1. Work-place behavioral interventions for improving diet choices and weight management can be automated and personalized based on cafeteria purchase history.
2. Personalized, automated behavioral intervention did not alter weight but improved diet choices during the 2-year observational period.
Evidence Rating Level: 1 (Excellent)
With the growing obesity epidemic in the US, effective and sustainable weight management interventions are urgently needed, especially at the workplace. However, most workplace interventions are short-term and based on biometric screenings or education regarding food choices. Therefore, interventions that can promote effective and long-term behavioral changes in diet choice and weight management are critically needed.
This randomized control trial tested the effectiveness of an automated, personalized behavioral intervention program in preventing weight gain and improving diet amongst 602 adult (124 men and 478 women) hospital employees. All participants purchased food from hospital cafeteria at least 4 times a week. Participants who were pregnant, had a history of eating disorder, weight loss surgery, or enrolled in another weight loss program were excluded. 299 participants were randomized to the intervention group and received automated emails twice a week containing personalized feedback and suggestions regarding cafeteria purchases and a monthly letter with peer comparisons and financial incentives for healthier food purchases. 303 participants were randomized to the control group and received a monthly letter with general healthy lifestyle tips. The primary outcome was change in weight.
The intervention group did not have a significant difference in weight change at 12 or 24-months follow-up. However, the intervention group made healthier purchases and had decreased calories purchased per day compared with control group. This study was limited in its generalizability and feasibility given there were predominant female participants and a prerequisite for a food purchase tracking system. Nonetheless, the observed long-term improvement in food choices and potential consequent benefits warrants further studies of automated, personalized work-place interventions.
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