Body weight and the role of working conditions: A qualitative participatory investigation

Introduction
The causes of energy imbalance (insufficient exercise, excessive eating) are usually designated as “personal behaviors,” although environmental influences have recently received attention. The specific contributions of the work environment, however, are under-appreciated, despite a growing body of research on the effects of exposures as diverse as regular night work (disruption of sleep and diurnal rhythms), psychosocial job stressors, and endocrine disruptors. We are conducting a qualitative study of perceived contributions of work to weight gain and/or difficulty losing weight among low-income workers.

Methods
The study design involved 2 focus groups (8-10 participants) per job or sector: hotel cleaning / housekeeping; restaurant & food service; construction; nursing homes & other healthcare services; and light manufacturing. A focus group script was developed based on literature review and anecdotal information from workers in some of these settings and revised with input from experienced worker trainers. Study materials were translated and back-translated between English and Spanish. Focus groups were scheduled with female and male workers, both Latin-American (facilitated in Spanish) and African-American (in English). Individuals were compensated for their participation. Discussions were recorded, key themes were identified, and selected quotations were transcribed to represent each theme.

Results
Findings to date include (1) direct contributions of working conditions, especially shiftwork and work schedules, to weight-relevant behaviors; and (2) secondary mechanisms such as side effects of medication for conditions such as work-related asthma or anxiety following an assault at work, and disability following an injury, asthma, or other condition that interferes with exercise.

Discussion
Low-income workers have a broad range of work experiences that might influence weight gain or inability to lose weight. After systematic compilation of the focus group discussions, the full results will be communicated back to members of the participating populations for discussion of interpretation and brainstorming about recommendations to employers and for public policy action.