Abstract P213: A Behavioral Economics Workplace Healthy Eating Intervention Similarly Benefits Employees With and Without Chronic Disease Risk

Introduction: Workplace interventions using behavioral economics approaches may provide low-cost opportunities for promoting healthy lifestyle. It is unknown if employees at higher chronic disease risk are more likely to benefit from workplace health promotion programs than employees at lower risk. This analysis assessed the differential effect of a 12-month behavioral workplace healthy eating intervention on improving dietary choices of employees’ with and without chronic disease risk. Hypothesis: We hypothesized that the intervention effect on cafeteria food purchases and diet quality would be stronger among employees with chronic disease risk compared to those without. Methods: This was a secondary data analysis of the ChooseWell 365 RCT conducted among hospital employees to test the effect of personalized feedback, peer comparisons, and financial incentives on improving cafeteria purchases, dietary intake, and weight. All hospital cafeterias used traffic-light food labeling. Published main results showed an intervention effect on cafeteria purchases but not overall diet quality or weight change. Diet quality was calculated from dietary recalls and measured via the Healthy Eating Index (HEI-2015), scored 0-100 (healthiest). Healthy purchasing scores (HPS) were calculated for each participant, weighting purchases’ color categories (red=0, yellow=0.5, green=1), scaled from 0-100 (healthiest). HEI-2015 and HPS were calculated at baseline, 6, 12, and 24 months. Participants were classified as having chronic disease risk if they self-reported hypertension, hyperlipidemia, heart disease, stroke, pre-diabetes, diabetes, cancer or another serious illness at baseline. Mixed models with random effects were used to compare dietary changes by study arm and risk categorization adjusted for body mass index, age, and race. Results: Participants (N=562) were mostly female (80.3%) and white (81.1%) with a median (p25, p75) age of 42 (33, 55) years; 38.1% reported at least one chronic disease risk condition. There was no differential intervention effect on HPS at any timepoint by chronic disease risk (all p-interaction>0.05): Among those with chronic disease risk, intervention participants increased HPS (unadjusted mean [SD]) from baseline through 24 months (68 [13] to 74 [13]) compared to control (68 [14] to 68 [16]). This was similar to the difference between intervention (67 [12] to 72 [13]) and control participants (69 [12] to 72 [12]) without risk. There was no differential intervention effect on HEI by chronic disease risk (all p-interaction>0.05). Conclusions: The ChooseWell 365 behavioral intervention improved the healthfulness of cafeteria purchases of employees with and without chronic disease risk, suggesting that workplace health promotion programs can improve lifestyle behaviors that contribute to both the prevention and treatment of chronic disease.