The price is right: making workplace wellness financially sustainable

Obesity and Diet Predict Attitudes towards Health Promotion in Pre-Registered Nurses and Midwives

Nurses and midwives are integral to public health promotion; in the UK, they are advised to act as role models by their governing body, but overweight or obesity rates are high. We explored whether obesity and dietary habits are related to attitudes towards healthy role modelling and health promotion practice. A total of 346 pre-registered UK nurses and midwives (92.6% female; 18–53 years) completed an online survey. Items included body composition, dietary habits assessed by the Lifestyle Behaviour Questionnaire (LBQ), attitudes towards being role models for health (RA: role attitudes) and attitudes toward health promotion practice (ATHPP): 33.8% of the sample self-reported as overweight or obese; 67.6% did not consume 5-a-day portions of fruit/veg; 31.5% reported a healthy diet; and 89.6% believed their diet could be healthier. Positive RA was significantly linked to health promotion engagement (HP) (ß = 0.33, p < 0.001). Positive ATHPP was significantly predicted by lower BMI (ß = −0.08, p = 0.078), positive RA (ß = 0.67, p < 0.001), lower HP (ß = −0.25, p < 0.001) and male gender (ß = 0.09, p = 0.02). Greater confidence in patients valuing healthcare professional’s advice was predicted by healthier diet (ß = 0.11, p = 0.03), lower BMI (ß = −0. 16, p < 0.01), more positive RA (ß = 0.14, p < 0.01) as well as HP engagement during training (ß = 0.20, p < 0.01). One’s own motivation to promote health, similarly to ATHPP, was predicted by RA (ß = 0.17, p = 0.001) and previous HP engagement (ß = 0.39, p < 0.001). Findings show that overweight and obesity are prevalent in pre-registered nurses and midwives; the majority did not consume a healthy diet. Individual’s body composition, diet and attitudes towards role modelling are positively associated with their attitudes towards, and confidence in, health promotion practice. Experiences of health promotion practice during training can have either a positive or a negative influence on attitudes. Mentors and educators could actively promote healthy lifestyles for pre-registered nurses and midwives and facilitate more opportunities for health promotion practice during placements, which includes time for reflection.

Accessing Voluntary HIV Testing in the Construction Industry: A Qualitative Analysis of Employee Interviews from the Test@Work Study

HIV, globally, remains a significant public health issue and community HIV testing can help to identify those with HIV at an early stage of disease. The workplace offers a prime location for provision of opt-in HIV testing as part of wider health promotion initiatives. The construction industry offers a key opportunity for HIV testing provision in a generally male-dominated group exhibiting some risky behaviors related to HIV. The intervention was an optional one-off individual health check with tailored health advice and signposting, offered to the construction workforce in health check events delivered as part of a large-scale multi-site research program called Test@Work. The events were undertaken at 10 participating organizations (21 events across 16 different sites), none had previously offered sexual health awareness or HIV testing to their workforce. Participants were invited to participate in a semi-structured interview following general health checks which included HIV testing. Out of 426 employees attending the health check events, 338 (79.3%) consented to interview on exit. Accessing HIV testing at work was valued because it was convenient, quick, and compatible with work demands. Interviewees identified HIV risks for construction including drug use, high numbers of sexual partners and job-related exposures, e.g., to used needles. Health seeking in construction was limited by stigma and low support, with particular barriers for non-permanent workers. The organization of the construction industry is complex with multiple organizations of different sizes having responsibility for varying numbers of employees. A disparity between organizational policies and employment circumstances is evident, and this generates significant health inequalities. To combat this, we recommend that organizations in the construction sector offer their employees awareness-raising around health behaviors and health protection in packages, such as toolbox talks. We recommend these be accompanied by annual health checks, including sexual health awareness and opt-in workplace HIV testing. This approach is highly acceptable to the workforce in the industry and removes barriers to access to healthcare.

COVID-Well Study: Qualitative Evaluation of Supported Wellbeing Centres and Psychological First Aid for Healthcare Workers during the COVID-19 Pandemic

Supported wellbeing centres were set up in UK hospital trusts as an early intervention aimed at mitigating the psychological impact of COVID-19 on healthcare workers. These provided high quality rest spaces with peer-to-peer psychological support provided by National Health Service (NHS) staff volunteers called 'wellbeing buddies', trained in psychological first aid. The aim of the study was to explore the views of centre visitors and operational staff towards this COVID-19 workforce wellbeing provision. Qualitative semi-structured interviews were undertaken with twenty-four (20F, 4M) employees from an acute hospital trust in the UK. Interviews were digitally recorded and transcribed, data were handled and analysed using thematic analysis. Interviews generated 3 over-arching themes, and 13 sub-themes covering 'exposure and job roles', 'emotional impacts of COVID-19 and 'the wellbeing centres'. Supported wellbeing centres were viewed as critical for the wellbeing of hospital employees during the first surge of COVID-19 in the UK. Wellbeing initiatives require managerial advocacy and must be inclusive. Job-related barriers to work breaks and accessing staff wellbeing provisions should be addressed. High quality rest spaces and access to peer-to-peer support are seen to benefit individuals, teams, organisations and care quality. Training NHS staff in psychological first aid is a useful approach to supporting the wellbeing of the NHS workforce during and beyond the COVID-19 pandemic.

WHIRL Study: Workplace Health Interprofessional Learning in the Construction Industry

Interprofessional learning (IPL) is essential to prepare healthcare trainees as the future public health workforce. WHIRL (Workplace Health InteRprofessional Learning) was an innovative IPL intervention that engaged volunteer healthcare trainees (n = 20) in multi-professional teams to deliver health checks (n = 464), including tailored advice and signposting, to employees in the UK construction industry (across 21 events, 16 sites, 10 organisations) as part of an ongoing research programme called Test@Work. Volunteers undertook a four-part training and support package of trainer-led education, observations of practice, self-directed learning and clinical supervision, together with peer mentoring. In a one-group post-test only design, IPL outcomes were measured using the Inventory of Reflective Vignette-Interprofessional Learning (IRV-IPL), and the psychometric properties of the IRV-IPL tool were tested. WHIRL demonstrably improved healthcare trainees' interprofessional skills in all five areas of collaboration, coordination, cooperation, communication, and commendation. The IRV-IPL tool was found to be a valid and reliable measure of interprofessional competencies across three scenarios; before and after health promotion activities, and as a predictor of future health promotion competence. This industry-based workplace IPL programme resulted in the attainment of health check competencies and bridged the gap between research, education and clinical practice.

Employer attitudes towards general health checks and HIV testing in the workplace

OBJECTIVE

There is a need to increase HIV testing rates in the UK. One approach is to increase access to testing through general health checks (GHCs) in the workplace. However, it is unclear whether GHCs are routinely offered by organisations, and employer perceptions of HIV testing are largely unknown.

STUDY DESIGN

Online survey to assess attitudes towards and provision of general health checks and HIV testing in the workplace.

METHODS

Ninety-eight employers from 25 job sectors completed an online survey. Employers were 61 small and medium-sized enterprises (SME), 37 large organisations; 86% employing mobile workers, 77.6% employing migrant workers and 51.7% of employees were male workers. Items included employer attitudes around workplace health, GHC provision, content and delivery and attitudes towards workplace HIV testing including perceived benefits and barriers to HIV testing.

RESULTS

Only one company offered opt-in workplace HIV testing. Seventy-eight companies (80%) did not provide any form of workplace GHC for employees. Decisions about health check provisions were not commonly informed by staff consultation (n = 6) or national guidelines (n = 4). Overall, 100% of companies (n = 98) reported at least one benefit of HIV testing and 68 (69%) believed that HIV testing should be offered in the workplace. Perceived barriers to HIV testing in the workplace were: [a] not having enough knowledge about HIV and testing; [b] not having trained staff to undertake HIV testing; and, [c] not knowing how to access HIV testing kits. Fifty-six companies (57.14%) would consider HIV testing as a future provision at their organisation. Sixty-seven companies (68.37%) would like further guidance on workplace HIV testing.

CONCLUSIONS

Few employers offer general health testing for employees, and opt-in HIV testing is exceptionally rare, despite positive attitudes towards it. There is a need to provide evidence-based guidance and support for employers around HIV testing in the workplace.

Healthy Lifestyle Behaviors and Health Promotion Attitudes in Preregistered Nurses: A Questionnaire Study

BACKGROUND

Nurses report inadequacies in health promotion practices. This study investigated attitudes toward being role models for healthy eating, and examined predictors of health promotion attitudes in preregistered nurses.

METHOD

A questionnaire was completed by 493 preregistered nurses. Measures included health promotion attitudes, healthy lifestyle index, self-esteem, and body satisfaction.

RESULTS

Preregistered nurses (89.5%) felt that nurses should be role models for health. However, 37% had a negative health promotion attitude and were more likely to be dissatisfied with their body and lead less healthy lifestyles. Most preregistered nurses (96%) felt that delivering health promotion would be a key element of their job and held positive health promotion attitudes. Healthy lifestyle was the most consistent significant predictor of health promotion attitude.

CONCLUSION

Preregistered nurses with an unhealthy lifestyle and lower self-esteem held a more negative health promotion attitude. Intervention is needed to support preregistered nurses in making healthy lifestyle choices, improving their self-perception and health promotion attitude. [J Nurs Educ. 2017;56(2):94-103.].

Survey process quality: a question of healthcare manager approach

Purpose The purpose of this paper is to explore how healthcare first-line managers think about and act regarding workplace survey processes. Design/methodology/approach This interview study was performed at a hospital in south Sweden. First-line healthcare managers ( n=24) volunteered. The analysis was inspired by phenomenography, which aims to describe the ways in which different people experience a phenomenon. The phenomenon was a workplace health promotion (WHP) survey processes. Findings Four main WHP survey process approaches were identified among the managers: as a possibility, as a competition, as a work task among others and as an imposition. For each, three common subcategories emerged; how managers: stated challenges and support from hospital management; described their own work group and collaboration with other managers; and expressed themselves and their situation in their roles as first-line managers. Practical implications Insights into how hospital management can understand their first-line managers' motivation for survey processes and practical suggestions and how managers can work proactively at organizational, group and individual level are presented. Originality/value Usually these studies focus on those who should respond to a survey; not those who should run the survey process. Focusing on managers and not co-workers can lead to more committed and empowered managers and thereby success in survey processes.

Nurses' views on workplace wellbeing programmes

Workplace stress is prevalent among nurses. Healthcare employers have implemented complementary and alternative therapies (CATs) for relaxation and stress management within workplace wellbeing programmes. In-depth interviews were conducted with 12 registered nurses to explore the perceptions and experiences of nurses towards accessing CATs in and outside the workplace. Interviews were audio recorded and transcribed verbatim. Data were analysed using conventional, qualitative thematic techniques. Themes identified were 'perceptions of complementary and alternative therapies for stress management' and 'engagement with workplace wellness schemes'. CATs have a role within workplace wellbeing programmes and nurses are not averse to accessing them, although there are barriers to access that need to be addressed.

Workplace wellness strategies for small businesses

Purpose

The purpose of this paper is to identify strategies used within small- to mid-size organizations that run effective workplace wellness programs, and remedy a current research gap that exists in the available academic literature regarding this topic.

Design/methodology/approach

Data were collected from four organizations in the form of case studies. Similarities, differences and patterns between different cases were explored, and thematic analysis was used to identify and explain meaningful commonalities between the programs studied.

Findings

The analysis revealed five overarching common concepts: innovation, company culture, employee-centric, environment, and altruism. Under these five concepts, 19 common themes were identified that represent common workplace wellness strategies.

Research limitations/implications

A relatively small number of participants were included in the study, which could be viewed as a limitation of the qualitative approach.

Practical implications

This study identified several strategies used by small- to mid-sized businesses (SMBs) with effective and viable workplace wellness programs and could help inform the practices of other small businesses. The study’s findings could also be applied to broader theory in organizational and social psychology.

Social implications

Strategies from this study potentially could be used to help improve the well-being of employees in SMBs.

Originality/value

The study challenges some of the established views on workplace wellness and provides a better understanding of the unique attributes of successful SMB programs, especially when compared to the attributes of workplace wellness programs operating in larger enterprises.

The Bioecological Model: applications in holistic workplace well-being management

Purpose

– The purpose of this paper is to exemplify how the bioecological model (BM) may be used as a systems approach framework to address workplace well-being in a holistic, meaningful and practical way.

Design/methodology/approach

– This conceptual paper is structured according to the design of Bronfenbrenner’s (1999) BM. As such, the different layers of the model are described and then examples from the recent international and interdisciplinary literature and current policy from Australia are provided to support the argument. These selected examples represent some key themes in the field of workplace health and well-being management.

Findings

– The BM is ideal in holistically analysing workplace health promotion and management. This finding supports future research using this model. The limitations of the model are that it can lend itself to research projects that are unfocused. It is suggested that determining the research aims and objectives and then using the model to respond to this agenda would use the model effectively.

Research limitations/implications

– This paper proposes the applicability of a specific model to a research agenda suggesting that interested parties could design a project around this model to investigate workplace health and well-being management.

Practical implications

– The model gives weight to the lived experiences of employees and suggests that business owners and policy makers hold power in controlling aspects that influence employee well-being. This model could be used to inform policy makers about the holistic nature of employee well-being urging inclusive policies that support positive well-being practices.

Originality/value

– This paper provides a unique contribution to the field by offering a topic-specific model useful to those concerned with workplace health and well-being management.

Evaluation of occupational health checks for hospital employees

Purpose

– The purpose of this paper is to ascertain which employees choose to access occupational health checks (OHCs), their perceptions of the usefulness of information received and whether they choose to act on tailored advice provided.

Design/methodology/approach

– In total, 253 hospital employees attended workplace OHC then completed online questionnaire survey.

Findings

– Participants included new cases (80 per cent) and those who had accessed the service previously (20 per cent), all age categories (23-69 years) and all occupational groups, although the vast majority were in office-based sedentary job roles, nursing or allied health professions (AHP) (78.3 per cent). Almost half were overweight or obese (46.7 per cent); many reported existing health problems or family history of chronic disease. Participants perceived OHC s to be convenient, informative and useful for raising their awareness of health issues, reassurance and monitoring, early identification of potential health problems and signposting to appropriate services. Participants reported post-check dietary changes (41 per cent) and increases in physical activity (30 per cent); smokers reported quitting or cutting down (44 per cent) and those exceeding alcohol limits reported cutting frequency or units of consumption (48 per cent). More than half those advised to visit their GP complied (53 per cent).

Research limitations/implications

– Future studies should investigate the efficacy of OHCs and whether reported lifestyle changes are sustained in the long-term.

Originality/value

– General health checks can be feasibly delivered in a multi-site hospital workplace setting with diverse appeal. Provision of tailored health information can help to raise health awareness and motivate health behaviour change or maintenance amongst hospital employees, including those reporting risk factors for chronic disease. Employees value the investment of healthcare organisations in the health and wellbeing of their workforce.

Five-year workplace wellness intervention in the NHS

AIMS

Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace.

METHOD

A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to encourage employees to make healthy lifestyle choices and sustained behaviour changes. An employee questionnaire survey was distributed at baseline (n = 1,452) and at five years (n = 1,134), including measures of physical activity, BMI, diet, self-efficacy, social support, perceived general health and mood, smoking behaviours, self-reported sickness absence, perceived work performance and job satisfaction.

RESULTS

Samples were comparable at baseline and follow-up. At five years, significantly more respondents actively travelled (by walking or cycling both to work and for non-work trips) and more were active while at work. Significantly more respondents met current recommendations for physical activity at five years than at baseline. Fewer employers reported 'lack of time' as a barrier to being physically active following the intervention. Significantly lower sickness absence, greater job satisfaction and greater organisational commitment was reported at five years than at baseline.

CONCLUSIONS

Improvements in health behaviours, reductions in sickness absence and improvements in job satisfaction and organisational commitment were observed following five years of a workplace wellness intervention for NHS employees. These findings suggest that health-promoting programmes should be embedded within NHS infrastructure.