A soup to remember: Using CHLI to improve Alabama worksites

Background: Obesity contributes to an array of adverse health outcomes such as end stage renal disease, hypertension, and type 2 diabetes. Economic costs including low occupational productivity, absenteeism, and high health care expenditures are additional burdens. Alabama is one of six states with an obesity prevalence rate above 30%, which indicates a need for intervention. Therefore, policy and environmental approaches towards decreasing this disparity should be explored in various settings, including worksites. The Community Healthy Living Index (CHLI), a rapid assessment and planning tool developed by the YMCA of the USA in partnership with Stanford University, Harvard University, and St. Louis University, allows organizations to engage in such explorations. Methods: Jefferson County Department of Health used community engagement techniques to target small and medium sized worksites, in Jefferson County, AL, from August – December of 2009. Worksites were asked to select key stakeholders to convene and answer 59 questions in the following categories: administrative support, health promotion, opportunities for physical activity, physical environment related to physical activity, healthy eating opportunities, and physical environment related to food/nutrition. Responses were electronically recorded and qualitative outcomes were generated using a continuum similar to Prochaska and Diclemente's Stages of Change Model. Results: A total of five worksites were assessed. Baseline outcomes ranged from “planting seeds” to “harvesting rewards”. Additionally, five improvement plans were developed to maximize simple opportunities for worksite physical activity and nutrition. Conclusion: CHLI can potentially empower worksites to change their organizational practices regarding sedentary behaviors and unhealthy eating practices.