Application of the Environmental Assessment Tool (EAT) as a process measure for a worksite weight management intervention

Healthy People 2010 goals emphasize the worksite as an important setting for introducing environmental changes aimed at reducing the incidence of obesity. The Environmental Assessment Tool (EAT) was developed to measure physical and social environmental supports of obesity prevention interventions. The tool contains three scales: physical activity, nutrition and weight management, and organizational support for weight loss. This presentation summarizes the utilization of the EAT, which has demonstrated reliability and validity in this sample, as a process evaluation measure for a randomized controlled trial of a two-year environmental weight management intervention. EAT data were collected at four time points (baseline, intervention year one, intervention year two, and post-intervention) and intervention outcomes were collected at three time points (baseline, mid-intervention, and post-intervention). The EAT reflected the environmental changes implemented as part of the intervention. Intervention sites (N=9) demonstrated significantly greater changes in EAT scores, from baseline to intervention year two, compared to control sites (N=3) for the nutrition and weight management (β=8.28, p=.012) and organizational support (β=6.59, p=.010) scales as well as the total EAT score (β=16.10, p=.002). Changes in the total EAT scores were also related to the primary study outcome of weight loss with a 0.4% increase in the prevalence of employees who lost weight per point increase in the total EAT score (p=.013). Changes in the EAT organizational support, physical activity, and nutrition and weight management scales demonstrated similar trends. Possible explanations for these results, including the strengths and weaknesses of utilizing the EAT, will be discussed.