1
|
Schouw DD, Mash R. Cost and consequence analysis of the Healthy Choices at Work programme to prevent non-communicable diseases in a commercial power plant, South Africa. Afr J Prim Health Care Fam Med 2020; 12:e1-e8. [PMID: 32634016 PMCID: PMC7343951 DOI: 10.4102/phcfm.v12i1.2217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 03/17/2020] [Accepted: 01/15/2020] [Indexed: 01/16/2023] Open
Abstract
Background The workplace is an ideal setting for the implementation of a health promotion programmes to prevent non-communicable diseases (NCD). There are limited resources assigned to workplace health promotion programmes in low-and middle-income countries (LMIC). Aim This study aimed to conduct a cost and consequence analysis of the Healthy Choices at Work programme. Setting This study was conducted at a commercial power plant in South Africa. Methods Incremental costs were obtained for the activities of the Healthy Choices at Work programme over a two-year period. A total of 156 employees were evaluated in the intervention, although the effect was experienced by all employees. An annual health risk factor assessment at baseline and follow up evaluated the consequences of the programme. Results The total incremental costs over the two-year period accumulated to $4015 for 1743 employees. The cost per employee on an annual basis was $1.15 and was associated with a −10.2mmHg decrease in systolic blood pressure, −3.87mmHg in diastolic blood pressure, −0.45mmol/l in total cholesterol and significant improvement in harmful alcohol use, fruit and vegetable intake and physical inactivity (p < 0.001). There was no correlation between sickness absenteeism and risk factors for NCDs. Conclusion The cost to implement the multicomponent HCW programme was low with significant beneficial consequences in transforming the workplace environment and reducing risks factors for NCDs. Findings of this study will be useful for small, medium and large organisations, the national department of health, and similar settings in LMICs.
Collapse
Affiliation(s)
- Darcelle D Schouw
- Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town.
| | | |
Collapse
|
2
|
McIntire RK, Romney MC, Alonzo G, Hutt J, Bartolome L, Wood G, Klein G, Goldfarb NI. Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health. Prev Chronic Dis 2019; 16:E95. [PMID: 31344336 PMCID: PMC6716388 DOI: 10.5888/pcd16.180631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities. Methods We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel linear modeling to explore relationships between community health and 3 outcome variables: emergency department (ED) use, hospital use, and paid claims. Business leaders reviewed findings and offered insights on preparedness to invest in community health improvement. Results Poorer community health was associated with high use of ED services, after controlling for age and sex. After including a summary measure of racial composition at the zip code region level, the relationship between community health and ED use became nonsignificant. No significant relationships between community health and hospitalizations or paid claims were identified. Business leaders expressed interest in further understanding health needs of communities where their employees live. Conclusion The health of communities in which adult employees and dependents live was associated with ED use, but similar relationships were not seen for hospitalizations or paid claims. This finding suggests a need for more primary care access. Despite limited quantitative evidence, business leaders expressed interest in guidance on investing in community health improvement.
Collapse
Affiliation(s)
| | - Martha C Romney
- Jefferson College of Population Health, Philadelphia, Pennsylvania
| | - Greg Alonzo
- Gallagher Benefit Services, Princeton, New Jersey
| | - Jill Hutt
- Greater Philadelphia Business Coalition on Health, Philadelphia, Pennsylvania
| | - Lauren Bartolome
- Jefferson College of Population Health, Philadelphia, Pennsylvania
| | | | - Gary Klein
- Public Health Management Corporation, Philadelphia, Pennsylvania
| | - Neil I Goldfarb
- Greater Philadelphia Business Coalition on Health, 123 South Broad St, Suite 1235, Philadelphia, PA 19109.
| |
Collapse
|
3
|
Schouw D, Mash R, Kolbe-Alexander T. Transforming the workplace environment to prevent non-communicable chronic diseases: participatory action research in a South African power plant. Glob Health Action 2019; 11:1544336. [PMID: 30474516 PMCID: PMC6263095 DOI: 10.1080/16549716.2018.1544336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: The workplace is an important setting for the prevention of non-communicable diseases (NCDs). Policies for transformation of the workplace environment for occupational health and safety in South Africa have focused more on what to do and less on how to do it. There are no guidelines and little evidence on workplace-based interventions for NCDs. Objective: The aim of this study was to learn how to transform the workplace environment in order to prevent and control cardio-metabolic risk factors for NCDs amongst the workforce at a commercial power plant in Cape Town, South Africa. Methods: The study design utilized participatory action research in the format of a cooperative inquiry group (CIG). The researcher and participants engaged in a cyclical process of planning, action, observation and reflection over a two-year period. The group used outcome mapping to define the vision, mission, boundary partners, outcomes and strategies required. At the end of the inquiry the CIG reached a consensus on their key learning. Results: Substantial change was observed in the boundary partners: catering services (78% of progress markers achieved), sport and physical activities (75%), health and wellness services (66%) and managerial support (65%). Highlights from a 10-point consensus on key learning included the need for: authentic leadership; diverse composition and functioning of the CIG; value of outcome mapping; importance of managerial engagement in personal and organizational change; and making healthy lifestyle an easy choice. Conclusion: Transformation included a multifaceted approach and an engagement with the organization as a living system. Future studies will evaluate changes in the risk profile of the workforce, as well as the costs and consequences for the organization.
Collapse
Affiliation(s)
- Darcelle Schouw
- a Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
| | - Robert Mash
- a Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
| | - Tracy Kolbe-Alexander
- b School of Health and Wellbeing , University of Southern Queensland , Ipswich , Australia
| |
Collapse
|
4
|
Pronk NP. Connecting the Dots Between Health and Well-being, Business, Community, and Prosperity. ACSM'S HEALTH & FITNESS JOURNAL 2019. [DOI: 10.1249/fit.0000000000000446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
5
|
Chigumete TG, Townsend N, Srinivas SC. Facilitating and limiting factors of workplace health promotion at Rhodes University, South Africa. Work 2018; 59:599-606. [PMID: 29733050 DOI: 10.3233/wor-182707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Workplace health promotion programs, when well designed and implemented are beneficial to both employees and their employers. OBJECTIVE To investigate the factors that affect workplace health promotion initiatives intended for support staff at Rhodes University. To explore ways in which future initiatives that aim to reduce the prevalence of non-communicable diseases in the workplace may be improved. METHODS A qualitative study, using semi-structured interviews and focus group discussions with key stakeholders and support staff. All interviews and focus group discussions were voice recorded and then transcribed verbatim. Transcripts were uploaded into NVivo® 10 for coding and thematic analysis. RESULTS Key stakeholders reported that health promotion initiatives have been attempted and were advertised, however the turnout was poor. The support staff in turn, stated that past initiatives were not tailored to their health needs and they lacked context-specificity and cultural sensitivity. They also suggested improvements for future initiatives such as convenient venues and using films and short plays as a means of delivering health information. CONCLUSIONS Based on inputs from key stakeholders and support staff, there are several factors that affect the success of health promotion initiatives in the workplace. Employees, who are the recipients of the planned initiatives, need to be involved in all stages of the planning and implementation.
Collapse
|
6
|
Magnavita N. Obstacles and Future Prospects: Considerations on Health Promotion Activities for Older Workers in Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061096. [PMID: 29843423 PMCID: PMC6025276 DOI: 10.3390/ijerph15061096] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 12/20/2022]
Abstract
The ageing of workers is one of the most important issues for occupational health and safety in Europe. The ageing of the active population means that health promotion is a necessity rather than a mere option. This review considers barriers and perspectives for workplace health promotion for older workers. Lack of awareness on the part of management and inflexibility in the occupational health and safety system appear to be major barriers. To overcome these, it will be necessary to disseminate knowledge regarding the effectiveness of health promotion actions for older workers, encourage greater involvement on the part of social partners, recover resources by replacing medical consumerism and bureaucratic practices, adopt an integrated approach combining the prevention of occupational risks and the promotion of healthy lifestyles, and recognize subsidiarity and the ability of working communities to regulate themselves.
Collapse
Affiliation(s)
- Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
| |
Collapse
|
7
|
Exploration Into the Business Priorities Related to Corporate Engagement in Community Health Improvement Partnerships. J Occup Environ Med 2017; 59:1041-1046. [DOI: 10.1097/jom.0000000000001111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
8
|
McLellan DL, Williams JA, Katz JN, Pronk NP, Wagner GR, Cabán-Martinez AJ, Nelson CC, Sorensen G. Key Organizational Characteristics for Integrated Approaches to Protect and Promote Worker Health in Smaller Enterprises. J Occup Environ Med 2017; 59:289-294. [PMID: 28267100 PMCID: PMC7372726 DOI: 10.1097/jom.0000000000000949] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate relationships between worksite organizational characteristics (size, industrial sector, leadership commitment, and organizational supports) and integrated approaches to protecting and promoting worker health implemented in smaller enterprises. METHODS We analyzed web-based survey data of Human Resource Managers at 114 smaller enterprises (<750 employees) to identify organizational factors associated with levels of integrated approaches among their worksites. RESULTS The companies' mean integration score was 13.6 (SD = 9.6) of a possible 44. In multivariate analyses, having a safety committee (P = 0.035) and top leadership support for health promotion (HP) (P = 0.004) were positively associated with higher integration scores. CONCLUSIONS Smaller enterprises in one U.S. region have relatively low levels of implementing integrated safety and promotion approaches. Having a safety committee and leadership support for HP may be important contributors to implementing integrated approaches in smaller enterprises.
Collapse
Affiliation(s)
- Deborah L. McLellan
- Dana-Farber Cancer Institute, Boston, Mass
- Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Jessica A. Williams
- Dana-Farber Cancer Institute, Boston, Mass
- University of Kansas, School of Medicine, Kansas City, KS
| | - Jeffrey N. Katz
- Harvard T.H. Chan School of Public Health, Boston, Mass
- Brigham and Women’s Hospital, Boston, Mass
| | - Nicolaas P. Pronk
- Harvard T.H. Chan School of Public Health, Boston, Mass
- HealthPartners, Inc., Minneapolis, Minn
| | - Gregory R. Wagner
- Harvard T.H. Chan School of Public Health, Boston, Mass
- National Institute for Occupational Safety and Health (NIOSH/CDC), Washington, DC
| | - Alberto J. Cabán-Martinez
- Harvard T.H. Chan School of Public Health, Boston, Mass
- University of Miami, Miller School of Medicine Medical School, Miami, Fla
| | | | - Glorian Sorensen
- Dana-Farber Cancer Institute, Boston, Mass
- Harvard T.H. Chan School of Public Health, Boston, Mass
| |
Collapse
|
9
|
Koyama AK, Bali V, Yermilov I, Legorreta AP. Identification of Undiagnosed Hyperlipidemia: Do Work Site Screening Programs Work? Am J Health Promot 2016; 32:971-978. [PMID: 27687615 DOI: 10.1177/0890117116671537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE We evaluated the rate of hyperlipidemia identified during workplace screening in previously undiagnosed individuals, the association between workplace hyperlipidemia screening and use of medical care during follow-up, and changes in lipid profile among individuals with hyperlipidemia at screening. DESIGN Nonexperimental longitudinal study. SETTING Employees who participated in a workplace health screening. PARTICIPANTS A total of 18 993 individuals from 39 self-insured employers in the United States. MEASURES Total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides were measured during screening. A claims-based algorithm was used to identify hyperlipidemia cases. ANALYSIS Discrete-time survival analysis was used to estimate monthly rates of new hyperlipidemia diagnoses or prescriptions. Paired t tests were used to evaluate 1-year changes in lipid profile. RESULTS A total of 1872 (9.9%) individuals had hyperlipidemia at screening. Among all individuals, a significantly greater rate of new hyperlipidemia diagnoses was observed during the first month after screening, compared to the 3 months before screening (odds ratio [95% CI]: 2.99 [2.66-3.36]). Among the 987 individuals who were followed up 1 year later, significant improvements were observed in total cholesterol (-8.5% ± 13.6%) and LDL levels (-10.2% ± 19.3%). CONCLUSION Workplace health screenings in an insured population were associated with a subsequent increase in physician visits and prescriptions for hyperlipidemia. After 1 year, significant improvements in total cholesterol and LDL levels were observed among individuals who screened positive for hyperlipidemia.
Collapse
Affiliation(s)
| | | | | | - Antonio P Legorreta
- 3 Department of Health Policy and Management, University of California Fielding School of Public Health, Los Angeles, CA, USA
| |
Collapse
|
10
|
Organizational Characteristics Influence Implementation of Worksite Health Protection and Promotion Programs: Evidence From Smaller Businesses. J Occup Environ Med 2016; 57:1009-16. [PMID: 26340290 DOI: 10.1097/jom.0000000000000517] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We explored associations between organizational factors (size, sector, leadership support, and organizational capacity) and implementation of occupational safety and health (OSH) and worksite health promotion (WHP) programs in smaller businesses. METHODS We conducted a web-based survey of human resource managers of 117 smaller businesses (<750 employees) and analyzed factors associated with implementation of OSH and WHP among these sites using multivariate analyses. RESULTS Implementation of OSH, but not WHP activities, was related to industry sector (P = 0.003). Leadership support was positively associated with OSH activities (P < 0.001), but negatively associated with WHP implementation. Organizational capacity (budgets, staffing, and committee involvement) was associated with implementation of both OSH and WHP. Size was related to neither. CONCLUSIONS Leadership support and specifically allocated resources reflecting that support are important factors for implementing OSH and WHP in smaller organizations.
Collapse
|
11
|
Pomeranz JL, Garcia AM, Vesprey R, Davey A. Variability and Limits of US State Laws Regulating Workplace Wellness Programs. Am J Public Health 2016; 106:1028-31. [PMID: 27077349 DOI: 10.2105/ajph.2016.303144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We examined variability in state laws related to workplace wellness programs for public and private employers. We conducted legal research using LexisNexis and Westlaw to create a master list of US state laws that existed in 2014 dedicated to workplace wellness programs. The master list was then divided into laws focusing on public employers and private employers. We created 2 codebooks to describe the variables used to examine the laws. Coders used LawAtlas(SM) Workbench to code the laws related to workplace wellness programs. Thirty-two states and the District of Columbia had laws related to workplace wellness programs in 2014. Sixteen states and the District of Columbia had laws dedicated to public employers, and 16 states had laws dedicated to private employers. Nine states and the District of Columbia had laws that did not specify employer type. State laws varied greatly in their methods of encouraging or shaping wellness program requirements. Few states have comprehensive requirements or incentives to support evidence-based workplace wellness programs.
Collapse
Affiliation(s)
- Jennifer L Pomeranz
- Jennifer L. Pomeranz is with the College of Global Public Health, New York University, New York. At the time of the study, Andrea M. Garcia was with the Association of State and Territorial Health Officials, Washington, DC. Randy Vesprey is with the College of Public Health and the James E. Beasley School of Law, Temple University, Philadelphia, PA. Adam Davey is with the College of Public Health, Temple University
| | - Andrea M Garcia
- Jennifer L. Pomeranz is with the College of Global Public Health, New York University, New York. At the time of the study, Andrea M. Garcia was with the Association of State and Territorial Health Officials, Washington, DC. Randy Vesprey is with the College of Public Health and the James E. Beasley School of Law, Temple University, Philadelphia, PA. Adam Davey is with the College of Public Health, Temple University
| | - Randy Vesprey
- Jennifer L. Pomeranz is with the College of Global Public Health, New York University, New York. At the time of the study, Andrea M. Garcia was with the Association of State and Territorial Health Officials, Washington, DC. Randy Vesprey is with the College of Public Health and the James E. Beasley School of Law, Temple University, Philadelphia, PA. Adam Davey is with the College of Public Health, Temple University
| | - Adam Davey
- Jennifer L. Pomeranz is with the College of Global Public Health, New York University, New York. At the time of the study, Andrea M. Garcia was with the Association of State and Territorial Health Officials, Washington, DC. Randy Vesprey is with the College of Public Health and the James E. Beasley School of Law, Temple University, Philadelphia, PA. Adam Davey is with the College of Public Health, Temple University
| |
Collapse
|
12
|
Corporate America and community health: exploring the business case for investment. J Occup Environ Med 2016; 57:493-500. [PMID: 25806415 DOI: 10.1097/jom.0000000000000431] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The principal aim of this project was to learn from corporate executives about the most important components of a business case for employer leadership in improving community health. METHODS We used dialogue sessions to gain insight into this issue. RESULTS The strongest elements included metrics and measurement, return on investment, communications, shared values, shared vision, shared definitions, and leadership. Important barriers included lack of understanding, lack of clear strategy, complexity of the problem, trust, lack of resources and leadership, policies and regulations, and leadership philosophy. Substantial variability was observed in the degree of understanding of the relationship between corporate health and community health. CONCLUSIONS The business case for intentional and strategic corporate investment in community health occurs along a continuum has a set of clearly defined elements that address why investment may make sense, but also asks questions about the "what-to-do" and the "how-to-do-it."
Collapse
|
13
|
|