Factors Associated With Availability of, and Employee Participation in, Comprehensive Workplace Health Promotion in a Large and Diverse Australian Public Sector Setting: A Cross-Sectional Survey

Shaping Public Servant Well-Being: Lessons from Brazil's SIASS Program

This study aims to identify how the health and well-being of public servants are promoted and managed at the Federal University of Technology-Paraná (UTFPR). The Integrated Subsystem for Attention to the Health of Public Servants (SIASS), established by the federal government in 2009, is an initiative that integrates health actions, work safety, and social assistance. This qualitative study utilized the analysis of institutional documents and semi-structured interviews with managers involved in SIASS implementation at the UTFPR. The analysis reveals that, despite the creation of the SIASS, the UTFPR faces challenges such as resource scarcity, reliance on procurement processes, and a reactive rather than preventive approach to occupational health issues. The structural diversity across campuses and the lack of systematic evaluation of working conditions further limit the effectiveness of policies. It is recommended that the UTFPR adopt a more integrated, data-driven, and proactive approach to occupational health management. Strengthening interinstitutional partnerships, optimizing resource allocation, and developing continuous evaluation systems are essential steps to ensure a work environment that effectively promotes the health and well-being of its employees.

The Potentials of Digital Workplace Health Promotion

Workplace Health Promotion (WHP) can sustainably impact organizations by improving employee health and strengthening legitimization. Digital Workplace Health Promotion (DWHP) may have even more impact thanks to its scope. This study reports on a hospital in Austria wherein DWPH was introduced into the existing WHP structure in combination with a digitalization effort for the entire organization. The approach was mainly quantitative with a few open questions and included a survey before and an evaluation after the project with about 240 respondents each. The use, intentions, barriers and benefits of DWHP from the employees' perspectives were reported on to evaluate the potentials of DWHP for furthering sustainable developments within organizations. While DHWP is perceived as positive, current use is low. Nevertheless, intended future use is promising and perceived benefits are higher after implementation. However, perceived barriers are still high, requiring organizational efforts.

Barrier profiles in workplace health promotion in Germany

Workplace health promotion (WHP) is often faced with low-participation rates despite high relevance. This limits the potential for creating positive effects for the organization and its staff. Therefore, we investigated the barriers perceived by employees themselves using a representative sample (regarding age, gender and education) in Germany. Data were collected using a quantitative online questionnaire and then analyzed regarding underlying patterns. We found that there are different barrier types, and their importance differs depending on demographic criteria of the participants and the organizations they work for. These results can help organizations to reduce participation barriers to WHP for their staff.

Predicting Employee Participation in, and Satisfaction With, Wellness Programs: The Role of Employee, Supervisor, and Organizational Support

OBJECTIVE

To examine the role of employee, supervisor, and organizational support in the prediction of employee participation in wellness programs.

METHODS

Data were collected at two-time points (T1 and T2) from 194 Australian employees.

RESULTS

Hierarchical binary logistic regressions revealed that higher levels of employee and supervisor support for wellness at T1 each predicted T2 participation, and high supervisor support was more effective when organizational support was high and did not compensate for when organizational support was low. Employees with higher perceptions of T1 poor general health had a lower likelihood of T2 participation, and higher levels of T1 supervisor support was a further deterrent to participation.

CONCLUSIONS

Different sources of support for wellness predict employee attendance at wellness programs and it is important to ensure that supervisor and organizational support are aligned.

How Managers Perceive and (Do Not) Participate in Health Promotion Measures-Results from a Cross-Sectional Mixed-Methods Survey in a Large ICT Company

Managers often face stress and high work demands. Yet they have received limited attention as targets of workplace health promotion measures (HPMs). This study’s primary objective (1) is to examine managers’ self-reported participation in HPMs and factors associated with HPM participation. The secondary objective (2) is to examine managers’ perceptions of their working conditions. A cross-sectional mixed-methods online survey was conducted with a nonrandom sample of 179 managers in a large German ICT company. Stepwise logistic regression and qualitative content analysis were used for data analysis. Quantitative findings revealed that 57.9% of managers had not participated in HPMs yet. “Workload relief through digital tools” resulted as a significant predictor of managers’ previous HPM participation (OR: 2.84, 95% CI: 1.42–5.66). In qualitative findings, workload, time, lack of knowledge, and lack of demand were reported as participation barriers (1). Managers reported that work facility traits, workload, social support, and corporate culture should be improved to make their working conditions more health-promoting (2). These findings suggest that providing adequate organizational working conditions may help improve managers’ HPM participation rates and their perception of health-promoting work.

Actions Speak Louder Than Words: Workplace Social Relations and Worksite Health Promotion Use

OBJECTIVE

To study whether workplace social relations explain use of worksite health promotion (WHP), by examining colleagues' and team managers' WHP encouragement of a healthy lifestyle, and colleague WHP uptake.

METHODS

Multilevel data came from the second wave of the European Sustainable Workforce Survey (4345 employees of 402 team in 9 countries). Linear probability models were used to test use of two types of WHP: healthy menus and sport facilities.

RESULTS

Employees are more likely to use healthy menus and sport facilities when more colleagues do so too and when colleagues encourage a healthy lifestyle. Surprisingly, encouragement by one's manager plays no role.

CONCLUSIONS

Social contact among colleagues can facilitate WHP use, and WHP initiatives should pay attention to the influential role of colleagues.

The effectiveness of workplace health promotion programs on self-perceived health of employees with a low socioeconomic position: An individual participant data meta-analysis

The aim of the current study was to evaluate whether workplace health promotion programs improve self-perceived health of employees with a low socioeconomic position (SEP), and whether differential effects exist between individuals with a low SEP for gender, marital status or age. Individual participant data from six Dutch intervention studies aiming at promoting healthy behavior and preventing obesity in the work setting, with a total of 1906 participants, were used. The overall intervention effect and interaction effects for gender, marital status and age were evaluated using two-stage meta-analyses with linear mixed regression models. In the first stage effect sizes of each study were estimated, which were pooled in the second stage. Compared to control conditions, workplace health promotion programs did not show an overall improvement in self-perceived health of employees with a low SEP (β0.03 (95%CI: −0.03 to 0.09)). Effects did not differ across gender, marital status and age. Future research could be focused on the determinants of self-perceived health next to health behavior to improve the health of employees with a low SEP.

Worksite health promotion and social inequalities in health

It is well-documented that higher educated employees have better health than the lower educated. The workplace has been put forward as a contributor to this inequality. We extend previous work on workplace characteristics that could influence employee health by asking to what extent workplace health promotion (WHP) can account for the relation between education and health. Two ways in which WHP may relate to health inequalities are addressed: higher educated employees may be more likely to use WHP than lower educated employees and the effect of WHP on health may be stronger for higher educated than for lower educated employees. Using data from the European Sustainable Workforce Survey which contains information on over 11000 employees in 259 organisations, we test whether three types of WHP mediate or moderate the relation between education and health: healthy menus, sports facilities and health checks. We find that higher educated employees are in better health and that use of WHP positively relates to health. Use of healthy menus and sports facilities in the workplace can contribute to increasing health inequalities, as lower educated employees are less likely to make use of these. Health checks could contribute to diminishing health inequalities, as lower educated employees are more likely to use them compared to higher educated employees. The effect of WHP is not contingent on education. We advise stimulating lower educated employees to make more use of WHP, which can contribute to decreasing health inequalities.

Availability of and Participation in Workplace Health Promotion Programs by Sociodemographic, Occupation, and Work Organization Characteristics in US Workers

PURPOSE

To examine how the availability of and participation in workplace health promotion programs (WHPPs) vary as a function of sociodemographic, occupation, and work organization characteristics.

DESIGN

Cross-sectional study.

SETTING

2015 National Health Interview Survey and Occupational Health Supplement.

PARTICIPANTS

The study sample included 17 469 employed adults who completed the WHPP questions.

MEASURES

The 2 dependent outcome measures were availability of WHPPs and participation in these programs when available. Independent variables included occupation and 8 work organization and employment characteristics: company size, hours worked, supervisory responsibility, hourly pay, paid sick leave, health insurance offered by employer, work schedule, and work arrangement.

ANALYSIS

Poisson regression analyses were conducted with SUDAAN 11.0.1.

RESULTS

Overall, 57.8% of 46.6% employees who have WHPPs available reported participating in these programs. This study found that adults who worked ≤20 h/wk, worked regular night shifts, were paid by the hour, or worked for temporary agencies were less likely to participate in WHPPs. Workers who supervised others were 13% more likely to participate than nonsupervisors. Borderline associations were seen for having access to employer-sponsored health insurance and working at a site with <10 employees.

CONCLUSION

Despite the potential for improving physical and mental health, only 58% of US workers participated in WHPPs. Since barriers to WHPP participation (eg, time constraints, lack of awareness, and no perceived need) may vary across occupations and work organization characteristics, employers should tailor WHPPs based on their specific work organization characteristics to maximize participation.

Enrollment Strategies, Barriers to Participation, and Reach of a Workplace Intervention Targeting Sedentary Behavior

PURPOSE

To review enrollment strategies, participation barriers, and program reach of a large, 2-year workplace intervention targeting sedentary behavior.

APPROACH

Cross-sectional, retrospective review.

SETTING

Twenty-four worksites balanced across academic, industry, and government sectors in Minneapolis/Saint Paul (Minnesota) and Phoenix (Arizona) regions.

PARTICIPANTS

Full-time (≥30+ h/wk), sedentary office workers.

METHODS

Reach was calculated as the proportion of eligible employees who enrolled in the intervention ([N enrolled/(proportion of eligible employees × N total employees)] × 100). Mean (1 standard deviation) and median worksite sizes were calculated at each enrollment step. Participation barriers and modifications were recorded by the research team. A survey was sent to a subset of nonparticipants (N = 57), and thematic analyses were conducted to examine reasons for nonparticipation, positive impacts, and negative experiences.

RESULTS

Employer reach was 65% (56 worksites invited to participate; 66% eligible of 56 responses; 24 enrolled). Employee reach was 58% (1317 invited to participate, 83% eligible of 906 responses; 632 enrolled). Postrandomization, on average, 59% (15%) of the worksites participated. Eighteen modifications were developed to overcome participant-, context-, and research-related participation barriers.

CONCLUSION

A high proportion of worksites and employees approached to participate in a sedentary behavior reduction intervention engaged in the study. Interventions that provide flexible enrollment, graded participant engagement options, and adopt a participant-centered approach may facilitate workplace intervention success.

Factors Associated With Interest in Worksite Health-Related Discussions/Events Among Employed Adults With Chronic Conditions

OBJECTIVE

Worksite health promotion interventions have the potential to reach half of Americans nationally, but low participation rates hinder optimal intervention effectiveness. This study examines factors associated with employee interest in worksite health-related discussions/events.

METHOD

We analyzed cross-sectional survey data from a representative sample of employed adults in California with one or more chronic conditions. An ordinal regression model was developed.

RESULTS

Employees who reported more interest in worksite health-related discussions/events had higher coworkers support, perceived greater value from learning health-related knowledge and getting practical tips from others, and reported higher interest in health discussions/events held in community settings.

CONCLUSION

Efforts are needed to enhance the culture of worksite health and encourage communication and support among workers. Practitioners should consider connecting different settings to enhance reach and accessibility, and applying multiple delivery strategies to increase employee interest and engagement.

The Associations of Multimorbidity With Health-Related Productivity Loss in a Large and Diverse Public Sector Setting: A Cross-Sectional Survey

OBJECTIVE

To evaluate absenteeism, presenteeism, and total lost productive time (LPT) associated with multimorbidity.

METHODS

Cross-sectional data from 3228 state-government employees from Tasmania were collected in 2013. The validated measures of absenteeism, presenteeism, and LPT were obtained from employees' self-reported data over a 28-day period. Analyses were stratified by sex. Negative binomial models were used to estimate the associations between multimorbidity and LPT.

RESULTS

The average health-related total LPT was 1.2 (standard deviation [SD] = 2.4) and 1.7 (SD = 3.5) days for men and women with multimorbidity, respectively. Women (rate ratio [RR] = 2.9, 95% confidence interval [CI] 1.8 to 4.9) and men (RR = 4.4, 95%CI 3.0 to 6.2) with 4+ chronic conditions were significantly more likely to report LPT compared with those without any chronic conditions.

CONCLUSION

We found multimorbidity is of concern within the workforce, with a positive association of multimorbidity and LPT observed, and significant differences in LPT between men and women reporting multimorbidity.

Workplace Health Promotion and Mental Health: Three-Year Findings from Partnering Healthy@Work

This study aimed to investigate the association between mental health and comprehensive workplace health promotion (WHP) delivered to an entire state public service workforce (~28,000 employees) over a three-year period. Government departments in a state public service were supported to design and deliver a comprehensive, multi-component health promotion program, Healthy@Work, which targeted modifiable health risks including unhealthy lifestyles and stress. Repeated cross-sectional surveys compared self-reported psychological distress (Kessler-10; K10) at commencement (N = 3406) and after 3 years (N = 3228). WHP availability and participation over time was assessed, and associations between the K10 and exposure to programs estimated. Analyses were repeated for a cohort subgroup (N = 580). Data were weighted for non-response. Participation in any mental health and lifestyle programs approximately doubled after 3 years. Both male and female employees with poorer mental health participated more often over time. Women's psychological distress decreased over time but this change was only partially attributable to participation in WHP, and only to lifestyle interventions. Average psychological distress did not change over time for men. Unexpectedly, program components directly targeting mental health were not associated with distress for either men or women. Cohort results corroborated findings. Healthy@Work was successful in increasing participation across a range of program types, including for men and women with poorer mental health. A small positive association of participation in lifestyle programs with mental health was observed for women but not men. The lack of association of mental health programs may have reflected program quality, its universality of application or other contextual factors.

Does employee participation in workplace health promotion depend on the working environment? A cross-sectional study of Danish workers

OBJECTIVES

To investigate if participation in workplace health promotion (WHP) depends on the work environment.

METHODS

Questionnaire data on participation in WHP activities (smoking cessation, healthy diet, exercise facilities, weekly exercise classes, contact with health professionals, health screenings) and the work environment (social support, fatiguing work, physical, quantitative and emotional demands, job control and WHP availability setting) were collected cross-sectionally in 2010 in a representative sample (n=10 605) of Danish workers. Binary regression analyses of the association between work environment characteristics and participation in WHP were conducted and adjusted for age, gender and industry.

RESULTS

WHP offered during leisure time was associated with lower participation in all measured activities compared with when offered during working hours. Low social support and fatiguing work were associated with low participation in WHP. No associations with participation in WHPs were observed for physical work or quantitative demands, work pace or job strain. However, high physical demands/low job control and high emotional demands/low job control were associated with low participation.

CONCLUSIONS

Lower participation in WHP was associated with programmes during leisure, low social support, very fatiguing work and high physical or emotional demands with low job control. This suggests that to obtain proper effect of health promotion in a workplace setting, a good work environment is essential.

Does workplace health promotion contribute to job stress reduction? Three-year findings from Partnering Healthy@Work

BACKGROUND

Workplace health promotion (WHP) has been proposed as a preventive intervention for job stress, possibly operating by promoting positive organizational culture or via programs promoting healthy lifestyles. The aim of this study was to investigate whether job stress changed over time in association with the availability of, and/or participation in a comprehensive WHP program (Healthy@Work).

METHOD

This observational study was conducted in a diverse public sector organization (~28,000 employees). Using a repeated cross-sectional design with models corroborated using a cohort of repeat responders, self-report survey data were collected via a 40 % employee population random sample in 2010 (N = 3406) and 2013 (N = 3228). Outcomes assessed were effort and reward (self-esteem) components of the effort-reward imbalance (ERI) measure of job stress. Exposures were availability of, and participation in, comprehensive WHP. Linear mixed models and Poisson regression were used, with analyses stratified by sex and weighted for non-response.

RESULTS

Higher WHP availability was positively associated with higher perceived self-esteem among women. Women's mean reward scores increased over time but were not statistically different (p > 0.05) after 3 years. For men, higher WHP participation was associated with lower perceived effort. Men's mean ERI increased over time. Results were supported in the cohort group.

CONCLUSIONS

For women, comprehensive WHP availability contributed to a sense of organizational support, potentially impacting the esteem component of reward. Men with higher WHP participation also benefitted but gains were modest over time and may have been hindered by other work environment factors.