Importance:
Workplace health promotion programs often have limited reach and effectiveness because they are time-intensive and not integrated with the work environment.
Objective:
Conduct a randomized controlled trial testing an automated intervention combined with workplace cafeteria traffic-light labels to prevent weight gain and increase healthy food choices.
Methods:
602 hospital employees who regularly used 6 on-site cafeterias and paid with their ID were randomized in 2016-18. Cafeteria labels identified healthy (green), less healthy (yellow), and unhealthy (red) items. Participants completed visits, surveys, and dietary recalls at baseline and 12 months (end of intervention). The intervention group received personalized emails (2/week) and letters (1/month) that were automatically generated by a software platform that integrated cafeteria sales, health, and survey data. Emails included a log of weekly purchases (item, traffic light label, and calories) and health tips. Letters included social norm comparisons and small incentives for healthy purchases. The control group received standard lifestyle advice in monthly letters. A Healthy Purchasing Score was calculated by weighting purchased items by traffic light labels (red=0; yellow=0.5; green=1) using 12 mo of purchases during both baseline (pre-intervention) and intervention. Differences in differences in health outcomes, purchases, and dietary quality were compared, with missing values imputed.
Results:
Participants were 43.6 years (mean), 79% female, and 81% white. The intervention group increased healthy purchases compared to control, but changes in BMI and health outcomes were not different (see Table).
Conclusion:
An automated intervention linked to the workplace food environment increased healthy food choices but did not prevent weight gain. To improve health, this scalable healthy eating intervention could be augmented with additional technology to improve other health behaviors, such as physical activity, both at work and home.
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