gms | German Medical Science

Background: Occupational physicians (OPs) may be involved in health promotion activities. Due to a lack of knowledge and evidence- based methods, this is hardly being implemented by many OPs.

Objectives: To develop and evaluate an evidence-based occupational health guideline on prevention of weight gain among employees.

Methods: Supported by professional association of OPs, a group of OPs and lifestyle experts developed a draft guideline based on literature, intervention mapping ; interviews with employers; and focus groups with employees. In a randomized controlled trial including 16 OPs and 523 employees, (cost-)effectiveness of guideline-based care was compared to usual care. Measurements took place at baseline and 6, 12, and 18 months thereafter. Outcome measures included waist circumference, daily physical activity and dietary behavior, productivity, absenteeism, and cost-effectiveness.

Results: The developed draft guideline consisted of recommendations for OPs how to advise employers to promote employees’ physical activity and diet, and to counsel employees. In the RCT, no significant (cost-)effectiveness of guideline-based care was found on body weight-related outcomes, blood pressure, total serum cholesterol or quality of life.

Discussion: Although various barriers existed to implementation, such as time constraints, OPs knowledge and skill level, lack of management support, the guideline in its current form will not be published and implementation in its current form is not advised.

Implications for guideline developers/users: Combining a guideline project with an RCT leads to a substantial extension of the development period. In complex or relatively new topics in the field, this, however, may be a valuable approach.