Progress 08/01/09 to 07/31/11
Outputs
OUTPUTS: This project focused on prevention of obesity, the strongest modifiable risk factor for breast cancer and one which affects one third of U.S. women. Overall project aims were to understand: a) the acceptance and practicality of a worksite ecological intervention for weight gain prevention among workers, worksite leaders, and community nutrition professionals; and b) the effect of participation in an ecological intervention on workers' food choices and physical activity at a 6 month follow up point. The research built upon our worksite ecological intervention Small Steps are Easier Together (SS). Cornell Cooperative Extension (CCE) educators and worksite leaders from 5 small and medium sized rural worksites implemented locally determined environmental strategies to increase healthy eating and physical activity at their worksites. The first aim was addressed through a process evaluation that was conducted using a mixed method approach that included open-ended interviews with CCE partners (n=3), worksite leaders (n=4) and workers (n=10), and 4 focus groups with workers (n=22) in intervention sites. The second aim was addressed through a by-mail follow up survey with 65 intervention group participants (28 comparison participants) in the SS intervention 6 months after the end of the active intervention period (35% of intervention enrolled; 30% of comparison). We disseminated our environmental approach for obesity prevention at multiple scientific and professional meetings, reaching about 475 researchers and health professionals, 237 community educators, and worksite leaders and members, and 300 graduate students through scientific, professional, and community meetings including: the American Public Health Association and the International Society for Behavioral Nutrition and Physical Activity, and in-service education for CCE Educators and worksite leaders. We contributed to the BCERF website including a webcast on Diet, Lifestyle and Breast Cancer Risk, a web-based tutorial, on our community environmental approach to obesity prevention with community nutrition and health professionals. PARTICIPANTS: Nothing significant to report during this reporting period. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Our environmentally-based healthy eating and active living worksite intervention for rural communities Small Steps are Easier Together (SS) was completed in 5 small to medium sized rural worksites. A process evaluation of SS revealed that both participants and worksite leaders were very enthusiastic about the SS program. Positive outcomes included perceptions of increased support for walking and healthy eating as well as worksite environmental changes for improved access to low or no calorie beverages and fruits and vegetables. Characteristics of sites with high reach and dose delivered were leadership from upper management, a hands-on worksite leader, group input into choice of strategies, a critical mass of employees participating, visible environmental strategies, and feelings of accountability to co-workers. Feedback from monitoring and logging walking steps and healthy eating strategies on the project web site and weekly motivational messages contributed to participation. Individuals and sites with lower levels of participation cited lack of leadership and competing time concerns as reasons for their low participation. We conclude that local leadership, visible changes, and a critical mass of engaged participants are important for site-specific changes in worksite food and activity environments. In analysis of the 6 month follow up survey, intervention participants reported that the pre to post gains in worksite availability of healthy foods, fruits and vegetables, water and the ease of choosing smaller portions were sustained at follow up. However pre to post intervention gains in employer and co-worker support for walking and healthy eating were not sustained. These findings offer promise for the improved success of worksite ecological weight gain prevention interventions.
Publications
- Maley M, Devine C, Warren B. 2010. Perceptions of the environment for eating and exercise in a rural community. Journal of Nutrition Education and Behavior. 42: 185-191.
- Warren, B, Maley, M, Sugarwala, L., Devine, C. 2010. Small Steps Are Easier Together: An Environmental Goal Based Program To Increase Walking In Rural Worksites. Preventive Medicine. 50: 230-234.
- Devine C, Maley M, Farrell T, Warren B, Sadigov S, Carroll J. 2012. Process Evaluation of an Environmental Walking and Healthy Eating Pilot in Small Rural Worksites. Evaluation and Program Planning 35: 88-96. doi: 10.1016/j.evalprogplan.2011.08.002
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Progress 08/01/09 to 07/31/10
Outputs
OUTPUTS: This project focused on prevention of obesity, the strongest modifiable risk factor for breast cancer and one which affects one third of U.S. women. Overall project aims were to understand: a) the acceptance and practicality of a worksite ecological intervention for weight gain prevention among workers, worksite leaders, and community nutrition professionals; and b) the effect of participation in an ecological intervention on workers' food choices and physical activity at 6 month follow up. The research built upon our worksite ecological intervention Small Steps are Easier Together (SS) in 2008-09. Cornell Cooperative Extension (CCE) educators and worksite leaders from 5 small and medium sized rural worksites implemented locally determined environmental strategies to increase healthy eating and physical activity at their worksites. The first aim was addressed through a process evaluation that was conducted using a mixed method approach that included open-ended interviews with CCE partners (n=3), worksite leaders (n=4) and workers (n=10), 4 focus groups with workers (n=22) in intervention sites. The second aim was addressed through a by-mail follow up survey with 65 intervention group participants (28 comparison participants) in the SS intervention 6 months after the end of the active intervention period (35% of intervention enrolled; 30% of comparison). We disseminated our environmental approach for obesity prevention at multiple scientific and professional meetings, reaching about 275 researchers and health professionals, 33 community educators, and worksite leaders and members, and 100 graduate students through scientific, professional, and community meetings including: the American Public Health Association and the International Society for Behavioral Nutrition and Physical Activity, and in-service education for CCE Educators and worksite leaders. We contributed to the BCERF website at http://envirocancer.cornell.edu including a webcast on "Diet, Lifestyle and Breast Cancer Risk," a web-based tutorial, on our community environmental approach to obesity prevention with community nutrition and health professionals, and fact sheets reviewing the breast cancer research literature on obesity and breast cancer risk, obesity and all cancers, physical activity and breast cancer risk were posted on the BCERF website. PARTICIPANTS: Nothing significant to report during this reporting period. TARGET AUDIENCES: Nothing significant to report during this reporting period. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
Our environmentally-based healthy eating and active living worksite intervention for rural communities Small Steps are Easier Together (SS) was completed in 5 small rural worksites. Preliminary findings of a process evaluation of SS revealed that both participants and worksite leaders were very enthusiastic about the SS program. Positive outcomes included perceptions of increased support for walking and healthy eating as well as worksite environmental changes for improved access to low or no calorie beverages and fruits and vegetables. Characteristics of sites with high reach and dose delivered were leadership from upper management, a hands-on worksite leader, group input into choice of strategies, visible environmental strategies, and feelings of accountability to co-workers. Individuals reported that feedback from monitoring and logging their walking steps and healthy eating strategies on the project web site and weekly motivational messages contributed to participation. Individuals and sites with lower levels of participation cited lack of leadership and competing time concerns as reasons for their low participation; a few cited pedometer problems and web reporting as barriers. We conclude that local leadership and a critical mass of engaged participants are important for site-specific changes in worksite food and activity environments. In preliminary analysis of the 6 month follow up survey, intervention participants reported that the pre to post gains in worksite availability of healthy foods, fruits and vegetables, water and the ease of choosing smaller portions were sustained at follow up. However pre to post intervention gains in employer and co-worker support for walking and healthy eating were not sustained. These findings offer promise for the improved success of worksite ecological weight gain prevention interventions. There were 59,953 page views and about 15000 file downloads per month to the project website. A webcast on "Diet, Lifestyle and Breast Cancer Risk" received 103 hits per month. Our web-based tutorial, designed to share the tools and procedures for our community environmental approach to obesity prevention with community nutrition and health professionals registered an average of 73 hits per month. The searchable bibliography on the relationship of lifestyle and environmental risk factors to cancer received an average of 270 requests per month.
Publications
- Devine C, Maley M, Warren B. (2010) Small Steps are Easier Together: an ecological, locally adapted, walking and healthy eating intervention for small rural worksites. International Society for Behavioral Nutrition and Physical Activity.
- Devine C, Maley M, Warren B. (2009) Small Steps are Easier Together: increasing walking steps using web-based reporting and individual goal setting at work. American Public Health Association.
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