Design of ChooseWell 365: Randomized controlled trial of an automated, personalized worksite intervention to promote healthy food choices and prevent weight gain.

Douglas E Levy, Emily D Gelsomin, Eric B Rimm, Mark Pachucki, Jenny Sanford, Emma Anderson, Charles Johnson, Rose Schutzberg, Anne N Thorndike

Journal: Contemporary clinical trials 2019;75():78-86

PMID: 30414448

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Abstract

BACKGROUND/AIMS

Behavioral nudges in the food environment increase healthy choices, but it is unknown if they improve diet and health. The ChooseWell 365 study will determine if an automated, personalized worksite intervention to nudge healthier choices improves overall diet and cardiometabolic health.

DESIGN

Randomized controlled trial of 602 hospital employees who regularly use on-site cafeterias and pay with an employee ID.

INTERVENTION

The intervention combines an environmental strategy (traffic-light labeling) with objective feedback and personalized nudges (health/lifestyle tips, social norms, incentives) to promote healthy food choices. The ChooseWell 365 software platform automatically generates personalized emails and letters that integrate employees' weight goals with health, lifestyle, and cafeteria purchasing data. Over one year, the intervention group receives two weekly emails. One provides a log of daily purchases; the second provides personalized health/lifestyle tips. The intervention group receives monthly mailed letters with social norm comparisons and financial incentives for healthier purchases. The one-year intervention will be completed in February 2019; all follow-up will be completed March 2020.

OUTCOMES

Weight, cardiometabolic risk factors, and dietary intake at one and two-year follow-up. Other outcomes include worksite food purchases by study participants and other non-participant employees who are socially connected (inferred from purchasing data) to participants.

CONCLUSIONS

ChooseWell 365 tests a novel strategy to deliver a scalable worksite prevention program that is integrated into the workday. The intervention is personalized but automated and therefore does not require costlier individual counseling. In the future, this program could be applied broadly in other worksite settings.

Address: Mongan Institute Health Policy Center, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.; Department of Nutrition and Food Services, Massachusetts General Hospital, Boston, MA, United States.; Harvard Medical School, Boston, MA, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, United States.; Sociology and Computational Social Science Institute, University of Massachusetts, Amherst, MA, United States.; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States.; StudyMaker LLC, Boston, MA, United States.; University of Massachusetts Medical School, Worcester, MA, United States.; Harvard Medical School, Boston, MA, United States; Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States. Electronic address: [email protected].

DOI: 10.1016/j.cct.2018.11.004

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MeSH Terms: Humans, Choice Behavior, Diet, Healthy, Electronic Mail, Health Promotion, Motivation, Obesity, Occupational Health Services, Personnel, Hospital, Social Norms, Randomized Controlled Trials as Topic