Organizational factors and the attitude toward health promotion in German ICT-companies

A Creative Concept to empower office workers addressing work-related health risks

Among office workers, the sedentary work-related health challenges are mainly associated with the fact that they often sit for up to 10 hr a working day. Members of the Research Group conducted a research program to assist the office workers of an international telecommunication company's affiliate in Budapest to enhance comfort levels in the office work environment. The data collection included a Comfort Survey to reveal employees' sense of comfort related to Indoor Environmental Quality (IEQ) components and the characteristics of employees' feelings and behavior during working hours. Moreover, a measurement of IEQ components was carried out and focused on air quality, lighting, sound exposure and thermal comfort parameters. Based on the survey's results, a Creative Concept was developed to empower office workers to address work-related health risks, notably sedentary work risks. The Creative Concept consists of five elements: a Comfort Map as an IEQ-related application to select a suitable workplace, redesigning concepts to increase the use of lounges, a newly developed work pad to improve personal hygiene in an office environment, recommendations for creating a health-enabling work environment and a workplace training program to raise health awareness. After validation, our Creative Concept can function as a multi-component workplace health promotion method to offer assistance for a wide variety of offices to create a health-enabling working environment.

[Workplace Health Promotion in Germany for All? Results of the 2018 BIBB/BAuA survey of Employed People]

AIM OF THE STUDY

This secondary analysis aims to investigate the prevalence and uptake of workplace health promotion (WHP) in Germany.

METHODS

Our data base was the 2018 BIBB-/BAuA Survey in Germany, which is a randomized representative CATI survey of 20,012 employed persons aged 15 and older. Proportions were compared among different groups and a binary logistic regression model was estimated.

RESULTS

47% of the employees reported that WHP interventions had been implemented in their company in the last two years. 25% of the employees had taken up the offer of WHP. The proportion of employees who confirmed that WHP was offered in their company increased sharply with the company size, but the take-up rates decreased. Employees in companies with a works/staff council stated a disproportionately high rate of implementation of WHP. However, employees with a low socioeconomic status reported WHP offer to a relatively small extent. In particular, employees without a vocational qualification, in a fixed-term employment, at risk of dismissal and temporary agency workers reported a relatively low implementation of WHP in their company. Logistic regression analyses aimed to identify predictors for the WHP offer. Compared to small companies, workers in medium-sized companies were more than twice as likely (OR=2.17) to have a WHP offer in their company and more than five times as likely (OR=5.64) in large companies. In the public sector, the chances of employees having WHP in their company were significantly better than in industry, crafts, trade or other sectors. Compared to German employees, employees with a foreign citizenship had a significantly lower chance of WHP being offered in their company (OR=0.78). A very good or excellent health status was associated with a slightly increased OR of 1.15 for WHP in the company. In companies in which employees were very satisfied with their work overall, the probability of a WHP offer was significantly increased (OR=1.70).

CONCLUSION

The analysis reveals large disparities in the WHP. There is a need for WHP strategies for targeting the small companies and the employees with a low socioeconomic status within the companies.

A bibliometric analysis of Health Promotion International content regarding unions, unionization and collective agreements

A recent article brought together the health benefits of unionization and working under collective agreements. It was noted how Canadian health promotion texts, reports and statements made no mention of unionization and working under collective agreements as promoting health. This was seen as a significant omission and reasons for this were considered. In this article this analysis is extended to consider how contributors to the flagship health promotion journal Health Promotion International (HPI) conceptualize unions, unionization and working under collective agreements as promoting health. Of 2443 articles published in HPI since its inception, 87 or 3.6% make mention of unions, unionization, collective agreements or collective bargaining, with most saying little about their promoting health. Instead, 20 make cursory references to unions or merely see them as providing support and engagement opportunities for individuals. Forty-five depict unions or union members as involved in a health promotion programme or activity carried out by the authors or by government agencies. Only 33 articles explicitly mention unions, unionization or collective agreements as potentially health promoting, representing 1.3% of total HPI content since 1986. We conclude that the health promoting possibilities of unionization and working under collective agreements is a neglected area amongst HPI contributors. Reasons for this are explored and an Organisation for Economic Cooperation and Development report on the importance of collective bargaining is drawn upon to identify areas for health promotion research and action.

Promoting physical activity and health literacy: study protocol for a longitudinal, mixed methods evaluation of a cross-provider workplace-related intervention in Germany (The AtRisk study)

Background

Physical activity and health literacy are topics of utmost importance in the prevention of chronic diseases. The present article describes the study protocol for evaluating a cross-provider workplace-related intervention promoting physical activity and health literacy.

Methods

The RE-AIM Framework will be the conceptual framework of the AtRisk study. A controlled natural experiment and a qualitative study will be conducted. The cross-provider intervention is based on the cooperation of the German Pension Fund Rhineland and cooperating German Statutory Health Insurances. It combines two components: a behavior-oriented lifestyle intervention and the assignment of a health coach. The single-provider intervention only includes the behavior-oriented lifestyle intervention.

The quantitative study (natural experiment) encompasses three measuring points (T0 = start of the behavior-oriented lifestyle intervention (baseline); T1 = end of the behavior-oriented lifestyle intervention (16 weeks); T2 = 6 month follow-up) and will compare the effectiveness of the cross-provider workplace-related intervention compared with the single provider intervention. Participants are employees with health related risk factors. ANCOVA will be used to evaluate the effect of the intervention on the outcome variables leisure time physical (primary outcome) activity and health literacy (secondary outcome). The qualitative study comprises semi-structured interviews, systematic field notes of stakeholder meetings and document analyses.

Discussion

The AtRisk study will contribute towards the claim for cross-provider interventions and workplace-related approaches described in the new Preventive Health Care Act. The results of this study will inform providers, payers and policy makers about the effectiveness of a cross-provider workplace-related lifestyle intervention compared to a single-provider intervention. Beyond, the study will identify challenges for implementing cross-provider preventive interventions. With respect to the sustainability of preventive interventions the AtRisk study will give insight in the expectations and needs on health coaching from the perspective of different stakeholders.

Trial registration

DRKS00010693.

Workplace health promotion and labour market performance of employees

This paper investigates the average effects of firm-provided workplace health promotion measures on labour market outcomes of the firms' employees. Exploiting linked employer-employee panel data that consist of rich survey-based and administrative information on firms, workers and regions, we apply a flexible propensity score matching approach that controls for selection on observables and time-constant unobserved factors. While the effects of analysing sickness absenteeism appear to be rather limited, our results suggest that health circles/courses increase tenure and job stability across various age groups. A key finding is that health circles/courses strengthen the labour force attachment of elderly employees (51-60), implying potential cost savings for public transfer schemes such as unemployment insurance or early retirement schemes.

Patterns and predictors of workplace health promotion: cross-sectional findings from a company survey in Germany

Background

Although the popularity of workplace health promotion (WHP) has considerably increased over the years, there are still concerns about the way this concept is being implemented by the companies. There is, however, a seeming lack of empirical knowledge about variations in WHP practice. Therefore, the aim of this study was to determine the prevalence of different patterns (and related quality levels) of WHP activity and the effect of organisational predictors on the chances of these WHP activity levels being implemented.

Methods

Data from an establishment survey (N = 6,500) were used to calculate the prevalences of four configurations of WHP among German companies. Furthermore, multinominal logistic regressions were performed to determine odds ratios for these WHP activity levels according to several organisational characteristics.

Results

9% of companies exhibited the most comprehensive type of WHP including analysis, individual-directed prevention measures and participatory groups concerned with working conditions improvement (level A), 18% featured a combination of analysis and individual-directed prevention (level B), 29% had reported measures from only one of these categories (level C), and 44% showed no WHP activity at all (level D). In the multivariate analysis company size turned out to be the strongest predictor of WHP at all levels. WHP was also predicted by a good economic situation of the company, the availability of safety specialist assistance, the availability of specialist assistance in occupational health and the presence of an employee representative body. These effects usually became stronger when moving up in the hierarchy of WHP levels. For the two sector-level variables (private vs. public, production vs. services) no statistically significant associations with WHP were found.

Conclusions

WHP still shows great potential for improvement both in quantitative and qualitative terms. Especially required are additional efforts in developing and implementing WHP practice models and dissemination strategies which are tailored to the particular conditions and needs of small companies. However, findings suggest that the chances for achieving progress in WHP also depend on developments in adjacent policy areas such as labour relations or occupational safety and health.

Health promotion in small business: a systematic review of factors influencing adoption and effectiveness of worksite wellness programs

OBJECTIVE

To assess the evidence regarding the adoption and efficacy of worksite health promotion programs (WHPPs) in small businesses.

METHODS

Peer-reviewed research articles were identified from a database search. Included articles were published before July 2013, described a study that used an experimental or quasiexperimental design and either assessed adoption of WHPPs or conducted interventions in businesses with fewer than 500 employees. A review team scored the study's rigor using the WHO-adapted GRADEprofiler "quality of evidence" criteria.

RESULTS

Of the 84 retrieved articles, 19 met study inclusion criteria. Of these, only two met criteria for high rigor.

CONCLUSIONS

Fewer small businesses adopt WHPPs compared with large businesses. Two high-rigor studies found that employees were healthier postintervention. Higher quality research is needed to better understand why small businesses rarely adopt wellness programs and to demonstrate the value of such programs.

Workplace health promotion and working conditions as determinants of employee health

Purpose

– The purpose of this paper is to investigate general psychosocial work conditions and specific workplace health promotion (WHP) measures in relation to employee health and sickness absence in Swedish municipal social care organizations.

Design/methodology/approach

– In a random sample of 60 out of the 290 municipalities in Sweden, 15,871 municipal social care employees working with elderly and disabled clients were sent a questionnaire concerning psychosocial work environment, WHP, and self-rated health. The responses (response rate 58.4 per cent) were complemented by register data on sickness absence (>14 days). All data were aggregated to employer level.

Findings

– A structural equation modelling analysis using employer-level data demonstrated that employers with more favourable employee ratings of the psychosocial work conditions, as well as of specific health-promoting measures, had better self-rated health and lower sickness absence level among employees.

Practical implications

– The results from this representative nationwide sample of employers within one sector indicate that employers can promote employee health both by offering various health-specific programmes and activities, such as work environment education, fitness activities, and lifestyle guidance, as well as by forming a high-quality work environment in general including developmental and supportive leadership styles, prevention of role conflicts, and a supportive and comfortable social climate.

Originality/value

– This study with a representative nationwide sample demonstrates: results in line with earlier studies and explanations to the challenges in comparing effects from specific and general WHP interventions on health.

Worksite Health Promotion Program Participation

This study explores the relationship between organizational health climate and worksite health promotion program participation, specifically engaging individuals who are unlikely to make positive health behavior choices on their own. Participants consisted of employees at three separate furniture-manufacturing facilities completing a voluntary survey. Using responses ( n = 349) from the health climate instrument, which is a measure of the collective attitudes, beliefs, and readiness to change a health behavior, this study identified two factors that were significant contributors to worksite health promotion program participation. Health norms, the collective attitudes regarding healthy lifestyle, as measured by the subscales—health scale and intention to make a behavior change—and “optimistic bias,” the overassessment of one’s personal health, were found to be predictors of participation. Additionally, significant ( p < .05) predictors of self-assessed health, included perceived control to initiate, competence to carry out, and the organizational support of the health behavior change. The findings suggest that the organization’s health norms and self-assessed health are associated with the worker’s motivation to become involved with health promotion interventions. Offering worksite health screenings and advanced programming and creating a culture of health at work can help address program participation.