Effectiveness of an integrated approach for workplace health promotion on lifestyle of employees: results of a cluster randomized controlled trial

TL;DR

This study tested an integrated workplace health program but found no improvement in employees' lifestyles over a year.

Contribution

The study evaluates an integrated workplace health promotion approach using a cluster randomized trial.

Findings

The integrated WHPP did not improve overall employee lifestyle.

Sugary drink consumption increased in the intervention group over time.

Poor implementation and short exposure may explain the lack of effectiveness.

Abstract

Evidence for the effectiveness of workplace health promotion programs (WHPPs) is small to moderate. More impact can be expected from an integrated WHPP, including activities at the individual and organizational levels. Since evidence regarding the effectiveness of integrated WHPPs is scarce, the aim of this study was to evaluate the effect of an integrated WHPP on the lifestyle of employees.

A two-armed cluster randomized controlled trial with measurements at baseline and at six and twelve months of follow-up was conducted. The intervention consisted of health promotion activities aimed at two (out of six) health behaviors, targeting the individual and organizational levels. The main outcome was an overall lifestyle-score measured using twelve items from the Simple Lifestyle Indicator Questionnaire. The secondary outcome measures were six separate health behaviors, i.e. physical activity, nutrition, mental balance, smoking, alcohol consumption, and sleep. Intervention effects at six and twelve months were analyzed by conducting either longitudinal linear or (ordinal) logistic multilevel analyses, or generalized estimating equations.

A total of 173 employees from four Dutch organizations participated. No effect was observed for overall lifestyle. The consumption of sugary drinks was higher over time (OR: 2.4, 95%CI: 1.1–5.4) and after twelve months of follow-up (OR: 2.9, 95%CI: 1.03–8.0) for the intervention condition compared to the control condition.

The integrated WHPP was not effective in improving the lifestyle of employees. The short duration of employees’ exposure to activities, poor implementation (i.e., not meeting the criteria of the integrated WHPP), and the minimal implemented activities may explain the absence of effect.

LTR (onderzoekmetmensen.nl), NL9526. Registered on 3 June 2021.

The online version contains supplementary material available at 10.1186/s12889-025-24522-1.

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