Investigating Employee-Reported Benefits of Participation in a Comprehensive Australian Workplace Health Promotion Program

The precarious resilience of aged care employees enrolled in an Australian online dementia course: A cross-sectional study of occupational health and well-being

OBJECTIVE

Australian aged care workforce surveys offer limited information about those who engage in online dementia education regarding their occupational health and well-being. A salutogenic approach was applied to an aged care context to quantitatively assess both positive and negative aspects of health at work to inform the development of workplace interventions tailored to those interested in self-development.

METHODS

Physical, psychological and occupational health were measured in an online cross-sectional survey of general health, chronic conditions, psychological distress, positive and negative affect, job satisfaction, access to workplace amenities and turnover intentions of aged care workers undertaking an online dementia course in October 2014.

RESULTS

Participants (N = 662) rated their general physical health as good and a minority experienced chronic conditions such as obesity. Overall, workers had average levels of positive and negative affect and low distress. However, 25% were likely to have a mental health condition. While most were employed on a permanent basis (80%) and reported moderate job satisfaction, 18% were likely to leave their job. There were some gaps in workplace amenities to support health and well-being: for example, 13% reported no access to lunch break areas.

CONCLUSIONS

Results suggest precarious resilience in aged care workers enrolled in an Australian online dementia course. Workplace interventions that focus on preventative health strategies are required to address the health risks associated with higher than national averages of obesity and mental health, and reduce exposure of workers to physical and psychological harms.

Activate Your Health: impact of a real-life programme promoting healthy lifestyle habits in Canadian workers

The workplace has been suggested as a good setting for the promotion of healthy lifestyles. This article examines the impact of Activate Your Health programme, provided over an average of 1.35 years, on employee health and lifestyle habits (actual and intention to improve). Companies selected one of the programme's four options (number of interventions in parentheses): Control (2), Light (8), Moderate (13) and High (14). Employees (n = 524) completed an online questionnaire at baseline and post-intervention. Mixed-effect models and generalized estimating equations models were used, where appropriate. There was an interaction effect of time by option for the number of employees intending to improve sleep habits (p = 0.030): +11.0% in Light (p = 0.013). No significant interaction effect of time by option was observed for body weight, body mass index, number of health problems or lifestyle habits (actual and intention to improve). When stratified by sex, there was an interaction effect of time by option for the number of women intending to improve sleep habits (p = 0.023): -26.1% in Moderate (p = 0.014). There was an interaction effect of time by option for body weight in men (p = 0.001): -0.58 kg in High (p = 0.031) and +2.58 kg in Control (p = 0.005). Other outcomes of interest were stable or improved post-intervention, regardless of option. The Activate Your Health programme allowed employees to maintain or improve outcomes related to health and lifestyle habits. A package like High may be beneficial for body weight regulation in men.

Association of organizational factors with knowledge of effectiveness indicators and participation in corporate health and productivity management programs

OBJECTIVES

The working-age population is rapidly declining in Japan, so the government has adopted "health and productivity management" (HPM). This policy initiative aims to encourage corporations to view health promotion activities as an investment in their employees' health. The objective of this study was to examine the association between organizational factors and knowledge of the organization's effectiveness and program participation levels, and to understand the factors that affect effectiveness of corporations' activities.

METHODS

We used data from all corporations that completed the HPM Survey Sheets in 2018 (n = 1800). The explanatory variables were organizational factors: written company-wide policy, agenda item at management-level meetings, regular education for managers, and full-time occupational health staff. The outcome variables were knowledge of the corporation's status on the effectiveness indicators (employees' exercise habits, risk for high blood pressure, visiting hospital after a health examination, and long-term sickness absences) and rates of participation in four areas (health education, exercise program, dietary program, and influenza vaccination). The associations between organizational factors and knowledge on effectiveness indicators and rates of program participation were analyzed using multiple logistic regression analysis.

RESULTS

All the organizational factors were related to knowledge of effectiveness indicators, but only some were associated with the program participation indicators in the model, including all explanatory variables.

CONCLUSION

Enhancing organizational factors may lead to improvement of HPM programs and higher program participation among employees in corporations.

Promoting Smoking Cessation in Costa Rica: A Focus Group Study of Smokers and Ex-Smokers

In developing worksite smoking cessation programs in Costa Rica, it is necessary to gain an understanding of smokers and ex-smokers. For smokers, it was necessary to know the barriers to quitting and what they thought may help them. For ex-smokers, we wanted to identify the main factors that helped them to successfully quit. Two separate focus groups were conducted of smokers ( n = 6) and ex-smokers ( n = 9) who worked at the Department of Justice. Results indicated that the key factors for both ex-smokers and smokers were social factors—family and coworkers. Participants viewed family support as fundamental to successful quitting. Smokers mentioned that the Justice Department could help them stop smoking by eliciting the support of ex-smoking coworkers. Major barriers to quitting were workplace stress and the presence of other smokers. In conclusion, family members and ex-smoking coworkers can play an important role in worksite smoking cessation programs in Costa Rica.

Workplace Smoking Cessation in Costa Rica: Pilot Study Findings

Background: In Costa Rica, the leading cause of preventable death is smoking. Adults spend one third of their lives at work making the workplace an optimal site for smoking cessation interventions. Therefore, we developed a workplace smoking cessation pilot program among Costa Rican Justice Department government employees based on key Costa Rican values and best practices. Methods: First, focus groups were conducted among exsmokers and smokers. Participants in the focus groups and in the subsequent smoking cessation pilot study were invited to take part in the study through flyers, information sheets, and announcements from the Justice Department. The focus groups revealed that social factors were fundamental to quitting. Therefore, based on these results two programs (14 participants) were conducted consisting of seven sessions encouraging employees to utilize their family and exsmokers. Data were collected before and after the seven sessions on smoking behavior, social influence, and other factors. Findings: Five of 14 (36%) quit smoking. None of the quitters lived with a smoker, as compared with 56% of nonquitters who lived with a smoker. Also, quitters were less likely to have friends (40% vs. 67%) and coworkers (20% vs. 33%) who smoked compared with nonquitters. Conclusion/Application to Practice: Workplace smoking cessation programs should help smokers to increase their social contacts with nonsmokers/exsmokers. Smoking cessation programs should assess not only smoking patterns, but also social contacts, such as family, friends, and coworkers. Based on these assessments, smokers should be encouraged to seek-out nonsmokers/exsmokers to assist them in quitting.

Cardiovascular Disease and Type 2 Diabetes Risk Across Occupational Groups and Industry in a Statewide Study of an Australian Working Population

OBJECTIVE

The aim of this study was to investigate prevalence of type 2 diabetes (diabetes) and cardiovascular disease (CVD) risk in occupational and industry groups in a large, diverse working population.

METHODS

Five hundred thousand Victorian workers undertook health checks, including lifestyle, anthropometric, and biomedical cardiovascular risk factor assessment. Five-year diabetes (AUSDRISK) and absolute CVD risk were estimated.

RESULTS

High diabetes and CVD risk was increased in many occupational groups and industries relative to managers and Professional/Scientific/Technical Services, respectively. Significantly more blue-collar workers had high diabetes risk [males prevalence ratio (PR) 1.19 (95% confidence interval, 95% CI 1.17 to 1.20); females 1.34 (95% CI 1.30 to 1.38)], high CVD risk [males 1.45 (95% CI 1.37 to 1.53); females 1.48 (95% CI 1.17 to 1.88], and risk factors including smoking [males 2.26 (95% CI 2.22 to 2.30); females 2.20 (95% CI 2.13 to 2.27)], compared with white-collar workers.

CONCLUSION

Targeting occupational and industry groups within sustainable workplace programs could assist in reducing chronic diseases, lowering sickness absence, and improving productivity.

Modelo de Promoción de la salud en el lugar de trabajo: una propuesta

Objetivo: proponer un modelo de promoción de salud en el lugar de trabajo fundamentado en los modelos de Nola Pender y de condiciones de trabajo de la Universidad Nacional de Colombia.Síntesis del contenido: los trabajadores son un grupo poblacional que puede verse afectado por acciones desarrolladas en los espacios de trabajo, por tanto, la implementación de programas de promoción de la salud es primordial para la persona que labora y para la organización. Desde el sustento teórico-científico de la disciplina de enfermería, el modelo de promoción de la salud de Nola Pender puede ser un primer acercamiento para aportar al marco de promoción de la salud en el lugar de trabajo en Colombia.Conclusiones: el modelo de promoción de la salud de Nola Pender y el de condiciones de trabajo de la Universidad Nacional de Colombia permiten crear un acercamiento a un modelo integral de promoción de la salud en el lugar de trabajo para la implementación de programas enfocados en su contexto, el comportamiento, la percepción de salud y todas aquellas necesidades individuales de los trabajadores.

Strategies to improve the implementation of workplace-based policies or practices targeting tobacco, alcohol, diet, physical activity and obesity

BACKGROUND

Given the substantial period of time adults spend in their workplaces each day, these provide an opportune setting for interventions addressing modifiable behavioural risk factors for chronic disease. Previous reviews of trials of workplace-based interventions suggest they can be effective in modifying a range of risk factors including diet, physical activity, obesity, risky alcohol use and tobacco use. However, such interventions are often poorly implemented in workplaces, limiting their impact on employee health. Identifying strategies that are effective in improving the implementation of workplace-based interventions has the potential to improve their effects on health outcomes.

OBJECTIVES

To assess the effects of strategies for improving the implementation of workplace-based policies or practices targeting diet, physical activity, obesity, tobacco use and alcohol use.Secondary objectives were to assess the impact of such strategies on employee health behaviours, including dietary intake, physical activity, weight status, and alcohol and tobacco use; evaluate their cost-effectiveness; and identify any unintended adverse effects of implementation strategies on workplaces or workplace staff.

SEARCH METHODS

We searched the following electronic databases on 31 August 2017: CENTRAL; MEDLINE; MEDLINE In Process; the Campbell Library; PsycINFO; Education Resource Information Center (ERIC); Cumulative Index to Nursing and Allied Health Literature (CINAHL); and Scopus. We also handsearched all publications between August 2012 and September 2017 in two speciality journals: Implementation Science and Journal of Translational Behavioral Medicine. We conducted searches up to September 2017 in Dissertations and Theses, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Registry. We screened the reference lists of included trials and contacted authors to identify other potentially relevant trials. We also consulted experts in the field to identify other relevant research.

SELECTION CRITERIA

Implementation strategies were defined as strategies specifically employed to improve the implementation of health interventions into routine practice within specific settings. We included any trial with a parallel control group (randomised or non-randomised) and conducted at any scale that compared strategies to support implementation of workplace policies or practices targeting diet, physical activity, obesity, risky alcohol use or tobacco use versus no intervention (i.e. wait-list, usual practice or minimal support control) or another implementation strategy. Implementation strategies could include those identified by the Effective Practice and Organisation of Care (EPOC) taxonomy such as quality improvement initiatives and education and training, as well as other strategies. Implementation interventions could target policies or practices directly instituted in the workplace environment, as well as workplace-instituted efforts encouraging the use of external health promotion services (e.g. gym membership subsidies).

DATA COLLECTION AND ANALYSIS

Review authors working in pairs independently performed citation screening, data extraction and 'Risk of bias' assessment, resolving disagreements via consensus or a third reviewer. We narratively synthesised findings for all included trials by first describing trial characteristics, participants, interventions and outcomes. We then described the effect size of the outcome measure for policy or practice implementation. We performed meta-analysis of implementation outcomes for trials of comparable design and outcome.

MAIN RESULTS

We included six trials, four of which took place in the USA. Four trials employed randomised controlled trial (RCT) designs. Trials were conducted in workplaces from the manufacturing, industrial and services-based sectors. The sample sizes of workplaces ranged from 12 to 114. Workplace policies and practices targeted included: healthy catering policies; point-of-purchase nutrition labelling; environmental supports for healthy eating and physical activity; tobacco control policies; weight management programmes; and adherence to guidelines for staff health promotion. All implementation interventions utilised multiple implementation strategies, the most common of which were educational meetings, tailored interventions and local consensus processes. Four trials compared an implementation strategy intervention with a no intervention control, one trial compared different implementation interventions, and one three-arm trial compared two implementation strategies with each other and a control. Four trials reported a single implementation outcome, whilst the other two reported multiple outcomes. Investigators assessed outcomes using surveys, audits and environmental observations. We judged most trials to be at high risk of performance and detection bias and at unclear risk of reporting and attrition bias.Of the five trials comparing implementation strategies with a no intervention control, pooled analysis was possible for three RCTs reporting continuous score-based measures of implementation outcomes. The meta-analysis found no difference in standardised effects (standardised mean difference (SMD) -0.01, 95% CI -0.32 to 0.30; 164 participants; 3 studies; low certainty evidence), suggesting no benefit of implementation support in improving policy or practice implementation, relative to control. Findings for other continuous or dichotomous implementation outcomes reported across these five trials were mixed. For the two non-randomised trials examining comparative effectiveness, both reported improvements in implementation, favouring the more intensive implementation group (very low certainty evidence). Three trials examined the impact of implementation strategies on employee health behaviours, reporting mixed effects for diet and weight status (very low certainty evidence) and no effect for physical activity (very low certainty evidence) or tobacco use (low certainty evidence). One trial reported an increase in absolute workplace costs for health promotion in the implementation group (low certainty evidence). None of the included trials assessed adverse consequences. Limitations of the review included the small number of trials identified and the lack of consistent terminology applied in the implementation science field, which may have resulted in us overlooking potentially relevant trials in the search.

AUTHORS' CONCLUSIONS

Available evidence regarding the effectiveness of implementation strategies for improving implementation of health-promoting policies and practices in the workplace setting is sparse and inconsistent. Low certainty evidence suggests that such strategies may make little or no difference on measures of implementation fidelity or different employee health behaviour outcomes. It is also unclear if such strategies are cost-effective or have potential unintended adverse consequences. The limited number of trials identified suggests implementation research in the workplace setting is in its infancy, warranting further research to guide evidence translation in this setting.

Employee Perceptions of Workplace Health Promotion Programs: Comparison of a Tailored, Semi-Tailored, and Standardized Approach

In the design of workplace health promotion programs (WHPPs), employee perceptions represent an integral variable which is predicted to translate into rate of user engagement (i.e., participation) and program loyalty. This study evaluated employee perceptions of three workplace health programs promoting nutritional consumption and physical activity. Programs included: (1) an individually tailored consultation with an exercise physiologist and dietitian; (2) a semi-tailored 12-week SMS health message program; and (3) a standardized group workshop delivered by an expert. Participating employees from a transport company completed program evaluation surveys rating the overall program, affect, and utility of: consultations (n = 19); SMS program (n = 234); and workshops (n = 86). Overall, participants’ affect and utility evaluations were positive for all programs, with the greatest satisfaction being reported in the tailored individual consultation and standardized group workshop conditions. Furthermore, mode of delivery and the physical presence of an expert health practitioner was more influential than the degree to which the information was tailored to the individual. Thus, the synergy in ratings between individually tailored consultations and standardized group workshops indicates that low-cost delivery health programs may be as appealing to employees as tailored, and comparatively high-cost, program options.

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.