Transcript Mudita Upadhyaya - Southern Obesity Summit

TMC Overweight and Obesity (O2) Challenge
Diet and food-labeling intervention
Mudita Upadhyaya, DrPH
The University of Texas School of Public Health
Southern Obesity Summit
November 14, 2016
Houston, tx
WHAT IS TMC O2 CHALLENGE?
• Flagship program initiated by TMC Inc., along with GE and
UTSPH (evaluation)
• Multiple organizations to achieve a common goal of obesity
prevention among employees through implementing three
obesity prevention work-site program across varied work-sites
in Texas Medical Center, and Greater Houston :
• Commercially available diet program
• Vending labeling
• Cafeteria menu labeling
WHY TMC O2 CHALLENGE
• Obesity—A Costly Problem for TMC
• Among 780 TMC employees screened in a recent study by the
UT School of Public Health:
– 50% were obese (BMI of 30 or more), and another 28% were overweight (BMI
of 25-29.9) * compared to 66% in Texas, and 69% nationwide
• Using the more conservative Texas numbers:
SEGMENT
OVERWEIGHT
OBESE
% of Employee Population
35%
31%
OVERWEIGHT &
OBESE
66%
Excess medical costs per
employee/year
$346
$1,128
$1,474
Excess medical +
productivity costs per
employee/year
$478
$3,285
$3,763
SEGMENT
% of Employee
Population
Excess medical
costs per
employee/year
Excess medical +
productivity costs
per employee/year
*Sharma SV, Upadhyaya M*, Karhade M*, Baun B, Perkison WB, Feltovich M, Pompeii L, Brown HS, Hoelscher DM. Are hospital workers healthy?
A study of cardiometabolic, behavioral and psychosocial factors associated with obesity among hospital workers. Journal of Occupational and
Environmental Medicine. In Press.
WHAT IS OUR AIM?
• To determine the feasibility and effectiveness of three evidence
based programs implemented across multiple institutions (i.e.
Do the programs work?) :
• Two commercially available weight-loss programs
(Weight Watchers & iDiet) in reducing body weight
among overweight or obese employees across nine
diverse worksites in Houston, Texas
• Vending machine labeling interventions (Red-Yellow
Green traffic light) across thirty-two institutions in Texas
Medical Center
• Cafeteria menu labeling intervention across nine
cafeterias in Texas Medical Center
Institutions consent to participate
Weight
arm
Vending
labeling
arm
Cafeteria menu
labeling arm
Organizations self
select to participate in
the 2 program
Randomly sample
employees across each
program based on
screening criteria
Dietary/wellness staff
chose labeling criteria,
vending machines
Dietary, wellness staff
chose labeling criteria,
cafeteria menu items
Pre labeling sales data
shared with UT (2-3
months)
Pre labeling sales data
shared with UT (2-3
months)
Consent and Baseline
measures (wt. & Survey)
Vending machines
labeled
Cafeteria menu labeled
Monitoring visits
Post labeling sales data
shared with UT (3
months)
Implementation
of programs
Measures at 6m and 12 m
post-baseline
Post intervention sales
data shared with UT (3
months)
Outcome(s) measured
• Diet arm: Change in weight/BMI of the employees from
baseline to 6 & 12 months
• Vending labeling arm: Proportion of vending sales that were
green, yellow or red from baseline to 3 months
• Cafeteria labeling arm :Proportion of cafeteria food items
sales that were green, yellow or red from baseline to post
labeling period
TMC O2 Challenge Overview
Over view of the TMC O2 Challenge project arms
Sno
1.
Arms of the
study
Diet arm
Weight
Watchers
iDiet
Number of
organizations
currently
enrolled
(employees)
6 (123)
Baseline/preintervention
data collected
6
5 (100)
5
1 (23)
1
Post
intervention/mi
dline data
collection
In progress
2.
Vending labeling
28
25
25
3.
Cafeteria Menu
labeling
7
In progress
In progress
Vending labeling arm
Vending labeling arm overview
Number of
organizations
Labeling criteria used
Green dot only
2
Red Yellow Green
22
Befit
1
Total
25
Itemized sales
5
Gross sales
4
Gross units sold per RYG
category
Itemized units sold
9
Total
25
Type of data received
7
Cafeteria labeling arm:
Cafeteria menu labeling arm criteria
Number of
organizations
Labeling criteria used
MGM-Boston Hospital traffic light criteria
3
TMC-Red Yellow Green criteria
Other criteria
Total
3
1
7
CONSIDERATIONS
• Diet arm
• Participant retention
• Continuous engagement (of the participants, wellness
staff, weight program implementers)
• Vending & Cafeteria: our study does not examine individuallevel data
• Information-based labeling intervention: does not
account for decision biases in many individuals’ health
behaviors
• Environmental cues could translate into health benefits
over time
• Continuous engagement and collaboration
required(the dining & cafeteria staff, the vendors, and
the wellness staff)
FUTURE DIRECTION
Small(er)-scale focused implementation and evaluation in year 1
with subsequent dissemination in the following year(s).
Acknowledgement: Dr. Tim Garson, Health Policy Institute.
Dr. Shreela. V. Sharma, UTSPH
Dr. Stephen Linder, UTSPH
QUESTIONS ?
THANK YOU