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Saito J, Odawara M, Fujimori M, Kuchiba A, Oyamada S, Swe KT, Saito E, Fukai K, Tatemichi M, Nakamura M, Uchitomi Y, Shimazu T. Interactive assistance via eHealth for small- and medium-sized enterprises' employer and health care manager teams on tobacco control (eSMART-TC): protocol for a cluster randomized hybrid type II trial (N-EQUITY2101/J-SUPPORT2102). Implement Sci Commun 2023; 4:61. [PMID: 37287041 DOI: 10.1186/s43058-023-00444-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 05/25/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Tobacco control should be a higher public health priority in Japan. Some workplaces provide smoking cessation support and connect employees to effective smoking cessation treatments such as outpatient clinics. However, tobacco control measures have not been sufficiently implemented in Japan, especially in small- and medium-sized enterprises (SMEs), where resources are limited. Organizational commitment and consistent leadership are crucial to facilitate implementation, but research on whether supporting organizational leaders leads to health behavior changes among employees is limited. METHODS This hybrid type II cluster randomized effectiveness implementation trial (eSMART-TC) aims to examine the effects of interactive assistance for SME management on health and implementation outcomes. We will provide interactive assistance to employers and health managers for 6 months, aiming to promote the utilization of reimbursed smoking cessation treatments by public health insurance and to implement smoke-free workplaces. The intervention will consist of three strategies: supporting employees through campaigns, tailored ongoing facilitation, and ensuring executive engagement and support. The primary health and implementation outcomes will be salivary cotinine-validated 7-day point-prevalence abstinence rate, and the adoption of two recommended measures (promoting utilization of smoking cessation treatment and implementing smoke-free workplaces) 6 months after the initial session, respectively. Other outcomes for implementation (e.g., penetration of smoking cessation clinic visits), health (e.g., salivary cotinine-validated 7-day point-prevalence abstinence rate at 12 months), and process (e.g., adherence and potential moderating factors) will be collected via questionnaires, interviews, logbooks, and interventionists' notes at 6 and 12 months. An economic analysis will be undertaken to assess the cost-effectiveness of the implementation interventions at 12 months. DISCUSSION This will be the first cluster randomized controlled trial to evaluate the effectiveness of an implementation intervention with interactive assistance for employers and health managers in SMEs on smoking cessation and implementation of evidence-based tobacco control measures in SMEs. The findings of this trial targeting management in SMEs have the potential to accelerate the implementation of evidence-based smoking cessation methods as well as abstinence rates among employees in SMEs across Japan. TRIAL REGISTRATION The study protocol has been registered in the UMIN Clinical Trials Registry (UMIN-CTR; ID: UMIN000044526). Registered on 06/14/2021.
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Affiliation(s)
- Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Aya Kuchiba
- Division of Biostatistical Research, Institute for Cancer Control/Biostatistics Division, CRAS, National Cancer Center, Tokyo, Japan
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kanagawa, Japan
| | | | - Khin Thet Swe
- Research Center for Health Policy and Economics, Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kota Fukai
- Department of Preventive Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - Masakazu Nakamura
- Health Promotion Research Center, Institute of Community Medicine, Japan Association for Development of Community Medicine, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Survivorship Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
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Guerin RJ, Barile JP, Groenewold MR, Free HL, Okun AH. COVID-19 Workplace Mitigation Strategies and Employee Leave Policies Implemented during the Height of the Pandemic, United States, Fall 2020 and 2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2894. [PMID: 36833588 PMCID: PMC9956394 DOI: 10.3390/ijerph20042894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 workplace mitigation strategies implemented within US businesses have been effective at preventing disease and protecting workers, but the extent of their use is not well understood. We examined reported COVID-19 workplace mitigation strategies by business size, geographic region, and industry using internet panel survey data from US adult respondents working full- or part-time outside the home (fall 2020, N = 1168) andfull- or part-time, inside or outside the home (fall 2021, N = 1778). We used chi-square tests to assess the differences in the strategies used (e.g., masking and COVID-19 screening) and ANOVA tests to examine the group differences on a mitigation strategies summative score. Fewer COVID-19 mitigation strategies were reported by respondents in fall 2021 (compared to fall 2020) across businesses of different sizes and regions. The participants in microbusinesses (1-10 employees) reported significantly (p < 0.05) lower mitigation scores than all other business sizes, and the respondents in these businesses were significantly less likely (p < 0.05) to have paid leave than those in enterprises with >10 employees. The healthcare and education sectors had the highest reported mean score of COVID-19 workplace mitigation strategies. Small and essential businesses are critical to the US economy. Insight is needed on their use of mitigation strategies to protect workers during the current and future pandemics.
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Affiliation(s)
- Rebecca J. Guerin
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA
| | - John P. Barile
- College of Social Sciences, Department of Psychology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Matthew R. Groenewold
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA
| | - Hannah L. Free
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA
| | - Andrea H. Okun
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA
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Archibald A, Murphy M, Cohen T, Lowenfels A. Using CDC’s Worksite Health ScoreCard to Evaluate Nutrition and Physical Activity Interventions in Priority Communities in New York State, 2015–2020. Health Promot Pract 2022; 23:34S-43S. [DOI: 10.1177/15248399221114338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of our study was to evaluate a statewide obesity prevention program, designed to improve two social determinants of health (access to healthy foods and opportunities for physical activity) by changing worksite policies, systems, and environments. We used data on social determinants of health to identify priority communities and funded 25 contractors to recruit and engage worksites in those communities. We employed a pre/post quasi-experimental design and used the Centers for Disease Control and Prevention’s Worksite Health ScoreCard to assess implementation of nutrition and physical activity strategies. Contractors collaborated with partners to conduct pre- and postassessments at 313 worksites. Worksites were successful at implementing all except one strategy; implementation doubled for eight strategies and tripled for three. We used weighted scores to incorporate strength of the evidence-base and level of impact into our analysis; increases in strategy implementation were statistically significant in worksites that provided places to purchase food and beverages and in those that did not. Our study revealed several important recommendations for practice. Use available data to prioritize communities experiencing health disparities and identify PSE change strategies to increase access to nutritious foods and physical activity opportunities. Engage with reputable community-based partners from different sectors when designing and implementing programs. Use standardized tools, such as the Worksite Health ScoreCard, to evaluate public health initiatives.
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Affiliation(s)
| | - Megan Murphy
- New York State Department of Health, Albany, NY, USA
| | - Theresa Cohen
- New York State Department of Health, Albany, NY, USA
| | - Ann Lowenfels
- New York State Department of Health, Albany, NY, USA
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Odawara M, Saito J, Yaguchi-Saito A, Fujimori M, Uchitomi Y, Shimazu T. Using implementation mapping to develop strategies for preventing non-communicable diseases in Japanese small- and medium-sized enterprises. Front Public Health 2022; 10:873769. [PMID: 36276371 PMCID: PMC9582744 DOI: 10.3389/fpubh.2022.873769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Workplace programs to prevent non-communicable diseases (NCDs) in the workplace can help prevent the incidence of chronic diseases among employees, provide health benefits, and reduce the risk of financial loss. Nevertheless, these programs are not fully implemented, particularly in small- and medium-sized enterprises (SMEs). The purpose of this study was to develop implementation strategies for health promotion activities to prevent NCDs in Japanese SMEs using Implementation Mapping (IM) to present the process in a systematic, transparent, and replicable manner. Methods Qualitative methods using interviews and focus group discussions with 15 SMEs and 20 public health nurses were conducted in a previous study. This study applied the Consolidated Framework for Implementation Research and IM to analyze this dataset to develop implementation strategies suitable for SMEs in Japan. Results In task 2 of the IM, we identified performance objectives, determinants, and change objectives for each implementation stage: adoption, implementation, and maintenance; to identify the required actors and actions necessary to enhance implementation effectiveness. Twenty-two performance objectives were identified in each implementation stage. In task 3 of the IM, the planning group matched behavioral change methods (e.g., modeling and setting of graded tasks, framing, self-re-evaluation, and environmental re-evaluation) with determinants to address the performance objectives. We used a consolidated framework for implementation research to select the optimal behavioral change technique for performance objectives and determinants and designed a practical application. The planning team agreed on the inclusion of sixteen strategies from the final strategies list compiled and presented to it for consensus, for the overall implementation plan design. Discussion This paper provides the implementation strategies for NCDs prevention for SMEs in Japan following an IM protocol. Although the identified implementation strategies might not be generalizable to all SMEs planning implementation of health promotion activities, because they were tailored to contextual factors identified in a formative research. However, identified performance objectives and implementation strategies can help direct the next steps in launching preventive programs against NCDs in SMEs.
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Affiliation(s)
- Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Yosuke Uchitomi
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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Roehl MT. Putting implementation into context: Exploring the influence of physical, social, and task contexts on the implementation of health promotion programs. GERMAN JOURNAL OF HUMAN RESOURCE MANAGEMENT-ZEITSCHRIFT FUR PERSONALFORSCHUNG 2022. [DOI: 10.1177/23970022221108117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this paper is to empirically examine the influence of organizational context on the implementation effectiveness of human resource management (HRM) practices with the aim of maintaining the health and well-being of employees, known as health promotion programs (HPPs). HPPs are a strategic function in HRM and play a crucial role in creating and maintaining human capital. Effective implementation is typically viewed as a critical prerequisite for the success of HPPs. By exploring the influence of organizational context on the implementation of HPPs, this paper offers a fresh approach to understanding HRM implementation in a relatively neglected area of research. To uncover contextual influences a multiple-case study in four German organizations operating in the chemical industry was conducted. Data was collected using a multi-method design consisting of an analysis of documents and 28 semi-structured interviews. The study is among the first to apply the categorical model of context by Johns to the investigation of the implementation of health promotion programs. The results contribute to a more nuanced view of HRM implementation by highlighting the interrelationships between contextual factors stemming from the physical, social, and task context and implementation fidelity. By providing initial empirical evidence of the mechanisms underlying this relationship, this study sheds light on the complexity and breadth of contextual influences during the implementation of HPPs and offers several theoretical and practical implications.
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Effectiveness of a Worksite-Based Lifestyle Intervention on Employees' Obesity Control and Prevention in China: A Group Randomized Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116738. [PMID: 35682322 PMCID: PMC9180232 DOI: 10.3390/ijerph19116738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 02/05/2023]
Abstract
Background: This study was to culturally adapt a lifestyle intervention for employees’ obesity control and prevention using a participatory process, and evaluate the effectiveness of the project at worksites. Methods: A group randomized experimental study included four worksites (two intervention, two control) in the Yangtze River Delta in China was conducted. A total of 388 participants (216 in the intervention worksites and 172 in the control worksites) were finally recruited from 955 employees at the four worksites (464 in the intervention worksites and 491 in the control worksites). The final evaluation was completed by two hundred and seventy-eight employees (159 in the intervention worksites and 119 in the control worksites, respectively). Data of demographic information, weight, BMI, waist circumference, hip circumference and weight-related behaviors including diary behaviors and physical activities were collected before and after a 12-month intervention and analyzed using descriptive statistics, t-test, chi-square test, linear mixed regression and logistic mixed regression. Results: Although the intervention worksites had a reduction in body mass index (23.21 to 22.95, p < 0.01), hip circumference (95.97 to 95.28, p = 0.03) and waist-to-height ratio (0.49 to 0.48, p = 0.01), the differential changes compared to those of the control group were not statistically significant. The frequency of sweet beverages (−1.81, 95%CI: −0.52, −3.11), frequency of vegetable intake (5.66, 95%CI: 1.59, 9.74), daily servings of vegetables (0.53, 95%CI: 0.24, 0.82), frequency of fruit intake (3.68, 95%CI: 1.25, 6.12), daily servings of fruit (0.26, 95%CI: 0.44, 0.92), daily servings of vegetables and fruit (0.79, 95%CI: 0.43, 1.16), daily steps (863.19, 95%CI: 161.42, 1564.97) and self-efficacy to change physical activity (OR = 1.91, 95%CI: 1.02,3.60) were more improved in the intervention group than were those measures in the control group. Conclusions: The worksite-based lifestyle intervention project for obesity control and prevention improved several employees’ dietary behaviors and physical activities at worksites in China in a short time. Long-term intervention with larger samples in more worksites should be further examined.
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Kava CM, Ruiz RA, Harris JR, Hannon PA. Worksite tobacco control - a qualitative study on perspectives from employers and employees at small worksites. BMC Public Health 2022; 22:904. [PMID: 35524298 PMCID: PMC9073486 DOI: 10.1186/s12889-022-13346-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence-based interventions (EBIs) for tobacco control can be implemented in worksite settings to reduce tobacco use. Small worksites are less likely to adopt tobacco control EBIs than large worksites. The purpose of this qualitative study was to 1) explore factors that impact small employers' decisions to offer tobacco control EBIs, and 2) understand employees' perceptions of tobacco control at small worksites. METHODS Working with staff from small worksites (20-250 employees), we analyzed data from 12 semi-structured interviews with employers (via key informants) and four focus groups with employees. We recruited employers and employees through a purchased business list and market research company, respectively. Interview and focus group topics included perceptions of worksite tobacco control; internal and external forces shaping worksite tobacco control implementation; and perceived worksite support for cessation. We conducted thematic data analysis. RESULTS Key themes from the employer interviews included: the local environment played an important role in implementation of tobacco control EBIs; tobacco control was perceived as important but not a priority; and tobacco control decisions were driven by worksite culture. Key themes from the employee focus groups included: perceived employer support for tobacco cessation was limited although there was interest from employees; employees who currently used tobacco were stigmatized for their behavior; and incentives and coaching were considered ideal tobacco control EBIs. CONCLUSIONS Tobacco control has not been prioritized at small worksites, despite employees welcoming additional cessation support. This study contributes important information on contextual factors and employee preferences that could be targeted to improve tobacco control EBI implementation. Worksites should implement comprehensive tobacco-free policies, minimize stigma when promoting cessation, establish equitable break policies, and involve employees in decision-making related to tobacco control.
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Affiliation(s)
- Christine M Kava
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
- Health Promotion Research Center, University of Washington, 3980 15th Avenue NE, Seattle, WA, 98195, USA.
| | - Raymond A Ruiz
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Jeffrey R Harris
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Peggy A Hannon
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
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Harris JR, M. Kava C, Gary Chan KC, Kohn MJ, Hammerback K, Parrish AT, Helfrich CD, Hannon PA. Pathways to Employee Outcomes in a Workplace Health Promotion Program. Am J Health Promot 2022; 36:662-672. [PMID: 34983199 PMCID: PMC9012684 DOI: 10.1177/08901171211066898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE This study examined the relationship between employee outcomes and employer implementation of evidence-based interventions (EBIs) for chronic disease prevention. DESIGN Cross-sectional samples collected at 3 time points in a cluster-randomized, controlled trial of a workplace health promotion program to promote 12 EBIs. SETTING King County, WA. SAMPLE Employees of 63 small, low-wage workplaces. MEASURES Employer EBI implementation; 3 types of employee outcomes: perceived implementation of EBIs; perceived employer support for health; and health-related behaviors, perceived stress, depression risk, and presenteeism. ANALYSIS Intent-to-treat and correlation analyses using generalized estimating equations. We tested bivariate associations along potential paths from EBI implementation, through perceived EBI implementation and perceived support for health, to several employee health-related outcomes. RESULTS The intent-to-treat analysis found similar employee health-related behaviors in intervention and control workplaces at 15 and 24 months. Workplaces implemented varying combinations of EBIs, however, and bivariate associations were significant for 4 of the 6 indicators of physical activity and healthy eating, as well as perceived stress, depression risk, and presenteeism. We did not find significant positive associations for cancer screening and tobacco cessation. CONCLUSION Our findings support broader dissemination of EBIs for physical activity and healthy eating, as well as more focus on improving employer support for employee health. They also suggest we need better interventions for cancer screening and tobacco cessation.
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Affiliation(s)
- Jeffrey R. Harris
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Christine M. Kava
- Department of Health Systems and Population Health, University of Washington, Seattle
| | | | - Marlana J. Kohn
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Kristen Hammerback
- Department of Health Systems and Population Health, University of Washington, Seattle
| | - Amanda T. Parrish
- Department of Health Systems and Population Health, University of Washington, Seattle
| | | | - Peggy A. Hannon
- Department of Health Systems and Population Health, University of Washington, Seattle
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Engels M, Boß L, Engels J, Kuhlmann R, Kuske J, Lepper S, Lesener L, Pavlista V, Diebig M, Lunau T, Ruhle SA, Zapkau FB, Angerer P, Hoewner J, Lehr D, Schwens C, Süß S, Wulf IC, Dragano N. Facilitating stress prevention in micro and small-sized enterprises: protocol for a mixed method study to evaluate the effectiveness and implementation process of targeted web-based interventions. BMC Public Health 2022; 22:591. [PMID: 35346127 PMCID: PMC8959270 DOI: 10.1186/s12889-022-12921-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Workplace-related stress is a major risk factor for mental and physical health problems and related sickness absence and productivity loss. Despite evidence regarding the effectiveness of different workplace-based interventions, the implementation of stress prevention interventions is rare, especially in micro and small-sized enterprises (MSE) with fewer than 50 employees. The joint research project “PragmatiKK”+ aims to identify and address the specific barriers to the implementation of stress prevention interventions in MSE. This study protocol describes a mixed method study design to evaluate the effectiveness of adapted stress prevention interventions and the implementation process via an integrated web-based platform (“System P”) specifically targeted at MSE. Methods First, we develop a web-based intervention, which accounts for the specific working conditions in MSE and addresses stress prevention at a structural and behavioral level. Second, we use common methods of implementation research to perform an effect and process evaluation. We analyze the effectiveness of the web-based stress prevention interventions by comparing depressive symptoms at baseline and follow-up (after 6 months and 12 months). Indicators for a successful implementation process include acceptability, adoption, feasibility, reach, dose, and fidelity, which we will measure with quantitative web-based questionnaires and qualitative interviews. We will also analyze the accumulated usage data from the web-based platform. Discussion Collecting data on the implementation process and the effectiveness of a web-based intervention will help to identify and overcome common barriers to stress prevention in MSE. This can improve the mental health of employees in MSE, which constitute more than 90% of all enterprises in Germany. + Full Project Name: „PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben “(= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises). Trial registration German Register of Clinical Studies (DRKS): DRKS00026154, date of registration: 2021-09-16. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12921-7.
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Hannon PA, Hammerback K, Kava CM, Bravo-Acevedo P, Strait M, Harris JR. By the Seat of Our Pants: the Experience of Small Businesses in the COVID-19 Pandemic, Washington State, March-October 2020. Prev Chronic Dis 2022; 19:E14. [PMID: 35324423 PMCID: PMC8992682 DOI: 10.5888/pcd19.210366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Most US businesses are small, yet they employ almost half of the nation's workforce. Literature is limited about how small employers (those with 20-250 employees) have made decisions about operating their businesses during the COVID-19 pandemic. We sought to learn how employers made these decisions, what information sources they used, what information they wanted, and to what extent they worked with or used information from their local health department. METHODS We conducted qualitative, semistructured interviews with 26 employers in Washington State, from August through October 2020. Employers were recruited from 7 counties (4 urban and 3 rural) that were experiencing either higher or lower COVID-19 case rates than Washington State overall. RESULTS Employers relied heavily on national government resources to make decisions about how to operate their businesses during the COVID-19 pandemic. Few employers had relationships with or turned to their local health departments for information or support. Employers wanted information about COVID-19 safety that was specific to their business operations and industry. Employers also described the emotional toll of COVID-19 and the challenge of trying to make high-stakes decisions with rapidly evolving information. CONCLUSION Small employers showed little awareness of their local health departments and the information and assistance they could provide. Local health departments could increase their visibility and build relationships with small employers by partnering with them on value-added services such as workplace health promotion. Establishing these relationships could support more rapid collaboration between local health departments and small employers during future public health crises.
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Affiliation(s)
- Peggy A Hannon
- Department of Health Systems and Population Health, University of Washington, 3980 15th Ave NE, 4th Floor, UW Mailbox 351621, Seattle, WA 98105.
| | - Kristen Hammerback
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
| | - Christine M Kava
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
| | - Perla Bravo-Acevedo
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
| | - Michelle Strait
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
| | - Jeffrey R Harris
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington
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Saito J, Odawara M, Takahashi H, Fujimori M, Yaguchi-Saito A, Inoue M, Uchitomi Y, Shimazu T. Barriers and facilitative factors in the implementation of workplace health promotion activities in small and medium-sized enterprises: a qualitative study. Implement Sci Commun 2022; 3:23. [PMID: 35236511 PMCID: PMC8889638 DOI: 10.1186/s43058-022-00268-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/01/2022] [Indexed: 03/27/2024] Open
Abstract
Background There is an immense difference between large companies and small and medium-sized enterprises (SMEs) in implementation of evidence-based interventions (EBIs). Previous literature reveals various barriers that SMEs face during implementation, such as a lack of time, accessibility, and resources. However, few studies have comprehensively examined those influential factors at multi-levels. This study aims to identify the factors influencing the implementation of non-communicable disease prevention activities (tobacco, alcohol, diet, physical activity, and health check-up) in SMEs using Consolidated Framework for Implementation Research (CFIR). Methods We conducted 15 semi-structured interviews with health managers and/or employers in 15 enterprises with less than 300 employees, and four focus groups among public health nurses/nutritionists of health insurers who support SMEs in four prefectures across Japan. A qualitative content analysis by a deductive directed approach was performed. After coding the interview transcript text into the CFIR framework constructs by two independent researchers, the coding results were compared and revised in each enterprise until an agreement was reached. Results Of the 39 CFIR constructs, 25 were facilitative and 7 were inhibitory for workplace health promotion implementation in SMEs, which were across individual, internal, and external levels. In particular, the leadership engagement of employers in implementing the workplace health promotion activities was identified as a fundamental factor which may influence other facilitators, including “access to knowledge and information,” “relative priority,” “learning climate,” at organizational level, and “self-efficacy” at the health manager level. The main barrier was the beliefs held by the employer/manager that “health management is one’s own responsibility.” Conclusions Multi-level factors influencing the implementation of non-communicable diseases prevention activities in SMEs were identified. In resource-poor settings, strong endorsement and support, and positive feedback from employers would be important for health managers and employees to be highly motivated and promote or participate in health promotion. Future studies are needed to develop context-specific strategies based on identified barriers and facilitative factors, and empirically evaluate them, which would contribute to narrowing the differences in worksite health promotion implementation by company size. Supplementary Information The online version contains supplementary material available at 10.1186/s43058-022-00268-4.
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Affiliation(s)
- Junko Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Miyuki Odawara
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hirokazu Takahashi
- Division of Screening Assessment and Management, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Maiko Fujimori
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akiko Yaguchi-Saito
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yosuke Uchitomi
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Division of Supportive Care, Survivorship and Translational Research, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Taichi Shimazu
- Division of Behavioral Sciences, National Cancer Center Institute for Cancer Control, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
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Tenney L, Huebschmann AG, Brown CE, Schwatka NV, Newman LS. Leveraging an Implementation Science Framework to Measure the Impact of Efforts to Scale Out a Total Worker Health® Intervention to Employers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031372. [PMID: 35162408 PMCID: PMC8834848 DOI: 10.3390/ijerph19031372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 12/04/2022]
Abstract
The role of dissemination and implementation (D&I) science is critical to the translation of Total Worker Health® into practice and to the success of interventions in addressing current and future implications for worker safety, health, and well-being. D&I frameworks can guide researchers to design Total Worker Health (“TWH”) delivery approaches that use flexible implementation strategies to implement the core components of programs for employers with varying contextual factors, including small/mid/large-sized businesses and different industry types. To date, there have been very few examples of applying implementation frameworks for the translation and delivery of interventions into organizational settings that require adoption and implementation at the business level to benefit the working individuals. We present a TWH case study, Health Links™, to illustrate an approach to applying an existing implementation framework, RE-AIM, to plan, design, build, and then evaluate TWH implementation strategies. Our case study also highlights key concepts for scaling-out TWH evidence-based interventions where they are implemented in new workplace settings, new delivery systems, or both. Our example provides strong support of key implementation planning constructs including early and consistent stakeholder engagement, tailored messaging and marketing, flexibility, and adaptations in implementation strategies to maximize adoption, implementation, and maintenance among participating businesses.
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Affiliation(s)
- Liliana Tenney
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
- Correspondence: ; Tel.: +1-303-724-6640
| | - Amy G. Huebschmann
- Adult & Child Consortium for Outcomes Research and Delivery Science (ACCORDS) Dissemination and Implementation Program, University of Colorado School of Medicine, Aurora, CO 80045, USA;
- Division of General Internal Medicine and Ludeman Family Center for Women’s Health Research, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Carol E. Brown
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
| | - Natalie V. Schwatka
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
| | - Lee S. Newman
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
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13
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Hadgraft N, Winkler E, Goode AD, Gunning L, Dunstan DW, Owen N, Sugiyama T, Healy GN. How supportive are workplace environments for sitting less and moving more? A descriptive study of Australian workplaces participating in the BeUpstanding program. Prev Med Rep 2022; 24:101616. [PMID: 34976672 PMCID: PMC8684026 DOI: 10.1016/j.pmedr.2021.101616] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 01/26/2023] Open
Abstract
Workplaces varied in the number of activity-supportive characteristics present. Spatial characteristics were more common than resource or policy characteristics. Characteristics absent in most workplaces were likely to be modifiable or low cost (“easy wins”). Almost all workplaces had some room for improvement in terms of activity-supportive factors.
Desk-based workers are highly sedentary; this has been identified as an emerging work health and safety issue. To reduce workplace sitting time and promote physical activity it is important to understand what factors are already present within workplaces to inform future interventions. This cross-sectional study examined the prevalence of supportive environmental factors, prior to workplaces taking part in a ‘sit less, move more’ initiative (BeUpstanding). Participants were 291 Australian-based workplace champions (representing 230 organisations) who unlocked the BeUpstanding program’s online toolkit between September 2017 and mid-November 2020, and who completed surveys relating to champion characteristics, organisation and workplace characteristics, and the availability of environmental factors to support sitting less and moving more. Factors were characterized using descriptive statistics and compared across key sectors and factor categories (spatial; resources/initiatives; policy/cultural) using mixed logistic regression models. Of the 42 factors measured, only 11 were present in > 50% of workplaces. Spatial design factors were more likely to be present than resources/initiatives or policy/cultural factors. Centralised printers were the most commonly reported attribute (94%), while prompts to encourage stair use were the least common (4%). Most workplace factors with < 50% prevalence were modifiable and/or were considered modifiable with low cost. Organisations that were public sector, not small/medium, not regional/remote, and not blue-collar had higher odds of having supportive factors than their counterparts; however, workplaces varied considerably in the number of factors present. These findings can assist with developing and targeting initiatives and promoting feasible strategies for desk-based workers to sit less and move more.
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Affiliation(s)
- Nyssa Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia.,Baker Heart & Diabetes Institute, Melbourne, Australia
| | - Elisabeth Winkler
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Ana D Goode
- The University of Queensland, School of Public Health, Brisbane, Australia
| | | | - David W Dunstan
- Baker Heart & Diabetes Institute, Melbourne, Australia.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia.,Baker Heart & Diabetes Institute, Melbourne, Australia
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Australia.,Baker Heart & Diabetes Institute, Melbourne, Australia
| | - Genevieve N Healy
- The University of Queensland, School of Public Health, Brisbane, Australia.,Baker Heart & Diabetes Institute, Melbourne, Australia
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14
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Minamitani M, Tatemichi M, Mukai T, Katano A, Nakagawa K. Effect of employers' concerns about cancer countermeasures on the implementation of cancer screening and support for balancing cancer treatment and work in small and medium-sized Japanese enterprises. J Occup Health 2022; 64:e12352. [PMID: 35989472 PMCID: PMC9393347 DOI: 10.1002/1348-9585.12352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/04/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Japan has recently implemented screening and support to balance cancer treatment and work. The present study evaluated whether the interest of employers in small and medium-sized enterprises (SMEs) affects cancer control in the workplace. METHODS Cancer preparedness at work was examined by a Japanese life insurance company contracting 370 000 SMEs. The analysis targeted SMEs hiring ≤50 employees whose employer was aged ≥40 years. The endpoints were performing one or more screening for stomach, colon, or lung cancer recommended for both sexes in Japan and implementing three or more supportive measures from the nine systems listed in a questionnaire. Logistic regression analysis was performed to predict these endpoints using other factors. RESULTS The survey was completed from January 5 to 28, 2022 and included 5268 eligible companies. Around half were small enterprises with up to five employees. Screenings were performed for stomach (32%), colorectal (27%), and lung (26%) cancers. Sick leave (36%) was the most common support for balancing cancer treatment and work. Logistic regression analysis revealed that employer's concern was a significant predictor of screening (odds ratio [OR] = 3.59, P < .001) and support (OR = 2.55, P < .01) compared with "not concerned at all," along with industry type, annual sales, experience of employees with cancer, and employer's participation in screening. CONCLUSION Our findings suggested that employers' interest was a powerful predictor of implementing cancer control in SMEs. Educational intervention targeted toward the employer could play a critical role in improving SMEs.
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Affiliation(s)
- Masanari Minamitani
- Department of Comprehensive Radiation OncologyThe University of TokyoTokyoJapan
| | - Masayuki Tatemichi
- Department of Preventive MedicineTokai University School of MedicineIsehara‐ShiJapan
| | - Tomoya Mukai
- Graduate Schools for Law and PoliticsThe University of TokyoTokyoJapan
| | - Atsuto Katano
- Department of RadiologyThe University of Tokyo HospitalTokyoJapan
| | - Keiichi Nakagawa
- Department of Comprehensive Radiation OncologyThe University of TokyoTokyoJapan
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15
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Boß L, Angerer P, Dragano N, Ebert D, Engels M, Heber E, Kuhlmann R, Ruhle S, Schwens C, Wulf IC, Lehr D. Comparative effectiveness of guided internet-based stress management training versus established in-person group training in employees - study protocol for a pragmatic, randomized, non-inferiority trial. BMC Public Health 2021; 21:2177. [PMID: 34837999 PMCID: PMC8626923 DOI: 10.1186/s12889-021-12229-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Occupational stress is a major public health challenge that requires a variety of evidence-based preventative approaches to increase their reach within the working population. Behavioral stress management interventions are considered an established approach for occupational stress prevention. Both in-person group-based stress management training (gSMT) and individual Internet-based training (iSMT) have been shown to be effective at reducing stress in employees. However, there remains a lack of evidence on the comparative efficacy of the newer digital format compared to well-established, in-person, group-based training. This study aims (1) to directly compare an evidence-based iSMT with an established gSMT on stress in employees, (2) to analyze the two conditions from a cost perspective, and (3) to explore moderators of the comparative efficacy. METHODS In a randomized, controlled, non-inferiority trial employees from the general working population will be allocated to iSMT or gSMT. The primary outcome will be perceived stress, assessed using the Perceived Stress Scale, three months after randomization. The non-inferiority margin for the primary outcome measure will be set at 2 points (Cohen's d = 0.29). This trial will also compare the two interventions from a health economics perspective, and conduct explorative analyses to identify potential effect moderators. DISCUSSION To reach a larger proportion of the working population, well-established gSMT should be complemented with interventions that fit today's society's increasingly digital lifestyle. The current trial will provide evidence supporting the responsible implementation of Internet-based stress management training if the digital format proves to at least be non-inferior to established group-based training. Additional explorative moderator analyses may guide future practices to aid in matching select programs with select users. TRIAL REGISTRATION German Register of Clinical Studies (DRKS): DRKS00024892, date of registration: 2021-04-09. Protocol version: 02, 16-10-2021.
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Affiliation(s)
- Leif Boß
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lüneburg, Lüneburg, Germany.
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - David Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Miriam Engels
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Elena Heber
- GET.ON Institut für Online Gesundheitstrainings GmbH, Hamburg, Germany
| | - Rebekka Kuhlmann
- Chair of Business Administration, in particular Work, Human Resource Management and Organization Studies, Faculty of Business Administration and Economics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Sascha Ruhle
- Chair of Business Administration, in particular Work, Human Resource Management and Organization Studies, Faculty of Business Administration and Economics, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Christian Schwens
- Endowed Chair for Interdisciplinary Management Science, School of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
| | - Ines Catharina Wulf
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lüneburg, Lüneburg, Germany
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16
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Siegel A, Hoge AC, Ehmann AT, Martus P, Rieger MA. Attitudes of Company Executives toward a Comprehensive Workplace Health Management-Results of an Exploratory Cross-Sectional Study in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111475. [PMID: 34769990 PMCID: PMC8583484 DOI: 10.3390/ijerph182111475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
Workplace health management (WHM) in Germany aims at maintaining and increasing the health and well-being of employees. Little is known about company executives’ attitudes toward WHM. To gain more insight, we conducted a large-scale survey in companies in the German county of Reutlingen in 2017. We sent a standardized questionnaire to 906 companies, containing inter alia 26 self-constructed declarative statements depicting company executives’ opinions on various WHM aspects; 222 questionnaires could be evaluated. By exploratory factor analysis we assigned the 26 items to six factors reflecting different attitudes toward WHM. Factor values were standardized to a scale from 0 to 10. The attitude ‘positive view of general health services in the company’, for example, achieved by far the lowest mean agreement (3.3 points). For the attitude ‘general skepticism toward WHM’, agreement and disagreement were balanced (5.0 points). Using multiple regression analyses, we searched for variables that could partially explain respondents’ agreement with attitudes. In conclusion, a general WHM skepticism was widespread, but not dominant. The idea that general health services should be offered in companies was predominantly rejected. Older respondents and respondents from smaller companies and craft enterprises were more skeptical than average about WHM and its possible extensions.
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Affiliation(s)
- Achim Siegel
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
- Correspondence: ; Tel.: +49-7071-29-86812
| | - Aileen C. Hoge
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
| | - Anna T. Ehmann
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, University Hospital Tübingen, Silcherstr. 5, 72076 Tübingen, Germany;
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
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17
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Zusman EZ, Kapanen AI, Klaassen A, Reardon J. Workplace cardiovascular risk reduction by healthcare professionals-a systematic review. Occup Med (Lond) 2021; 71:270-276. [PMID: 34415353 DOI: 10.1093/occmed/kqab104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cardiovascular disease has a significant impact on public health and is largely preventable by addressing modifiable risk factors. As most adults spend on average half of their waking hours at work, this provides a significant opportunity to address modifiable risk factors through health promotion interventions. Healthcare professionals have the knowledge and skills to provide workplace interventions aimed at cardiovascular risk reduction. AIMS This study was aimed to assess the literature regarding the effect of workplace interventions led by healthcare professionals on cardiovascular risk factors. METHODS Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, MEDLINE, PsycINFO and SPORTDiscus were systematically searched from inception to March 2021. Included studies evaluated impact of workplace interventions by healthcare professionals on cardiovascular health. Data on study design, baseline characteristics, interventions, outcomes and conclusions were extracted and qualitatively analysed. RESULTS Forty-five studies representing 77 633 participants were included in the analysis. Healthcare professionals involved included: nurses, nurse practitioners, physicians, dietitians, pharmacists, physician assistants, medical technicians/emergency medical technicians and physiotherapists. Workplace interventions by healthcare professionals generally improved surrogate markers of cardiovascular health. Success varied based on provider and nature of the intervention. Addressing motivation and including follow-up were key factors for successful intervention to reduce cardiovascular risk factors. CONCLUSIONS Workplace health promotion initiatives delivered by healthcare professionals may improve cardiovascular risk markers if they are evidence based and customized for target populations. More research is needed to determine clinical relevance of interventions and ideal interventions for specific employee groups.
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Affiliation(s)
- E Z Zusman
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - A I Kapanen
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - A Klaassen
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - J Reardon
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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18
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Calitz C, Pratt C, Pronk NP, Fulton JE, Jinnett K, Thorndike AN, Addou E, Arena R, Brown AGM, Chang C, Latts L, Lerner D, Majors M, Mancuso M, Mills D, Sanchez E, Goff D. Cardiovascular Health Research in the Workplace: A Workshop Report. J Am Heart Assoc 2021; 10:e019016. [PMID: 34459251 PMCID: PMC8649235 DOI: 10.1161/jaha.120.019016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Heart disease and stroke are the first and fifth leading causes of death in the United States, respectively. Employers have a unique opportunity to promote cardiovascular health, because >60% of US adults are employed, and most spend half of their waking hours at work. Despite the scope of the opportunity, <1 in 5 businesses implement evidence-based, comprehensive workplace health programs, policies, and practices. Integrated, systems-based workplace health approaches that harness data science and technology may have the potential to reach more employees and be cost-effective for employers. To evaluate the role of the workplace in promoting cardiovascular health across the lifespan, the National Heart, Lung, and Blood Institute, the National Institute for Occupational Safety and Health, and the American Heart Association convened a workshop on March 7, 2019, to share best practices, and to discuss current evidence and knowledge gaps, practical application, and dissemination of the evidence, and the need for innovation in workplace health research and practice. This report presents the broad themes discussed at the workshop and considerations for promoting worker cardiovascular health, including opportunities for future research.
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Affiliation(s)
| | | | | | | | - Kimberly Jinnett
- University of California San Francisco and GenentechSan FranciscoCA
| | | | - Ebyan Addou
- National Heart Lung and Blood InstituteBethesdaMD
| | - Ross Arena
- University of Illinois at ChicagoIL
- Healthy Living for Pandemic Event Protection NetworkChicagoIL
| | | | - Chia‐Chia Chang
- National Institute for Occupational Safety and Health/Centers for Disease Control and PreventionWashingtonDC
| | - Lisa Latts
- Colorado Department of Health Care Policy and FinancingDenverCO
| | | | | | | | | | | | - David Goff
- National Heart Lung and Blood InstituteBethesdaMD
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19
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Pavlista V, Angerer P, Diebig M. Barriers and drivers of psychosocial risk assessments in German micro and small-sized enterprises: a qualitative study with owners and managers. BMC Public Health 2021; 21:1376. [PMID: 34247620 PMCID: PMC8273035 DOI: 10.1186/s12889-021-11416-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 06/29/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The negative effect of unfavorable working conditions and long-term work stress on health has been demonstrated in previous research. To address these challenges, systematic approaches such as psychosocial risk assessments (PRA) have been developed in many countries worldwide. Despite legal obligations, psychosocial risk assessments are rarely carried out in micro and small-sized enterprises (MSE). Even though those enterprises constitute a large proportion of the general workforce, this area remains largely untouched by research. In order to enable starting points for a greater dissemination in organizational practice, the present study explores barriers and drivers of psychosocial risk assessments in micro and small-sized enterprises. METHODS A total of 18 owners and managers from 15 micro and small-sized enterprises in North-Rhine Westphalia, Germany, were interviewed. The interviews were audio-recorded, transcribed, and analyzed. A qualitative approach was applied: Content analysis was used to analyze the data, using deductive as well as inductive coding techniques. RESULTS The following barriers emerged from the interviews: Negative PRA image, stigmatization of mental health, lacking acceptance of employees, fear of excessive authority interference, ignorance of PRA, not understanding the necessity, inappropriate approach, and limited resources. The identified drivers were: Easy access to PRA material, external support from experts, renaming the term "workplace risk assessment", understanding content and benefit of PRA, simplify and revise PRA process, and noticeable consequences of PRA execution and non-execution. The results are comparable with those in larger companies. They emphasize the importance of mental health education, improving the process of psychosocial risk assessments, and the ongoing support in overcoming limited financial as well as human resources. CONCLUSIONS To improve implementation of PRA in organizational practice, a simplification of the process is proposed, accompanied by information campaigns and an improvement in the health literacy of owners and managers of MSE. In view of the results, the full revision of the PRA approach should also be considered.
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Affiliation(s)
- Valeria Pavlista
- Heinrich-Heine University, Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society; Medical Faculty, 40225 Dusseldorf, Germany
| | - Peter Angerer
- Heinrich-Heine University, Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society; Medical Faculty, 40225 Dusseldorf, Germany
| | - Mathias Diebig
- Heinrich-Heine University, Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society; Medical Faculty, 40225 Dusseldorf, Germany
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20
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Harris JR, Hammerback K, Brown M, Ryan DE, Coe NB, Pike KJ, Santiago PM, Hannon PA. Local Health Jurisdiction Staff Deliver Health Promotion to Small Worksites, Washington. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:117-124. [PMID: 31738191 PMCID: PMC7220816 DOI: 10.1097/phh.0000000000001105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Worksites can serve as community sites for local health jurisdictions (LHJs) to assist with implementation of evidence-based interventions (EBIs) to prevent and control chronic diseases. OBJECTIVE To assess the feasibility and effectiveness of using LHJ staff to disseminate Connect to Wellness (CtW), an effective dissemination package for increasing implementation of EBIs for chronic disease control by small worksites. DESIGN Single-arm, multisite intervention trial, with measurement at baseline, after 6 months of intervention, and after a maintenance period of 6 months. SETTING Six geographically dispersed counties in Washington State. Target worksites had 20 to 250 employees. PARTICIPANTS Nine staff members from 6 LHJs delivered CtW to 35 worksites. INTERVENTION Connect to Wellness seeks to increase worksites' implementation of 14 EBIs classified as communication, policy, or program approaches to increasing 4 behaviors: cancer screening, healthy eating, physical activity, and tobacco cessation. MAIN OUTCOME MEASURE Evidence-based intervention implementation measured on a scale from 0% to 100%. RESULTS Participating worksites showed a significant increase (P < .001, t test) in total mean implementation scores from baseline (33%) to 6-month follow-up (47%). Increases in implementation for communications, policy, healthy eating, and tobacco EBIs were statistically significant at 6 months and maintained at 12 months. Increased implementation at 6 months of a group physical activity program was not sustained after the program became unavailable, and total implementation scores at 12 months (38%) showed little change from baseline. CONCLUSIONS Local health jurisdiction-delivered CtW increased worksites' implementation of EBIs at 6 months, and increased implementation in communication, policy, healthy eating, and tobacco was maintained at 12 months. This package, delivered by LHJ staff working part-time on CtW, was nearly as successful as prior delivery by staff working full-time on CtW.
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Affiliation(s)
- Jeffrey R. Harris
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
| | - Kristen Hammerback
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
| | - Meagan Brown
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
| | - Daron E. Ryan
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
| | - Norma B. Coe
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
| | - K. Joanne Pike
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
| | - Patti M. Santiago
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
| | - Peggy A. Hannon
- Department of Health Services, School of Public Health, University of Washington, Seattle, Washington (Drs Harris, Coe, and Hannon, Mss Hammerback, Brown, and Ryan); Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (Dr Coe); Alzheimer's Association, Chicago, Illinois (Dr Pike); and Washington State Department of Health, Tumwater, Washington (Ms Santiago)
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Kava CM, Passey D, Harris JR, Chan KCG, Hannon PA. The Workplace Support for Health Scale: Reliability and Validity of a Brief Scale to Measure Employee Perceptions of Wellness. Am J Health Promot 2021; 35:179-185. [PMID: 32808553 PMCID: PMC7870498 DOI: 10.1177/0890117120949807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the reliability and validity of a brief measure (the Workplace Support for Health [WSH] scale) to assess employees' perceived support for a healthy lifestyle. DESIGN Repeated cross-sectional surveys. SETTING We collected employer- and employee-level survey data from small, low-wage workplaces in King County, WA enrolled in a randomized controlled trial. SAMPLE We analyzed data from 68 workplaces that had 2,820 and 2,640 employees complete surveys at baseline and 15 months, respectively. MEASURES The WSH scale consisted of five items. To assess validity, we examined associations between the WSH scale and employer implementation of evidence-based interventions for health promotion, employee self-rated health, and job satisfaction. ANALYSIS We performed an exploratory factor analysis to assess the unidimensionality of the WSH scale items, and produced Cronbach's alpha coefficients to examine scale reliability. We ran regression models using generalized estimating equations to examine validity. RESULTS The factor analysis indicated one factor, which accounted for 59% of the total variance in the workplace support for health items. The scale had good reliability at baseline (α = 0.82) and 15 months (α = 0.83). Employer evidence-based intervention implementation was positively associated with WSH. WSH was also associated with higher self-rated health and job satisfaction. These associations indicate good concurrent validity. CONCLUSION The WSH scale is a reliable and valid measure of perceived workplace support for health. Employers can use the scale to identify gaps in support and create a plan for improvement.
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Affiliation(s)
- Christine M. Kava
- Health Promotion Research Center, Department of Health Services, University of Washington, Seattle, WA
| | - Debbie Passey
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Jeffrey R. Harris
- Health Promotion Research Center, Department of Health Services, University of Washington, Seattle, WA
| | - Kwun C. Gary Chan
- Health Promotion Research Center, Department of Health Services, University of Washington, Seattle, WA
| | - Peggy A. Hannon
- Health Promotion Research Center, Department of Health Services, University of Washington, Seattle, WA
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Health Links™ Assessment of Total Worker Health® Practices as Indicators of Organizational Behavior in Small Business. J Occup Environ Med 2020; 61:623-634. [PMID: 31045750 DOI: 10.1097/jom.0000000000001623] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to conduct a cross-sectional assessment of the adoption of Total Worker Health (TWH) policies and practices by business size and evaluate extent and alignment of their safety and health. METHODS We conducted an analysis of 382 businesses that completed the Health Links Assessment. We measured organizational adoption of TWH across six benchmarks: organizational supports, workplace assessments, health policies and programs, safety, engagement, and evaluation. RESULTS Benchmark scores were significantly associated with business size. Larger businesses were more likely to score higher across each benchmark. CONCLUSION Small businesses are implementing TWH in a variety of ways and the level of implementation differs by business size. Practical interventions as well as dissemination and implementation research should take business size into account to ensure that TWH is both effective and sustainable in meeting the needs of employees.
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Association Between the Characteristics of Organizations and Their Profile of Performance Against Quality Benchmarks for Workplace Health Promotion. J Occup Environ Med 2020; 61:424-430. [PMID: 30870394 DOI: 10.1097/jom.0000000000001584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study explored subgroups of performance profiles measured by organizations' Well Workplace Checklist (WWC) benchmark scores and examined company characteristics associated with performance subgroups. METHODS The sample included 3728 US organizations that completed the WWC in 2008 to 2015. Latent profile analysis (LPA) was used to extract distinct subgroups of organizations based on benchmark performance. Multinomial logistic regression analysis was used to examine associations between the characteristics of organizations and their performance subgroup. RESULTS Three distinct subgroups of performance resulted from the LPA. Significant associations were found between subgroup assignment and characteristics such as size, industry, how WHP initiatives were paid for, and reasons for implementing WHP initiatives. CONCLUSION The characteristics associated with subgroups of performance suggest utility for developing specific interventions tailored to different types of organizations to improve their overall quality of WHP initiatives.
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Certified Nursing Assistants’ Barriers and Facilitators to Accessing and Using Worksite Health Promotion Programs. J Occup Environ Med 2020; 62:943-952. [DOI: 10.1097/jom.0000000000002007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Vaughn AE, Willis EA, Ward DS, Smith F, Grummon A, Linnan LA. Workplace-based opportunities to support child care workers' health and safety. Prev Med Rep 2020; 19:101154. [PMID: 32714774 PMCID: PMC7369321 DOI: 10.1016/j.pmedr.2020.101154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/09/2020] [Accepted: 06/26/2020] [Indexed: 11/26/2022] Open
Abstract
Child care workers earn among the lowest wages in the United States and they struggle with many health issues. The purpose of this study was to describe workplace supports for nutrition, physical activity, other health behaviors (e.g., smoking cessation, stress management), and occupational health and safety available to child care workers, and thereby inform the development of future workplace-based interventions to improve worker well-being. Between 2015 and 2016, 74 North Carolina child care centers (and directors), participating in a larger randomized controlled trial, completed a Workplace Health and Safety Assessment (interview and observation) measuring four domains: Infrastructure, Organizational Policies and Procedures, Programs and Promotions, and Internal Physical Environment. This study used baseline data to report means and standard deviations. Participating child care centers employed, on average, 12.7 ± 8.4 employees. Total scores from the Workplace Health and Safety Assessment averaged 41.3 ± 12.6 out of a possible 154, demonstrating many missed opportunities for supporting health/safety. More specifically, centers scored on average 9.5 ± 3.9 on Infrastructure (35% of potential points), 11.1 ± 3.9 on Organizational Policies and Procedures (32% of potential), 7.6 ± 5.4 on Programs and Promotions (12% of potential), and 13.1 ± 2.2 on Internal Physical Environment (49% of potential). The most frequent supports available were for occupational health and safety issues, while fewer supports were available for physical activity and other health behaviors. Child care workers could benefit greatly from more comprehensive workplace health and safety interventions; however, strategies must overcome centers' limited capacity and resources.
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Affiliation(s)
- Amber E Vaughn
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., CB 7426, Chapel Hill, NC 27599-7426, USA
| | - Erik A Willis
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., CB 7426, Chapel Hill, NC 27599-7426, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., CB 7426, Chapel Hill, NC 27599-7426, USA.,Department of Nutrition, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 2202 McGavran-Greenberg Hall, CB7461, Chapel Hill, NC 27599-7461, USA
| | - Falon Smith
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., CB 7426, Chapel Hill, NC 27599-7426, USA
| | - Anna Grummon
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., CB 7426, Chapel Hill, NC 27599-7426, USA.,Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 307 Rosenau Hall, CB 7440, Chapel Hill, NC 27599-7440, USA
| | - Laura A Linnan
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 307 Rosenau Hall, CB 7440, Chapel Hill, NC 27599-7440, USA
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Ryu H, Jung J, Moon J. Health promotion program for office workers with SEM based on the WHO’s healthy workplace framework. Health Promot Int 2020; 35:1369-1382. [DOI: 10.1093/heapro/daaa007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Abstract
This study attempts to develop and verify the effectiveness of a health promotion program for office workers based on the social ecological model and the World Health Organization’s Healthy Workplace Framework. This study involved 272 office workers of a small and medium-sized enterprise in Korea. Data were analyzed through descriptive statistics, repeated measures analysis of variance (ANOVA) and Bonferroni correction using SPSS/WIN 23.0. Workplace environmental support was provided to all workers, while a 6-month intensive core program based on social support was implemented for the intensive management group. Based on the participation rate, individuals were divided into the core and dropout groups. In all office workers, there were negative changes in high-density lipoprotein cholesterol and job stress during the period. Meanwhile, the intensive group showed significant changes in body mass index and diastolic blood pressure. The study suggests that the organization’s support for a healthy environment and an individual’s continued participation based on social support are essential for the effectiveness of a health promotion program for office workers.
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Affiliation(s)
- Hosihn Ryu
- College of Nursing, Korea University, Seoul 02841, Korea
| | - Jiyeon Jung
- College of Nursing, Korea University, Seoul 02841, Korea
| | - Jihyun Moon
- College of Nursing, Korea University, Seoul 02841, Korea
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Size Matters: A Latent Class Analysis of Workplace Health Promotion Knowledge, Attitudes, Practices and Likelihood of Action in Small Workplaces. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041251. [PMID: 32075229 PMCID: PMC7068264 DOI: 10.3390/ijerph17041251] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 11/16/2022]
Abstract
Workplace health programs (WHPs) have been shown to improve employee health behaviours and outcomes, increase productivity, and decrease work-related costs over time. Nonetheless, organizational characteristics, including size, prevent certain workplaces from implementing these programs. Past research has examined the differences between small and large organizations. However, these studies have typically used a cut-off better suited to large countries such as the USA. Generalizing such studies to countries that differ based on population size, scale of economies, and health systems is problematic. We investigated differences in WHP knowledge, attitudes, and practices between organizations with under 20 employees, 20–99 employees, and more than 100 employees. In 2017–2018, a random sample of employers from 528 workplaces in Alberta, Canada, were contacted for participation in a cross-sectional survey. Latent Class Analysis (LCA) was used to identify underlying response pattern and to group clusters of similar responses to categorical variables focused on WHP knowledge, attitudes, practices and likelihood of action. Compared to large organizations, organizations with fewer than 20 employees were more likely to be members of the Medium–Low Knowledge of WHP latent class (p = 0.01), the Low Practices for WHP latent class (p < 0.001), and more likely to be members of Low Likelihood of Action in place latent class (p = 0.033). While the majority of workplaces, regardless of size, recognized the importance and benefits of workplace health, capacity challenges limited small employers’ ability to plan and implement WHP programs. The differences in capacity to implement WHP in small organizations are masked in the absence of a meaningful cut-off that reflects the legal and demographic reality of the region of study.
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Reynolds GS, Bennett JB. A Brief Measure of Organizational Wellness Climate: Initial Validation and Focus on Small Businesses and Substance Misuse. J Occup Environ Med 2019; 61:1052-1064. [PMID: 31626071 PMCID: PMC7691977 DOI: 10.1097/jom.0000000000001739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Organizations with fewer than 100 employees comprise most businesses in the United States. Since small businesses lack comparable resources, they may benefit from a simple valid tool for broadly assessing positive wellness climate, especially because climate contributes to employee wellbeing. METHODS Using an ethnically and occupationally diverse sample of 45 businesses (n = 1512), the current study developed and tested a brief self-report measure of organizational wellness climate. RESULTS Confirmatory factor analysis shows that a 9-item measure has good model fit (RMSEA = 0.06, CFI = 0.91), inter-item consistency of 0.74, and mean Rwg(j) of 0.87. The new measure is significantly positively correlated with physical health and wellbeing, and negatively correlated with substance use behavior. CONCLUSIONS Findings indicate that a 9-item measure has good reliability, construct, and criterion validity. Implications for practical use of the measure are discussed.
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Qualitative Exploration of the Feasibility and Acceptability of Workplace-Based Microgrants to Improve Physical Activity: The 10,000 Steps Pedometer Microgrant Scheme. J Occup Environ Med 2019; 60:e406-e411. [PMID: 29851733 DOI: 10.1097/jom.0000000000001376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Despite the benefits associated with workplace health programs, many organizations are unable to offer them due to financial constraints. To address this barrier, the existing 10,000 Steps program trialed the 10,000 Steps Pedometer Microgrant Scheme. This study assessed the feasibility and acceptability of the Microgrant Scheme. METHODS Semi-structured interviews with employee representatives (n = 19) were used to explore perceptions of the Microgrant Scheme. Thematic inductive analysis was conducted. RESULTS Three main themes emerged: 1) the need for workplace initiatives to address health promotion issues (The Need); 2) the factors associated with the application and implementation process (The Process); and 3) employee and employer benefits associated with the Microgrant Scheme (The Outcomes). CONCLUSION These findings highlight the potential utility of a Microgrant Scheme to extend the reach and long-term sustainability of workplace health promotion activities.
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Hannon PA, Hammerback K, Kohn MJ, Kava CM, Gary Chan KC, Parrish AT, Allen C, Helfrich CD, Mayotte C, Beresford SA, Harris JR. Disseminating Evidence-Based Interventions in Small, Low-Wage Worksites: A Randomized Controlled Trial in King County, Washington (2014-2017). Am J Public Health 2019; 109:1739-1746. [PMID: 31622155 DOI: 10.2105/ajph.2019.305313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To determine whether (1) participating in HealthLinks, and (2) adding wellness committees to HealthLinks increases worksites' evidence-based intervention (EBI) implementation.Methods. We developed HealthLinks to disseminate EBIs to small, low-wage worksites. From 2014 to 2017, we conducted a site-randomized trial in King County, Washington, with 68 small worksites (20-200 employees). We assigned worksites to 1 of 3 arms: HealthLinks, HealthLinks plus wellness committee (HealthLinks+), or delayed control. At baseline, 15 months, and 24 months, we assessed worksites' EBI implementation on a 0% to 100% scale and employees' perceived support for their health behaviors.Results. Postintervention EBI scores in both intervention arms (HealthLinks and HealthLinks+) were significantly higher than in the control arm at 15 months (51%, 51%, and 23%, respectively) and at 24 months (33%, 37%, and 24%, respectively; P < .001). Employees in the intervention arms perceived greater support for their health at 15 and 24 months than did employees in control worksites.Conclusions. HealthLinks is an effective strategy for disseminating EBIs to small worksites in low-wage industries.Public Health Implications. Future research should focus on scaling up HealthLinks, improving EBI maintenance, and measuring impact of these on health behavior.
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Affiliation(s)
- Peggy A Hannon
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Kristen Hammerback
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Marlana J Kohn
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Christine M Kava
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Kwun C Gary Chan
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Amanda T Parrish
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Claire Allen
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Christian D Helfrich
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Caitlin Mayotte
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Shirley A Beresford
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Jeffrey R Harris
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
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Schwatka NV, Smith D, Weitzenkamp D, Atherly A, Dally MJ, Brockbank CVS, Tenney L, Goetzel RZ, Jinnett K, McMillen J, Newman LS. The Impact of Worksite Wellness Programs by Size of Business: A 3-Year Longitudinal Study of Participation, Health Benefits, Absenteeism, and Presenteeism. Ann Work Expo Health 2019; 62:S42-S54. [PMID: 30212884 DOI: 10.1093/annweh/wxy049] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/26/2018] [Indexed: 11/14/2022] Open
Abstract
Objective Worksite wellness programs (WWP) may positively impact employee health, medical expenditures, absenteeism, and presenteeism. However, there has been little research to assess the benefits of WWP in small businesses. The purpose of this study is to prospectively evaluate changes in health, absenteeism, and presenteeism for employees who participated in a WWP. Methods We conducted an observational, 3-year cohort study of 5766 employees from 314 businesses of differing sizes. We followed two cohorts of employees, who completed at least two annual health risk assessments (HRA) between May 2010 and December 2014. Changes from baseline to the first and second follow-up periods were assessed for chronic and non-chronic health conditions, absenteeism, and presenteeism. Results Small business employees were more likely to participate in the WWP than were employees from large businesses. Changes in chronic and non-chronic health conditions varied by size of business, with small business employees showing improvements in stress, overall health, depression, smoking status, vegetable and fruit consumption, and physical activity, and in their perceptions of job health culture. In contrast, large business employees experienced improvements in stress, vegetable consumption, and alcohol use. No changes in absenteeism or presenteeism were observed. Conclusions Small businesses achieve higher employee participation rates and more health improvements when compared to employees from large employers. Findings suggest that small businesses may gain the most from a WWP.
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Affiliation(s)
- Natalie V Schwatka
- Department of Environmental and Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Derek Smith
- Department of Biostatistics and Informatics, Center for Health, Work and Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - David Weitzenkamp
- Department of Biostatistics and Informatics, Center for Health, Work and Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Adam Atherly
- Department of Health Systems, Management and Policy, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Miranda J Dally
- Department of Environmental and Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | - Liliana Tenney
- Department of Environmental and Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Ron Z Goetzel
- Institute for Health and Productivity Studies, Johns Hopkins University Bloomberg School of Public Health, Washington, DC, USA.,IBM Watson Health, Bethesda, MD, USA
| | - Kimberly Jinnett
- Center for Workforce Health and Performance, University of California San Francisco, San Francisco, CA, USA.,Institute for Health and Aging, University of California San Francisco, San Francisco, CA, USA
| | | | - Lee S Newman
- Department of Environmental and Occupational Health, Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.,Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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Kava CM, Parker EA, Baquero B, Curry SJ, Gilbert PA, Sauder M, Sewell DK. Associations Between Organizational Culture, Workplace Health Climate, and Employee Smoking at Smaller Workplaces. Tob Use Insights 2019; 12:1179173X19835842. [PMID: 30906195 PMCID: PMC6421609 DOI: 10.1177/1179173x19835842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/09/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Smaller workplaces frequently employ low-wage earners, who have higher smoking rates. Organizational culture and workplace health climate are two characteristics that could influence employee smoking. The purpose of this study was to examine the associations between organizational culture, workplace health climate, and smoking among employees at small (20-99 employees) and very small (<20 employees) workplaces. We proposed the following hypotheses: a stronger clan culture will be associated with a better workplace health climate (HP1); a better workplace health climate will be associated with lower odds of current smoking (HP2); and there will be an association between workplace health climate and smoking intensity (HP3) and between workplace health climate and quit intention (HP4). Methods: Executives and employees completed separate online questionnaires. Data collection occurred between June and October 2017. We used regression and Fisher’s exact tests to answer study hypotheses. Results: Workplaces with stronger clan cultures had a better workplace health climate (b = 0.27, P < .05), providing support for HP1. A better workplace health climate was associated with lower odds of being a current smoker (odds ratio [OR] = 0.08; 95% confidence interval [CI]: 0.01, 0.53), providing support for HP2. No significant relationship existed between workplace health climate and smoking intensity (P = .50) or between workplace health climate and intention to quit smoking (P = .32); therefore, HP3 and HP4 were not supported. Conclusion: Certain culture types may inform an organization’s health climate. Despite a lower likelihood of current smoking in workplaces with better health climates, a better health climate may not be sufficient to produce changes in smoking behavior and intentions.
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Affiliation(s)
- Christine M Kava
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA.,Health Promotion Research Center, University of Washington, Seattle, WA, USA
| | - Edith A Parker
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Barbara Baquero
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Susan J Curry
- Department of Health Management and Policy, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Paul A Gilbert
- Department of Community and Behavioral Health, College of Public Health, The University of Iowa, Iowa City, IA, USA
| | - Michael Sauder
- Department of Sociology, The University of Iowa, Iowa City, IA, USA
| | - Daniel K Sewell
- Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, IA, USA
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Lier LM, Breuer C, Dallmeyer S. Organizational-level determinants of participation in workplace health promotion programs: a cross-company study. BMC Public Health 2019; 19:268. [PMID: 30894160 PMCID: PMC6427860 DOI: 10.1186/s12889-019-6578-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attracted by the expected benefits such as reduced absenteeism and increased productivity, more and more firms decide to implement workplace health promotion programs (WHPPs). However, those programs can only be effective if employees actually participate. This study aims to (1) gain insight into the degree of enrolment rates in such programs across companies and (2) identify organizational level factors that are associated with employee participation. Building on existing theory on organizational drivers of participation in corporate wellness programs, the study's main goal is to investigate which organizational factors determine whether employees enroll in a corporate fitness program or not. METHODS A business-to-business fitness platform company provided organizational level data on 61 client firms that have recently implemented a corporate wellness program. The data contained information on the enrolment rate per company and different organizational level variables. The following potential determinants of participation were analyzed: firm size, organizational program support and employee co-payment. A random effects model was used to examine associations between potential determinants and the program enrolment rate. RESULTS The average participation is limited (15.37%) but varies highly across companies (range 0.07-100.00%, monthly basis). Looking at the determinants of program enrolment, we find that organizational program support - the degree to which firm leadership encourages participation - positively influences the enrolment rate (β = 0.051 p < 0.001) while employee co-payment - the financial contribution employees have to make to participate - has a negative impact (β = - 0.002, p < 0.001). Furthermore, firm size has a negative relationship with firm enrolment. CONCLUSIONS Enrolment rates in WHPPs are limited, as many companies have difficulties to promote participation in WHPPs among employees. Strong organizational program support and low employee co-payment were identified as drivers of employee participation in corporate health programs. Hence, intensifying both social and financial support of employee participation may help to drive enrolment rates. Firm size was found to negatively affect the enrolment rate in WHPPs, implying that larger firms have to account for their size and corresponding complexity when implementing such a program.
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Affiliation(s)
- Liesa Marie Lier
- Institute of Sport Economics and Sport Management, German Sport University Cologne, Cologne, Germany
| | - Christoph Breuer
- Institute of Sport Economics and Sport Management, German Sport University Cologne, Cologne, Germany
| | - Sören Dallmeyer
- Institute of Sport Economics and Sport Management, German Sport University Cologne, Cologne, Germany
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Hoge A, Ehmann AT, Rieger MA, Siegel A. Caring for Workers' Health: Do German Employers Follow a Comprehensive Approach Similar to the Total Worker Health Concept? Results of a Survey in an Economically Powerful Region in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050726. [PMID: 30823428 PMCID: PMC6427417 DOI: 10.3390/ijerph16050726] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 11/16/2022]
Abstract
Similar to ‘Total Worker Health’ in the United States (USA), ‘Workplace Health Management’ in Germany is a holistic strategy to protect, promote, and manage employees’ health at the workplace. It consists of four subcategories. While the subcategories ‘occupational health and safety’ and ‘reintegration management’ contain measures prescribed by law, ‘workplace health promotion’ and ‘personnel development’ can be designed more individually by the companies. The present study focused on the current implementation of voluntary and legally required measures of the four subcategories, as well as companies’ satisfaction with the implementation. A total of N = 222/906 companies (small, medium, and big enterprises of one German county) answered a standardized questionnaire addressing the implementation of health-related measures, satisfaction with the implementation, and several company characteristics. In the subcategory ‘occupational health and safety’, 23.9% of the companies fulfilled all of the legally required measures, whereas in the category ‘reintegration management’, that rate amounted to 50.9%. There was a positive correlation between company size and the implementation grade, and as well between company size and the fulfilling of measures required by law. Companies tended to be more satisfied with higher implementation grades. Nevertheless, a surprisingly high proportion of the companies with poor implementation indicated satisfaction with the measures’ implementation.
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Affiliation(s)
- Aileen Hoge
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Anna T Ehmann
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Monika A Rieger
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Achim Siegel
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
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Kava CM, Parker EA, Baquero B, Curry SJ, Gilbert PA, Sauder M, Sewell DK. Organizational culture and the adoption of anti-smoking initiatives at small to very small workplaces: An organizational level analysis. Tob Prev Cessat 2018; 4:39. [PMID: 32411865 PMCID: PMC7205048 DOI: 10.18332/tpc/100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/26/2018] [Accepted: 11/29/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Many workplaces have adopted anti-smoking initiatives to reduce smoking behavior, but small workplaces are less likely to adopt these initiatives. One factor that could influence adoption is organizational culture, defined as the values and assumptions shared by members of an organization. The aim of this study was to examine the types of organizational culture associated with smoking policy strength and adoption of smoking cessation activities at small (20–99 employees) and very small (<20 employees) workplaces. Two study hypotheses were made: An increase in clan culture (characterized by participation in decision-making and human resources development) will be associated with an increase in smoking policy strength (H1) and higher odds of having cessation activities in the workplace (H2). METHODS Between June and October 2017, executives and employees coming from small and very small workplaces participated in separate surveys. Executives answered questions about their workplace’s anti-smoking initiatives, while employees completed a 12-item questionnaire about organizational culture. We aggregated employee data to perform linear and logistic regression at the organizational level. RESULTS Organizational culture was not significantly associated with smoking policy strength, therefore H1 was not supported. Counter to H2, an increase in clan culture was associated with lower odds of offering smoking cessation activities (OR=0.06; 95% CI: 0.01–0.58). CONCLUSIONS We did not find support for the hypothesized relationships. External factors and additional cultural characteristics may explain study findings. Continued research on culture and ways to improve tobacco control within smaller workplaces is needed.
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Affiliation(s)
- Christine M Kava
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Barbara Baquero
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Susan J Curry
- Department of Health Management and Policy, University of Iowa College of Public Health, Iowa, United States
| | - Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa, United States
| | - Michael Sauder
- Department of Sociology, University of Iowa, Iowa, United States
| | - Daniel K Sewell
- Department of Biostatistics, University of Iowa College of Public Health, Iowa, United States
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Kava CM, Parker EA, Baquero B, Curry SJ, Gilbert PA, Sauder M, Sewell DK. A qualitative assessment of the smoking policies and cessation activities at smaller workplaces. BMC Public Health 2018; 18:1094. [PMID: 30185177 PMCID: PMC6125884 DOI: 10.1186/s12889-018-6001-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 08/29/2018] [Indexed: 12/02/2022] Open
Abstract
Background To reduce the negative consequences of smoking, workplaces have adopted and implemented anti-smoking initiatives. Compared to large workplaces, less research exists about these initiatives at smaller workplaces, which are more likely to hire low-wage workers with higher rates of smoking. The purpose of this study was to describe and compare the smoking policies and smoking cessation activities at small (20–99 employees) and very small (< 20 employees) workplaces. Methods Thirty-two key informants coming from small and very small workplaces in Iowa completed qualitative telephone interviews. Data collection occurred between October 2016 and February 2017. Participants gave descriptions of the anti-smoking initiatives at their workplace. Additional interview topics included questions on enforcement, reasons for adoption, and barriers and facilitators to adoption and implementation. The data were analyzed using counts and content and thematic analysis. Results Workplace smoking policies were nearly universal (n = 31, 97%), and most workplaces (n = 21, 66%) offered activities to help employees quit smoking. Reasons for adoption included the Iowa Smokefree Air Act, to improve employee health, and organizational benefits (e.g., reduced insurance costs). Few challenges existed to adoption and implementation. Commonly cited facilitators included the Iowa Smokefree Air Act, no issues with compliance, and support from others. Compared to small workplaces, very small workplaces offered cessation activities less often and had fewer tobacco policy restrictions. Conclusions This study showed well-established tobacco control efforts in small workplaces, but very small workplaces lagged behind. To reduce potential health disparities in smoking, future research and intervention efforts in tobacco control should focus on very small workplaces.
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Affiliation(s)
- Christine M Kava
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA. .,Health Promotion Research Center, University of Washington, Box 354804, 1107 NE 45th St., Suite 200, Seattle, WA, 98105, USA.
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Barbara Baquero
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Susan J Curry
- Department of Health Management and Policy, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Paul A Gilbert
- Department of Community and Behavioral Health, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
| | - Michael Sauder
- Department of Sociology, University of Iowa, 140 Seashore Hall, Iowa City, IA, 52242, USA
| | - Daniel K Sewell
- Department of Biostatistics, University of Iowa College of Public Health, 145 N. Riverside Dr., Iowa City, IA, 52242, USA
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Arandia G, Vaughn AE, Bateman LA, Ward DS, Linnan LA. Development of a Workplace Intervention for Child Care Staff: Caring and Reaching for Health's (CARE) Healthy Lifestyles Intervention. Health Promot Pract 2018; 21:277-287. [PMID: 30033775 DOI: 10.1177/1524839918786214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Child care staff are among the lowest wage workers, a group at increased risk for a wide array of chronic diseases. To date, the health of child care staff has been largely ignored, and there have been very few interventions designed for child care staff. This article describes the development of the Caring and Reaching for Health (CARE) Healthy Lifestyles intervention, a workplace intervention aimed at improving physical activity and health behaviors among child care staff. Theory and evidence-based behavior change techniques informed the development of intervention components with targets at multiple social ecological levels. Final intervention components included an educational workshop held at a kick-off event, followed by three 8-week campaigns. Intervention components within each campaign included (1) an informational magazine, (2) goal setting and weekly behavior self-monitoring, (3) weekly tailored feedback, (4) e-mail/text prompts, (5) center-level displays that encouraged team-based goals and activities, and (6) coaching for center directors. This multilevel, theory-driven intervention is currently being evaluated as part of a larger randomized controlled trial. Process evaluation efforts will assess the extent to which child care staff participated in, engaged with, and were satisfied with the intervention. Lessons learned will guide future intervention research engaging child care workers.
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Affiliation(s)
- Gabriela Arandia
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber E Vaughn
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lori A Bateman
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura A Linnan
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Young Workers' Access to and Awareness of Occupational Safety and Health Services: Age-Differences and Possible Drivers in a Large Survey of Employees in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071511. [PMID: 30018272 PMCID: PMC6069130 DOI: 10.3390/ijerph15071511] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/13/2018] [Accepted: 07/14/2018] [Indexed: 11/16/2022]
Abstract
Young workers are in particular need of occupational safety and health (OSH) services, but it is unclear whether they have the necessary access to such services. We compared young with older workers in terms of the access to and awareness of OSH services, and examined if differences in employment conditions accounted for age-differences. We used survey data from Italy (INSuLA 1, 2014), with a sample of 8000 employed men and women aged 19 to 65 years, including 732 young workers aged under 30 years. Six questions measured access to services, and five questions assessed awareness of different OSH issues. Several employment conditions were included. Analyses revealed that young workers had less access and a lower awareness of OSH issues compared with older workers. For instance, odds ratios (OR) suggest that young workers had a 1.44 times higher likelihood [95%—confidence interval 1.21–1.70] of having no access to an occupational physician, and were more likely (2.22 [1.39–3.38]) to be unaware of legal OSH frameworks. Adjustment for selected employment conditions (company size, temporary contract) substantially reduced OR’s, indicating that these conditions contribute to differences between older and younger workers. We conclude that OSH management should pay particular attention to young workers in general and, to young workers in precarious employment, and working in small companies in particular.
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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.
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Affiliation(s)
- Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy.
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Ward DS, Vaughn AE, Hales D, Viera AJ, Gizlice Z, Bateman LA, Grummon AH, Arandia G, Linnan LA. Workplace health and safety intervention for child care staff: Rationale, design, and baseline results from the CARE cluster randomized control trial. Contemp Clin Trials 2018; 68:116-126. [PMID: 29501740 PMCID: PMC5944351 DOI: 10.1016/j.cct.2018.02.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 02/22/2018] [Accepted: 02/27/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Low-wage workers suffer disproportionately high rates of chronic disease and are important targets for workplace health and safety interventions. Child care centers offer an ideal opportunity to reach some of the lowest paid workers, but these settings have been ignored in workplace intervention studies. METHODS Caring and Reaching for Health (CARE) is a cluster-randomized controlled trial evaluating efficacy of a multi-level, workplace-based intervention set in child care centers that promotes physical activity and other health behaviors among staff. Centers are randomized (1:1) into the Healthy Lifestyles (intervention) or the Healthy Finances (attention control) program. Healthy Lifestyles is delivered over six months including a kick-off event and three 8-week health campaigns (magazines, goal setting, behavior monitoring, tailored feedback, prompts, center displays, director coaching). The primary outcome is minutes of moderate and vigorous physical activity (MVPA); secondary outcomes are health behaviors (diet, smoking, sleep, stress), physical assessments (body mass index (BMI), waist circumference, blood pressure, fitness), and workplace supports for health and safety. RESULTS In total, 56 centers and 553 participants have been recruited and randomized. Participants are predominately female (96.7%) and either Non-Hispanic African American (51.6%) or Non-Hispanic White (36.7%). Most participants (63.4%) are obese. They accumulate 17.4 (±14.2) minutes/day of MVPA and consume 1.3 (±1.4) and 1.3 (±0.8) servings/day of fruits and vegetables, respectively. Also, 14.2% are smokers; they report 6.4 (±1.4) hours/night of sleep; and 34.9% are high risk for depression. CONCLUSIONS Baseline data demonstrate several serious health risks, confirming the importance of workplace interventions in child care.
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Affiliation(s)
- Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB 7461, Chapel Hill, NC 27599-7461, USA; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., Chapel Hill, NC 27599-7426, USA.
| | - Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., Chapel Hill, NC 27599-7426, USA.
| | - Derek Hales
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 245 Rosenau Hall, CB 7461, Chapel Hill, NC 27599-7461, USA; Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., Chapel Hill, NC 27599-7426, USA.
| | - Anthony J Viera
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, Chapel Hill, NC 27599, USA.
| | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., Chapel Hill, NC 27599-7426, USA.
| | - Lori A Bateman
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin L. King Jr. Blvd., Chapel Hill, NC 27599-7426, USA.
| | - Anna H Grummon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB 7440, Chapel Hill, NC 27599-7440, USA.
| | - Gabriela Arandia
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB 7440, Chapel Hill, NC 27599-7440, USA.
| | - Laura A Linnan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB 7440, Chapel Hill, NC 27599-7440, USA.
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The Centers for Disease Control and Prevention: Findings From The National Healthy Worksite Program. J Occup Environ Med 2018; 59:631-641. [PMID: 28594703 DOI: 10.1097/jom.0000000000001045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate employers' implementation of evidence-based interventions, and changes in employees' behaviors associated with participating in the national healthy worksite program (NHWP). METHODS NHWP recruited 100 small and mid-sized employers and provided training and support for 18 months. Outcome measures were collected with an employer questionnaire, an employee survey, and biometric data at baseline and 18 months later. RESULTS The 41 employers who completed the NHWP implemented significantly more evidence-based interventions and had more comprehensive worksite health promotion programs after participating. Employees made significant improvements in physical activity and nutritional behaviors, but did not significantly improve employee weight. CONCLUSIONS Training and technical support can help small and mid-sized employers implement evidence-based health interventions to promote positive employee behavior changes. A longer follow up period may be needed to assess whether NHWP led to improvements in clinical outcomes.
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Roy S, Hansen AR, Ross L, Larson R. A Qualitative Study to Assess Barber Perceptions of the Feasibility of the Employer as a Health Advisor for Obesity Prevention. Am J Mens Health 2018; 12:1450-1462. [PMID: 29658399 PMCID: PMC6142171 DOI: 10.1177/1557988318768586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Obesity has become a serious issue affecting millions of Americans, especially in the southern United States. One avenue for addressing obesity is the workplace setting. This formative research study examined the feasibility of an obesity prevention worksite intervention in the barbershop for African American barbershop owners (employers) and barbers (employees). The study proposes an intervention where the owner of the barbershop would be trained to educate his barbers about obesity prevention. Twenty in-depth interviews were conducted with the owners (n = 5) and barbers (n = 15) of five barbershops in Statesboro, Georgia, to determine the feasibility of the intervention. The results of this study indicated that the owners and barbers all felt that the intervention was feasible and could be implemented in the barbershop. The owners and barbers felt that obesity was an important issue in their community. Additional themes identified include program benefits, empowerment of owners and barbers, and motivational components to help produce healthy habits. The owners felt comfortable educating their barbers about obesity prevention, and the barbers were receptive toward the idea of being educated by their employer. In order for this intervention to be implemented and effective, it must be tailored to fit within the barbershop environment. This intervention addresses known health disparities that exist in the African American community and underscores the need for additional worksite health promotion programs in medically underserved communities.
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Affiliation(s)
| | - Andrew R Hansen
- 2 Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Levi Ross
- 3 The University of Alabama, Tuscaloosa, AL, USA
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Biswas A, Smith PM, Gignac MAM. Naturally occurring workplace facilities to increase the leisure time physical activity of workers: A propensity-score weighted population study. Prev Med Rep 2018; 10:263-270. [PMID: 29868378 PMCID: PMC5984222 DOI: 10.1016/j.pmedr.2018.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/16/2018] [Accepted: 03/28/2018] [Indexed: 12/02/2022] Open
Abstract
The benefit of providing access to physical activity facilities at or near work to support the leisure time physical activity (LTPA) of workers is uncertain. We examined the association between access to physical activity facilities at or near work and the LTPA of workers after adjusting for a range of individual and occupational characteristics. Data was obtained from 60,650 respondents to the 2007–2008 Canadian Community Health Survey. Participants were employed adults ≥18 years of age who had no long-term health condition which reduced their participation in physical activity. Latent class analysis determined naturally occurring combinations of physical activity facilities at or near work. Each combination was balanced by 19 individual and occupational covariate characteristics using inverse probability of treatment weights derived from propensity scores. The association between combinations of physical activity facilities at or near work on LTPA level was estimated by multinomial logistic regression. Five different combinations of physical activity facilities were available to respondents at or near work. Data were analyzed in 2017. All possible physical facilities increased the likelihood for LTPA (OR, 2.08, 95% CI, 1.03–4.20) and other combinations were also positively associated. Respondents with no physical activity facilities were characterized as having a low education, low income, high physically demanding work, poor health and mental health, non-white racial background, and being an immigrant. Access to supportive workplace environments can help workers be physically active. Future research should assess a range of personal, social and environmental factors that may be driving this relationship. A quarter of Canadian workers reported no access to facilities at or near work to promote physical activity. Five naturally occurring combinations of physical activity facilities available in Canadian workplaces All facilities; and a place to walk, showers/change rooms and health programs promising strategies for physical activity
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Affiliation(s)
- Aviroop Biswas
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario M5G 2E9, Canada
| | - Peter M Smith
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario M5G 2E9, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7, Canada
| | - Monique A M Gignac
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario M5G 2E9, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7, Canada
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Schwatka NV, Tenney L, Dally MJ, Scott J, Brown CE, Weitzenkamp D, Shore E, Newman LS. Small business Total Worker Health: A conceptual and methodological approach to facilitating organizational change. ACTA ACUST UNITED AC 2018; 2:25-41. [PMID: 30740514 DOI: 10.1007/s41542-018-0013-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Nearly half of Americans are employed by small businesses, and future projections suggest that the number of those employed by small businesses will rise. Despite this, there is relatively little small business intervention research on the integration of health protection and health promotion, known as Total Worker Health® (TWH). We first discuss the importance of studying small businesses in TWH research and practice. Second, we describe an example of a small business TWH intervention, Health Links™ plus TWH owner/senior manager leadership training, that we are evaluating via the Small+Safe+Well (SSWell) study. Key features of the intervention and the SSWell study include attention to multi-level influences on worker health, safety and well-being; organizational change; and dissemination and implementation science strategies via the RE-AIM model. We offer several considerations for future small business TWH research and practice both in terms of the small business context as well as intervention development and evaluation. Our goal is to provide TWH researchers and practitioners with a framework and an example of how to approach small business TWH interventions. Ultimately, through the SSWell study, we aim to provide small businesses with strong evidence to support the use of TWH strategies that are practical, effective and sustainable.
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Affiliation(s)
- Natalie V Schwatka
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045.,Corresponding author. , 303-724-4607
| | - Liliana Tenney
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Miranda J Dally
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Joshua Scott
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Carol E Brown
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | | | - Erin Shore
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Lee S Newman
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
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Dodson EA, Hipp JA, Lee JA, Yang L, Marx CM, Tabak RG, Brownson RC. Does Availability of Worksite Supports for Physical Activity Differ by Industry and Occupation? Am J Health Promot 2018; 32:517-526. [PMID: 27810951 PMCID: PMC5415420 DOI: 10.1177/0890117116668795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore combinations of worksite supports (WSS) for physical activity (PA) that may assist employees in meeting PA recommendations and to investigate how availability of WSS differs across industries and occupations. DESIGN Cross-sectional. SETTING Several Missouri metropolitan areas. PARTICIPANTS Adults employed >20 h/wk outside the home. MEASURES Survey utilized existing self-reported measures (eg, presence of WSS for PA) and the International Physical Activity Questionnaire. ANALYSIS Logistic regression was conducted for 2 outcome variables: leisure and transportation PA. Independent variables included 16 WSS. Of particular interest were interaction effects between WSS variables. Analyses were stratified by 5 occupation and 7 industry types. RESULTS Overall, 2013 people completed the survey (46% response rate). Often, availability of 1 WSS did not increase the likelihood of meeting PA recommendations, but several pairs of WSS did. For example, in business occupations, the odds of meeting PA recommendations through transportation PA increased when employees had access to showers and incentives to bike/walk (odds ratio [OR] = 1.6; 95% confidence interval [CI] = 1.16-2.22); showers and maps (OR = 1.25; 1.02-1.55); maps and incentives to bike/walk (OR = 1.48; 1.04-2.12). CONCLUSION Various combinations of WSS may increase the likelihood that employees will meet PA recommendations. Many are of low or no cost, including flexible time for exercise and maps of worksite-adjacent walk/bike routes. Findings may be instructive for employers seeking to improve employee health through worksite PA.
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Affiliation(s)
- Elizabeth A Dodson
- 1 Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, MO, USA
| | - J Aaron Hipp
- 2 Department of Parks, Recreation, and Tourism Management, College of Natural Resources, North Carolina State University, Raleigh, NC, USA
| | - Jung Ae Lee
- 3 Agricultural Statistics Laboratory, University of Arkansas, Fayetteville, AR, USA
| | - Lin Yang
- 4 Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria; formerly at Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Christine M Marx
- 5 Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel G Tabak
- 1 Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, MO, USA
| | - Ross C Brownson
- 1 Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, MO, USA
- 6 Department of Surgery, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
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Stiehl E, Shivaprakash N, Thatcher E, Ornelas IJ, Kneipp S, Baron SL, Muramatsu N. Worksite Health Promotion for Low-Wage Workers: A Scoping Literature Review. Am J Health Promot 2018; 32:359-373. [PMID: 28893085 PMCID: PMC5770241 DOI: 10.1177/0890117117728607] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine: (1) What research has been done on health promotion interventions for low-wage workers and (2) what factors are associated with effective low-wage workers' health promotion programs. DATA SOURCE This review includes articles from PubMed and PsychINFO published in or before July 2016. Study Inclusion/Exclusion Criteria: The search yielded 130 unique articles, 35 met the inclusion criteria: (1) being conducted in the United States, (2) including an intervention or empirical data around health promotion among adult low-wage workers, and (3) measuring changes in low-wage worker health. DATA EXTRACTION Central features of the selected studies were extracted, including the theoretical foundation; study design; health promotion intervention content and delivery format; intervention-targeted outcomes; sample characteristics; and work, occupational, and industry characteristics. DATA ANALYSIS Consistent with a scoping review, we used a descriptive, content analysis approach to analyze extracted data. All authors agreed upon emergent themes and 2 authors independently coded data extracted from each article. RESULTS The results suggest that the research on low-wage workers' health promotion is limited, but increasing, and that low-wage workers have limited access to and utilization of worksite health promotion programs. CONCLUSION Workplace health promotion programs could have a positive effect on low-wage workers, but more work is needed to understand how to expand access, what drives participation, and which delivery mechanisms are most effective.
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Affiliation(s)
- Emily Stiehl
- 1 Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Namrata Shivaprakash
- 2 Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Esther Thatcher
- 3 University of Virginia Health System, University Medical Associates Clinic, Charlottesville, VA, USA
| | - India J Ornelas
- 4 Health Services, University of Washington, Seattle, WA, USA
| | - Shawn Kneipp
- 5 Health Care Environments Division, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sherry L Baron
- 6 Queens College, Barry Commoner Center for Health and the Environment, Flushing, NY, USA
| | - Naoko Muramatsu
- 7 School of Public Health and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Lin KH, Bondurant S, Messamore A. Union, Premium Cost, and the Provision of Employment-based Health Insurance. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2018; 4:10.1177/2378023118798502. [PMID: 38344247 PMCID: PMC10857863 DOI: 10.1177/2378023118798502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The decline of employment-based health plans is commonly attributed to rising premium costs. Using restricted data and a matched sample from the Medical Expenditure Panel Survey-Insurance Component, the authors extend previous studies by testing the relationships among premium costs, employment relationships, and the provision of health benefits between 1999 and 2012. The authors report that both establishment- and state-level union densities are associated with a higher likelihood of employers' providing health plans, whereas right-to-work legislation is associated with lower provision. These factors combined rival rising premium cost in predicting offering. This finding indicates that the declining provision of health benefits could be in part driven by the transformation of the employment relationship in the United States and that labor unions may remain a critical force in sustaining employment-based coverage in the twenty-first century.
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Affiliation(s)
- Ken-Hou Lin
- University of Texas at Austin, Austin, TX, USA
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Tung CY, Yin YW, Zhou YP, Chang CC, Lin PY, Liu CY. An analysis of healthy workplace accreditation and health promotion efforts based on employees' perspectives. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2017; 73:322-329. [PMID: 28796581 DOI: 10.1080/19338244.2017.1365683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 08/03/2017] [Indexed: 06/07/2023]
Abstract
This study was conducted to analyze the effects of health promotion efforts in relation to a workplace accreditation program and differing workplace sizes. The research population for the study consisted of 966 employees working at a total of 84 different worksites located in Taipei, Taiwan. The survey instructions used were developed by the European Network for Workplace Health Promotion (WHP). The results indicate that accredited workplaces have better WHP quality than nonaccredited workplaces (p < .001) and commonly implement health promotion measures related to specific health issues. It is recommended that the government provide more health-related resources in workplaces, especially those of small and medium companies.
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Affiliation(s)
- Chen-Yin Tung
- a Health Promotion and Health Education , National Taiwan Normal University , Taipei , Taiwan
| | - Yun-Wen Yin
- b Nursing and Management, Jen-Teh Junior College of Medicine , Tainan , Taiwan
| | - Yi-Ping Zhou
- a Health Promotion and Health Education , National Taiwan Normal University , Taipei , Taiwan
| | - Chia-Chen Chang
- a Health Promotion and Health Education , National Taiwan Normal University , Taipei , Taiwan
| | - Pei-Ying Lin
- a Health Promotion and Health Education , National Taiwan Normal University , Taipei , Taiwan
| | - Chia-Yun Liu
- a Health Promotion and Health Education , National Taiwan Normal University , Taipei , Taiwan
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Lang J, Cluff L, Rineer J, Brown D, Jones-Jack N. Building Capacity for Workplace Health Promotion: Findings From the Work@Health® Train-the-Trainer Program. Health Promot Pract 2017; 18:902-911. [PMID: 28829622 DOI: 10.1177/1524839917715053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Small- and mid-sized employers are less likely to have expertise, capacity, or resources to implement workplace health promotion programs, compared with large employers. In response, the Centers for Disease Control and Prevention developed the Work@Health® employer training program to determine the best way to deliver skill-based training to employers of all sizes. The core curriculum was designed to increase employers' knowledge of the design, implementation, and evaluation of workplace health strategies. The first arm of the program was direct employer training. In this article, we describe the results of the second arm-the program's train-the-trainer (T3) component, which was designed to prepare new certified trainers to provide core workplace health training to other employers. Of the 103 participants who began the T3 program, 87 fully completed it and delivered the Work@Health core training to 233 other employers. Key indicators of T3 participants' knowledge and attitudes significantly improved after training. The curriculum delivered through the T3 model has the potential to increase the health promotion capacity of employers across the nation, as well as organizations that work with employers, such as health departments and business coalitions.
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Affiliation(s)
- Jason Lang
- 1 Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Laurie Cluff
- 2 RTI International, Research Triangle Park, NC, USA
| | | | - Darigg Brown
- 2 RTI International, Research Triangle Park, NC, USA
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Program Development and Effectiveness of Workplace Health Promotion Program for Preventing Metabolic Syndrome among Office Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080878. [PMID: 28777320 PMCID: PMC5580582 DOI: 10.3390/ijerph14080878] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 12/18/2022]
Abstract
This paper aims to develop and analyze the effects of a socio-ecological model-based intervention program for preventing metabolic syndrome (MetS) among office workers. The intervention program was developed using regular health examinations, a “health behavior and need” assessment survey among workers, and a focus group study. According to the type of intervention, subjects took part in three groups: health education via an intranet-based web magazine (Group 1), self-monitoring with the U-health system (Group 2), and the target population who received intensive intervention (Group 3). The intervention programs of Group 1 and Group 2, which relied on voluntary participation, did not show significant effects. In Group 3, which relied on targeted and proactive programs, showed a decrease in waist circumference and in fasting glucose (p < 0.001). The MetS score in both males (−0.61 ± 3.35 versus −2.32 ± 2.55, p = 0.001) and females (−3.99 ± 2.05 versus −5.50 ± 2.19, p = 0.028) also showed a statistically significant decrease. In light of the effectiveness of the intensive intervention strategy for metabolic syndrome prevention among workers used in this study, companies should establish targeted and proactive health care programs rather than providing a healthcare system that is dependent on an individual’s voluntary participation.
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