Occupational
Time-Varying Participation Patterns in a Workplace Health Promotion Program and Metabolic Health Hanae Nagata* Hanae Nagata Koryu Sato Koichiro Shiba Sho Takeda Naoki Kondo
Background: Workplace health promotion programs are widely implemented, but their long-term effects remain unclear. This study estimated the effects of time-varying participation patterns over a 5-year period on metabolic outcomes.
Methods: The Hakuhodo DY Group, a Japanese advertising company, introduced a voluntary health promotion program called “Checkup Championship” (Kenshin-sen in Japanese) during annual health checkup periods for its employees in 2019, applying behavioral science principles to enhance engagement compared to traditional methods. We used data from the health checkups of 3,697 employees (2,818 men and 879 women; mean age: 40.7 years) from 2018 to 2023. Our outcomes of interest were weight, waist circumference, BMI, blood pressure, LDL cholesterol and HbA1c in 2023. To assess the associations with these outcomes, we compared the participation patterns as follows: (1) consistent participation in all 5 years versus non-participation, (2) number of continuous participation sessions, and (3) continuous versus intermittent participation, such as participating every other year. We used longitudinal targeted maximum likelihood estimation (TMLE) to control for time-dependent confounding including exercise habits and other factors.
Results: Employees with consistent participation over 5 years showed significantly lower weight (-1.37 kg, 95% CI: -1.92 to -0.82), waist circumference (-1.16 cm, -1.78 to -0.55), BMI (-0.48kg/m2, -0.67 to -0.28), and LDL cholesterol (-3.86 mg/dL, -7.61 to -1.46) compared to non-participants. Sustained participation was associated with the outcomes when it was at least 4 years for weight and BMI, and at least 3 years for waist circumference and LDL cholesterol. Intermittent participation showed similar associations as the ones for continuous participation, but the association diminished with intermittent participation beyond two years. No significant differences in blood pressure or HbA1c were observed across any participation patterns.
Conclusion: Behavioral science-based workplace health promotion programs may improve metabolic outcomes of employees, when the participation was sustained at least for 3 to 4 years. These findings highlight the need for strategies that promote long-term engagement to enhance program effectiveness.