Results of the Workplace Health in America Survey

Association between workplace health promotion service utilisation and depressive symptoms among workers: a nationwide survey

OBJECTIVES

Workplace-related factors are associated with the risk of depression. Despite implementation of workplace health promotion (WHP) programmes in China to promote the physical and mental well-being of workers, the relationship between WHP and depression has received limited attention. This study investigated the association between WHP service utilisation and depressive symptoms among workers.

STUDY DESIGN

This was a cross-sectional survey.

METHODS

A researcher-designed questionnaire was used to collect information on socio-demographic and occupational characteristics, WHP service utilisation, and mental health status. The Lasso method was used for variable selection to achieve dimension reduction, and logistic regression was used to assess the association between WHP service utilisation and depressive symptoms.

RESULTS

The analysis included 11,710 workers, of whom 17.0% had depressive symptoms. Lasso regression resulted in 6 of 18 WHP services showing significant negative associations with depressive symptoms, including occupational safety training, mental health services, health check-ups, sports activities, fitness rooms, and healthy canteens. The logistic regression results showed that, after adjusting for sociodemographic and occupational factors, utilisation of these six services was associated with a decreased likelihood of depressive symptoms. The adjusted odds ratio (aOR) was 0.84 (95% confidence interval [CI]: 0.73-0.96) for occupational safety training, aOR: 0.82 (95% CI: 0.68-0.99) for mental health services, aOR: 0.80 (95% CI: 0.71-0.90) for health check-ups, aOR: 0.68 (95% CI: 0.57-0.80) for sports activities, aOR: 0.59 (95% CI: 0.47-0.74) for fitness rooms and aOR: 0.72 (95% CI: 0.59-0.87) for healthy canteens.

CONCLUSIONS

Utilisation of WHP services was associated with a lower prevalence of depressive symptoms. Implementation of WHP services and the provision of a supportive workplace environment should be prioritised to benefit the mental health of workers.

Understanding lactation policies and resources across a university system: survey and document review

BACKGROUND

In the U.S., employees often return to work within 8-12 weeks of giving birth, therefore, it is critical that workplaces provide support for employees combining breastfeeding and work. The Affordable Care Act requires any organization with more than 50 employees to provide a space other than a restroom to express breastmilk and a reasonable amount of time during the workday to do so. States and worksites differ in the implementation of ACA requirements and may or may not provide additional support for employees combining breastfeeding and work. The purpose of this study was to conduct an analysis of the policies and resources available at 26 institutions within a state university system to support breastfeeding when employees return to work after giving birth.

METHODS

Survey data was collected from Well-being Liaisons in the human resources departments at each institution. In addition, we conducted a document review of policies and online materials at each institution. We used univariate statistics to summarize survey results and an inductive and deductive thematic analysis to analyze institutional resources available on websites and in policies provided by the liaisons.

RESULTS

A total of 18 (65.3%) liaisons participated in the study and revealed an overall lack of familiarity with the policies in place and inconsistencies in the resources offered to breastfeeding employees across the university system. Only half of the participating liaisons reported a formal breastfeeding policy was in place on their campus. From the document review, six major themes were identified: placing the burden on employees, describing pregnancy or postpartum as a "disability," having a university-specific policy, inclusion of break times for breastfeeding, supervisor responsibility, and information on lactation policies.

CONCLUSION

The review of each institution's online resources confirmed the survey findings and highlighted the burden placed on employees to discover the available resources and advocate for their needs. This paper provides insight into how institutions support breastfeeding employees and provides implications on strategies to develop policies at universities to improve breastfeeding access for working parents.

Employment Characteristics and Tobacco Product Use, U.S., 2021

INTRODUCTION

Over 30 million U.S. working adults use tobacco, and tobacco use varies by occupation. Limited information is available on employment characteristics and tobacco use prevalence. The purpose of this study was to describe the prevalence of current tobacco use by employment characteristics and occupation group among U.S. working adults.

METHODS

This cross-sectional study used 2021 National Health Interview Survey data for currently working adults (n=16,461) analyzed in 2023. Multivariable logistic regression was used to estimate adjusted odds of tobacco use by employment characteristics and occupation group.

RESULTS

In 2021, 20.0% of working adults used tobacco. Any tobacco use was significantly lower among workers who were offered workplace health insurance (AOR=0.86, 95% CI=0.77-0.97), had paid sick leave (AOR=0.81, 95% CI=0.73-0.91), and government versus private employment (AOR=0.61, 95% CI=0.52-0.70). Any tobacco use was significantly higher among workers who usually worked ≥35 hours per week versus did not usually work ≥35 hours per week (AOR=1.21, 95% CI=1.06-1.39), worked a rotating or "some other" shift versus daytime shift (AOR=1.19, 95% CI=1.02-1.38), experienced schedule instability (AOR=1.17, 95% CI=1.03-1.31), and worked while physically ill in the past 3 months (AOR=1.25, 95% CI=1.11-1.41). Tobacco use by employment characteristics also varied by occupation group.

CONCLUSIONS

Current tobacco use varied according to employment characteristics and occupation group. Findings from this study could inform workplace tobacco cessation interventions and policies (e.g., access to paid sick leave or insurance coverage) to better support tobacco cessation and overall worker health.

Who chooses "healthy" meals? An analysis of lunchtime meal quality in a workplace cafeteria

BACKGROUND

The workplace can play an important role in shaping the eating behaviors of U.S. adults. Unfortunately, foods obtained in the workplace tend to be low in nutritional quality. Questions remain about the best way to approach the promotion of healthy food purchases among employees and to what extent health promotion activities should be tailored to the demographic characteristics of the employees. The purpose of this study was to (1) assess the nutritional quality of lunchtime meal purchases by employees in cafeterias of a large organization, (2) examine associations between lunchtime meal quality selection and the demographic characteristics of employees, and (3) determine the healthfulness of foods and beverages offered in the cafeterias of this organization.

METHODS

A cross-sectional analysis was conducted using secondary data from a food labeling study implemented in three worksite cafeterias. Demographic data was collected via surveys and meal data was collected using a photo capture system for 378 participants. The Healthy Eating Index 2015 (HEI-2015) was used to determine meal quality and a total score for the menu of options available in the cafeterias during the study period. Summary statistics were generated, and the analysis of variance (ANOVA) was used to compare the HEI-2015 scores between groups.

RESULTS

The mean HEI-2015 total score for the menu items offered (n = 1,229) in the cafeteria during the study period was 63.1 (SD = 1.83). The mean HEI-2015 score for individual lunchtime meal observations (n = 378) was 47.1 (SD = 6.8). In general, HEI-2015 total scores were higher for non-smokers, individuals who self-identified as Asian, had higher physical activity levels, scored higher on numeracy and literacy assessments, and reported higher education levels, incomes, and health status.

CONCLUSIONS

The overall HEI-2015 scores indicate that the menu of options offered in the cafeterias and individual meal selections did not align with the Dietary Guidelines for Americans, and there were significant associations between average lunchtime meal quality scores and several demographic characteristics. These results suggest that healthy eating promotion activities in workplaces may need to be tailored to the demographic characteristics of the employees, and efforts to improve the food environment in the workplace could improve meal quality for all employees.

Evaluation of orderliness of underground workplace system based on occupational ergonomics: A case study in guangzhou and chengdu metro depots

BACKGROUND

An underground workplace (UGW) is a complex system with multiple subsystems that interact with each other. However, the research on UGW from a systemic perspective has not received due attention.

OBJECTIVE

This study constructs an evaluation approach to the orderliness of UGW and systematically evaluates the UGW with Guangzhou and Chengdu metro depots as case studies.

METHODS

First, the evaluation index system is established based on occupational ergonomics. Second, the system entropy model is constructed based on information entropy. Third, a dissipative structure judgment model is built based on the Brusselator. Fourth, the orderliness evaluation model is constructed based on information entropy and synergetics.

RESULTS

The UGW of the metro depot has not yet reached the dissipative structure and is in a medium-order state. But the system is in the trend of orderly development. The entropy increase caused by the physical environment and health status is the main obstacle for the system to move toward order. The equipment configuration is an essential source of system negative entropy. The coordination between equipment configuration, health status, and physical environment is low, and that of work effectiveness, equipment aging and failure, and organizational environment is high.

CONCLUSIONS

Equipment configuration cannot fully cope with the harsh physical environment and meet the needs of underground workers. Safety security equipment has more room for improvement. Humanized support facilities can introduce more negative entropy to the system. Organizational intervention can reduce the negative impact of adverse factors on the system.

Barriers and Facilitators to Participation and Key Components of Sleep Health Programs: Perspectives for the Corporate Work Environment

OBJECTIVE

The aim of the study is to explore the barriers and facilitators of participation and key components for sleep health programs designed for corporate work environments.

METHODS

Semistructured interviews with corporate executives and occupational medicine specialists in the decision making and management of workplace health promotion programs (WHPP) within their companies were held before and during COVID-19. Interviews were transcribed verbatim and analyzed using thematic content analysis to identify themes.

RESULTS

Barrier and facilitator themes emerging from the data include sleep health awareness, work culture, work-family balance, and confidentiality. Key components for sleep health programs included the following: identifying the need for a program, incorporating sleep health risk screening to WHPP, and promoting sleep health by raising awareness thereof.

CONCLUSIONS

The identified barriers and facilitators to employee participation and key components of an ideal sleep health program provide guidance for further WHPP.

Return to work after Post-COVID: describing affected employees' perceptions of personal resources, organizational offerings and care pathways

Background

Most individuals recover from the acute phase of infection with the SARS-CoV-2 virus, however, some encounter prolonged effects, referred to as the Post-COVID syndrome. Evidence exists that such persistent symptoms can significantly impact patients' ability to return to work. This paper gives a comprehensive overview of different care pathways and resources, both personal and external, that aim to support Post-COVID patients during their work-life reintegration process. By describing the current situation of Post-COVID patients pertaining their transition back to the workplace, this paper provides valuable insights into their needs.

Methods

A quantitative research design was applied using an online questionnaire as an instrument. Participants were recruited via Post-COVID outpatients, rehab facilities, general practitioners, support groups, and other healthcare facilities.

Results

The analyses of 184 data sets of Post-COVID affected produced three key findings: (1) The evaluation of different types of personal resources that may lead to a successful return to work found that particularly the individuals' ability to cope with their situation (measured with the FERUS questionnaire), produced significant differences between participants that had returned to work and those that had not been able to return so far (F = 4.913, p = 0.001). (2) In terms of organizational provisions to facilitate successful reintegration into work-life, predominantly structural changes (i.e., modification of the workplace, working hours, and task) were rated as helpful or very helpful on average (meanworkplace 2.55/SD = 0.83, meanworking hours 2.44/SD = 0.80; meantasks 2.55/SD = 0.83), while the remaining offerings (i.e., job coaching or health courses) were rated as less helpful or not helpful at all. (3) No significant correlation was found between different care pathways and a successful return to work.

Conclusion

The results of the in-depth descriptive analysis allows to suggests that the level of ability to cope with the Post-COVID syndrome and its associated complaints, as well as the structural adaptation of the workplace to meet the needs and demands of patients better, might be important determinants of a successful return. While the latter might be addressed by employers directly, it might be helpful to integrate training on coping behavior early in care pathways and treatment plans for Post-COVID patients to strengthen their coping abilities aiming to support their successful return to work at an early stage.

Effects of Workplace Variables on Workers Intentions to Misuse Prescription Opioids

OBJECTIVE

Workers in industries with high rates of opioid dispensing as well as those with high rates of non-fatal work-related injuries are at greater risk for opioid misuse, which can lead to addiction, overdose, or death.

METHODS

Using secondary cross-sectional data collected from 856 healthcare workers, this pilot study examines a conceptual model for workers' intentions to seek out prescription opioids and intentions to use opioids at higher doses over longer periods.

RESULTS

Results showed significant protective effects of beliefs, injunctive and subjective norms, and behavioral control on intentions to seek out opioids. On intentions to use higher doses over a longer time, knowledge, beliefs, behavioral control, patient-provider communication, workplace safety, and workplace autonomy had significant protective effects.

CONCLUSIONS

Findings from this study could be used to inform future multilevel interventions to prevent opioid misuse among employee populations.

More of a Good Thing: A Framework to Grow and Strengthen the PALTC Careforce

The current staffing shortage across all disciplines of post-acute and long-term care (PALTC) settings is affecting the health and safety of residents, as well as the well-being of the current staff. The need to retain and recruit new talent to this challenging but fulfilling setting demands that we look to existing evidence-based strategies and identify ways to implement them quickly, effectively, and in a sustainable way. Using the 4 Ms Framework of the Age-Friendly Health System developed by the Institute for Healthcare Improvement and the John A. Hartford Foundation (What Matters, Medication, Mentation, and Mobility), we can build on successful strategies to address what matters to staff, mental health, career mobility, and the overall safety and wellness of our nation's careforce. This paper summarizes "More of a Good Thing: A Framework to Grow and Strengthen the PALTC Careforce," a series of 6 roundtable discussions held in 2022 that brought together clinicians, industry leaders, and change-makers to share strategies that have been researched and successfully implemented and discuss ways to scale and disseminate them to a broader audience. The role of PALTC leadership is highlighted, with key points from the final roundtable discussion outlined, and challenging leadership to think about what they can begin doing immediately to build trust with existing staff and lay the foundation for a stronger nursing home careforce. Next steps for "More of a Good Thing" include a survey of participants about what they have tried, what has been successful, and what barriers they face; a series of focused interviews with leaders; and potential collaboration with quality improvement organizations to help facilities build on and implement the strategies presented.

Development and maturation of the occupational health services research field in the United States over the past 25 years: Challenges and opportunities for the future

Work is an important social determinant of health; unfortunately, work-related injuries remain prevalent, can have devastating impact on worker health, and can impose heavy economic burdens on workers and society. Occupational health services research (OHSR) underpins occupational health services policy and practice, focusing on health determinants, health services, healthcare delivery, and health systems affecting workers. The field of OHSR has undergone tremendous expansion in both definition and scope over the past 25 years. In this commentary, focusing on the US, we document the historical development and evolution of OHSR as a research field, describe current doctoral-level OHSR training, and discuss challenges and opportunities for the OHSR field. We also propose an updated definition for the OHSR field: Research and evaluation related to the determinants of worker health and well-being; to occupational injury and illness prevention and surveillance; to healthcare, health programs, and health policy affecting workers; and to the organization, access, quality, outcomes, and costs of occupational health services and related health systems. Researchers trained in OHSR are essential contributors to improvements in healthcare, health systems, and policy and programs to improve worker health and productivity, as well as equity and justice in job and employment conditions. We look forward to the continued growth of OHSR as a field and to the expansion of OHSR academic training opportunities.

Building the Worksite Wellness Foundation Infrastructure: A Critical Component of the WorkWell KS Strategic Framework

OBJECTIVE

Workplace health programs can be ineffective, and changes are likely to be temporary without first establishing a wellness infrastructure. This study sought to determine whether attending a WorkWell KS Building the Worksite Wellness Foundation (Foundation) workshop enabled worksites to develop this infrastructure.

METHODS

Survey data were collected from worksites before attending a workshop and approximately 1 year later. Survey items were designed to assess whether the worksite was implementing best practices.

RESULTS

In total, 212 worksites participated in a workshop and completed both a baseline and follow-up assessments. At follow-up, more worksites reported having a wellness committee (89.6% vs 59.7%, P < 0.001) and having wellness committee duties included in position descriptions (26.2% vs 6.4%, P < 0.001).

CONCLUSIONS

This study suggests that Foundation workshops can support worksites' implementation of best practices to establish worksite wellness infrastructure.

The Validity and Reliability of the Workplace Culture of Health Scale-Short Form

OBJECTIVE

A positive workplace culture of health can have significant benefits for both employees and organizations. The objective of this study was to test the validity and reliability of the Workplace Culture of Health (COH) Scale-Short Form.

METHODS

We conducted a confirmatory factor analysis on data collected from a sample of 12,907 employees across 14 organizations. We examined the construct validity of the 14-item short-form version of the Workplace COH scale and assessed its reliability using internal consistency measures.

RESULTS

Our confirmatory factor analysis demonstrated that the Workplace COH Scale-Short Form had strong model fit, indicating good construct validity. In addition, we found that all constructs had strong internal consistency reliability.

CONCLUSIONS

Findings suggest that the Workplace COH Scale-Short Form is a valid and reliable way to practically assess workplace culture of health from the employee perspective.

Feasibility of Implementing a Total Worker Health® Intervention During the COVID-19 Pandemic in Small and Medium Businesses : Results From the Carolina PROSPER Study

OBJECTIVE

In response to the COVID-19 pandemic's disruptive effect on employers and workers, an interdisciplinary team launched the Carolina Promoting Safe Practices for Employees' Return study to assess the feasibility of providing tailored technical assistance to small and medium North Carolina businesses using a Total Worker Health (TWH) ® approach.

METHODS

Feasibility of the approach was assessed via surveys and interviews of business representatives from four participating businesses ranging in size from 3 to 110 employees.

RESULTS

The TWH approach is feasible, that is, in demand, practical, and acceptable to protect and promote worker safety, health, and well-being. Potential challenges include implementation cost, difficulty engaging all employees, and difficulty accessing tailored health and safety materials in a timely manner.

CONCLUSIONS

Additional refinement and testing of the TWH approach postpandemic with more worksites is warranted.

Implementing a resilience coach program to support first year housestaff during the COVID-19 pandemic: early pilot results and comparison with non-housestaff sessions

BACKGROUND

In response to the COVID-19 pandemic, we launched the Penn Medicine Coping First Aid program to provide psychosocial supports to our health system community. Our approach leveraged lay health worker volunteers trained in principles of Psychological First Aid to deliver coaching services through a centralized virtual platform.

METHODS

We emailed all (n = 408) first year housestaff (i.e., residents and fellows) with an invitation to schedule a session with a resilience coach. We compared the mental health concerns, symptoms, and Psychological First Aid techniques recorded in (n = 67) first year housestaff sessions with (n = 91) sessions of other employees in the health system.

RESULTS

Between June and November 2020, forty-six first year housestaff attended at least one resilience coaching session. First year housestaff most commonly presented with feelings of anxiety and sadness and shared concerns related to the availability of social support. Resilience coaches most frequently provided practical assistance and ensured safety and comfort to first year housestaff. First year housestaff reported fewer physical or mental health symptoms and held shorter sessions with resilience coaches than non-housestaff.

CONCLUSIONS

This work offers insights on how to address psychosocial functioning through low-intensity interventions delivered by lay personnel. More research is needed to understand the efficacy of this program and how best to engage housestaff in wellness and resilience programs throughout training, both during and beyond COVID-19.

Evaluation of a Diabetes Coaching Program on Clinical Outcomes in a Self-Insured Grocery Chain

Background: Diabetes is among the most prevalent and costly disease states to treat. Many self-insured employers offer employee wellness programs to decrease healthcare expenditures for chronic illnesses, such as diabetes. Existing literature demonstrates that pharmacists can positively impact treatment of patients with diabetes and assist in lowering costs of care, but no current literature examines pharmacist intervention within an employee wellness program over a prolonged period of time. Objectives: To quantify the hemoglobin A1c (HbA1c) lowering achieved through participation in a pharmacist-led diabetes coaching program within a self-insured company. Methods: A retrospective chart review was conducted at a self-insured grocery store chain in the Kansas City area with an employee wellness program called Start Now. Patients who enrolled in the Start Now Program for Diabetes Care (SN-DM) between July 1, 2008 and July 1, 2021 with at least two documented HbA1c measurements were included in the analysis. Results: A total of 355 charts were included in the analysis. The average HbA1c reduction observed in program patients was 0.61% (P < .001). At baseline, 40% of program patients were considered to have controlled diabetes (A1c <7%) compared with 60% of patients at most recent HbA1c (P < .001). There was no correlation between HbA1c lowering and number of pharmacist coaching visits; however, greater HbA1c lowering was observed in patients with a higher baseline HbA1c. Conclusion: Patients who participated in the SN-DM program achieved a significant decrease in mean HbA1c. More patients were considered controlled at last or most recent HbA1c according to the American Diabetes Association guidelines.

Yoga perspective on personal excellence and well-being

The discussions on conceptualization, operationalization, measures, and means of well-being (WB) and personal excellence (PE) are dynamic and debatable. Therefore, this study aims to coin a perspective of PE based on the Patanjali Yoga Sūtra (PYS). For this, professional, psychological, philosophical, and yogic perspectives of WB and PE are analyzed to derive a viable yogic framework for PE. The WB and the consciousness-based constructs of PE are discussed in terms of psychic tensions (PTs) (nescience, egoism, attachment, aversion, and love for life), yogic hindrances (YHs) (illness, apathy, doubt, procrastination, laziness, over somatosensory indulgence, delusion, inability, and unstable progress), psychosomatic impairments (pain, despair, tremors, arrhythmic breath), and yogic aids (wellness, intrinsic motivation, faith, role punctuality, physical activity, sensory control, clarity, competence, and sustainable progress). The PYS operationalizes PE as the dynamic level of WB and self-awareness until one attains Dharmamegha Samādhi (super consciousness). Lastly, Ashtanga Yoga (AY) is discussed as a universal principle, process, and practice for thinning PTs, vanishing YHs, empowering holistic WB, awakening extrasensory potentials, advancing self-awareness, and PE. This study will be a pioneering base for further observational and interventional studies to develop measures and personalized protocols for PE.

Effectiveness of Multicomponent Interventions and Physical Activity in the Workplace to Reduce Obesity: A Systematic Review and Meta-Analysis

BACKGROUND

Overweight and obesity are public health problems that affects the workplace. This paper aims to analyse the effectiveness of workplace health promotion interventions in reducing Body Mass Index (BMI); Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, MEDLINE, and SCOPUS databases. The inverse variance statistical method was used for the meta-analysis with a random effects analysis model and standardised means. The results have been represented by Forest Plots and Funnel Plots graphs; Results: The multicomponent approach had the best results for reducing BMI (-0.14 [-0.24, -0.03], 95% CI; p = 0.009) compared to performing physical activity only (-0.09 [-0.39, 0.21], 95% CI; p = 0.56). However, both methods resulted in positive changes in reducing BMI in the general analysis (-0.12 [-0.22, -0.02], 95% CI; p = 0.01). The GRADE evaluation showed low certainty due to the high heterogeneity between interventions (I² = 59% for overall analysis).

CONCLUSIONS

The multicomponent approach could be an effective intervention to reduce obesity in the working population. However, workplace health promotion programs must be standardised to conduct quality analyses and highlight their importance to workers' well-being.

Health check-ups as interventions for work disability management: supervisors and occupational healthcare follow the recommendations to a great extent

OBJECTIVES

Work disability management is a problem globally. This study was designed to find out whether the initiation, process and outcome of health check-ups (HCUs) follow the national legislation and whether supervisors and occupational healthcare (OHC) units act according to the legislation-based recommendations.

METHODS

Data of 1092 employees with reduced work ability were collected during 2013-2018 in 15 OHC units across Finland. Nine reasons for HCUs, eight process activities and three recommendations were analysed. Cross-tabulation and multinomial logistic regression analysis were used in the analyses.

RESULTS

Employees themselves initiated an HCU for early support more often (OR with 95% CI 2.37; 1.04 to 5.40) compared with supervisors. Personnel in OHC units initiated an HCU in musculoskeletal disorders more often (OR 1.58; 95% CI 1.05 to 2.37) and in mental disorders less often (OR 0.52; 95% CI 0.35 to 0.76) compared with supervisors. These findings were reflected in the recommendations after the HCU, where rehabilitation was recommended for employees with musculoskeletal disorders more often than for employees with mental disorders (ORs 5.48; 95% CI 1.91 to 15.67 and 1.59; 95% CI 0.74 to 3.43, respectively).

CONCLUSION

Supervisors and OHC units followed the recommendations for management of work disability to a great extent. Employees were active in looking for help early when they had problems with work ability. This positive finding should be promoted even more. OHC units did not initiate HCUs or recommend rehabilitation in mental disorders as actively as they did in musculoskeletal disorders. Support of employees with mental disorders should be improved and studied more. Registration of the study The study protocol was approved and registered on 22 September 2017 by the Doctoral Program of Health Sciences, Faculty of Medicine, University of Eastern Finland, registration no. 189067.

Managers' Action-Guiding Mental Models towards Mental Health-Related Organizational Interventions-A Systematic Review of Qualitative Studies

Research indicates that managers' active support is essential for the successful implementation of mental health-related organizational interventions. However, there is currently little insight into what subjective beliefs and perceptions (=mental models) make leaders support such interventions. To our knowledge, this is the first qualitative systematic review of this specific topic, and it considers 17 qualitative studies of managers' perspective. Based on the theory of planned behavior, this review provides an overview of three action-guiding factors (attitudes, organizational norms and behavioral control) that can serve as starting points for engaging managers in the implementation of mental health-related measures and ensuring their success. Our results provide evidence that supportive organizational norms may particularly help to create a common sense of responsibility among managers and foster their perceived controllability with respect to changing working conditions. Our study thus contributes to a more differentiated understanding of managers' mental models of health-related organizational interventions.

Association of Workplace Culture of Health and Employee Emotional Wellbeing

The study aimed to examine associations between workplace culture of health and employee work engagement, stress, and depression. Employees (n = 6235) across 16 companies voluntarily completed the Workplace Culture of Health (COH) Scale and provided data including stress, depression, and biometrics through health risk assessments and screening. We used linear regression analysis with COH scores as the independent variable to predict work engagement, stress, and depression. We included age, gender, job class, organization, and biometrics as covariates in the models. The models showed that total COH scores were a significant predictor of employee work engagement (b = 0.75, p < 0.001), stress (b = -0.08, p < 0.001), and depression (b = 0.08, p < 0.001). Job class was also a significant predictor of work engagement (b = 2.18, p < 0.001), stress (b = 0.95, p < 0.001), and depression (b = 1.03, p = 0.02). Gender was a predictor of stress (b = -0.32, p < 0.001). Overall, findings indicate a strong workplace culture of health is associated with higher work engagement and lower employee stress and depression independent of individual health status. Measuring cultural wellbeing supportiveness can help inform implementation plans for companies to improve the emotional wellbeing of their employees.

Completing a worksite health risk assessment correlates with continuing employment, lower health care costs and utilization

OBJECTIVES

Companies that understand the collective health risks of their employees, as well as worker productivity as it relates to health risks can provide more effective and necessary interventions. Health Risk Assessments (HRAs) are an important source of information for understanding overall health risks of a company's employees. However, HRA data tend to represent only a subset of employees, thereby providing employers an incomplete picture of employee health risks. The current study identifies the representativeness of those completing a worksite HRA by selected demographics, health care costs, and health risks in a large US company.

MATERIAL AND METHODS

A retrospective analysis of employees in a large US company during 2017-2019, with statistically significant results reported, adjusted for sex, age, and year.

RESULTS

The percentage of employees completing the HRA increased from 23.9% in 2017 to 28.4% in 2018 to 32.3% in 2019. These employees were more likely women, middle aged, have lower health care costs, remain employed from year to year, and have better health behaviors and biometric scores. If all employees looked like employees completing the HRA, total medical costs would be 17% lower. If all employees looked like employees completing the HRA who had a health perception rating (1-10 [excellent]) of 7-8 (57.4%) or 9-10 (25.2%) vs. 1-6, total medical costs would be 21.9% and 25.6% lower, respectively.

CONCLUSIONS

A minority of employees completed the worksite HRA. Basing overall employee health risks on the HRA underestimates health risks and can result in a poorly representative health intervention program. Int J Occup Med Environ Health. 2022;35(4):449-57.

Examining the Relationship Between Return to Work After Giving Birth and Maternal Mental Health: A Systematic Review

INTRODUCTION

The negative impacts of mental health disorders on the well-being of women and their infants are clear. However, less is known about the relationship between returning to work after giving birth and mental health. Previous reviews examined the relationship between maternity leave and mental health, but we defined return to work as the process of returning to part-time or full-time work after giving birth and caring for infant. This systematic review aims to: (1) describe operational definitions for return to work and (2) describe the evidence on the relationship between return to work and maternal mental health.

METHODS

We searched PubMed, PsycINFO, CINAHL, and Web of Science for peer-reviewed studies. Articles were selected if they were published within the past 20 years, examined at least one mental health condition (e.g., depression, anxiety), and included a study sample of U.S. working mothers.

RESULTS

We identified 20 articles published between 2001 and 2020. We found conflicting evidence from longitudinal and cross-sectional data demonstrating that return to work was associated with improvements and negative consequences to mental health. Work-related predictors of mental health included: access to paid maternity leave, work-family conflict, total workload, job flexibility, and coworker support.

DISCUSSION

This review provides evidence that return to work and mental health are related, though the study samples have limited generalizability to all U.S. working mothers. More research is needed to understand the direction of this relationship throughout the perinatal period and how return to work affects other mental health conditions (e.g., anxiety, stress).

Employment Industry and Occupational Class in Relation to Serious Psychological Distress in the United States

Occupational characteristics may influence serious psychological distress (SPD) and contribute to health inequities; yet, few studies have examined multiple employment industries and occupational classes in a large, racially diverse sample of the United States. Using data from the National Health Interview Survey, we investigated employment industry and occupational class in relation to SPD in the overall population and by race/ethnicity, gender, age, household income, and health status. We created eight employment industry categories: professional/administrative/management, agricultural/manufacturing/construction, retail trade, finance/information/real estate, educational services, health care/social assistance, accommodation/food services, and public administration/arts/other services. We also created three occupational class categories: professional/management, support services, and laborers. SPD was measured using the Kessler Psychological Distress Scale and scores ≥13 indicated SPD. We adjusted for confounders and used Poisson regression to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). Among the 245,038 participants, the mean age was 41.7 ± 0.1 years, 73% were Non-Hispanic (NH)-White, and 1.5% were categorized as having SPD. Compared to the professional/administrative/management industry, working in other industries (e.g., manufacturing/construction (PR = 0.82 [95% CI: 0.70–0.95]) and educational services (PR = 0.79 [95% CI: 0.66–0.94])) was associated with lower SPD. Working in support services and laborer versus professional/management positions were both associated with 19% higher prevalence of SPD (95% CI: 1.04–1.35; 95% CI: 1.04–1.38, respectively). Furthermore, working in a support services or laborer versus professional/management position was associated with higher SPD in most employment industries. Industry-specific workplace interventions to equitably improve mental health are warranted.

Strategic Choice and Implementation of Workplace Wellness Programs in the United States

Despite widespread discussion and public policy support for workplace wellness programs in the United States, their diffusion has been slow. Using data from the 2017 Workplace Health Administration Survey, this paper explored the importance of establishment characteristics, unionization, and strategic choice in the adoption of workplace health initiatives and employee participation in these programs. An ordinary least squares analysis revealed that unionization (β = 1.59, 95% CI = 1.20−1.97, p < 0.001) and management support (β = 1.67, 95% CI = 1.25−2.10, p < 0.001) were the strongest predictors of the number of programs adopted by an establishment. In logistic regression analyses of nine workplace wellness programs, it was also found that unionization and management were the strongest predictors of the adoption of these programs. Management support was also correlated with employee participation of in nutrition (OR = 2.66, 95% CI = 1.23−5.71, p < 0.05) and obesity programs (OR = 3.66, 95% CI = 1.03−12.97, p < 0.05).

The CDC Worksite Health ScoreCard: A Tool to Advance Workplace Health Promotion Programs and Practices

Introduction

The CDC Worksite Health ScoreCard (ScoreCard) is a free, publicly available survey tool designed to help employers assess the extent to which they have implemented evidence-based interventions or strategies at their worksites to improve the health and well-being of employees. We examined how, how broadly, and to what effect the ScoreCard has been applied.

Methods

We analyzed peer-reviewed and grey literature along with the ScoreCard database of online submissions from January 2012 through January 2021. Our inclusion criteria were workplace settings, adult working populations, and explicit use of the ScoreCard.

Results

We found that the ScoreCard had been used in 1) surveillance efforts by states, 2) health promotion training and technical assistance, 3) research on workplace health promotion program effectiveness, and 4) employer efforts to improve program design, implementation, and evaluation.

Conclusion

The ScoreCard has been used as intended to support the development, planning, monitoring, and continuous improvement of workplace health promotion programs. Our review revealed gaps in the tool and opportunities to improve it by 1) enhancing surveillance efforts, 2) engaging employers in low-wage industries, 3) adding new questions or topic areas, and 4) conducting quantitative studies on the relationship between improvements in the ScoreCard and employee health and well-being outcomes.

Preventive Measures against COVID-19 in Small- and Mid-sized Enterprises from an Early Stage of the Epidemic in Daegu and Gyeongsangbuk-do

Background

In the early stage of the coronavirus disease 2019 (COVID-19) epidemic, small- and mid-sized enterprises (SMEs) may be an important transmission consideration. The study aimed to identify the pattern of COVID-19 prevention measures during the outbreaks in Daegu and Gyeongsangbuk-do at the early stage of COVID-19. Moreover, we investigated whether SME size and past experiences affected the preventive measures implemented in the region.

Methods

A survey detailing the general characteristics and implementation of 12 preventive activities was conducted in 122 SMEs in Daegu and Gyeongsangbuk-do. The survey was analyzed by size and operation period.

Results

The study subjects consisted of 53 (43.4%) workplaces with 1–5 employees, 50 (40.9%) workplaces with 6–30 employees, and 19 (15.6%) workplaces with 31–49 employees. The lowest three items among those surveyed were ‘symptomatic workers to stay home for 3–4 days’ (17.2%), ‘work remotely’ (18.9%), and ‘video meetings’ (20.5%). There were significant differences in the rate of several preventive measures implemented. The larger sized SMEs, the higher the number of implementations (p < 0.01). The operation period had no significant relationship with the implementation of preventive measures. The same pattern was observed in multiple generalized linear regression with covariate adjustment.

Conclusion

Preventive measures among SMEs with fewer than 50 employees were identified. Even within SMEs, a gap in preventive measures according to size was confirmed. To prevent the spread of infection and protect workers' right to health, different support for different sized SMEs is necessary.

Clinical and Financial Outcomes Associated With a Workplace Mental Health Program Before and During the COVID-19 Pandemic

IMPORTANCE

Investment in workplace wellness programs is increasing despite concerns about lack of clinical benefit and return on investment (ROI). In contrast, outcomes from workplace mental health programs, which treat mental health difficulties more directly, remain mostly unknown.

OBJECTIVE

To determine whether participation in an employer-sponsored mental health benefit was associated with improvements in depression and anxiety, workplace productivity, and ROI as well as to examine factors associated with clinical improvement.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study included participants in a US workplace mental health program implemented by 66 employers across 40 states from January 1, 2018, to January 1, 2021. Participants were employees who enrolled in the mental health benefit program and had at least moderate anxiety or depression, at least 1 appointment, and at least 2 outcome assessments.

INTERVENTION

A digital platform that screened individuals for common mental health conditions and provided access to self-guided digital content, care navigation, and video and in-person psychotherapy and/or medication management.

MAIN OUTCOMES AND MEASURES

Primary outcomes were the Patient Health Questionnaire-9 for depression (range, 0-27) score and the Generalized Anxiety Disorder 7-item scale (range, 0-21) score. The ROI was calculated by comparing the cost of treatment to salary costs for time out of the workplace due to mental health symptoms, measured with the Sheehan Disability Scale. Data were collected through 6 months of follow-up and analyzed using mixed-effects regression.

RESULTS

A total of 1132 participants (520 of 724 who reported gender [71.8%] were female; mean [SD] age, 32.9 [8.8] years) were included. Participants reported improvements from pretreatment to posttreatment in depression (b = -6.34; 95% CI, -6.76 to -5.91; Cohen d = -1.11; 95% CI, -1.18 to -1.03) and anxiety (b = -6.28; 95% CI, -6.77 to -5.91; Cohen d = -1.21; 95% CI, -1.30 to -1.13). Symptom change per log-day of treatment was similar post-COVID-19 vs pre-COVID-19 for depression (b = 0.14; 95% CI, -0.10 to 0.38) and anxiety (b = 0.08; 95% CI, -0.22 to 0.38). Workplace salary savings at 6 months at the federal median wage was US $3440 (95% CI, $2730-$4151) with positive ROI across all wage groups.

CONCLUSIONS AND RELEVANCE

Results of this cohort study suggest that an employer-sponsored workplace mental health program was associated with large clinical effect sizes for employees and positive financial ROI for employers.

Worksite tobacco control - a qualitative study on perspectives from employers and employees at small worksites

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.

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

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.

Cost Analysis of Developing, Implementing, and Evaluating a Multi-Disciplinary Teaching Kitchen

INTRODUCTION

Teaching kitchens have emerged as strategies to deliver lifestyle medicine principles and practices. However, a better understanding of their implementation, delivery cost, and potential benefits are needed. This article provides a comprehensive analysis of the costs associated with the development, deployment, and evaluation of the Emory Healthy Kitchen Collaborative (EHKC) teaching kitchen clinical trial.

METHODS

The actual number of hours spent and costs incurred to develop and deploy the EHKC teaching kitchen were recorded and broadly categorized into 1 of 4 areas: program development, course delivery, research, and optional enhancements. Costs of each item were assigned as fixed or variable, enabling calculation of the marginal per participant program cost.

RESULTS

Total costs were US$123,898, with 3/4 incurred for program development, research, and optional enhancements. Delivery of the course alone (not including program development costs, research, or any optional enhancements) cost US$30,194. The total cost per participant for the course was US$755, with a marginal participant cost of US$141.

CONCLUSION

Teaching kitchens represent viable options to deliver lifestyle medicine interventions. However, more research and cost analyses are needed to better understand the value teaching kitchens provide to determine if they are an effective and economical way to deliver lifestyle medicine.

Barriers and facilitative factors in the implementation of workplace health promotion activities in small and medium-sized enterprises: a qualitative study

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.

Evaluating "The REST of your Life," a workplace health program to improve employee sleep, health, energy, and productivity

Purpose Sleep is critical for employee health, well-being, and productivity. Our purpose is to evaluate a sleep-focused interactive workplace health promotion program. Design We evaluate sleep and mental health before and after exposure to the program using a pre/post quasi-experimental pilot study design with surveys administered at baseline and 1-, 6-, and 12-months post-exposure (Phase 1). We design program evaluation surveys for dissemination when the program is offered broadly to hospital employees (Phase 2). Setting The study was conducted at a large teaching hospital in the Southeast U.S. in 2016. Subjects Subjects were full-time hospital employees. Intervention The program was presented to subjects in one four-hour interactive session. Measures In Phase 1 (n=55), surveys included the validated Apnea Risk Evaluation System (ARES), Dysfunctional Beliefs About Sleep (DBAS), Generalized Anxiety Disorder-7 (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire (PHQ-9). Phase 2 (n=3,935) utilized program evaluation surveys. Analysis We compare survey responses between pre- and post-program using ANOVA with post-hoc tests. Results Statistically significant improvement in all sleep and mental health domains was demonstrated. In Phase 2, 81.9% reported "strongly agree" to willingness to recommend the program to co-workers. Conclusion We demonstrate improvement in employee sleep and mental health after exposure to a novel workplace health promotion program to improve sleep.

Physical Activity Surveillance in the United States for Work and Commuting: Understanding the Impact on Population Health and Well-being

OBJECTIVE

To summarize and describe the current US surveillance systems that assess physical activity (PA) for work and commuting.

METHODS

An expert group conducted an environmental scan, generating a list (n = 18) which was ultimately reduced to 12, based on the inclusion of PA and/or sedentary behavior data.

RESULTS

The 12 surveys or surveillance systems summarized provide nationally representative data on occupational-level PA or individual-level PA at work, data on active commuting, some are scorecards that summarize workplace health best practices and allow benchmarking, and one is a comprehensive nationally representative survey of employers assessing programs and practices in different worksites.

CONCLUSIONS

The various surveillance systems and surveys/scorecards are disparate and need to be better analyzed and summarized to understand the impact of occupational-level PA and commuting on population health and well-being, life expectancy, and workforce productivity.

Adoption and Implementation Barriers for Worksite Health Programs in the United States

Worksite health promotion programs have been identified as having the potential to mitigate chronic health risks. In the most recent 2017 U.S. CDC survey of workplace health promotion, respondents identified several perceived barriers related to program adoption and implementation. The analysis indicates that challenges negatively associated with having worksite program were lack of senior management support (OR = 0.50, 95% CI: 0.32–0.78), lack of qualified vendors (OR = 0.56, 95% CI: 0.4–0.79), lack of qualified personnel (OR = 0.56, 95% CI: 0.35–0.73), and cost (OR = 0.58, 95% CI: 0.39–0.88). Challenges associated with having a program were lack of employee interest (OR = 2.09, 95% CI = 1.44–3.03), lack of space (OR = 1.76, 95% CI: 1.26–2.48), and demonstrating program results (OR = 2.09, 95% CI = 1.44–3.03). These findings can provide insights to policy makers, insurers, and employers seeking to implement workplace-based health promotion initiatives.

Attitudes of Company Executives toward a Comprehensive Workplace Health Management-Results of an Exploratory Cross-Sectional Study in Germany

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.

Has the COVID-19 Pandemic Accelerated the Future of Work or Changed Its Course? Implications for Research and Practice

The COVID-19 pandemic is a unique transboundary crisis which has disrupted people's way of life more dramatically than any event in generations. Given the ambiguity surrounding the end of the COVID-19 pandemic and its enduring negative effects, it is important to understand how this has affected important future of work trends. The aim of the current paper is to assess the impact of the COVID-19 pandemic on commonly discussed future of work trends relevant to occupational safety and health priority areas. These topics include work arrangements, compensation and benefits, and the organization of work. For each topic, we assess trends leading up to the COVID-19 pandemic, discuss the impact of the pandemic on these trends, and conclude with implications for research and practice. Overall, the pandemic appears to have both accelerated and disrupted various trends associated with future of work topic areas. These effects are discussed in terms of implications for both policymakers and organizations.

Cardiovascular Health Research in the Workplace: A Workshop Report

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.

Examining the Implementation of Physical Activity and Healthy Eating Policies in a Large, Public Health Organization

OBJECTIVE

To examine the implementation of physical activity and healthy eating policies in eighteen locations of a large, public health organization.

METHODS

We used a mixed-methods design that included a survey of employees to describe location characteristics (ie, number of employees, race/ethnicity of employees), a survey of wellness ambassadors to determine which policies were implemented, and semi-structured, telephone interviews with wellness ambassadors to examine the barriers and facilitators to policy implementation.

RESULTS

Six locations implemented both policies, nine locations only implemented the physical activity policy, and two locations did not implement either policy. Structural characteristics and geographic spread impeded implementation, whereas leadership engagement and access to information about the policies facilitated implementation.

CONCLUSIONS

Consistent and adequate policy implementation in each location of an organization is critical to providing equity in health promotion programs for employees.

Vaping in the Workplace: Prevalence and Attitudes Among Employed US Adults

Describe workplace vaping, prevalence of observed use, attitudes, and perceptions among US adults.

Influence of Incentive Design and Organizational Characteristics on Wellness Participation and Health Outcomes

OBJECTIVE

To explore how changing incentive designs influence wellness participation and health outcomes.

METHODS

Aggregated retrospective data were evaluated using cluster analysis to group 174 companies into incentive design types. Numerous statistical models assessed between-group differences in wellness participation, earning incentives, and over-time differences in health outcomes.

RESULTS

Four incentive design groups based on requirements for earning incentives were identified. The groups varied in support for and participation in wellness initiatives within each company. All four design types were associated with improved low density lipoprotein (LDL) (P < 0.01), three with improved blood pressure (P < 0.001), and two with improved fasting glucose (P < 0.03). No incentive plan types were associated with improved body mass index (BMI), but designs predominantly focused on health outcomes (eg, Outcomes-Focused) exhibited a significant increase over time in BMI risk.

CONCLUSION

Incentive design and organizational characteristics impact population-level participation and health outcomes.

Participation in the Healthy Rewards Program Predicts Staying Employed, Medical Costs, and Utilization

OBJECTIVE

To identify who is participating in the healthy rewards program (HRP), how participation corresponds with employment, and to compare health care costs and utilization between partial and full participants with non-participants.

METHODS

A retrospective analysis of employees in a large US company during 2016 to 2019, with statistically significant results reported, adjusted for sex, age, and year.

RESULTS

Women, ages 30 to 59, and those employed in more recent years correspond with higher HRP participation. Participants were 15.7% more likely to remain employed from year to year. Compared with non-participants, partial and full participants experienced $740.43 and $884.07 lower annual costs. If all employees experienced the same health care costs as non-participants, partial participants, and full participants, there would be an 8% increase, 13% decrease, and 17% decrease in costs, respectively.

CONCLUSIONS

HRP participation is a marker of interest in healthier living.

Prevalence and characteristics of campus-based employee wellness programs among United States accredited colleges and universities

BACKGROUND

Employee wellness programs (EWPs) aim to support positive changes in employees' modifiable behavioral health risk factors for disease prevention and management.

OBJECTIVE

This study described the prevalence and characteristics of EWPs in US accredited college and university campuses.

METHODS

Identification of the prevalence of EWPs and programming activities offered in 3039 accredited higher education institutions/campuses, and characteristics of these institutions/campuses were conducted, mainly through searching the institution's web page.

RESULTS

Overall, 36%of the institutions/campuses offered EWPs, with a significantly larger percentage of 4-year public colleges/universities providing EWPs and wellness programming activities than the 4-year private colleges/universities and community colleges. When limiting the institutions/campuses to 4-year colleges and universities with at least 500 employees, the percentage of these institutions/campuses offering EWPs increased to 57.7%, which was comparable to the findings in the literature. The percentage of the institutions/campuses offering wellness programming activities ranged from 18.1%for injury prevention and ergonomics to 30.2%for stress management. The percentage of institutions/campuses offering injury prevention and ergonomics was significantly lower than the percentage of institutions/campuses offering other typical wellness activities.

CONCLUSIONS

The prevalence of EWPs offered in accredited college and university campuses do not meet the national goal of 75%, which was set by Healthy People 2010.

Social Determinants of Health Challenges Are Prevalent Among Commercially Insured Populations

OBJECTIVES

To evaluate the prevalence of social determinants of health (SDoH) factors in a large commercially-insured population and to characterize the prevalence of common conditions (eg, diabetes, behavioral health issues) and addressable health services utilization concerns (eg, lack of preventive care) for which employers offer no- and low-cost benefit programs.

METHODS

We identified groups with SDoH challenges within a commercially-insured population of 5.1 M through administrative data and self-report. Using medical claims and health assessment data, we identified populations with SDoH needs who had common conditions for which employers often provide no- or low-cost benefit programs (ie, diabetes, behavioral health conditions, high-risk pregnancy, overweight/obesity). Additionally, we sought populations with common addressable health services utilization concerns such as avoidable emergency room visits, lack of preventive care services, or non-adherence to medications. We used univariate analyses to describe the prevalence of SDoH risks in the population of interest.

RESULTS

Twenty-seven percent of this commercially-insured population live in a zip code where the median income is at or below 200% of the Federal Poverty Line. Respondents identified cost (55%) and family, school, or work responsibilities (26%) as key barriers to care. ER overutilization rates are higher in lower income zip codes than wealthier zip codes (34% vs 9%) as is the prevalence of diabetes, overweight/obesity, and behavioral issues, and decreased use of preventive services. Fifteen percent of the study population live in a low-access food area. There is considerable variability in access to employer-sponsored resources to address these needs (70% of employers provide behavioral health programs; 63% provide telehealth programs, but only 1% offer healthy food programs and less than 0.5% offer either child care or transportation support programs).

CONCLUSIONS

Commercially insured populations could benefit from employer-sponsored programs or benefits that address key SDoH barriers such as financial support, healthy food programs, child-care, and transportation.

Associations Between Occupational and Leisure-Time Physical Activity With Employee Stress, Burnout and Well-Being Among Healthcare Industry Workers

PURPOSE

Examine the associations of occupational and leisure-time physical activity with job stress, burnout, and well-being among healthcare industry workers.

DESIGN

Quantitative; cross-sectional.

SETTING

Healthcare Industry.

SAMPLE

US Amazon Mechanical Turk participants (n = 550) employed in the healthcare industry, worked 35 hours or more per week, had ≥ 1 supervisor and ≥ 1 co-worker, and were ≥ 18 years old.

MEASURES

Self-reported measures of occupational physical activity (OPA) and leisure-time physical activity (LTPA), employee well-being, job stress, and burnout operationalized as exhaustion and disengagement.

ANALYSIS

Associations between OPA and LTPA with employee well-being, job stress, exhaustion and disengagement were assessed with separate multiple linear regression models.

RESULTS

OPA had positive significant associations with job stress (β = 0.10, P value = .003) and exhaustion (β = 0.21, P value < .0001). No significant associations were found between OPA with other psychological outcomes. A significant inverse association was found between LTPA and exhaustion (β = -0.04, P value = .007).

CONCLUSION

In a sample of U.S. health care workers, and consistent with prior epidemiological studies, greater LTPA was associated with lower feelings of exhaustion. In contrast, health care workers with greater OPA reported higher perceptions of job stress and exhaustion. The findings underscore the need for more research aimed at understanding relationships between OPA and psychological health among healthcare workers.

Workplace Health in Kentucky: A Statewide Comparison

The objectives of this study were to assess the state of Kentucky’s workplace health promotion and occupational safety and health programs, to ensure the ability to comprehend any possible trends over the past six years in the state’s progress in offering workplace health promotion and health protection programs, to compare the results of this survey with the 2013 Kentucky state-wide assessment, and to identify gaps in Kentucky’s workplace health promotion and occupational safety and health based on Total Worker Health^® (TWH) concepts. Using Qualtrics research software, the Workplace Health in America assessment was sent to companies located in Kentucky and having 10 or more employees. Participants were identified using Dun and Bradstreet’s Hoover’s database. The results showed that, as with the 2013 survey, larger workplaces significantly were more likely to offer workplace health promotion programs than smaller companies (X² = 24.30; p < 0.001). However, more companies (78%) reported offering programs compared to the 2013 assessment (49%). Given the results of the current study as compared to the statewide assessment conducted in 2013, Kentucky’s WHP is moving in a positive direction; yet, there is still much to be done. There remains a strong need to provide cost-effective and accessible resources for all elements of TWH to small workplaces.