3 months • 4-6 months • Longer than 6 months

6. Intake and Stages of Change (Q3 and Q4) • Are you seriously thinking about eating more servings of fruits and vegetables starting sometime in the next six months? Yes No • Are you planning to eat more servings of fruits and vegetables during the next month? Yes No

7. Algorithm for Stages of Change Thompson, Byers, Kohlmeir. J Nutr. 124(11S), 2306-2308

8. Physical Activity • On average, how many times per week do you exercise? 0 1 2 3 4 5 or more • On average, how many minutes per session do you exercise? 0-9 10-19 20-29 30-39 40-49 50 or more

9. Demographics (1) • N = 733 (15% of workers) • Race/ethnicity • 43% White • 23% African-American • 16% Asian/Pacific Islander • 15% Hispanic • 3% Other

10. Age/Age Group Mean age 46 60% 35-50 30% 51-64 Income Group 18% < $50K 50% $50K-$65K 31% $65K+ Gender 34% Female 66% Male Education Group 26% High school or less 41% Some college 33% 4-year degree+ Demographics (2)

11. Self-reported Fruit and Vegetable Consumption and Belief About Amount Needed for Good Health Percent of Workers 60 52 50 40 37 30 20 11 10 0 0-2 3-4 5+ Servings FV Needed for Good Health California Dept. of Health Services, 2000

12. Self-reported consumption of fruits and vegetables, by age group Mean servings of fruits and vegetables 5.5 5 ** 4.5 4.1 4 3.5 3.1 3.1 3.1 3 2.5 2 1.5 1 0.5 0 Total Age 35-50 Age 25-34 Age 51-64 **p < .01 California Dept. of Health Services, 2000

13. Stages of Change Percent of Workers 100 90 80 68 70 60 50 40 30 15 20 11 3 10 2 0 Precontemplation Preparation Maintenance Contemplation Action Stage of Change California Dept. of Health Services, 2000

14. Belief in Number of Servings Needed Was Associated with Increased Consumption of Fruits and Vegetables

15. Belief Was Highly Related to Stage of Change

16. Physical Activity • “Adequate” - 8% • “Inadequate - 92% Adequate Inadequate • Age 25-34 - 20%** 80% • Age 35-50 - 7% 93% • Age 51-64 - 7% 93% **p < .01

17. Relationship Between Adequate Exercise and Fruit/Vegetable Consumption *** ***p < .001 California Dept. of Health Services, 2000

18. Most Significant Factors Related to Total Fruit and Vegetable Consumption • After controlling for demographics, two factors contributed unique components in terms of predicting the dependent variable • Belief in number of servings for good health • Adequate vs. inadequate exerciser • The model accounts for 31.1% of the variance in fruit/vegetable intake

19. Leading Reasons for Not Eating More Fruits and Vegetables California Dept. of Health Services, 2000

20. Leading Reasons for Not Eating More Fruits and Vegetables by Amount Reported*** ***p < .001 California Dept. of Health Services, 2000

21. Preferred source for health information • Electronic and Print Media 30% • Doctor’s office 30% • At work 20% • Grocery store 10%

22. Using Stages of Change for Dietary Intervention: Preparation • Key strategies • Resolve ambivalence • Develop firm commitment and specific action plan • Treatment “do’s” • Encourage clients to set specific, achievable goals • Reinforce small changes client may have already achieved Adapted from Kristal et al. JADA; 99 (6); 684

23. Using Stages of Change for Dietary Intervention: Preparation • Treatment “don’ts” • Not using this as a time to recommend general behavior change, i.e. “eat more fruits and vegetables” • Not downgrading small changes that have already been made Adapted from Kristal et al. JADA; 99 (6); 684

24. 5 a Day Worksite Campaign:Next Steps (1) • Formative research • Literature search • successful programs • gaps • barriers • potential partners • Roundtables & key informant interviews with gatekeepers/employers of large numbers of low and middle-income employees

25. 5 a Day Worksite Campaign:Next Steps (2) Developmental Research • Funding an individualized, on-line screening, assessment and delivery of tailored messages for increasing F/V and decreasing fat intake in worksite setting

26. Sharon B. Sugerman Public Health Institute PO Box 942732, MS-662 Sacramento, CA 94234-7320 916-324-3059 (phone) 916-322-1532 (fax) ssugerma@dhs.ca.gov