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Open Access Highly Accessed Study protocol

Working on wellness (WOW): A worksite health promotion intervention programme

Tracy L Kolbe-Alexander14*, Karin I Proper2, Estelle V Lambert1, Marieke F van Wier2, Julian D Pillay1, Craig Nossel3, Leegale Adonis3 and Willem Van Mechelen2

Author Affiliations

1 UCT/MRC Research Unit for Exercise Science and Sports Medicine, Department of Human Biology, UCT School of Health Sciences, University of Cape Town, Cape Town, South Africa

2 Department of Public and Occupational Health, and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands

3 Discovery Health, Johannesburg, South Africa

4 MRC/UCT Research Unit for Exercise Science and Sports Medicine Department of Human Biology, Faculty of Health Sciences University of Cape Town, P.O. Box 115, Newlands, Cape Town, 7725, South Africa

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BMC Public Health 2012, 12:372  doi:10.1186/1471-2458-12-372

Published: 24 May 2012



Insufficient PA has been shown to cluster with other CVD risk factors including insufficient fruit and vegetable intake, overweight, increased serum cholesterol concentrations and elevated blood pressure. This paper describes the development of Working on Wellness (WOW), a worksite intervention program incorporating motivational interviewing by wellness specialists, targeting employees at risk. In addition, we describe the evaluation the effectiveness of the intervention among employees at increased risk for cardiovascular disease.


The intervention mapping (IM) protocol was used in the planning and design of WOW. Focus group discussions and interviews with employees and managers identified the importance of addressing risk factors for CVD at the worksite. Based on the employees’ preference for individual counselling, and previous evidence of the effectiveness of this approach in the worksite setting, we decided to use motivational interviewing as part of the intervention strategy. Thus, as a cluster-randomised, controlled control trial, employees at increased risk for CVD (N = 928) will be assigned to a control or an intervention group, based on company random allocation. The sessions will include motivational interviewing techniques, comprised of two face-to-face and four telephonic sessions, with the primary aim to increase habitual levels of PA. Measures will take place at baseline, 6 and 12 months. Secondary outcomes include changes in nutritional habits, serum cholesterol and glucose concentrations, blood pressure and BMI. In addition, healthcare expenditure and absenteeism will be measured for the economic evaluation. Analysis of variance will be performed to determine whether there were significant changes in physical activity habits in the intervention and control groups at 6 and 12 months.


The formative work on which this intervention is based suggests that the strategy of targeting employees at increased risk for CVD is preferred. Importantly, this study extends the work of a previous, similar study, Health Under Construction, in a different setting. Finally, this study will allow an economic evaluation of the intervention that will be an important outcome for health care funders, who ultimately will be responsible for implementation of such an intervention.

Trial registration

United States Clinical Trails Register NCT 01494207