Associations of Sleep Duration and Screen Time with Incidence of Overweight in European Children: The IDEFICS/I.Family Cohort

IntroductionOver the past decades, children have been increasingly using screen devices, while at the same time their sleep duration has decreased. Both behaviors have been associated with excess weight, and it is possible they act as mutually reinforcing behaviors for weight gain. The aim of the study was to explore independent, prospective associations of screen time and sleep duration with incident overweight in a sample of European children.MethodsData from 4,285 children of the IDEFICS/I.Family cohort who were followed up from 2009/2010 to 2013/2014 were analyzed. Hours per day of screen time and of sleep duration were reported by parents at baseline. Logistic regression analyses were carried out in separate and mutually adjusted models controlled for sex, age, European country region, parental level of education, and baseline BMI z-scores.ResultsAmong normal weight children at baseline (N = 3,734), separate models suggest that every hour increase in screen time and every hour decrease in sleep duration were associated with higher odds of the child becoming overweight or obese at follow-up (OR = 1.16, 95% CI: 1.02–1.32 and OR = 1.23, 95% CI: 1.05–1.43, respectively). In the mutually adjusted model, both associations were attenuated slightly (screen time OR = 1.13, 95% CI: 0.99–1.28; sleep duration OR = 1.20, 95% CI: 1.03–1.40), being consistently somewhat stronger for sleep duration.Discussion/ConclusionBoth screen time and sleep duration increased the incidence of overweight or obesity by 13–20%. Interventions that include an emphasis on adequate sleep and minimal screen time are needed to establish their causal role in the prevention of overweight and obesity among European children.     

青少年依恋对家庭动力与心理健康状况的中介效应

目的探讨青少年依恋对家庭动力与心理健康状况之间的中介效应。方法使用系统家庭动力学自评量表（SSFD）、青少年父母同伴依恋量表（IIPA）和症状自评量表（SCL一90）对393名中学生被试进行评估,并进行统计分析。结果回归分析显示,SSFD中家庭气氛和个性化维度对青少年的心理健康状况有显著的主效应（R。=0．063,P=0．000;R。=0．016,P=0．012）,青少年的父母同伴依恋在家庭气氛和心理健康状况之间起部分中介的作用（P〈0．05,母亲、父亲及同伴依恋依次为P=0．056;P=0．040;P=0．001）,青少年的父母同伴依恋在个性化与心理健康状况之间起完全中介的作用（P〉0．05,母亲、父亲及同伴依恋依次为P=0．746;p=0．317;P=0．125）。结论青少年家庭动力中的家庭气氛和个性化是其心理健康状况的重要影响因素。     

家庭生活模式与青少年心理健康的关系

目的了解青少年心理健康状况与父母养育方式的关系,揭示在不同家庭生活模式中教养的子女会有何种心理差异,并导致不同心理问题的产生。方法运用症状自评量表(SCL-90)和本研究自行设计的青少年调查问卷,同全国青少年常模进行统计学比较,用统计工具SPSS 13.0进行单样本t检验。结果①与父母交流少的子女因子得分明显高于1986年全国青少年常模(躯体化t=2.95,强迫t=7.56,人际t=1.87,抑郁t=4.71,焦虑t=4.66,敌对t=7.16,恐怖t=4.20,偏执t=4.33,精神病性t=4.86;P≤0.001);②对学生不同居住模式进行分析,寄居亲属家的学生,强迫症状和敌对因子得分较高(强迫t=2.46,敌对t=3.40;P≤0.05);③认为父母对自己不了解的学生因子得分明显较高(躯体化t=6.01,强迫t=11.41,抑郁t=6.54,焦虑t=8.11,敌对t=12.42,偏执t=7.70,精神病性t=8.46;P≤0.01)。结论本组被试强迫和敌对等因子的均分普遍高于全国常模。父母应采用青少年易接受的方式与其交流,为其养成良好的思维模式和人格品质创造条件。     

Parental Perceptions of Children's Weight Status in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative: COSI 2015/2017

IntroductionParents can act as important agents of change and support for healthy childhood growth and development. Studies have found that parents may not be able to accurately perceive their child''s weight status. The purpose of this study was to measure parental perceptions of their child''s weight status and to identify predictors of potential parental misperceptions.MethodsWe used data from the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative and 22 countries. Parents were asked to identify their perceptions of their children''s weight status as “underweight,” “normal weight,” “a little overweight,” or “extremely overweight.” We categorized children''s (6–9 years; n = 124,296) body mass index (BMI) as BMI-for-age Z-scores based on the 2007 WHO-recommended growth references. For each country included in the analysis and pooled estimates (country level), we calculated the distribution of children according to the WHO weight status classification, distribution by parental perception of child''s weight status, percentages of accurate, overestimating, or underestimating perceptions, misclassification levels, and predictors of parental misperceptions using a multilevel logistic regression analysis that included only children with overweight (including obesity). Statistical analyses were performed using Stata version 15 1.ResultsOverall, 64.1% of parents categorized their child''s weight status accurately relative to the WHO growth charts. However, parents were more likely to underestimate their child''s weight if the child had overweight (82.3%) or obesity (93.8%). Parents were more likely to underestimate their child''s weight if the child was male (adjusted OR [adjOR]: 1.41; 95% confidence intervals [CI]: 1.28–1.55); the parent had a lower educational level (adjOR: 1.41; 95% CI: 1.26–1.57); the father was asked rather than the mother (adjOR: 1.14; 95% CI: 0.98–1.33); and the family lived in a rural area (adjOR: 1.10; 95% CI: 0.99–1.24). Overall, parents'' BMI was not strongly associated with the underestimation of children''s weight status, but there was a stronger association in some countries.Discussion/ConclusionOur study supplements the current literature on factors that influence parental perceptions of their child''s weight status. Public health interventions aimed at promoting healthy childhood growth and development should consider parents'' knowledge and perceptions, as well as the sociocultural contexts in which children and families live.     

仫佬族地区医务人员心理健康及其相关因素分析

目的探讨仫佬族地区医务人员心理健康与应对方式、人格特点、父母养育方式的相关性。方法整群抽样仫佬族地区403例医务人员,采用症状自评量表（SCL-90）、艾森克个性测验（EPQ）、简易应对方式问卷（SCSQ）、父母养育方式评价量表（EMBU）4个量表进行问卷调查。结果仫佬族地区医务人员SCL-90评分较一般人群高（P均〈0．01）;其心理健康状况与消极的应对方式、精神质人格特征或父母亲采用负面酊教育方式呈正相关（P〈0．05或P〈0．01）;仫佬族医务人员SCL-90评分与积极应对呈负相关（P〈0．05或P〈0．01）,而其他民族无相关性（P〉0．05）;除汉族外,所有民族医务人员SCL-90与神经质呈正相关（P〈0．05或P〈0．01）;父母亲的情感温暖、理解等积极的养育方式未见与子女的心理健康有相关性（P〉0．05）;工龄也是影响仫佬族医务人员心理健康的因素（P〈0．01）。结论仫佬族地区医务人员心理健康受多因素影响,应进行综合干预。     

Adolescent Illegal Drug Use: The Impact of Personality, Family, and Environmental Factors

This study examined the relationship between the domains of environmental factors, family illegal drug use, parental child-rearing practices, maternal and adolescent personality attributes, and adolescent illegal drug use. A nonclinical sample of 2,837 Colombian youths and their mothers were interviewed about intrapersonal, interpersonal, and environmental factors in their lives. Results indicated that certain environmental factors (e.g., violence, drug availability, and machismo), family drug use, a distant parent–child relationship, and unconventional behavior are risk factors for adolescent illegal drug use. As hypothesized, results showed that the adverse effects of family illegal drug use on adolescent drug use can be buffered by protective parental child-rearing practices and environmental factors, leading to less adolescent illegal drug use. Prevention and treatment efforts should incorporate protective environmental, familial, and intrapersonal components in order to reduce adolescent illegal drug use     

Status of Weight Change,Lifestyle Behaviors,Depression, Anxiety,and Diabetes Mellitus in a Cohort with Obesity during the COVID-19 Lockdown: Turk-Com Study Group

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic led to a lockdown period. Confinement periods have been related to unhealthy lifestyle behaviors. Our study aimed to determine weight change, changes in eating and exercise habits, the presence of depression and anxiety, and diabetes mellitus (DM) status in a cohort of patients with obesity.MethodsThe study was undertaken in nine centers of Collaborative Obesity Management (COM) of the European Association for the Study of Obesity (EASO) in Turkey. An e-survey about weight change, eating habits, physical activity status, DM status, depression, and anxiety was completed by patients. The International Physical Activity Questionnaire (IPAQ) score was used to determine physical activity in terms of metabolic equivalents (METs). A healthy nutrition coefficient was calculated from the different categories of food consumption. The Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) Questionnaire were used for determining depression and anxiety, respectively.ResultsFour hundred twenty-two patients (age 45 ± 12.7 years, W/M = 350/72) were included. The healthy nutrition coefficient before the pandemic was 38.9 ± 6.2 and decreased to 38.1 ± 6.4 during the pandemic (p < 0.001). Two hundred twenty-nine (54.8%) patients gained weight, 54 (12.9%) were weight neutral, and 135 (32.3%) lost weight. Patients in the weight loss group had higher MET scores and higher healthy nutrition coefficients compared with the weight gain and weight-neutral groups (p < 0.001). The PHQ and GAD scores were not different between the groups. Percent weight loss was related to healthy nutrition coefficient (CI: 0.884 [0.821–0.951], p = 0.001) and MET categories (CI: 0.408 [0.222–0.748], p = 0.004). One hundred seventy patients had DM. Considering glycemic control, only 12 (8.4%) had fasting blood glucose <100 mg/dL and 36 (25.2%) had postprandial BG <160 mg/dL. When patients with and without DM were compared in terms of dietary compliance, MET category, weight loss status, PHQ-9 scores, and GAD-7 scores, only MET categories were different; 29 (11.7%) of patients in the nondiabetic group were in the highly active group compared with 5 (2.9%) in the diabetic group.ConclusionThe COVID-19 lockdown resulted in weight gain in about half of our patients, which was related to changes in physical activity and eating habits. Patients with DM who had moderate glycemic control were similar to the general population in terms of weight loss but were less active.     

The Effect of Body Weight and Alcohol Consumption on Hyperuricemia and Their Population Attributable Fractions: A National Health Survey in China

IntroductionThe prevalence of hyperuricemia (HUA) is increasing worldwide; understanding of population attributable fraction of modifiable risk factors (MRFs) is important for disease prevention. Given the sparse evidence on how MRFs influence HUA in mainland China, we aimed to explore the effect of excess body weight and alcohol consumption and their population attributable fractions of HUA based on a national survey in mainland China.MethodsUsing data from the China National Health Survey which included 31,746 Han Chinese of 20–80 years of age from 10 provinces, we estimated the prevalence and MRFs (overweight/obesity and alcohol consumption) of HUA. HUA was defined as serum uric acid >417 μmol/L in men and >340 μmol/L in women. Restricted cubic-spline models were used to demonstrate the linear and nonlinear associations between exposures and HUA. The adjusted population attributable risk (PAR) was calculated to understand the relative importance of each MRF.ResultsThe prevalence of HUA was 25.1% in men and 15.9% in women. The population fraction of HUA cases that could be avoided by weight loss was 20.6% (19.3%–22.0%) in men and 18.1% (17.1%–19.0%) in women. The PAR of alcohol consumption was 12.8% (8.5%–17.1%) in men. Participants from Southwest China (Yunnan) had the highest HUA prevalence (47.9% in men and 29.9% in women) but with lower PAR of MRFs, especially in men (16.7%). Subjects in North China had lower HUA prevalence but higher PAR of MRFs. Around 44.8% male HUA cases in Inner Mongolia (26.9% of HUA prevalence) and 37.7% cases in Heilongjiang (34.4% of HUA prevalence) were attributable to overweight/obesity and alcohol consumption.ConclusionThere are significant sex and geographic difference on PAR of HUA due to MRFs. More tailored prevention strategies are needed to prevent HUA through weight loss and reduction of alcohol consumption.     

Self-Reported Health in HIV-Positive African American Women: The Role of Family Stress and Depressive Symptoms

This prospective study examined the association between stressful life events and self-reported health in 72 inner-city, low-income African American women with HIV. Depressive symptoms were examined as a potential mediator of this association. Findings indicated that family stressors predicted deterioration in self-reported health status over the 15-month assessment period. Additionally, the association between family stress and self-reported physical health was mediated by depressive symptoms such that the strength of the association between family stress and self-reported health was no longer statistically significant after depressive symptoms were entered in the model. This study suggests a potentially important target for prevention and intervention efforts aimed at enhancing the quality of life of women with HIV.     

Digital Inequalities of Family Life Information Seeking and Family Well-Being Among Chinese Adults in Hong Kong: A Population Survey

Background

Inequalities in Internet use and health information seeking are well documented, but less is known about information for family life activities.

Objective

We investigated the social determinants of online family life information seeking behaviors and its associations with family well-being among Chinese adults in Hong Kong.

Methods

A probability-based telephone survey was conducted in 2012 to record family life information seeking behaviors, including frequency of seeking and paying attention to family life information, levels of trust, and perceived usefulness of family life information. Family well-being was assessed using 3 single items on perceived family harmony, happiness, and health, with higher scores indicating greater well-being. Adjusted odds ratios for family life information seeking behaviors by socioeconomic characteristics and lifestyle behaviors, and adjusted beta coefficients for family well-being by family life information seeking behaviors were calculated.

Results

Of 1537 respondents, 57.57% (855/1537) had ever and 26.45% (407/1537) sought monthly family life information through the Internet. Lower educational attainment and household income, smoking, and physical inactivity were associated with less frequent seeking and paying attention (all P<.05). Greater perceived family health was associated with more frequent attention (adjusted β=.32, 95% CI.11-.52), greater levels of trust (adjusted β=.28, 95% CI .07-.48), and perceived usefulness (adjusted β=.23, 95% CI .01-.45) of family life information. Frequent attention and higher level of trust were also associated with greater family harmony (adjusted β=.22, 95% CI .002-.41) and happiness (adjusted β=.23, 95% CI .003-.42), respectively.

Conclusions

This is the first study investigating family life information seeking behaviors and suggested inequalities of online family life information seeking behaviors. The association between family life information seeking behavior and family well-being needs to be confirmed in prospective studies.     

Effect of Exposure to Paternal Smoking on Overweight and Obesity in Children: Findings from the Children Lifeway Cohort in Shenzhen,Southern China

IntroductionPaternal smoking associated with childhood overweight and obesity has been a concern, but studies have not investigated smoking exposure and smoking details. We investigated the association of exposures from paternal smoking as well as smoking details on offspring overweight/obesity.MethodsA total of 4,513 children (aged 7–8 years) in Shenzhen were enrolled. Four different exposures from paternal smoking as well as smoking quantity, duration of smoking, and age of starting smoking details were the exposure variables and demographic characteristics, and circumstances of birth, dietary intake, lifestyle, and nonpaternal-smoking exposure were covariates in the logistic regression analysis to determine the effect of paternal smoking on childhood overweight/obesity, estimating odds ratios (ORs), and 95% confidence intervals (CIs).ResultsPaternal smoking was positively associated with childhood overweight/obesity (p < 0.05). Moreover, only preconception exposure, and both pre- and postconception exposure were significantly associated with childhood overweight/obesity (OR 1.54 [95% CI: 1.14–2.08] and OR 1.73 [95% CI: 1.14–2.61], respectively), restricted to boys but not girls. Furthermore, for children with only preconception paternal-smoking exposure, the dose-response relation was positive between smoking quantity, duration of smoking, age at starting, and overweight/obesity for boy offspring (p trend <0.001). We did not find any significant association between only postnatal exposure to paternal smoking and childhood overweight/obesity (p > 0.05).ConclusionsOur findings suggest that paternal smoking is associated with boys'' overweight/obesity, and this association may be due to the paternal-smoking exposure before conception rather than the postnatal exposure to paternal smoking. Reducing paternal-smoking exposure before conception might help reduce overweight/obesity in boys.     

社会经济地位与儿童执行功能:父母教养方式的中介作用

目的:探讨小学中高年级儿童家庭社会经济地位、父母教养方式与儿童执行功能水平之间的关系。了解父母教养方式在家庭社会经济地位与儿童执行功能之间的作用。方法:应用方便取样在陕西省西安市招募243个家庭,最终获得有效样本237个,运用家庭社会经济地位调查表、中文版Buri父母权威问卷,执行功能神经心理测查(包括数字广度测验、连线测验和斯楚普色词测验)进行调查。结果:对于两个年级组的儿童,家庭社会经济地位与执行功能的关系存在差异。具体表现在,中年级组儿童家庭社会经济地位与父母教养方式的放任维度(r=-0.28,P0.05;r=-0.40,P0.01)和儿童认知灵活性、抑制控制呈负相关(r=-0.38,P0.01;r=-0.29,P0.05);高年级组儿童家庭社会经济地位与父母教养方式的父亲权威呈正相关(r=0.40,P0.01),与母亲专制呈负相关(r=-0.34,P0.05),而与儿童执行功能三成分得分均不存在相关。母亲放任在家庭社会经济地位对中年级儿童抑制控制的影响中起到了完全中介作用。结论:低社会经济地位家庭的母亲更多采取放任的教养方式对待并教养子女,进而阻碍了中年级组儿童抑制控制能力的发展。     

青少年情绪共情和抑郁的关系:羞耻倾向和心理弹性的链式中介作用

目的:探讨青少年情绪共情与抑郁之间的关系,以及羞耻倾向和心理弹性在其中的中介作用。方法:采用人际反应指针、内疚和羞耻倾向量表、心理弹性量表、流调中心抑郁量表对640名青少年进行测量。结果:相关分析结果显示,情绪共情、羞耻倾向、抑郁两两之间均存在显著正相关,心理弹性与情绪共情、羞耻倾向、抑郁均显著负相关;链式中介作用分析表明,情绪共情对抑郁的直接效应显著,羞耻倾向、心理弹性以及羞耻倾向—心理弹性在情绪共情和抑郁之间的中介和链式中介作用均显著。结论:青少年的情绪共情既可以直接影响其抑郁水平,也可以通过羞耻倾向、心理弹性的独立中介效应以及羞耻倾向—心理弹性的链式中介效应间接影响。     

The Role of Social Network Technologies in Online Health Promotion: A Narrative Review of Theoretical and Empirical Factors Influencing Intervention Effectiveness

Background

Social network technologies have become part of health education and wider health promotion—either by design or happenstance. Social support, peer pressure, and information sharing in online communities may affect health behaviors. If there are positive and sustained effects, then social network technologies could increase the effectiveness and efficiency of many public health campaigns. Social media alone, however, may be insufficient to promote health. Furthermore, there may be unintended and potentially harmful consequences of inaccurate or misleading health information. Given these uncertainties, there is a need to understand and synthesize the evidence base for the use of online social networking as part of health promoting interventions to inform future research and practice.

Objective

Our aim was to review the research on the integration of expert-led health promotion interventions with online social networking in order to determine the extent to which the complementary benefits of each are understood and used. We asked, in particular, (1) How is effectiveness being measured and what are the specific problems in effecting health behavior change?, and (2) To what extent is the designated role of social networking grounded in theory?

Methods

The narrative synthesis approach to literature review was used to analyze the existing evidence. We searched the indexed scientific literature using keywords associated with health promotion and social networking. The papers included were only those making substantial study of both social networking and health promotion—either reporting the results of the intervention or detailing evidence-based plans. General papers about social networking and health were not included.

Results

The search identified 162 potentially relevant documents after review of titles and abstracts. Of these, 42 satisfied the inclusion criteria after full-text review. Six studies described randomized controlled trials (RCTs) evaluating the effectiveness of online social networking within health promotion interventions. Most of the trials investigated the value of a “social networking condition” in general and did not identify specific features that might play a role in effectiveness. Issues about the usability and level of uptake of interventions were more common among pilot studies, while observational studies showed positive evidence about the role of social support. A total of 20 papers showed the use of theory in the design of interventions, but authors evaluated effectiveness in only 10 papers.

Conclusions

More research is needed in this area to understand the actual effect of social network technologies on health promotion. More RCTs of greater length need to be conducted taking into account contextual factors such as patient characteristics and types of a social network technology. Also, more evidence is needed regarding the actual usability of online social networking and how different interface design elements may help or hinder behavior change and engagement. Moreover, it is crucial to investigate further the effect of theory on the effectiveness of this type of technology for health promotion. Research is needed linking theoretical grounding with observation and analysis of health promotion in online networks.     

The Role of Exposomes in the Pathophysiology of Autoimmune Diseases I: Toxic Chemicals and Food

Autoimmune diseases affect 5–9% of the world’s population. It is now known that genetics play a relatively small part in the pathophysiology of autoimmune disorders in general, and that environmental factors have a greater role. In this review, we examine the role of the exposome, an individual’s lifetime exposure to external and internal factors, in the pathophysiology of autoimmune diseases. The most common of these environmental factors are toxic chemicals, food/diet, and infections. Toxic chemicals are in our food, drink, common products, the air, and even the land we walk on. Toxic chemicals can directly damage self-tissue and cause the release of autoantigens, or can bind to human tissue antigens and form neoantigens, which can provoke autoimmune response leading to autoimmunity. Other types of autoimmune responses can also be induced by toxic chemicals through various effects at the cellular and biochemical levels. The food we eat every day commonly has colorants, preservatives, or packaging-related chemical contamination. The food itself may be antigenic for susceptible individuals. The most common mechanism for food-related autoimmunity is molecular mimicry, in which the food’s molecular structure bears a similarity with the structure of one or more self-tissues. The solution is to detect the trigger, remove it from the environment or diet, then repair the damage to the individual’s body and health.     

警校大学生应对方式及影响因素研究

目的了解警校大学生应对方式状况及其影响因素。方法采用简易应对方式量表,对154名警校大学生进行测评。结果被试在遭遇应激性事件时采用积极应对方式的机率多于消极应对方式;警校大学生样本得分显著高于全国样本得分(积极应对t=5.92,P<0.001;消极应对t=-8.64,P<0.001);而影响警校大学生应对方式的主要因素有两个方面,即个人的人格特征和部分背景情况。结论警校大学生在遭遇应激性事件时采用积极应对方式多于消极应对方式,影响应对方式的主要因素是人格特征及个人背景情况。     

深圳某私营企业工人亚健康现状及其影响因素研究

目的研究深圳某私营企业工人的亚健康发生情况,为防治亚健康提供科学的依据。方法采用整群抽样及现场调查的方式,向深圳某私营企业1825名工人发放亚健康状态流行病学调查问卷．以文献回顾、专家讨论的方法确立亚健康的诊断标准,将合格问卷录入Epidata3．02,并对调查结果进行χ^2检验及Binary Logistic回归分析。结果共有1773份合格问卷,其中1104例处于亚健康状态,亚健康状态现患率为62．3％。Logistic回归分析结果表明．对工作能力的满意程度、加班、有精力做事情、饮食偏嗜、对现状满意程度等5个因素与该私营企业工人亚健康状态的发生有关（P〈0．05）。结论亚健康现患率高,关注和解决工人的亚健康问题势在必行。     

Rates and Determinants of Uptake and Use of an Internet Physical Activity and Weight Management Program in Office and Manufacturing Work Sites in England: Cohort Study

Background

Internet-based physical activity (PA) and weight management programs have the potential to improve employees’ health in large occupational health settings. To be successful, the program must engage a wide range of employees, especially those at risk of weight gain or ill health.

Objective

The aim of the study was to assess the use and nonuse (user attrition) of a Web-based and monitoring device–based PA and weight management program in a range of employees and to determine if engagement with the program was related to the employees’ baseline characteristics or measured outcomes.

Methods

Longitudinal observational study of a cohort of employees having access to the MiLife Web-based automated behavior change system. Employees were recruited from manufacturing and office sites in the North West and the South of England. Baseline health data were collected, and participants were given devices to monitor their weight and PA via data upload to the website. Website use, PA, and weight data were collected throughout the 12-week program.

Results

Overall, 12% of employees at the four sites (265/2302) agreed to participate in the program, with 130 men (49%) and 135 women (51%), and of these, 233 went on to start the program. During the program, the dropout rate was 5% (11/233). Of the remaining 222 Web program users, 173 (78%) were using the program at the end of the 12 weeks, with 69% (153/222) continuing after this period. Engagement with the program varied by site but was not significantly different between the office and factory sites. During the first 2 weeks, participants used the website, on average, 6 times per week, suggesting an initial learning period after which the frequency of website log-in was typically 2 visits per week and 7 minutes per visit. Employees who uploaded weight data had a significant reduction in weight (−2.6 kg, SD 3.2, P< .001). The reduction in weight was largest for employees using the program’s weight loss mode (−3.4 kg, SD 3.5). Mean PA level recorded throughout the program was 173 minutes (SE 12.8) of moderate/high intensity PA per week. Website interaction time was higher and attrition rates were lower (OR 1.38, P= .03) in those individuals with the greatest weight loss.

Conclusions

This Web-based PA and weight management program showed high levels of engagement across a wide range of employees, including overweight or obese workers, shift workers, and those who do not work with computers. Weight loss was observed at both office and manufacturing sites. The use of monitoring devices to capture and send data to the automated Web-based coaching program may have influenced the high levels of engagement observed in this study. When combined with objective monitoring devices for PA and weight, both use of the website and outcomes can be tracked, allowing the online coaching program to become more personalized to the individual.