Financial incentive policies for obesity prevention in worksite employees: a systematic review




Poster session 3


Tuesday 25 October 2016 - 10:30 to 11:00


All authors in correct order:

Sawada K1, Wada K2, Shahrook S3, Ota E4, Takemi Y5, Mori R6
1 Department of Food Science and Nutrition Faculty of Human Life and Environmental Sciences, Nagoya Women's University, Japan
2 Bureau of International Health Cooperation National Center for Global Health and Medicine (NCGM), Japan
3 Population Health Research Institute, Global Health, McMaster University and Hamilton Health Sciences,Hamilton, Ontario, Canada
4 St.Luke's International University, Graduate School of Nursing, Global Health Nursing, Japan
5 Department of Nutrition Sciences Kagawa Nutrition University (Joshi Eiyo Daigaku), Japan
6 Department of Health Policy, Research Institute, National Center for Child Health and Development, Japan
Presenting author and contact person

Presenting author:

Kimi Sawada

Contact person:

Abstract text
Background: Interventions such as discounted healthy menus, point-of-purchase advertisements, and sugar-free beverages for employees at worksites might prevent obesity in a manner similar to food-taxation strategies.

Objectives: We aimed to assess the effectiveness of food environmental interventions that incorporated financial incentive strategies for obesity prevention at the population level, unlike individual/group-focused nutrition education programs.

Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL and PsycINFO (January 2016) and included individual- and cluster-randomized controlled trials (RCTs) only. We followed standard Cochrane methods for trial eligibility criteria, 'Risk of bias' assessment, data extraction, and accuracy.

Results: We identified 42 full texts out of 2420 potentially eligible studies, from which two RCTs were included. Included studies compared the intervention versus none or multiple interventions, and involved a total of 595 employees. One of the trials was conducted in the USA and one in the Netherlands. The trials featured multi-components, e.g. low-priced healthy menus combined with nutrition education, food labeling, or portion size. For the primary outcomes, there was no significant effect on weight changes (mean difference (MD) 0.00 ㎏ confidence interval (CI) -11.69 to 11.69; one trial, 90 participants. Food/nutrition intake and cholesterol were secondarily assessed and followed by physical measures, e.g. weight changes. Data were not amenable to meta-analysis due to non-comparable effectiveness measurements. The trials had mostly an unclear to high risk of bias.

Conclusions: We found scarce evidence about the effectiveness of the assessed interventions. There was no significant effect of financial incentive policies targeting employees at worksite cafeterias for obesity prevention, and the trials had small sample sizes, wide confidence intervals, and uncertainty. In order to integrate these evaluations, it is necessary to accumulate further evidence from additional RCTs.