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Purpose: To explore the availability and utilization of workplace health supports by employees of small and large-sized employers., Design: Cross-sectional, telephone-based interviews collected on 16 workplace health supports for physical activity and diet., Setting: Participants selected by random-digit-dialing from 4 metropolitan areas of Missouri employees from 2012 to 2013., Participants: Two thousand fifteen working adults., Methods: We explored the availability and use of supports by employer size (<100 employees vs ≥100 employees), accounting for industry and personal factors., Analysis: We examined distributions and Poisson regression models of availability for supports by employer size and by industry and use of supports by employer size and personal factors., Results: One-fifth of the 1796 employees were employed by small-sized employers. Large employers offered more supports than small (mean: 6 vs 3), but a higher proportion of employees of small-sized employers used supports when available (59% vs 47%). The differences in offered supports between industries were not due to size alone. In regard to the determinants of participation, the personal factors of gender, age, weight, and income were associated with participation in 10 of the supports. Employer size was also associated with participation in 10 supports. No associations were found between personal factors or workplace size and participation for 3 supports., Conclusion: A higher proportion of employees working for smaller businesses use available supports than employees of larger businesses. Supports offered by employers should target the needs and interests of the workforce, particularly for the higher risk low-income employees.

Background: The workplace is an important setting for health promotion including nutrition and physical activity behaviors to prevent obesity. This paper explores the relationship between workplace social environment and cultural factors and diet and physical activity (PA) behaviors and obesity among employees., Methods: Between 2012 and 2013, telephone interviews were conducted with participants residing in four Missouri metropolitan areas. Questions included demographic characteristics, workplace socio/organizational factors related to activity and diet, and individual diet and PA behaviors, and obesity. Multivariate logistic regression was used to examine associations between the workplace socio/organizational environment and nutrition, PA, and obesity., Results: There were differences in reported health behaviors and socio/organizational environment by gender, race, age, income, and worksite size. For example, agreement with the statement the 'company values my health' was highest among Whites, older employees, and higher income workers. As worksite size increased, the frequency of reporting seeing co-workers doing several types of healthy behaviors (eat fruits and vegetables, doing PA, and doing PA on breaks at work) increased. In adjusted analyses, employees agreeing the company values my health were more likely to engage in higher PA levels (aOR=1.54, 95% CI: 1.09-2.16) and less likely to be obese (aOR=0.73, 95% CI: 0.54-0.98). Seeing co-workers eating fruits and vegetables was associated with increased reporting of eating at least one vegetable per day (aOR=1.43, 95% CI: 1.06-1.91) and seeing co-workers being active was associated with higher PA levels (aOR 1.56, 95% CI: 1.19-2.05)., Conclusions: This research suggests that social/organizational characteristics of the workplace environment, particularly feeling the company values the workers' health and to seeing co-workers engaging in healthy behaviors, may be related to nutrition and PA behaviors and obesity. These findings point to the potential for intervention targets including environment and policy changes.

Introduction: Few studies have examined the association between occupational sitting and body mass index (BMI). There is a particular lack of evidence among diverse populations. The objective of this study was to quantify the association between self-reported occupational sitting time and BMI by sex and race, independent of levels of occupational and leisure-time physical activity., Methods: In 2012 and 2013, participants residing in 4 Missouri metropolitan areas were interviewed via telephone. The interview included questions on sociodemographic characteristics and time spent sitting at work. Multinomial logistic regressions were used to examine the association between occupational sitting and BMI between men and women and between black and white women., Results: Overall 1,891 participants (66.9% women, 29.5% black) provided complete data. Median daily time spent by both men and women in occupational sitting was 180 minutes (interquartile range, 30 to 360 minutes); most participants were overweight (32.3%) or obese (33.6%). After adjusting for potential confounders, we found that black women in 3 categories of sitting time (31-180 minutes, 181-360 minutes, and >360 minutes) were approximately 2.5 times as likely (P for trend, .02) to be obese as black women who reported sitting for 30 minutes or less, independent of occupational and leisure-time physical activity. This association was not seen among white women. No significant associations were found among men., Conclusion: Occupational sitting is associated with an increased likelihood of obesity among black women, independent of occupational and leisure-time physical activity. Areas of future research include evaluating associations among various occupations and industries, assessing the association in prospective cohorts, and exploring the feasibility of worksite interventions that target sitting.

The purpose of this study was to explore the spatial relationship between park availability and chronic health conditions (CHCs) across age groups in Kansas City, MO. Multinomial logistic regression examined the association between having a park within one-half mile from home and the likelihood of having 0, 1, or 2 or more CHCs. Among respondents aged 40-59, those without a park within one-half mile from home were more than twice as likely to have 2 or more CHCs compared to respondents that had a park nearby. Parks may be an important protective factor for chronic diseases, especially among middle-aged adults among whom access to neighborhood recreational environments may be particularly important., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Ciclovias are active street events when roads are open to walkers, cyclists, and families and closed to automobiles. Over 70 cities in the USA have implemented ciclovias to promote physical activity. The authors evaluated four events during 2010 to determine what activities participants perform and who is attending. For two ciclovia events in St. Louis, Missouri, observation reports of activities, gender, and age of 1,452 participants were collected, and 82 adults were interviewed via direct approach. The survey covered six domains: physical activity, travel to event, sense of community, marketing, economic impact, and demographics. Each event occurred within the city, along multiple streets. Domains were selected from Ciclovia Recreativa developed by Ciclovia Bogota, Pan American Health Organization, and CDC. Additional questions addressed city-specific goals and matched similar evaluations in other cities. Over 50 % of participants met CDC-defined weekly minute thresholds for physical activity. Participants, primarily (>80 %) middle class, college educated, and white, were not representative of the majority minority city population, which has high rates of poverty, and low percentage of college graduates. Cities must work with residents to increase low-income minority population participation in ciclovia-based physical activity.

Context: Recent efforts to increase physical activity through changes to the built environment have led to strategies and programs that use existing public space, including bicycle lanes, temporary parks, and the ciclovia initiative (scheduled events in which streets are closed to motorized vehicles and opened for recreational activities) popularized in South America., Objective: This article describes and compares the processes and structures involved in developing and implementing a ciclovia-type program in 2 US urban contexts: San Francisco, California, and St Louis, Missouri. Considering the current growth of and interest in ciclovia initiatives, important outcomes, lessons learned are offered for application in other, similar settings., Design: Primary sources from both initiatives and from published research on ciclovias constitute the body of evidence and include year-end reports, grant applications, meeting minutes, budgets, published ciclovia guidelines, evaluation studies and Web sites, media sources, and interviews and personal communication with the organizers., Main Outcome Measures: Primary source documents were reviewed and included in this analysis if they offered information on 3 grounded questions: What processes were used in developing the initiative? What are the current structures and practices used in implementation of initiatives? What are important lessons learned and best practices from initiatives for recommendations to stakeholders and policy makers in other contexts?, Results: Among the categories compared, the structures and processes for implementation regarding buy-in and city department collaboration, route selection, programming, partnerships, media promotion, community outreach, and merchant support were relatively similar among the 2 initiatives. The categories that differed included staffing and volunteer engagement and funding., Conclusion: Buy-in from community partners, merchants, residents, and city agencies is critical for a positive experience in developing and implementing ciclovia-type initiatives in urban environments. When funding and staffing are inconsistent or limited, the quality and sustainability of the initiative is less certain.