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Adoption and Impacts of Integrated Pest Management in Bangladesh: Evidence from Smallholder Bitter Gourd Growers
Rahman, Md. Sadique; Norton, George W. (MDPI, 2019-04-17)
Determinants of integrated pest management (IPM) adoption, productivity and efficiency of bitter gourd (Momordica charantia L.) growers in Bangladesh were jointly measured using propensity score matching (PSM), sample selection stochastic frontier production function (SFPF) and inverse probability weighted regression adjustment (IPWRA) techniques. The significant value (P < 0.05) of the selectivity variable (ρ_(w,v)) coefficient justifies the use of the sample selection SFPF. The decision to adopt IPM was positively influenced by the training and other farmers’ decisions to adopt. Mean technical efficiency (MTE) was found to be significantly higher for adopters (0.59) compared to non-adopters (0.40). The MTE analysis suggests that arranging more training sessions and making farmers more familiar with the IPM practices would improve the technical efficiency of the growers. Adoption of IPM practices significantly reduced the number pesticide applications, which imply environmental benefits from their adoption.
Changes in the Healthy Beverage Index in Response to an Intervention Targeting a Reduction in Sugar-Sweetened Beverage Consumption as Compared to an Intervention Targeting Improvements in Physical Activity: Results from the Talking Health Trial
Hedrick, Valisa E.; Davy, Brenda M.; Myers, Emily A.; You, Wen; Zoellner, Jamie M. (MDPI, 2015-12-04)
The recently developed Healthy Beverage Index (HBI) was designed to evaluate overall beverage intake quality (including total fluid consumption and beverage calories), yet no known intervention studies have assessed longitudinal changes to the HBI. The objective of this investigation was to assess changes in HBI scores in response to a sugar-sweetened beverage (SSB) reduction trial as compared to a physical activity comparison group. Participants were enrolled into a six-month, community-based, controlled behavioral trial and randomized into either a SSB reduction group (SIPsmartER) or a physical activity group (MoveMore). Correlations and multilevel mixed-effects linear regression with intention-to-treat analyses are presented. Total HBI score significantly increased for SIPsmartER (n = 149) (mean increase = 7.5 points (5.4, 9.7), p ≤ 0.001) and MoveMore (n = 143) (mean increase = 3.4 points (1.6, 5.2), p ≤ 0.001) participants, with a significant between group effect (p ≤ 0.05), over the six-month intervention. Other significant changes in HBI components for SIPsmartER included increased SSB and total beverage calorie scores, and decreased low-fat milk and diet soda scores. Changes in total HBI scores were significantly correlated with changes in total Healthy Eating Index-2010 scores (r = 0.15, p ≤ 0.01). Our findings suggest that individual HBI component scores, beyond the SSB component, are influenced by intervention strategies that primarily focus on SSB reduction.
Cloud-Sourcing: Using an Online Labor Force to Detect Clouds and Cloud Shadows in Landsat Images
Yu, Ling; Ball, Sheryl B.; Blinn, Christine E.; Moeltner, Klaus; Peery, Seth; Thomas, Valerie A.; Wynne, Randolph H. (MDPI, 2015-02-26)
We recruit an online labor force through Amazon.com’s Mechanical Turk platform to identify clouds and cloud shadows in Landsat satellite images. We find that a large group of workers can be mobilized quickly and relatively inexpensively. Our results indicate that workers’ accuracy is insensitive to wage, but deteriorates with the complexity of images and with time-on-task. In most instances, human interpretation of cloud impacted area using a majority rule was more accurate than an automated algorithm (Fmask) commonly used to identify clouds and cloud shadows. However, cirrus-impacted pixels were better identified by Fmask than by human interpreters. Crowd-sourced interpretation of cloud impacted pixels appears to be a promising means by which to augment or potentially validate fully automated algorithms.
The curious case of C-88: impacts of a potato variety on farmers in Yunnan, China
Myrick, Stephanie; Pradel, Willy; Li, Canhui; Suarez, Victor; Hareau, Guy; Larochelle, Catherine; Norton, George W.; Alwang, Jeffrey R. (2021-01-19)
Background Limited analysis has been conducted of the role of agricultural research in promoting Chinese agricultural growth in less-favored areas. This paper analyzes how a particular potato variety generates benefits to producers and discusses how these benefits may have contributed to poverty reduction in Yunnan province. Cooperation 88 (C88) is a high-yielding, late blight-resistant variety that was developed through a partnership between the International Potato Center and Yunnan Normal University in Kunming, China. Methods Qualitative and quantitative methods are used to analyze determinants of adoption of C88, and to estimate impacts of adoption on producer well-being. A unique farm-household database is used to document the determinants of C88 adoption and disadoption. The quantitative assessment is supplemented with a qualitative analysis of the potato value chain to understand how seed availability and concern for processing attributes contributed to and eventually constrained diffusion. Market-level information was used in an economic surplus model to quantify the substantial economic impact of C88 over 20 years since its release. Results C88 spread rapidly in Yunnan following its release and was widely adopted by commercially oriented farmers. Disadoption began after 2010 with limited seed availability driving the shift toward newer varieties. Farmers, however, appreciate the ease of marketing, the 15% higher yields, and late-blight resistance associated with C88 suggesting that seed constraints are countervailing the economic benefits of the variety. Total impact on Yunnan potato farmers of the variety was estimated to be around $2.5 billion for the 1996–2015 period. Conclusions On per-person terms among C88 growing farm households, the economic advantage of the variety is likely to have contributed to poverty reduction. The aggregate impact of C88 diffusion occurred during a period of rapid poverty reduction in Yunnan and yield and disease-resistance benefits of C88 likely contributed to this reduction.
Disparities in obesity among rural and urban residents in a health disparate region
Hill, Jennie L.; You, Wen; Zoellner, Jamie M. (2014-10-08)
Background The burden of obesity and obesity-related conditions is not borne equally and disparities in prevalence are well documented for low-income, minority and rural adults in the United States. The current literature on rural versus urban disparities is largely derived from national surveillance data which may not reflect regional nuances. There is little practical research that supports the reality of local service providers such as county health departments that may serve both urban and rural residents in a given area. Conducted through a community-academic partnership, the primary aim of this study is to quantify the current levels of obesity (BMI), fruit and vegetable (FV) intake and physical activity (PA) in a predominately rural health disparate region. Secondary aims are to determine if a gradient exists within the region in which rural residents have poorer outcomes on these indicators compared to urban residents. Methods Conducted as part of a larger ongoing community-based participatory research (CBPR) initiative, data were gathered through a random digit dial telephone survey using previously validated measures (n = 784). Linear, logistic and quantile regression models are used to determine if residency (i.e. rural, urban) predicts outcomes of FV intake, PA and BMI. Results The majority (72%) of respondents were overweight (BMI = 29 ± 6-kg/m2), with 29% being obese. Only 9% of residents met recommendations for FV intake and 38% met recommendations for PA. Statistically significant gradients between urban and rural and race exist at the upper end of the BMI distribution. In other words, the severity of obesity is worse among black compared to white and for urban residents compared to rural residents. Conclusions These results will be used by the community-academic partnership to guide the development of culturally relevant and sustainable interventions to increase PA, increase FV intake and reduce obesity within this health disparate region. In particular, local stakeholders may wish to address disparities in BMI by allocating resources to the vulnerable groups identified.
Effects of Two Environmental Best Management Practices on Pond Water and Effluent Quality and Growth of Nile Tilapia, Oreochromis niloticus
Frimpong, Emmanuel A.; Ansah, Yaw B.; Amisah, Stephen; Adjei-Boateng, Daniel; Agbo, Nelson W.; Egna, Hillary (MDPI, 2014-02-04)
The trajectory of aquaculture growth in sub-Saharan Africa has necessitated closer attention to the use of environmental best management practices (BMPs). Two BMPs in particular, water reuse and floating feeds, are being promoted for adoption by pond fish farmers in sub-Saharan Africa. In this study, we investigated: (1) the effect of water source and feed type on water quality; (2) the effect of water source and feed type on tilapia growth; and (3) the quality of potential effluents from ponds using different water source and feed types. The study was conducted in Ghana using on-farm experiments involving monitoring of water quality and growth of Nile tilapia Oreochromis niloticus for 160 days. Although considered low-intensity production systems, nutrients and solids in the study ponds exceeded levels expected in intensive culture ponds by wide margins, whereas BOD₅ was within the range for semi-intensive ponds. Floating feed was associated with higher water quality, especially dissolved oxygen, and higher growth, but water source did not significantly affect growth. Water reuse appears to be a viable BMP for sustainable aquaculture in the region, but the use of floating feed as BMP will depend on the economic profitability of floating feed use.
Factors influencing high respiratory mortality in coal-mining counties: a repeated cross-sectional study
Shi, Ruoding; Meacham, Susan; Davis, George C.; You, Wen; Sun, Yu; Goessl, Cody (2019-11-08)
Background Previous studies have associated elevated mortality risk in central Appalachia with coal-mining activities, but few have explored how different non-coal factors influence the association within each county. Consequently, there is a knowledge gap in identifying effective ways to address health disparities in coal-mining counties. To specifically address this knowledge gap, this study estimated the effect of living in a coal-mining county on non-malignant respiratory diseases (NMRD) mortality, and defined this as “coal-county effect.” We also investigated what factors may accentuate or attenuate the coal-county effect. Methods An ecological epidemiology protocol was designed to observe the characteristics of three populations and to identify the effects of coal-mining on community health. Records for seven coal-mining counties (n = 19,692) were obtained with approvals from the Virginia Department of Health Office of Vital Statistics for the years 2005 to 2012. Also requested were records from three adjacent coal counties (n = 10,425) to provide a geographic comparison. For a baseline comparison, records were requested for eleven tobacco-producing counties (n = 27,800). We analyzed the association of 57,917 individual mortality records in Virginia with coal-mining county residency, county-level socioeconomic status, health access, behavioral risk factors, and coal production. The development of a two-level hierarchical model allowed the coal-county effect to vary by county-level characteristics. Wald tests detected sets of significant factors explaining the variation of impacts across counties. Furthermore, to illustrate how the model estimations help explain health disparities, two coal-mining county case studies were presented. Results The main result revealed that coal-mining county residency increased the probability of dying from NMRD. The coal-county effect was accentuated by surface coal mining, high smoking rates, decreasing health insurance coverage, and a shortage of doctors. In Virginia coal-mining regions, the average coal-county effect increased by 147% (p-value< 0.01) when one doctor per 1000 left, and the effect increased by 68% (p-value< 0.01) with a 1% reduction of health insurance rates, holding other factors fixed. Conclusions This study showed a high mortality risk of NMRD associated with residents living in Virginia coal-mining counties. Our results also revealed the critical role of health access in reducing health disparities related to coal exposure.
Genetically-Improved Tilapia Strains in Africa: Potential Benefits and Negative Impacts
Ansah, Yaw B.; Frimpong, Emmanuel A.; Hallerman, Eric M. (MDPI, 2014-06-10)
Two genetically improved tilapia strains (GIFT and Akosombo) have been created with Oreochromis niloticus (Nile tilapia), which is native to Africa. In particular, GIFT has been shown to be significantly superior to local African tilapia strains in terms of growth rate. While development economists see the potential for food security and poverty reduction in Africa from culture of these new strains of tilapia, conservationists are wary of potential ecological and genetic impacts on receiving ecosystems and native stocks of tilapia. This study reviews the history of the GIFT technology, and identifies potential environmental and genetic risks of improved and farmed strains and tilapia in general. We also estimate the potential economic gains from the introduction of genetically improved strains in Africa, using Ghana as a case country. Employing a combination of the Economic-Surplus model and Monte Carlo simulation, we found the mean net present value (NPV) of the introduction of the GIFT strain in Ghana to be approximately 1% of the country’s gross domestic product. Sensitivity analysis indicated that the difference in growth or yield between the GIFT and locally-available strains has the largest effect on mean NPV. We conclude that improvements in management practices and infrastructure could increase the yield and profitability of the local strains even if genetically-improved strains are not introduced. These improvements also will ensure the realization of the full potential of introduced strains.
Hedonic Analysis of Forest Pest Invasion: the Case of Emerald Ash Borer
Li, Xiaoshu; Holmes, Thomas P.; Boyle, Kevin J.; Crocker, Ellen V.; Nelson, C. Dana (MDPI, 2019-09-19)
The emerald ash borer (EAB) was first detected in North America in 2002, and since its introduction, this invasive pest has killed millions of ash trees. While EAB kills native North American ash trees in all settings, its impacts have been especially large in urban areas where ash has been a dominant street tree, especially in residential areas. While some management costs, such as insecticide treatment, tree removal, or tree replacement, are relatively straightforward to compute, the impact that EAB has had on residential property values is less clear. To better understand the economic cost of EAB in urban settings, we conducted a hedonic property value analysis to evaluate the impact of ash tree damages due to EAB infestation on housing sales prices. This study was conducted in the city of Milwaukee, Wisconsin, which had high stocking levels of ash trees prior to EAB’s arrival. The objectives of the study are to investigate: (1) how EAB-infested ash trees affect property values; (2) whether the benefits from healthy ash trees to property value change after arrival of EAB; and (3) whether healthy ash trees located within infested neighborhoods provide the same benefits as the healthy ash trees located outside of infested neighborhoods. In general, our results show that the EAB outbreak has had a negative impact on home values for properties located in close proximity to the ash tree component of the urban forest. This result holds true for neighborhoods where EAB does not yet pose an imminent threat, and is amplified for neighborhoods where EAB has been detected. Our results highlight the early stages of a dynamic economic process that impacts urban residential property owners subject to the risk of EAB or other tree pests and diseases. In general, we find that forward-looking behavior of residential property owners is capitalized into property values during the process of forest pest infestation.
Impact of demographic disparities in social distancing and vaccination on influenza epidemics in urban and rural regions of the United States
Singh, Meghendra; Sarkhel, Prasenjit; Kang, Gloria J.; Marathe, Achla; Boyle, Kevin J.; Murray-Tuite, Pamela; Abbas, Kaja M.; Swarup, Samarth (2019-03-04)
Background Self-protective behaviors of social distancing and vaccination uptake vary by demographics and affect the transmission dynamics of influenza in the United States. By incorporating the socio-behavioral differences in social distancing and vaccination uptake into mathematical models of influenza transmission dynamics, we can improve our estimates of epidemic outcomes. In this study we analyze the impact of demographic disparities in social distancing and vaccination on influenza epidemics in urban and rural regions of the United States. Methods We conducted a survey of a nationally representative sample of US adults to collect data on their self-protective behaviors, including social distancing and vaccination to protect themselves from influenza infection. We incorporated this data in an agent-based model to simulate the transmission dynamics of influenza in the urban region of Miami Dade county in Florida and the rural region of Montgomery county in Virginia. Results We compare epidemic scenarios wherein the social distancing and vaccination behaviors are uniform versus non-uniform across different demographic subpopulations. We infer that a uniform compliance of social distancing and vaccination uptake among different demographic subpopulations underestimates the severity of the epidemic in comparison to differentiated compliance among different demographic subpopulations. This result holds for both urban and rural regions. Conclusions By taking into account the behavioral differences in social distancing and vaccination uptake among different demographic subpopulations in analysis of influenza epidemics, we provide improved estimates of epidemic outcomes that can assist in improved public health interventions for prevention and control of influenza.
Investigating the Spatial Dimension of Food Access
Yenerall, Jackie; You, Wen; Hill, Jennie L. (MDPI, 2017-08-02)
The purpose of this article is to investigate the sensitivity of food access models to a dataset’s spatial distribution and the empirical definition of food access, which contributes to understanding the mixed findings of previous studies. Data was collected in the Dan River Region in the United States using a telephone survey for individual-level variables (n = 784) and a store audit for the location of food retailers and grocery store quality. Spatial scanning statistics assessed the spatial distribution of obesity and detected a cluster of grocery stores overlapping with a cluster of obesity centered on a grocery store suggesting that living closer to a grocery store increased the likelihood of obesity. Logistic regression further examined this relationship while controlling for demographic and other food environment variables. Similar to the cluster analysis results, increased distance to a grocery store significantly decreased the likelihood of obesity in the urban subsample (average marginal effects, AME = −0.09, p-value = 0.02). However, controlling for grocery store quality nullified these results (AME = −0.12, p-value = 0.354). Our findings suggest that measuring grocery store accessibility as the distance to the nearest grocery store captures variability in the spatial distribution of the health outcome of interest that may not reflect a causal relationship between the food environment and health.
Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation
Hill, Jennie L.; Zoellner, Jamie M.; You, Wen; Brock, Donna J.; Price, Bryan; Alexander, Ramine C.; Frisard, Madlyn I.; Brito, Fabiana A.; Hou, Xiaolu; Estabrooks, Paul A. (2019-01-29)
Background To describe the identification, adaptation, and testing of an evidence-based pediatric weight management program for a health disparate community. Methods A community advisory board (CAB) of decision-makers and staff from local health care, public health, and recreation organizations engaged with academic partners to select an evidence-based program (EBP) for local implementation. Three EBPs were identified (Traffic Light, Bright Bodies, Golan and colleagues Home Environmental Model) and each EBP was rated on program characteristics, implementation and adaptation, and adoptability. Following selection of the EBP that was rated highest, the POPS-CAB made adaptations based on the program principles described in peer-reviewed publications. The adapted intervention, iChoose, was then pilot tested in 3 iterative phases delivered initially by research partners, then co-delivered by research and community partners, then delivered by community partners. The RE-AIM framework was used to plan and evaluate the iChoose intervention across all waves with assessments at baseline, post program (3 months), and follow-up (6 months). Results Bright Bodies rated highest on program characteristics and adoptability (p’s < 0.05), while Home Environmental Model rated highest on implementation factors (p < 0.05). Qualitatively, the selection focused on important program characteristics and on matching those characteristics to the potential to fit within the community partner services. The adapted program—iChoose—had 18% reach and with participants that were representative of the target population on age, gender, ethnicity, and race. Effectiveness was demonstrated by modest, but significant reductions in BMI z-scores at post-program compared to baseline (MΔ = − 0.047; t = − 2.11, p = 0.046). This decrease returned to values similar to baseline 3 months (MΔ = 0.009) after the program was completed. Implementation fidelity was high and implementation fidelity did not differ between community or research delivery agents. Conclusions The process to help organizations identify and select evidence-based programs appropriate for their community led to consensus on a single EBP. While iChoose was successful in initiating changes in BMI z-scores, could be implemented in a low resource community with fidelity, it was insufficient to lead to sustained child BMI z-scores. In response to these data, maintenance of program effects and delivery are the current focus of the CBPR team.
Supporting maintenance of sugar-sweetened beverage reduction using automated versus live telephone support: findings from a randomized control trial
Zoellner, Jamie M.; You, Wen; Estabrooks, Paul A.; Chen, Yi-Chun Yvonnes; Davy, Brenda M.; Porter, Kathleen J.; Hedrick, Valisa E.; Bailey, Angela; Kružliaková, Natalie (2018-10-04)
Background Although reducing sugar-sweetened beverage (SSB) intake is an important behavioral strategy to improve health, no known SSB-focused behavioral trial has examined maintenance of SSB behaviors after an initial reduction. Guided by the RE-AIM framework, this study examines 6–18 month and 0–18 month individual-level maintenance outcomes from an SSB reduction trial conducted in a medically-underserved, rural Appalachia region of Virginia. Reach and implementation indicators are also reported. Methods Following completion of a 6-month, multi-component, behavioral RCT to reduce SSB intake (SIPsmartER condition vs. comparison condition), participants were further randomized to one of three 12-month maintenance conditions. Each condition included monthly telephone calls, but varied in mode and content: 1) interactive voice response (IVR) behavior support, 2) human-delivered behavior support, or 3) IVR control condition. Assessments included the Beverage Intake Questionnaire (BEVQ-15), weight, BMI, and quality of life. Call completion rates and costs were tracked. Analysis included descriptive statistics and multilevel mixed-effects linear regression models using intent-to-treat procedures. Results Of 301 subjects enrolled in the 6-month RCT, 242 (80%) were randomized into the maintenance phase and 235 (78%) included in the analyses. SIPsmartER participants maintained significant 0–18 month decreases in SSB. For SSB, weight, BMI and quality of life, there were no significant 6–18 month changes among SIPsmartER participants, indicating post-program maintenance. The IVR-behavior participants reported greater reductions in SSB kcals/day during the 6–18 month maintenance phase, compared to the IVR control participants (− 98 SSB kcals/day, 95% CI = − 196, − 0.55, p < 0.05); yet the human-delivered behavior condition was not significantly different from either the IVR-behavior condition (27 SSB kcals/day, 95% CI = − 69, 125) or IVR control condition (− 70 SSB kcals/day, 95% CI = − 209, 64). Call completion rates were similar across maintenance conditions (4.2–4.6 out of 11 calls); however, loss to follow-up was greatest in the IVR control condition. Approximated costs of IVR and human-delivered calls were remarkably similar (i.e., $3.15/participant/month or $38/participant total for the 12-month maintenance phase), yet implications for scalability and sustainability differ. Conclusion Overall, SIPsmartER participants maintained improvements in SSB behaviors. Using IVR to support SSB behaviors is effective and may offer advantages as a scalable maintenance strategy for real-world systems in rural regions to address excessive SSB consumption. Trial registry Clinicaltrials.gov; NCT02193009; Registered 11 July 2014. Retrospectively registered.
A systematic review of factors that influence food store owner and manager decision making and ability or willingness to use choice architecture and marketing mix strategies to encourage healthy consumer purchases in the United States, 2005–2017
Houghtaling, Bailey; Serrano, Elena L.; Kraak, Vivica; Harden, Samantha M.; Davis, George C.; Misyak, Sarah A. (2019-01-14)
Background Altering food store environments is a promising approach to encourage healthy product purchases by consumers to improve their diet quality and health. Food store owners and managers are intermediaries to ensure that environmental changes are enacted. Despite their role as gatekeepers to implement and sustain healthy food environment changes, no systematic review has been published that examines food store owner and manager (retailer) data. Thus a review of retailer information available within the expansive United States (US) food environment literature was the purpose of this research. Methods The PRISMA protocol was used. A search strategy, including published articles from years 1980–2017, was applied to six databases to locate relevant articles that addressed the perspective of food store retailers in the US. Data were extracted, organized, and agreed upon between two authors based on pre-designed constructs: (1) a social-ecological model to capture factors that influence retailer decision making; and (2) a marketing-mix and choice-architecture framework to examine perspectives of applied (or the prospective application of) strategies at the store-level. Study quality was assessed using quality criteria checklists for qualitative and quantitative research. Results Thirty-one articles met inclusion criteria and most studies (n = 22) were qualitative and conducted in urban food stores (n = 23). Multiple social-ecological factors influenced retailer decision making and ability or willingness to use marketing-mix and choice-architecture strategies to improve consumers’ healthy choices to support dietary quality. These factors included: conflicting training outcomes to enhance retailers’ knowledge and skills (individual, n = 9); the importance of trust (interpersonal, n = 8); views about marketing-mix and choice-architecture strategies in the food environment (n = 25); consumer demand or demographics (community, n = 19); supplier and food store management variables (systems or sectors, n = 18); local and federal policy (n = 8); and support for community health (norms/values, n = 8). Conclusions Research partnerships can support favorable business and public health outcomes to align with retailers’ business models and available resources. A participatory and translational approach to food environment research will likely maximize public health impact. Urban and rural food store retailers are important actors for future research to inform the feasibility of store retailers to apply MMCA strategies that are profitable and promote health.
Value-at-Risk and Models of Dependence in the U.S. Federal Crop Insurance Program
Ramsey, A. Ford; Goodwin, Barry K. (MDPI, 2019-04-16)
The federal crop insurance program covered more than 110 billion dollars in total liability in 2018. The program consists of policies across a wide range of crops, plans, and locations. Weather and other latent variables induce dependence among components of the portfolio. Computing value-at-risk (VaR) is important because the Standard Reinsurance Agreement (SRA) allows for a portion of the risk to be transferred to the federal government. Further, the international reinsurance industry is extensively involved in risk sharing arrangements with U.S. crop insurers. VaR is an important measure of the risk of an insurance portfolio. In this context, VaR is typically expressed in terms of probable maximum loss (PML) or as a return period, whereby a loss of certain magnitude is expected to return within a given period of time. Determining bounds on VaR is complicated by the non-homogeneous nature of crop insurance portfolios. We consider several different scenarios for the marginal distributions of losses and provide sharp bounds on VaR using a rearrangement algorithm. Our results are related to alternative measures of portfolio risks based on multivariate distribution functions and alternative copula specifications.
Who Participates in Internet-Based Worksite Weight Loss Programs?
You, Wen; Almeida, Fabio A.; Zoellner, Jamie M.; Hill, Jennie L.; Pinard, Courtney A.; Allen, Kacie C.; Glasgow, Russell E.; Linnan, Laura A.; Estabrooks, Paul A. (2011-09-20)
Background The reach and representativeness are seldom examined in worksite weight loss studies. This paper describes and illustrates a method for directly assessing the reach and representativeness of a internet-based worksite weight loss program. Methods A brief health survey (BHS) was administered, between January 2008 and November 2009, to employees at 19 worksites in Southwest Virginia. The BHS included demographic, behavioral, and health questions. All employees were blinded to the existence of a future weight loss program until the completion of the BHS. Results The BHS has a participation rate of 66 percent and the subsequent weight loss program has a participation rate of 30 percent. Employees from higher income households, with higher education levels and health literacy proficiency were significantly more likely to participate in the program (p's < .01). Conclusions Worksite weight loss programs should include targeted marketing strategies to engage employees with lower income, education, and health literacy.

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