Worksite Internet Nutrition (WIN)

Diets high in fat and low in fruits and vegetables have been associated with numerous health problems, including cardiovascular disease, cancer, diabetes, and obesity. Unfortunately, despite nutrition education and health campaigns, more than 80% of Americans do not meet dietary recommendations for consumption of fruits and vegetables or dietary fat. Interventions are needed that incorporate effective behavior-change principles and can be delivered inexpensively to large segments of the population.

The Worksite Internet Nutrition (WIN) intervention is designed to help people improve their eating habits by reducing fat intake and increasing fruit and vegetable intake. Employers contract directly with the developers who deliver WIN entirely through e-mail messages sent directly to employees once a week for 12 weeks. A company representative (for example, from human resources) sends an initial e-mail to all employees with screening questions on fat and fruit and vegetable intake. Employees who fill out the screening instrument instantly receive a dietary analysis comparing their fruit and vegetable intake with recommended levels, suggestions for improving their intake, and an opportunity to enroll to receive additional e-mails over the course of the 12-week program. Once enrolled, employees receive weekly e-mails that may include dietary information, suggestions to improve diet, and weekly goals chosen by the employee. 

The developers state that implementing WIN requires almost no administrative support, personnel time, or expertise from the employer or organization. Assessment, tailoring, and delivery of messages are fully automated.

Employers, human resource managers, and employees are the intended audiences.

The intervention is suitable for implementation in work settings.

Costs for the WIN program are assessed on a sliding-scale based on the number of users. Typically, the cost is $20 or less per employee.

WIN was evaluated at a corporate worksite employing 230 individuals in a single-group, pretest/posttest research design. Employees received an initial e-mail from the participating company indicating the company authorized the program and that participation was voluntary. Approximately one third of the employees (i.e., 84) chose to receive e-mails and filled out a pre-intervention questionnaire; 47 of those participants filled out the post-intervention questionnaire. The outcomes were self-reported increases in fruit and vegetable intake, decreases in fatty food intake, and progress on a measure of Stage of Change for healthy eating. 

Key Findings

• Self-reported intake of dietary fat was assessed by asking respondents to rate their intake on 15 items related to dietary fats (meats, dairy, spread, etc.).  Participants who responded to the posttest questionnaire reported their consumption of dietary fat decreased an average of 0.39 servings per day, compared to baseline (p<.001). 

 

• Self-reported intake of fruits and vegetables was assessed by asking respondents to describe their intake on seven items describing fruits and vegetables. The response options were 0= less than once per week, 1= about once per week, 2= 2-3 times per week, 3= 4-6 times per week, 4= every day, and 5= 2 or more times per day. Participants who responded to the posttest questionnaire reported their consumption of fruits and vegetables increased an average of 0.73 servings per day, compared to baseline (p<.01). 

• Stage of Readiness for Change was categorized in three stages: pre-contemplation, contemplation/preparation, and action/maintenance. Of those who were not in the action/maintenance category at baseline (and therefore had room for forward movement), 65% had forward movement in Stage of Change for dietary fat intake (p= .04), and 74% had forward movement in Stage of Change for fruit and vegetable intake (p= .03).