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Bensa K, Širok K. Is It Time to Re-Shift the Research Agenda? A Scoping Review of Participation Rates in Workplace Health Promotion Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032757. [PMID: 36768121 PMCID: PMC9916376 DOI: 10.3390/ijerph20032757] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 06/12/2023]
Abstract
Workplace health promotion programmes (WHPPs) are among the most important measures to improve the health and motivation of the ageing workforce. However, they are accompanied with certain challenges, such as low participation rates and higher participation levels of the more health-conscious workers, often failing to engage those who need such interventions the most. Following the PRISMA guidelines, this scoping review examined participation rates reported in articles on WHPPs to identify potential knowledge gaps. The results are worrying: participation rates are not only infrequently reported, but also low. Of the 58 articles, 37 report participation rates, with the majority (20) reporting an average participation rate of less than 50%. Reported participation rates refer either to different target groups, the type of intervention, or to single points in time, which makes it difficult to establish consistent criteria for comparison. We argue that despite the importance of WHPP efficacy, research focus should shift to the determinants of participation, as well as the issue of standardising the reporting of participation rates, alongside the potential problem of reporting bias.
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Affiliation(s)
- Katarina Bensa
- Faculty of Management, University of Primorska, 6000 Koper, Slovenia
| | - Klemen Širok
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia
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2
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Olson R, Cunningham TR, Nigam JAS, Anger WK, Rameshbabu A, Donovan C. Total Worker Health® and Organizational Behavior Management: Emerging Opportunities for Improving Worker Well-being. JOURNAL OF ORGANIZATIONAL BEHAVIOR MANAGEMENT 2022. [DOI: 10.1080/01608061.2022.2146256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ryan Olson
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
- Oregon Health & Science University-Portland State University, School of Public Health, Portland, Oregon, USA
- Portland State University, Department of Psychology, Portland, Oregon, USA
| | - Thomas R. Cunningham
- Division of Science Integration, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health,Cincinnati, USA
| | - Jeannie A. S. Nigam
- Division of Science Integration, Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health,Cincinnati, USA
| | - W. Kent Anger
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
| | - Anjali Rameshbabu
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
| | - Courtney Donovan
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
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Obana A, Asaoka R, Miura A, Nozue M, Takayanagi Y, Nakamura M. Improving Skin Carotenoid Levels in Young Students through Brief Dietary Education Using the Veggie Meter. Antioxidants (Basel) 2022; 11:antiox11081570. [PMID: 36009289 PMCID: PMC9405129 DOI: 10.3390/antiox11081570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/25/2022] Open
Abstract
The antioxidant and anti-inflammatory effects of carotenoid have been determined to aid in the prevention of a wide range of oxidative disorders, arteriosclerosis, obesity, and various types of cancers. In order to keep high carotenoid levels in the body, much of the vegetable and fruit (V/F) intake is mandatory. However, the actual intake of V/F is not enough in many countries. The aim of this study was to assess whether brief dietary education using the Veggie Meter (VM) that could measure skin carotenoid (SC) levels could induce the increase in carotenoid levels via V/F intake. Two hundred and sixty-one elementary and junior high school students (ages 7−14 years old) received brief educational session and SC evaluation by VM, and the changes in SC levels were examined after 6 months. The baseline VM scores ranged from 131 to 825, and the average significantly increased from 400.0 ± 124.7 (standard deviation) to 447.4 ± 140.4 at Month 6 (p < 0.0001). The percentage of increase at month 6 was negatively correlated with the baseline values (r = −0.36, p < 0.0001). This finding implies that subjects who became aware of their inferiority tended to make a significant effort to change their behavior. The multivariate logistic regression analysis demonstrated that subjects taking much of green and yellow vegetables, drinking vegetable/tomato juice, and eating any fruit had higher VM scores than the average value. In conclusion, the educational approach using VM was supposed to be an effective method of raising awareness of the V/F shortage and increasing V/F intake that could indue the increase in SC levels.
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Affiliation(s)
- Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City 430-8558, Shizuoka, Japan
- Department of Medical Spectroscopy, Institute for Medical Photonics Research, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City 431-3192, Shizuoka, Japan
- Correspondence: ; Tel.: +81-53-474-2222
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City 430-8558, Shizuoka, Japan
| | - Ayako Miura
- Faculty of Health Promotion Sciences, Department of Health and Nutritional Sciences, Tokoha University, 1230 Miyakoda-cho, Kita-ku, Hamamatsu City 431-2102, Shizuoka, Japan
| | - Miho Nozue
- Faculty of Health Promotion Sciences, Department of Health and Nutritional Sciences, Tokoha University, 1230 Miyakoda-cho, Kita-ku, Hamamatsu City 431-2102, Shizuoka, Japan
| | - Yuji Takayanagi
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu City 430-8558, Shizuoka, Japan
| | - Mieko Nakamura
- Department of Community Health & Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu City 431-3192, Shizuoka, Japan
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Reinhardt A, Adams J, Schöne K, Rose DM, Sammito S. Do working characteristics influence the participation at health measures? Findings from a trial phase of workplace health promotion. J Occup Med Toxicol 2020; 15:11. [PMID: 32477422 PMCID: PMC7238617 DOI: 10.1186/s12995-020-00262-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 04/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Health behavior is presumed to be influenced by organizational factors. This study analyzes how workplace characteristics influence health behavior in terms of participation at health measures. Methods Employees of the German Federal Ministry of Defense were surveyed at the beginning (January / February 2015) and at the end (June 2015) of the trial phase of workplace health promotion (WHP). Differences in participation of characteristic groups were calculated using Pearson's Chi2-Test and T-Test, chances of participation were estimated using multilevel logistic regression. Results Employees who reported higher satisfaction with work demand participated more often in health measures (aOR: 1.02, 95%-CI = 1.01, 1.04, p < 0.001). Large amount of variance in participation can be attributed to department level. Conclusion Participation at WHP varies significantly between settings after controlling for individuals' characteristics. Thus, working characteristics should be considered as a decisive factor for WHP effectiveness. There is consensus that behavioral prevention is most effective when conditional prevention is granted as behavior is presumed to be influenced by individuals´ environmental conditions. Though objective working conditions may seem similar further context characteristics which remain unconsidered may lead to different behavior patterns. This article shows that more attention must be payed to setting specific characteristics with regard to effective Occupational Health Promotion.This project is registered by the Federal Ministry of Defense (research number: E/U2AD/ED003/EF555).
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Affiliation(s)
- Annika Reinhardt
- 1Institute of Teachers' Health at the University Medical Center of the Johannes Gutenberg University of Mainz, Kupferbergterrasse 17-19, 55116 Mainz, Germany
| | - Johanna Adams
- 1Institute of Teachers' Health at the University Medical Center of the Johannes Gutenberg University of Mainz, Kupferbergterrasse 17-19, 55116 Mainz, Germany
| | - Klaus Schöne
- 1Institute of Teachers' Health at the University Medical Center of the Johannes Gutenberg University of Mainz, Kupferbergterrasse 17-19, 55116 Mainz, Germany
| | - Dirk-Matthias Rose
- 1Institute of Teachers' Health at the University Medical Center of the Johannes Gutenberg University of Mainz, Kupferbergterrasse 17-19, 55116 Mainz, Germany
| | - Stefan Sammito
- Bundeswehr Medical Service Headquarters, Section Health Promotion Sport and Nutrition Medicine, Koblenz, Germany.,Research & Development, Air Force Centre of Aerospace Medicine, Cologne, Germany
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Tabak RG, Strickland JR, Kirk B, Colvin R, Stein RI, Dart H, Colditz GA, Dale AM, Evanoff BA. Pilot test of an interactive obesity treatment approach among employed adults in a university medical billing office. Pilot Feasibility Stud 2020; 6:57. [PMID: 32355567 PMCID: PMC7187490 DOI: 10.1186/s40814-020-00599-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 04/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background There is a need for workplace programs promoting healthy eating and activity that reach low-wage employees and are scalable beyond the study site. Interventions designed with dissemination in mind aim to utilize minimal resources and to fit within existing systems. Technology-based interventions have the potential to promote healthy behaviors and to be sustainable as well as scalable. We developed an interactive obesity treatment approach (iOTA), to be delivered by SMS text messaging, and therefore accessible to a broad population. The aim of this pilot study was to evaluate participant engagement with, and acceptability of, this iOTA to promote healthy eating and activity behaviors among low-wage workers with obesity. Methods Twenty participants (self-reporting body mass index ≥ 30 kg/m2) of a single workgroup employed by a university medical practice billing office had access to the full intervention and study measures and provided feedback on the experience. Height and weight were measured by trained research staff at baseline. Each participant was offered a quarterly session with a health coach. Measured weight and a self-administered survey, including dietary and activity behaviors, were also collected at baseline, 3, 6, 12, 18, and 24 months. Participant engagement was assessed through responsiveness to iOTA SMS text messages throughout the 24-month pilot. A survey measure was used to assess satisfaction with iOTA at 3 months. Due to the small sample size and pilot nature of the current study, we conducted descriptive analyses. Engagement, weight change, and duration remaining in coaching are presented individually for each study participant. Results The pilot was originally intended to last 3 months, but nearly all participants requested to continue; we thus continued for 24 months. Most (14/20) participants remained in coaching for 24 months. At the 3-month follow-up, eight (47%) of the remaining 17 participants had lost weight; by 24 months, five (36%) of the remaining 14 participants had lost weight (one had bariatric surgery). Participants reported very high satisfaction. Conclusions This pilot provides important preliminary results on acceptability and participant engagement with iOTA, which has significant potential for dissemination and sustainability.
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Affiliation(s)
- Rachel G Tabak
- 1The Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130 USA
| | - Jaime R Strickland
- 2Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Bridget Kirk
- 2Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Ryan Colvin
- 2Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Richard I Stein
- 3Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8031, St. Louis, MO 63110 USA
| | - Hank Dart
- 4Division of Public Health Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8100, St Louis, MO 63110 USA
| | - Graham A Colditz
- 5Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO 63110 USA
| | - Ann Marie Dale
- 2Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Bradley A Evanoff
- 2Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
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Tsai R, Alterman T, Grosch JW, Luckhaupt SE. Availability of and Participation in Workplace Health Promotion Programs by Sociodemographic, Occupation, and Work Organization Characteristics in US Workers. Am J Health Promot 2019; 33:1028-1038. [PMID: 31014070 DOI: 10.1177/0890117119844478] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine how the availability of and participation in workplace health promotion programs (WHPPs) vary as a function of sociodemographic, occupation, and work organization characteristics. DESIGN Cross-sectional study. SETTING 2015 National Health Interview Survey and Occupational Health Supplement. PARTICIPANTS The study sample included 17 469 employed adults who completed the WHPP questions. MEASURES The 2 dependent outcome measures were availability of WHPPs and participation in these programs when available. Independent variables included occupation and 8 work organization and employment characteristics: company size, hours worked, supervisory responsibility, hourly pay, paid sick leave, health insurance offered by employer, work schedule, and work arrangement. ANALYSIS Poisson regression analyses were conducted with SUDAAN 11.0.1. RESULTS Overall, 57.8% of 46.6% employees who have WHPPs available reported participating in these programs. This study found that adults who worked ≤20 h/wk, worked regular night shifts, were paid by the hour, or worked for temporary agencies were less likely to participate in WHPPs. Workers who supervised others were 13% more likely to participate than nonsupervisors. Borderline associations were seen for having access to employer-sponsored health insurance and working at a site with <10 employees. CONCLUSION Despite the potential for improving physical and mental health, only 58% of US workers participated in WHPPs. Since barriers to WHPP participation (eg, time constraints, lack of awareness, and no perceived need) may vary across occupations and work organization characteristics, employers should tailor WHPPs based on their specific work organization characteristics to maximize participation.
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Affiliation(s)
- Rebecca Tsai
- 1 Division of Surveillance, Hazard Evaluation and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, OH, USA
| | - Toni Alterman
- 1 Division of Surveillance, Hazard Evaluation and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, OH, USA
| | - James W Grosch
- 2 Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Sara E Luckhaupt
- 1 Division of Surveillance, Hazard Evaluation and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, OH, USA
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Stein RI, Strickland JR, Tabak RG, Dale AM, Colditz GA, Evanoff BA. Design of a randomized trial testing a multi-level weight-control intervention to reduce obesity and related health conditions in low-income workers. Contemp Clin Trials 2019; 79:89-97. [PMID: 30664943 PMCID: PMC6521952 DOI: 10.1016/j.cct.2019.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 12/13/2022]
Abstract
Weight-control is a major public health focus for preventing multiple obesity-related health conditions. While clinic-based intensive lifestyle interventions are successful, low-socioeconomic-status (SES) populations, which have a higher burden of obesity, are difficult to reach; thus, the workplace offers a useful setting to target low-SES workers. The current paper presents the design of a study testing a workplace intervention aimed at low-SES employees. Partnering with a large healthcare system and affiliated university, this project will test an innovative multi-level intervention ("Working for You") adapted from existing group- and individual-level intervention models to promote healthy weight among low-wage workers. The individual-level component is an interactive obesity treatment approach (iOTA) program that involves assessment of behavior risks, collaborative goal-setting with a health coach, and interactive SMS text-messages for ongoing support and self-monitoring. This mHealth intervention is embedded in the group-level component, a workplace participatory program that involves worker teams engaged in the design and implementation of interventions to change their workplace environments. These nested interventions are being tested in a group-randomized trial among 22 work groups (~1000 total workers, ~300 workers with obesity). The primary outcome will be program effects on weight at 2-year follow-up, compared to control, and the secondary outcomes will be effects on diet and physical activity; iOTA adherence, process measures, and work environment/support will also be examined. This pragmatic clinical trial will test scalable interventions that can be translated to other work settings to reduce obesity and related health risks among low-SES workers. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02934113.
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Affiliation(s)
- Richard I Stein
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States.
| | - Jaime R Strickland
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Rachel G Tabak
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Ann Marie Dale
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Graham A Colditz
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
| | - Bradley A Evanoff
- Washington University School of Medicine, Department of Medicine, Division of Geriatrics and Nutritional Science, 660 S. Euclid, Campus Box 8083, St. Louis, MO 63110, United States
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Strickland JR, Kinghorn AM, Evanoff BA, Dale AM. Implementation of the Healthy Workplace Participatory Program in a Retail Setting: A Feasibility Study and Framework for Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E590. [PMID: 30781669 PMCID: PMC6406806 DOI: 10.3390/ijerph16040590] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/06/2019] [Accepted: 02/14/2019] [Indexed: 12/27/2022]
Abstract
Participatory methods used in Total Worker Health® programs have not been well studied, and little is known about what is needed to successfully implement these programs. We conducted a participatory health promotion program with grocery store workers using the Healthy Workplace Participatory Program (HWPP) from the Center for the Promotion of Health in the New England Workplace. We recruited a design team made up of six line-level workers and a steering committee with management and union representatives; a research team member facilitated the program. Using a formal evaluation framework, we measured program implementation including workplace context, fidelity to HWPP materials, design team and steering committee engagement, program outputs, and perceptions of the program. The HWPP was moderately successful in this setting, but required a substantial amount of worker and facilitator time. Design team members did not have the skills needed to move through the process and the steering committee did not offer adequate support to compensate for the team's shortfall. The evaluation framework provided a simple and practical method for identifying barriers to program delivery. Future studies should address these barriers to delivery and explore translation of this program to other settings.
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Affiliation(s)
- Jaime R Strickland
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Anna M Kinghorn
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine, Saint Louis, MO 63110, USA.
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Tabak RG, Strickland JR, Stein RI, Dart H, Colditz GA, Kirk B, Dale AM, Evanoff BA. Development of a scalable weight loss intervention for low-income workers through adaptation of interactive obesity treatment approach (iOTA). BMC Public Health 2018; 18:1265. [PMID: 30445939 PMCID: PMC6240310 DOI: 10.1186/s12889-018-6176-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/01/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Describing how and why an evidence-based intervention is adapted for a new population and setting using a formal evaluation and an adaptation framework can inform others seeking to modify evidence-based weight management interventions for different populations or settings. The Working for You intervention was adapted, to fit a workplace environment, from Be Fit Be Well, an evidence-based intervention that targets weight-control and hypertension in patients at an outpatient clinic. Workplace-based efforts that promote diet and activity behavior change among low-income employees have potential to address the obesity epidemic. This paper aims to explicitly describe how Be Fit Be Well was adapted for this new setting and population. METHODS To describe and understand the worksite culture, environment, and policies that support or constrain healthy eating and activity in the target population, we used qualitative and quantitative methods including key informant interviews, focus groups, and a worker survey; these data informed intervention adaptation. We organized the adaptations made to Be Fit Be Well using an adaptation framework from implementation science. RESULTS The adapted intervention, Working for You, maintains the theoretical premise and evidence-base underpinning Be Fit Be Well. However, it was modified in terms of the means of delivery (i.e., rather than using interactive voice response, Working for You employs automated SMS text messaging), defined as a modification to context by the adaptation framework. The adaptation framework also includes modifications to content; in this case the behavioral goals were modified for the target population based on updated science related to weight loss and to target a workplace population (e.g., a goal to avoiding free food at work). CONCLUSIONS If effective, this scalable and relatively inexpensive intervention can be translated to other work settings to reduce obesity and diabetes risk among low-SES workers, a group with a higher prevalence of these conditions. Using a formal evaluation and framework to guide and organize how and why an evidence-based intervention is adapted for a new population and setting can push the field of intervention research forward. TRIAL REGISTRATION ClinicalTrials.gov: NCT02934113 ; Received: October 12, 2016; Updated: November 7, 2017.
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Affiliation(s)
- Rachel G. Tabak
- Prevention Research Center in St. Louis, The Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130 USA
| | - Jaime R. Strickland
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Richard I. Stein
- Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8083, St. Louis, MO 63110 USA
| | - Hank Dart
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO 63110 USA
| | - Graham A. Colditz
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO 63110 USA
| | - Bridget Kirk
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Ann Marie Dale
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Bradley A. Evanoff
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
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10
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Flynn JP, Gascon G, Doyle S, Matson Koffman DM, Saringer C, Grossmeier J, Tivnan V, Terry P. Supporting a Culture of Health in the Workplace: A Review of Evidence-Based Elements. Am J Health Promot 2018; 32:1755-1788. [PMID: 29806469 DOI: 10.1177/0890117118761887] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To identify and evaluate the evidence base for culture of health elements. DATA SOURCE Multiple databases were systematically searched to identify research studies published between 1990 and 2015 on culture of health elements. STUDY INCLUSION AND EXCLUSION CRITERIA Researchers included studies based on the following criteria: (1) conducted in a worksite setting; (2) applied and evaluated 1 or more culture of health elements; and (3) reported 1 or more health or safety factors. DATA EXTRACTION Eleven researchers screened the identified studies with abstraction conducted by a primary and secondary reviewer. Of the 1023 articles identified, 10 research reviews and 95 standard studies were eligible and abstracted. DATA SYNTHESIS Data synthesis focused on research approach and design as well as culture of health elements evaluated. RESULTS The majority of published studies reviewed were identified as quantitative studies (62), whereas fewer were qualitative (27), research reviews (10), or other study approaches. Three of the most frequently studied culture of health elements were built environment (25), policies and procedures (28), and communications (27). Although all studies included a health or safety factor, not all reported a statistically significant outcome. CONCLUSIONS A considerable number of cross-sectional studies demonstrated significant and salient correlations between culture of health elements and the health and safety of employees, but more research is needed to examine causality.
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Affiliation(s)
| | | | | | | | | | | | | | - Paul Terry
- 6 Health Enhancement Research Organization, Waconia, MN, USA
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11
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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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Persson R, Cleal B, Jakobsen MØ, Villadsen E, Andersen LL. Reasons for using workplace wellness services: Cross-sectional study among 6000 employees. Scand J Public Health 2017; 46:347-357. [PMID: 28673125 DOI: 10.1177/1403494817714190] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS While workplace wellness services are proactively established to improve well-being and reduce sickness absence, knowledge of reasons for using these services remains sparse. This study investigates which factors determine use of an in-house wellness service at a large organization (the Danish Police) with several departments in different geographical locations. METHODS All potential users of the Wellness service ( n = 15,284) were invited to respond to a cross-sectional questionnaire. Of 6060 eligible respondents, 58% had used the service at least once (any use) and 17% had used the service at least three times (frequent users). Two items assessed the frequency of statements of justifications for using or not using the Wellness service. Associations between 32 demographic and psychosocial variables and use of the Wellness service were evaluated with unadjusted bivariate logistic regression analyses. RESULTS The two primary justifications for using the Wellness service were: to get a blood pressure assessment (37%) and to rehabilitate injury (26%). The two most common justifications for not using the Wellness service were: no perceived need (44%) and already physically active (34%). Of the 32 demographical and psychosocial variables included, 28 were associated with any use and 24 with frequent use. CONCLUSIONS Use of the Wellness service appears to be driven by a complex configuration of factors that resist easy translation into practical advice. Non-participation was accounted for in terms of both positive and negative barriers. Use of the service for purposes of primary prevention and health promotion was, relatively speaking, lagging behind.
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Affiliation(s)
- Roger Persson
- 1 Department of Psychology, Lund University, Sweden.,2 Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Bryan Cleal
- 3 Health Promotion Research, Steno Diabetes Center, Gentofte, Denmark
| | | | - Ebbe Villadsen
- 4 National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Lars Louis Andersen
- 4 National Research Centre for the Working Environment, Copenhagen, Denmark.,5 Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Aalborg University, Denmark
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Bagwell MM, Bush HA. Health Conception and Health Promotion in Blue Collar Workers: Program Planning Issues. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/216507999904701102] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Health conception and health promotion behaviors were measured in 160 blue collar workers ages 18 to 65, focusing on factors influencing blue collar workers' participation in health promotion programs. Results of Laffrey's Health Conception Scale (LHCS) and Pender's Health Promoting Lifestyle Profile (HPLP) indicated: • Health responsibility and interpersonal support were significantly greater for women than for men. • Exercise was significantly greater for younger workers than for older workers. • Nutrition was significantly greater for older workers than for younger workers. • Health conception was significantly greater for younger women and for older men. • A significant relationship exists between health conception and health promoting lifestyle. • Role and self actualization were significantly greater for older workers than for younger workers. Results suggest gender, age, and concept of health are important when planning health promotion programs at an industrial site.
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Affiliation(s)
| | - Helen A. Bush
- Texas Woman's University and School of Nursing, University of Texas at Arlington, Arlington, TX
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14
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Thomas B, Stamler LL, Lafreniere KD, Delahunt TD. Breast Health Educational Interventions. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/216507990205001007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health education programs supported by women's groups or workplaces have been successful in reaching large populations and changing intentions to perform breast health behaviors. This study examined the responses women working in the automotive industry had to two health education interventions, mailed pamphlets, and a combination of mailed material and classes at the worksite compared to a control group. A quasi-experimental design was used. Of the 948 women completing the pre-test, 437 also completed the post-test and were highly representative of the initial sample. The findings suggest that although the mailed information produced some change in practices and intentions, the classes in combination with the mailed pamphlets produced greater change. In addition, confidence in breast self examination as a method of detecting an existing breast lump increased from pre-test to post-test across all age groups. The reported influences on the women's decisions related to breast health varied across the life span. The results of this study can be used to support the development of effective health promotion programs for use at workplaces to increase the likelihood of women engaging in healthy breast practices.
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Schnall PL, Dobson M, Landsbergis P. Globalization, Work, and Cardiovascular Disease. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 46:656-92. [DOI: 10.1177/0020731416664687] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cardiovascular disease (CVD), a global epidemic, is responsible for about 30% of all deaths worldwide. While mortality rates from CVD have been mostly declining in the advanced industrialized nations, CVD risk factors, including hypertension, obesity, and diabetes, have been on the increase everywhere. Researchers investigating the social causes of CVD have produced a robust body of evidence documenting the relationships between the work environment and CVD, including through the mechanisms of psychosocial work stressors. We review the empirical evidence linking work, psychosocial stressors, and CVD. These work stressors can produce chronic biologic arousal and promote unhealthy behaviors and thus, increased CVD risk. We offer a theoretical model that illustrates how economic globalization influences the labor market and work organization in high-income countries, which, in turn, exacerbates job characteristics, such as demands, low job control, effort-reward imbalance, job insecurity, and long work hours. There is also a growing interest in “upstream” factors among work stress researchers, including precarious employment, downsizing/restructuring, privatization, and lean production. We conclude with suggestions for future epidemiologic research on the role of work in the development of CVD, as well as policy recommendations for prevention of work-related CVD.
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Affiliation(s)
- Peter L. Schnall
- Center for Occupational and Environmental Health, University of California, Irvine, 100 Theory Way, Irvine, California, USA
| | - Marnie Dobson
- Center for Occupational and Environmental Health, University of California, Irvine, 100 Theory Way, Irvine, California, USA
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Bull SS, Gillette C, Glasgow RE, Estabrooks P. Work Site Health Promotion Research: To what Extent can we Generalize the Results and what is Needed to Translate Research to Practice? HEALTH EDUCATION & BEHAVIOR 2016; 30:537-49. [PMID: 14582596 DOI: 10.1177/1090198103254340] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Information on external validity of work site health promotion research is essential to translate research findings to practice. The authors provide a literature review of work site health behavior interventions. Using the RE-AIM framework, they summarize characteristics and results of these studies to document reporting of intervention reach, adoption, implementation, and maintenance. The authors reviewed a total of 24 publications from 11 leading health behavior journals. They found that participation rates among eligible employees were reported in 87.5% of studies; only 25% of studies reported on intervention adoption. Data on characteristics of participants versus nonparticipants were reported in fewer than 10% of studies. Implementation data were reported in 12.5% of the studies. Only 8% of studies reported any type of maintenance data. Stronger emphasis is needed on representativeness of employees, work site settings studied, and longer term results. Examples of how this can be done are provided.
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Gans KM, Salkeld J, Risica PM, Lenz E, Burton D, Mello J, Bell JP. Occupation Is Related to Weight and Lifestyle Factors Among Employees at Worksites Involved in a Weight Gain Prevention Study. J Occup Environ Med 2015; 57:e114-20. [PMID: 26461872 PMCID: PMC4610011 DOI: 10.1097/jom.0000000000000543] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine the relationship between job type, weight status, and lifestyle factors that are potential contributors to obesity including, diet, physical activity (PA), and perceived stress among employees enrolled in the Working on Wellness project. METHODS Randomly selected employees at 24 worksites completed a baseline survey (n = 1700); some also an in-person survey and anthropometric measures (n = 1568). Employees were classified by US labor standards as white collar (n = 1297), blue collar (n = 303), or service worker (n = 92), and 8 unknown. Associations were analyzed using chi-square and general linear model procedures and adjusted for demographics using logistic regression. RESULTS In unadjusted models, body mass index of service workers was higher than white collar workers; fruit and vegetable intake was higher for service and blue collar than white collar; white collar workers reported highest stress levels in job and life. Nevertheless, in models adjusted for demographics, the only significant difference was for PA (ie, metabolic equivalent [MET]/min/wk), with blue collar workers reporting higher levels of PA than service workers, who reported higher levels than the white collar workers. CONCLUSIONS Future research should further examine the relationship between health and job status to corroborate the results of the current study and to consider designing future worksite health promotion interventions that are tailored by job category.
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Affiliation(s)
- Kim M Gans
- University of Connecticut (Dr Gans and Ms Lenz), Storrs; and Brown University Institute for Community Health Promotion (Dr Gans, Ms Salkeld, Dr Risica, Ms Burton, Ms Mello, and Ms Bell), Providence, Rhode Island
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Williams JAR, Nelson CC, Cabán-Martinez AJ, Katz JN, Wagner GR, Pronk NP, Sorensen G, McLellan DL. Validation of a New Metric for Assessing the Integration of Health Protection and Health Promotion in a Sample of Small- and Medium-Sized Employer Groups. J Occup Environ Med 2015; 57:1017-21. [PMID: 26340291 PMCID: PMC5189678 DOI: 10.1097/jom.0000000000000521] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To conduct validation analyses for a new measure of the integration of worksite health protection and health promotion approaches developed in earlier research. METHODS A survey of small- to medium-sized employers located in the United States was conducted between October 2013 and March 2014 (n = 111). Cronbach α coefficient was used to assess reliability, and Pearson correlation coefficients were used to assess convergent validity. RESULTS The integration score was positively associated with the measures of occupational safety and health and health promotion activities/policies-supporting its convergent validity (Pearson correlation coefficients of 0.32 to 0.47). Cronbach α coefficient was 0.94, indicating excellent reliability. CONCLUSIONS The integration score seems to be a promising tool for assessing integration of health promotion and health protection. Further work is needed to test its dimensionality and validate its use in other samples.
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Affiliation(s)
- Jessica A R Williams
- Dana-Farber Cancer Institute (Drs Williams, Nelson, Sorensen, and McLellen); Harvard T. H. Chan School of Public Health (Drs Williams, Nelson, Cabán-Martinez, Katz, Wagner, Pronk, Sorensen, and McLellan), Boston, Mass; University of Miami Medical School (Dr Cabán-Martinez), Fla; HealthPartners, Inc (Dr Pronk), Minneapolis, Minn; Brigham and Women's Hospital (Dr Katz), Boston, Mass; and National Institute for Occupational Safety and Health (Dr. Wagner), Washington, DC
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Stansfeld SA, Berney L, Bhui K, Chandola T, Costelloe C, Hounsome N, Kerry S, Lanz D, Russell J. Pilot study of a randomised trial of a guided e-learning health promotion intervention for managers based on management standards for the improvement of employee well-being and reduction of sickness absence: the GEM (Guided E-learning for Managers) study. PUBLIC HEALTH RESEARCH 2015. [DOI: 10.3310/phr03090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundPsychosocial work environments influence employee well-being. There is a need for an evaluation of organisational-level interventions to modify psychosocial working conditions and hence employee well-being.ObjectiveTo test the acceptability of the trial and the intervention, the feasibility of recruitment and adherence to and likely effectiveness of the intervention within separate clusters of an organisation.DesignMixed methods: pilot cluster randomised controlled trial and qualitative study (in-depth interviews, focus group and observation).ParticipantsEmployees and managers of a NHS trust. Inclusion criteria were the availability of sickness absence data and work internet access. Employees on long-term sick leave and short-term contracts and those with a notified pregnancy were excluded.InterventionE-learning program for managers based on management standards over 10 weeks, guided by a facilitator and accompanied by face-to-face meetings. Three clusters were randomly allocated to receive the guided e-learning intervention; a fourth cluster acted as a control.Main outcome measuresRecruitment and participation of employees and managers; acceptability of the intervention and trial; employee subjective well-being using the Warwick–Edinburgh Mental Wellbeing Scale (WEMWBS); and feasibility of collecting sickness absence data.ResultsIn total, 424 employees out of 649 approached were recruited and 41 managers out of 49 were recruited from the three intervention clusters. Of those consenting, 350 [83%, 95% confidence interval (CI) 79% to 86%] employees completed the baseline assessment and 291 (69%, 95% CI 64% to 73%) completed the follow-up questionnaires. Sickness absence data were available from human resources for 393 (93%, 95% CI 90% to 95%) consenting employees. In total, 21 managers adhered to the intervention, completing at least three of the six modules. WEMWBS scores fell slightly in all groups, from 50.4 to 49.0 in the control group and from 51.0 to 49.9 in the intervention group. The overall intervention effect was 0.5 (95% CI –3.2 to 4.2). The fall in WEMWBS score was significantly less among employees whose managers adhered to the intervention than among those employees whose managers did not (–0.7 vs. 1.6, with an adjusted difference of 1.6, 95% CI 0.1 to 3.2). The intervention and trial were acceptable to managers, although our study raises questions about the widely used concept of ‘acceptability’. Managers reported insufficient time to engage with the intervention and lack of senior management ‘buy-in’. It was thought that the intervention needed better integration into organisational processes and practice.ConclusionsThe mixed-methods approach proved valuable in illuminating reasons for the trial findings, for unpacking processes of implementation and for understanding the influence of study context. We conclude from the results of our pilot study that further mixed-methods research evaluating the intervention and study design is needed. We found that it is feasible to carry out an economic evaluation of the intervention. We plan a further mixed-methods study to re-evaluate the intervention boosted with additional elements to encourage manager engagement and behaviour change in private and public sector organisations with greater organisational commitment.Study registrationCurrent Controlled Trials ISRCTN58661009.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 3, No. 9. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Stephen A Stansfeld
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Lee Berney
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kamaldeep Bhui
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Tarani Chandola
- Cathie Marsh Centre for Census and Survey Research, School of Social Sciences, University of Manchester, Manchester, UK
| | - Céire Costelloe
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Natalia Hounsome
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sally Kerry
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Doris Lanz
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jill Russell
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Hammerback K, Hannon PA, Harris JR, Clegg-Thorp C, Kohn M, Parrish A. Perspectives on Workplace Health Promotion Among Employees in Low-Wage Industries. Am J Health Promot 2015; 29:384-92. [PMID: 25162321 PMCID: PMC5070972 DOI: 10.4278/ajhp.130924-qual-495] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Study goals were to (1) understand the attitudes of employees in low-wage industries toward workplace health promotion, including views on appropriateness of employer involvement in employee health and level of interest in workplace health promotion overall and in specific programs, and (2) determine the potential for extending workplace health promotion to spouses and partners of these employees. APPROACH The study used 42 interviews of 60 to 90 minutes. SETTING Interviews were conducted with couples (married or living together) in the Seattle/King County metropolitan area of Washington State. PARTICIPANTS Study participants were forty-two couples with one or more members working in one of five low-wage industries: accommodation/food services, education, health care/social assistance, manufacturing, and retail trade. METHOD The study employed qualitative analysis of interview transcripts using grounded theory to identify themes. RESULTS Employees consider workplace health promotion both appropriate and desirable and believe it benefits employers through increased productivity and morale. Most have little personal experience with it and doubt their employers would prioritize employee health. Employees are most interested in efforts focused on nutrition and physical activity. Both employees and their partners support extending workplace health promotion to include partners. CONCLUSION Employees and their partners are interested in workplace health promotion if it addresses behaviors they care about. Concern over employer involvement in their personal health decisions is minimal; instead, employees view employer interest in their health as a sign that they are valued.
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Strickland JR, Pizzorno G, Kinghorn AM, Evanoff BA. Worksite influences on obesogenic behaviors in low-wage workers in St Louis, Missouri, 2013-2014. Prev Chronic Dis 2015; 12:E66. [PMID: 25950573 PMCID: PMC4436042 DOI: 10.5888/pcd12.140406] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION More than one-third of US adults are obese. Workplace programs to reduce obesity and improve overall health are not available or accessible to all workers, particularly low-wage workers among whom obesity is more prevalent. The goal of the study was to identify modifiable workplace factors and behaviors associated with diet and exercise to inform future workplace interventions to improve health. METHODS We distributed paper and online surveys to 2 groups of low-wage workers, hospital workers and retail sales workers, at the worksites. The surveys assessed obesity, obesogenic behaviors, workplace factors, and worker participation in workplace health programs (WHPs). Descriptive and regression analyses were conducted to examine workplace factors associated with obesogenic behaviors. RESULTS A total of 529 surveys were completed (219 hospital workers and 310 retail workers). More than 40% of workers were obese and 27% were overweight. In general, workers had poor diets (frequent consumption of sugary and high-fat foods) and engaged in little physical activity (only 30.9% met recommended physical activity guidelines). Access to and participation in workplace health programs varied greatly between hospital and retail sales workers. We identified several modifiable workplace factors, such as food source and work schedule, that were associated with diet, exercise, or participation in workplace health programs. CONCLUSION This study illustrates the high prevalence of obesity and obesogenic behaviors workers in 2 low-wage groups. The differences between work groups indicated that each group had unique facilitators and barriers to healthy eating and exercise. An understanding of how socioeconomic, demographic, and work-related factors influence health will help to identify high-risk populations for intervention and to design interventions tailored and relevant to the target audiences.
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Affiliation(s)
- Jaime R Strickland
- Division of General Medical Sciences, Washington University School of Medicine, 660 S. Euclid Ave, Box 8005, St. Louis, MO 63110.
| | - Galen Pizzorno
- Washington University School of Medicine, St. Louis, Missouri
| | - Anna M Kinghorn
- Washington University School of Medicine, St. Louis, Missouri
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Strickland JR, Smock N, Casey C, Poor T, Kreuter MW, Evanoff BA. Development of targeted messages to promote smoking cessation among construction trade workers. HEALTH EDUCATION RESEARCH 2015; 30:107-20. [PMID: 25231165 PMCID: PMC4296889 DOI: 10.1093/her/cyu050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Blue-collar workers, particularly those in the construction trades, are more likely to smoke and have less success in quitting when compared with white-collar workers. Little is known about health communication strategies that might influence this priority population. This article describes our formative work to develop targeted messages to increase participation in an existing smoking cessation program among construction workers. Using an iterative and sequential mixed-methods approach, we explored the culture, health attitudes and smoking behaviors of unionized construction workers. We used focus group and survey data to inform message development, and applied audience segmentation methods to identify potential subgroups. Among 144 current smokers, 65% reported wanting to quit smoking in the next 6 months and only 15% had heard of a union-sponsored smoking cessation program, despite widespread advertising. We tested 12 message concepts and 26 images with the target audience to evaluate perceived relevance and effectiveness. Participants responded most favorably to messages and images that emphasized family and work, although responses varied by audience segments based on age and parental status. This study is an important step towards integrating the culture of a high-risk group into targeted messages to increase participation in smoking cessation activities.
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Affiliation(s)
- J R Strickland
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA and George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63112, USA
| | - N Smock
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA and George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63112, USA
| | - C Casey
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA and George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63112, USA
| | - T Poor
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA and George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63112, USA
| | - M W Kreuter
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA and George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63112, USA
| | - B A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA and George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63112, USA
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Toker S, Heaney CA, Ein-Gar D. Why won’t they participate? Barriers to participation in worksite health promotion programmes. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2014. [DOI: 10.1080/1359432x.2014.968131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
BACKGROUND The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation. OBJECTIVES 1. To categorize workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking.2. To collect and evaluate data on costs and cost effectiveness associated with workplace interventions. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register (July 2013), MEDLINE (1966 - July 2013), EMBASE (1985 - June 2013), and PsycINFO (to June 2013), amongst others. We searched abstracts from international conferences on tobacco and the bibliographies of identified studies and reviews for additional references. SELECTION CRITERIA We selected interventions conducted in the workplace to promote smoking cessation. We included only randomized and quasi-randomized controlled trials allocating individuals, workplaces, or companies to intervention or control conditions. DATA COLLECTION AND ANALYSIS One author extracted information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the studies, and a second author checked them. For this update we have conducted meta-analyses of the main interventions, using the generic inverse variance method to generate odds ratios and 95% confidence intervals. MAIN RESULTS We include 57 studies (61 comparisons) in this updated review. We found 31 studies of workplace interventions aimed at individual workers, covering group therapy, individual counselling, self-help materials, nicotine replacement therapy, and social support, and 30 studies testing interventions applied to the workplace as a whole, i.e. environmental cues, incentives, and comprehensive programmes. The trials were generally of moderate to high quality, with results that were consistent with those found in other settings. Group therapy programmes (odds ratio (OR) for cessation 1.71, 95% confidence interval (CI) 1.05 to 2.80; eight trials, 1309 participants), individual counselling (OR 1.96, 95% CI 1.51 to 2.54; eight trials, 3516 participants), pharmacotherapies (OR 1.98, 95% CI 1.26 to 3.11; five trials, 1092 participants), and multiple intervention programmes aimed mainly or solely at smoking cessation (OR 1.55, 95% CI 1.13 to 2.13; six trials, 5018 participants) all increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective (OR 1.16, 95% CI 0.74 to 1.82; six trials, 1906 participants), and two relapse prevention programmes (484 participants) did not help to sustain long-term abstinence. Incentives did not appear to improve the odds of quitting, apart from one study which found a sustained positive benefit. There was a lack of evidence that comprehensive programmes targeting multiple risk factors reduced the prevalence of smoking. AUTHORS' CONCLUSIONS 1. We found strong evidence that some interventions directed towards individual smokers increase the likelihood of quitting smoking. These include individual and group counselling, pharmacological treatment to overcome nicotine addiction, and multiple interventions targeting smoking cessation as the primary or only outcome. All these interventions show similar effects whether offered in the workplace or elsewhere. Self-help interventions and social support are less effective. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low.2. We failed to detect an effect of comprehensive programmes targeting multiple risk factors in reducing the prevalence of smoking, although this finding was not based on meta-analysed data. 3. There was limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer, although one trial demonstrated a sustained effect of financial rewards for attending a smoking cessation course and for long-term quitting. Further research is needed to establish which components of this trial contributed to the improvement in success rates.4. Further research would be valuable in low-income and developing countries, where high rates of smoking prevail and smoke-free legislation is not widely accepted or enforced.
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Affiliation(s)
- Kate Cahill
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK, OX2 6GG
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Sorensen G, McLellan D, Dennerlein JT, Pronk NP, Allen JD, Boden LI, Okechukwu CA, Hashimoto D, Stoddard A, Wagner GR. Integration of health protection and health promotion: rationale, indicators, and metrics. J Occup Environ Med 2013; 55:S12-8. [PMID: 24284762 PMCID: PMC4184212 DOI: 10.1097/jom.0000000000000032] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To offer a definition of an "integrated" approach to worker health and operationalize this definition using indicators of the extent to which integrated efforts are implemented in an organization. METHODS Guided by the question-How will we know it when we see it?-we reviewed relevant literature to identify available definitions and metrics, and used a modified Delphi process to review and refine indicators and measures of integrated approaches. RESULTS A definition of integrated approaches to worker health is proposed and accompanied by indicators and measures that may be used by researchers, employers, and workers. CONCLUSIONS A shared understanding of what is meant by integrated approaches to protect and promote worker health has the potential to improve dialogue among researchers and facilitate the research-to-practice process.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, Boston, MA
- Harvard School of Public Health, Boston, MA
| | | | | | - Nicolaas P. Pronk
- Harvard School of Public Health, Boston, MA
- HealthPartners, Inc., Minneapolis, MN
| | | | | | | | - Dean Hashimoto
- Partners HealthCare, Inc., Boston, MA
- Boston College Law School, Newton Centre, MA
| | | | - Gregory R Wagner
- Harvard School of Public Health, Boston, MA
- National Institute for Occupational Safety and Health, Washington, DC
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Workplace-Based Participatory Approach to Weight Loss for Correctional Employees. J Occup Environ Med 2013; 55:147-55. [DOI: 10.1097/jom.0b013e3182717cd4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Freak-Poli RLA, Wolfe R, Walls H, Backholer K, Peeters A. Participant characteristics associated with greater reductions in waist circumference during a four-month, pedometer-based, workplace health program. BMC Public Health 2011; 11:824. [PMID: 22024045 PMCID: PMC3262156 DOI: 10.1186/1471-2458-11-824] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 10/25/2011] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC) following participation in a four-month, pedometer-based, physical activity, workplace health program. METHODS 762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after) was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models. RESULTS Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a 'high-risk' baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to 'low risk' WC at the end of the program. CONCLUSIONS While employees with 'high-risk' WC at baseline experienced the greatest improvements in WC, the other variables associated with greater WC improvement were generally indicators of better baseline health. These results indicate that employees who started with better health, potentially due to lifestyle or recent behavioural changes, were more likely to respond positively to the program. Future health program initiators should think innovatively to encourage all enrolees along the health spectrum to achieve a successful outcome.
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Affiliation(s)
- Rosanne LA Freak-Poli
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Rory Wolfe
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Helen Walls
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Kathryn Backholer
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Anna Peeters
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
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Abstract
This study examines the exercise habits and perceived barriers to exercise of a convenience sample of 300 commercial truck drivers. Participants reported minimal amounts of exercise, with nearly 20% not exercising in the past week. A high prevalence of obesity was found in this sample: 93.3% of study participants had a body mass index (BMI) of 25 or higher. Drivers with BMIs of greater than 30 were significantly more likely to rate the exercise environment as terrible/bad. Drivers who had at least one health condition engaged in significantly less aerobic exercise, used fewer strengthening exercises, did not exercise for 30 minutes continuously, and had a higher BMI. Drivers who spent most of their off-duty time in their truck while their partner drove were also significantly more likely to not exercise regularly. Most drivers cited lack of time and place as the primary barriers to exercising. This study adds to the limited knowledge about exercise behaviors among commercial truck drivers.
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Turner LM, Reed DB. Exercise among commercial truck drivers. ACTA ACUST UNITED AC 2011; 59:429-36. [PMID: 21936482 DOI: 10.3928/08910162-20110916-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 07/07/2011] [Indexed: 11/20/2022]
Abstract
This study examines the exercise habits and perceived barriers to exercise of a convenience sample of 300 commercial truck drivers. Participants reported minimal amounts of exercise, with nearly 20% not exercising in the past week. A high prevalence of obesity was found in this sample: 93.3% of study participants had a body mass index (BMI) of 25 or higher. Drivers with BMIs of greater than 30 were significantly more likely to rate the exercise environment as terrible/bad. Drivers who had at least one health condition engaged in significantly less aerobic exercise, used fewer strengthening exercises, did not exercise for 30 minutes continuously, and had a higher BMI. Drivers who spent most of their off-duty time in their truck while their partner drove were also significantly more likely to not exercise regularly. Most drivers cited lack of time and place as the primary barriers to exercising. This study adds to the limited knowledge about exercise behaviors among commercial truck drivers.
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Affiliation(s)
- Lisa M Turner
- University of Kentucky, College of Nursing, Lexington, KY 40536, USA.
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Middlestadt SE, Sheats JL, Geshnizjani A, Sullivan MR, Arvin CS. Factors associated with participation in work-site wellness programs: implications for increasing willingness among rural service employees. HEALTH EDUCATION & BEHAVIOR 2011; 38:502-9. [PMID: 21482700 DOI: 10.1177/1090198110384469] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to identify factors underlying decisions to participate in work-site wellness programs. A sample of 279 full-time workers from a service division of a rural Midwestern university completed a survey assessing demographic and job characteristics, health status and health behaviors, and Reasoned Action Approach (RAA) variables for participating in work-site wellness activities. Regression analyses identified factors associated with intention; multivariate analyses of variance compared low to high intenders on salient beliefs. In sequential regression analyses, constructs of RAA predicted intention over and above the three significant background variables of age, exercise in past month, and fruit and vegetable consumption (R (2) = .469, R (2) change = .409, p < .001). Attitude had the highest relative weight (β = .445, p < .001); perceived norm had a significant weight (β = .273, p < .001). Significant differences in beliefs were found. To increase participation, planners should design programs that provide benefits employees perceive as advantageous and ensure coworker and supervisor support.
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Cherniack M, Henning R, Merchant JA, Punnett L, Sorensen GR, Wagner G. Statement on national worklife priorities. Am J Ind Med 2011; 54:10-20. [PMID: 20949545 PMCID: PMC5860803 DOI: 10.1002/ajim.20900] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The National Institute for Occupational Safety and Health (NIOSH) WorkLife Initiative (WLI) [http://www.cdc.gov/niosh/worklife] seeks to promote workplace programs, policies, and practices that result in healthier, more productive employees through a focus simultaneously on disease prevention, health promotion, and accommodations to age, family, and life stage. The Initiative incorporates the Institute's foundational commitment to workplaces free of recognized hazards into broader consideration of the factors that affect worker health and wellbeing. Workplace hazards, such as physical demands, chemical exposures, and work organization, often interact with non-work factors such as family demands and health behaviors to increase health and safety risks. New workplace interventions being tested by the first three NIOSH WLI Centers of WorkLife Excellence are exploring innovative models for employee health programs to reduce the human, social, and economic costs of compromised health and quality of life. Many parties in industry, labor, and government share the goals of improving employee health while controlling health care costs. NIOSH convened a workshop in 2008 with representatives of the three Centers of Excellence to develop a comprehensive, long-range strategy for advancing the WorkLife Initiative. The recommendations below fall into three areas: practice, research, and policy. Responding to these recommendations would permit the WorkLife Center system to establish a new infrastructure for workplace prevention programs by compiling and disseminating the innovative practices being developed and tested at the Centers, and elsewhere. The WLI would also extend the customary scope of NIOSH by engaging with multiple NIH Institutes that are already generating research-to-practice programs involving the working-age population, in areas such as chronic disease prevention and management. Research to Practice (r2p) is a concept focused on the translation of research findings, technologies, and information into evidence-based prevention practices and products that are adopted in the workplace or other "real-world" settings. NIOSH's goal is to overcome the translational issues that now prevent state-of-the-art occupational health, health promotion, and chronic disease research findings from benefiting working age populations immediately, regardless of workplace size, work sector, or region of the country.
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Affiliation(s)
- Martin Cherniack
- Center to Promote Health in the New England Workplace (CPH-NEW)
- Ergonomics Technology Center, University of Connecticut Health Center, Farmington, Connecticut
| | - Rob Henning
- Center to Promote Health in the New England Workplace (CPH-NEW)
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - James A. Merchant
- Department of Occupational and Environmental Health and Healthier Workforce Center for Excellence, University of Iowa, Iowa City, Iowa
| | - Laura Punnett
- Center to Promote Health in the New England Workplace (CPH-NEW)
- Department of Work Environment and Center for Women and Work, University of Massachusetts, Lowell, Lowell, Massachusetts
| | - Glorian R. Sorensen
- Center for Work, Health and Wellbeing, Harvard School of Public Health, and Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Gregory Wagner
- Harvard School of Public Health, Boston, Massachusetts
- National Institute for Occupational Safety and Health, Washington, District of Columbia
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Risk of Cardiovascular Disease and Diabetes in a Working Population With Sedentary Occupations. J Occup Environ Med 2010; 52:1132-7. [DOI: 10.1097/jom.0b013e3181f8da77] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Person AL, Colby SE, Bulova JA, Eubanks JW. Barriers to participation in a worksite wellness program. Nutr Res Pract 2010; 4:149-54. [PMID: 20461204 PMCID: PMC2867226 DOI: 10.4162/nrp.2010.4.2.149] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 04/07/2010] [Accepted: 04/07/2010] [Indexed: 11/04/2022] Open
Abstract
The purpose of this research was to determine barriers that prevent participation in an employee wellness program, Wellness Wednesdays: "Eat & Meet" About Healthy Living, conducted at East Carolina University (ECU) in Greenville, North Carolina. All ECU ARAMARK employees (n = 481) over the age of 18 were eligible to participate in the wellness program. Weekly 30 minute classes, taught by a Registered Dietitian, on various nutrition- and health-related topics were conducted for 10-weeks. Five question knowledge quizzes were administered to participants at the end of each class to determine the comprehension of material presented. Qualitative interviews (n = 19) were conducted with employees (participants and non-participants) and the program organizer after the completion of the 10-week program to identify barriers to program participation. A total of 50 (10.4% of the total number of potential participants) ECU ARAMARK employees, managers, and leadership team directors attended Wellness Wednesdays at least once during the 10-week program. Employees, on average, scored 71-100% on the weekly knowledge quizzes administered at the end of each class. The most common barriers to participation reported included (most often to least often reported): insufficient incentives, inconvenient locations, time limitations, not interested in topics presented, undefined reasons, schedule, marketing, health beliefs, and not interested in the program. Results showed that employee wellness programs can be effective in increasing knowledge of employees on nutrition- and health-related topics. However, program planning that addresses identified barriers including insufficient incentives, inconvenient locations, and time limitations may facilitate higher participation in future worksite wellness opportunities.
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Affiliation(s)
- Ashley Lynne Person
- Department of Nutrition and Dietetics, East Carolina University, Mail Stop 505, 333 Rivers Building, Greenville, NC 27858, USA
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Impact of workplace sociocultural attributes on participation in health assessments. J Occup Environ Med 2009; 51:797-803. [PMID: 19528837 DOI: 10.1097/jom.0b013e3181a4b9e8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the impact of sociocultural workplace attributes on participation in employer sponsored health assessments. METHODS Medical center employees were encouraged to participate in free, voluntary, and confidential biometric screening and on-line health risk appraisal. A job satisfaction database, aggregated by job type and work area, was used to identify workplace sociocultural attributes correlated with participation. RESULTS : Thirty-seven percent of the population engaged in the health assessments; however, participation varied widely by work area (10% to 83%) and by job type (17% to 56%). Participation was significantly correlated with selected aspects of job satisfaction. CONCLUSIONS Overall participation rates in employee population health assessments can disguise large variation in employee engagement. This variation is associated with work sociocultural characteristics. Attention to these attributes may be essential to improving involvement in employer sponsored health promotion.
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Carnethon M, Whitsel LP, Franklin BA, Kris-Etherton P, Milani R, Pratt CA, Wagner GR. Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association. Circulation 2009; 120:1725-41. [PMID: 19794121 DOI: 10.1161/circulationaha.109.192653] [Citation(s) in RCA: 182] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Neff RA, Palmer AM, Mckenzie SE, Lawrence RS. Food Systems and Public Health Disparities. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2009; 4:282-314. [PMID: 23173027 PMCID: PMC3489131 DOI: 10.1080/19320240903337041] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The United States has set a national goal to eliminate health disparities. This article emphasizes the importance of food systems in generating and exacerbating health disparities in the United States and suggests avenues for reducing them. It presents a conceptual model showing how broad food system conditions interplay with community food environments-and how these relationships are filtered and refracted through prisms of social disparities to generate and exacerbate health disparities. Interactions with demand factors in the social environment are described. The article also highlights the separate food systems pathway to health disparities via environmental and occupational health effects of agriculture.
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Affiliation(s)
- Roni A. Neff
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health and Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anne M. Palmer
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health and Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Shawn E. Mckenzie
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health and Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Robert S. Lawrence
- Center for a Livable Future, Johns Hopkins Bloomberg School of Public Health and Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Robroek SJ, van Lenthe FJ, van Empelen P, Burdorf A. Determinants of participation in worksite health promotion programmes: a systematic review. Int J Behav Nutr Phys Act 2009; 6:26. [PMID: 19457246 PMCID: PMC2698926 DOI: 10.1186/1479-5868-6-26] [Citation(s) in RCA: 281] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Accepted: 05/20/2009] [Indexed: 11/10/2022] Open
Abstract
Background The workplace has been identified as a promising setting for health promotion, and many worksite health promotion programmes have been implemented in the past years. Research has mainly focused on the effectiveness of these interventions. For implementation of interventions at a large scale however, information about (determinants of) participation in these programmes is essential. This systematic review investigates initial participation in worksite health promotion programmes, the underlying determinants of participation, and programme characteristics influencing participation levels. Methods Studies on characteristics of participants and non-participants in worksite health promotion programmes aimed at physical activity and/or nutrition published from 1988 to 2007 were identified through a structured search in PubMed and Web of Science. Studies were included if a primary preventive worksite health promotion programme on PA and/or nutrition was described, and if quantitative information was present on determinants of participation. Results In total, 23 studies were included with 10 studies on educational or counselling programmes, 6 fitness centre interventions, and 7 studies examining determinants of participation in multi-component programmes. Participation levels varied from 10% to 64%, with a median of 33% (95% CI 25–42%). In general, female workers had a higher participation than men (OR = 1.67; 95% CI 1.25–2.27]), but this difference was not observed for interventions consisting of access to fitness centre programmes. For the other demographic, health- and work-related characteristics no consistent effect on participation was found. Pooling of studies showed a higher participation level when an incentive was offered, when the programme consisted of multiple components, or when the programme was aimed at multiple behaviours. Conclusion In this systematic review, participation levels in health promotion interventions at the workplace were typically below 50%. Few studies evaluated the influence of health, lifestyle and work-related factors on participation, which hampers the insight in the underlying determinants of initial participation in worksite health promotion. Nevertheless, the present review does provide some strategies that can be adopted in order to increase participation levels. In addition, the review highlights that further insight is essential to develop intervention programmes with the ability to reach many employees, including those who need it most and to increase the generalizability across all workers.
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Affiliation(s)
- Suzan Jw Robroek
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
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Sorensen G, Quintiliani L, Pereira L, Yang M, Stoddard A. Work experiences and tobacco use: findings from the gear up for health study. J Occup Environ Med 2009; 51:87-94. [PMID: 19136877 DOI: 10.1097/jom.0b013e31818f69f8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the relationships between the work environment and amount smoked, intention to quit, and participation in a health promotion intervention. METHODS Cross-sectional data were collected from unionized truck drivers and dockworkers (N = 542; response rate = 78%) employed in eight trucking terminals as part of a larger intervention study targeting tobacco use cessation and weight management. RESULTS Prevalence of tobacco use was 40% (n = 216). Multivariable analyses of amount smoked and coworker norms encouraging cessation found significant associations with intention to quit and negative social consequences of tobacco use. Program participation was significantly associated with concern about job exposures, working the day shift, and intention to quit. CONCLUSIONS Work experiences represented in the social contextual model may help explain how the work environment affects tobacco-use behaviors and interest in quitting, and maybe guide interventions among blue-collar workers.
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Affiliation(s)
- Glorian Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Mass, USA.
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Abstract
BACKGROUND The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation. OBJECTIVES To categorize workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking or to reduce tobacco consumption. SEARCH STRATEGY We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2008, MEDLINE (1966 - April 2008), EMBASE (1985 - Feb 2008) and PsycINFO (to March 2008). We searched abstracts from international conferences on tobacco and the bibliographies of identified studies and reviews for additional references. SELECTION CRITERIA We selected interventions conducted in the workplace to promote smoking cessation. We included only randomized and quasi-randomized controlled trials allocating individuals, workplaces or companies to intervention or control conditions. DATA COLLECTION AND ANALYSIS Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the study was abstracted by one author and checked by another. Because of heterogeneity in the design and content of the included studies, we did not attempt formal meta-analysis, and evaluated the studies using qualitative narrative synthesis. MAIN RESULTS We include 51 studies covering 53 interventions in this updated review. We found 37 studies of workplace interventions aimed at individual workers, covering group therapy, individual counselling, self-help materials, nicotine replacement therapy and social support. The results were consistent with those found in other settings. Group programmes, individual counselling and nicotine replacement therapy increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective. We also found 16 studies testing interventions applied to the workplace as a whole. There was a lack of evidence that comprehensive programmes reduced the prevalence of smoking. Incentive schemes increased attempts to stop smoking, though there was less evidence that they increased the rate of actual quitting. AUTHORS' CONCLUSIONS 1. We found strong evidence that interventions directed towards individual smokers increase the likelihood of quitting smoking. These include individual and group counselling and pharmacological treatment to overcome nicotine addiction. All these interventions show similar effects whether offered in the workplace or elsewhere. Self-help interventions and social support are less effective. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low.2. There was limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer.3. We failed to detect an effect of comprehensive programmes in reducing the prevalence of smoking.
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Affiliation(s)
- Kate Cahill
- Department of Primary Health Care, University of Oxford, Rosemary Rue Building, Old Road Campus, Oxford, UK, OX3 7LF.
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Makrides L, Dagenais GR, Chockalingam A, LeLorier J, Kishchuk N, Richard J, Stewart J, Chin C, Alloul K, Veinot P. Evaluation of a workplace health program to reduce coronary risk factors. ACTA ACUST UNITED AC 2008. [DOI: 10.1108/14777270810867294] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Devine CM, Nelson JA, Chin N, Dozier A, Fernandez ID. "Pizza is cheaper than salad": assessing workers' views for an environmental food intervention. Obesity (Silver Spring) 2007; 15 Suppl 1:57S-68S. [PMID: 18073342 DOI: 10.1038/oby.2007.388] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE "Images of a Healthy Worksite" aims to provide easy access to healthful foods and to reduce sedentarism at the worksite-to prevent weight gain. Formative research for the nutrition intervention component was aimed at gaining a broad understanding of the sociocultural role of food and eating among workers and worker perspectives on socially feasible and culturally acceptable environmental intervention strategies. RESEARCH METHODS AND PROCEDURES Using an adapted PRECEDE health planning model, we conducted ecological, educational, environmental, and administrative assessments at the worksite. Through 15 in-depth interviews, five focus groups, and community mapping at two sites with 79 administrators, managers, workers, and food service personnel (51% men, 82% white), we assessed workers' perspectives on physical, sociocultural, economic, and policy environments. Data were coded for predisposing, enabling, and reinforcing factors related to intervention strategies in vending, cafeteria, catering, and informal food environments. After classification for reach, intensity, and sustainability, objectives and evaluation plans were developed for each highly ranked strategy. RESULTS Key sociocultural factors affecting food and eating included: stress-related eating in a downsizing workplace, enthusiasm for employer-sponsored weight gain prevention efforts that respect personal privacy, and the consequences of organizational culture on worker access to the food and eating environment. Workers supported healthier cafeteria and catering options, bringing healthful foods closer, and labeling of healthful options. DISCUSSION We provide a practical and systematic approach to formative research and assess the interrelatedness of the physical, policy, economic, and sociocultural factors that affect environmental worksite interventions to prevent weight gain among employees.
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Affiliation(s)
- Carol M Devine
- Division of Nutritional Sciences, Cornell University, 377 MVR, Ithaca, NY 14853-4401, USA.
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Drivas S, Rachiotis G, Vlastos FD, Zacharias C, Alexopoulos CG, Symvoulakis M, Vasiliou M, Behrakis PK. Occupational exposure to lignite and impact on respiratory system among heavy industry personnel. INDUSTRIAL HEALTH 2007; 45:409-14. [PMID: 17634690 DOI: 10.2486/indhealth.45.409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Objective is to evaluate the impact of occupational exposure to lignite dust on respiratory system. 103 blue-collar workers exposed to lignite dust and 62 controls completed a questionnaire on respiratory symptoms and underwent spirometry. Levels of lignite dust in workplace were measured. Univariate and multivariate analysis of the data were performed. The concentration of lignite dust varied from 0.6 to 1.4 mg/m3. Current smokers and workers exposed to lignite dust presented higher prevalence of chronic bronchitis symptoms and of FEV<80% and FEV1/FVC<70%. Multivariate analysis has shown that smoking and occupational exposure to lignite dust were independent predictors of chronic bronchitis symptoms, as well as of an obstructive ventilation pattern. Further analysis showed that exposed workers who were current smokers presented a five fold rate for developing an obstructive ventilation pattern in comparison to exposed workers non currently smokers. Occupational exposure to lignite dust and smoking were independent determinants of chronic bronchitis symptoms and obstructive ventilation pattern. There is some evidence for a combined effect of smoking and lignite dust exposure on respiratory system.
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Affiliation(s)
- Spyros Drivas
- Greek Institute for Occupational Safety and Health, Athens, Greece
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Sorensen G, Barbeau EM, Stoddard AM, Hunt MK, Goldman R, Smith A, Brennan AA, Wallace L. Tools for health: the efficacy of a tailored intervention targeted for construction laborers. Cancer Causes Control 2007; 18:51-9. [PMID: 17186421 DOI: 10.1007/s10552-006-0076-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2006] [Accepted: 08/27/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Novel approaches to worksite health promotion are needed for high-risk workers who change job sites frequently, and thus may have limited access to worksite health promotion efforts. The objective of this study was to test a behavioral intervention among construction laborers. METHODS Using a randomized-controlled design, we tested the efficacy of a tailored telephone-delivered and mailed intervention to promote smoking cessation and increased fruit and vegetable consumption (n = 582). RESULTS At baseline, 40% of control group participants and 45% of intervention group participants reported using any tobacco in the last seven days. At final, 8% of baseline cigarette smokers in the control group had quit, compared to 19% in the intervention group (p = 0.03). In both groups, the mean consumption of fruits and vegetables at baseline was over five servings per day. At final, the intervention group had increased consumption by approximately one and one-half servings, compared to a slight decrease in consumption in the control group (p < 0.001). CONCLUSIONS A tailored intervention can be efficacious in promoting tobacco use cessation and increased fruit and vegetable consumption among construction laborers, a high-risk, mobile workforce.
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Affiliation(s)
- Glorian Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, 44 Binney Street, SM258, Boston , MA 02115, USA.
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Chen YC, Wu YC, Chie WC. Effects of work-related factors on the breastfeeding behavior of working mothers in a Taiwanese semiconductor manufacturer: a cross-sectional survey. BMC Public Health 2006; 6:160. [PMID: 16787546 PMCID: PMC1538587 DOI: 10.1186/1471-2458-6-160] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2005] [Accepted: 06/21/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, the creation of supportive environments for encouraging mothers to breastfeed their children has emerged as a key health issue for women and children. The provision of lactation rooms and breast pumping breaks have helped mothers to continue breastfeeding after returning to work, but their effectiveness is uncertain. The aim of this study was to assess the effects of worksite breastfeeding-friendly policies and work-related factors on the behaviour of working mothers. METHODS This study was conducted at a large Taiwanese semiconductor manufacturer in August-September 2003. Questionnaires were used to collect data on female employees' breastfeeding behaviour, child rearing and work status when raising their most recently born child. A total of 998 valid questionnaires were collected, giving a response rate of 75.3%. RESULTS The results showed that 66.9% of survey respondents breastfed initially during their maternity leave, which averaged 56 days. Despite the provision of lactation rooms and breast pumping breaks, only 10.6% mothers continued to breastfeed after returning to work, primarily office workers and those who were aware of their company's breastfeeding-friendly policies. CONCLUSION In conclusion, breastfeeding-friendly policies can significantly affect breastfeeding behaviour. However, an unfavourable working environment, especially for fab workers, can make it difficult to implement breastfeeding measures. With health professionals emphasizing that the importance of breastfeeding for infant health, and as only females can perform lactation, it is vital that women's work "productive role" and family "reproductive role" be respected and accommodated by society.
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Affiliation(s)
- Yi Chun Chen
- School of Nutrition and Health Sciences, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan
| | - Ya-Chi Wu
- Division of Clinical Sciences, Center for Drug Evaluation, 1F, No15-1, Sec. 1, Hangjou S. Rd., Taipei 100, Taiwan
| | - Wei-Chu Chie
- Department of Public Health and Institute of Preventive Medicine, College of Public Health, National Taiwan University, room 520, No.17 Xu-Zhou Road, Taipei, 100, Taiwan
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Lund CH, Carruth AK, Moody KB, Logan CA. Theoretical Approaches to Motivating Change: A Farm Family Case Example. AMERICAN JOURNAL OF HEALTH EDUCATION 2005. [DOI: 10.1080/19325037.2005.10608197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Carole H. Lund
- a Nursing at Southeastern Louisiana University , SLU 10448, Hammond , LA , 70402 , USA
| | - Ann K. Carruth
- b Nursing and Healthy Farm Families Initiative at Southeastern Louisiana University , SLU 10835, Hammond , LA , 70402 , USA
| | - Karen B. Moody
- c Nursing at Southeastern Louisiana University , 4849 Essen Lane, Baton Rouge , LA , 70809 , USA
| | - Cynthia A. Logan
- d Nursing at Southern Louisiana University , 4849 Essen Lane, Baton Rouge , LA , 70809 , USA
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47
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Sorensen G, Barbeau E, Stoddard AM, Hunt MK, Kaphingst K, Wallace L. Promoting behavior change among working-class, multiethnic workers: results of the healthy directions--small business study. Am J Public Health 2005; 95:1389-95. [PMID: 16006422 PMCID: PMC1449371 DOI: 10.2105/ajph.2004.038745] [Citation(s) in RCA: 110] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the efficacy of a cancer prevention intervention designed to improve health behaviors among working-class, multiethnic populations employed in small manufacturing businesses. METHODS Worksites were randomly assigned to an intervention or minimal-intervention control condition. The intervention targeted fruit and vegetable consumption, red meat consumption, multivitamin use, and physical activity. RESULTS Employees in the intervention group showed greater improvements for every outcome compared with employees in the control group. Differences in improvement were statistically significant for multivitamin use and physical activity. Intervention effects were larger among workers than among managers for fruit and vegetable consumption and for physical activity. CONCLUSIONS The social-context model holds promise for reducing disparities in health behaviors. Further research is needed to improve the effectiveness of the intervention.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, Center for Community-Based Research, 44 Binney St, Boston MA 02115, USA.
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Bilodeau A, Filion G, Labrie L, Bouteiller D, Perreault M. [Is it possible to sustain health promotion programs in private companies? The case of four Quebec private companies of blue collar workers]. Canadian Journal of Public Health 2005. [PMID: 15850031 DOI: 10.1007/bf03403673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Sustained health promotion programmes in the workplace (HPPW) continues to be a public health challenge. This article presents an evaluation of the implementation and sustainability of such programmes in private blue-collar companies in Quebec to shed light on issues specific to this type of setting. METHOD A multiple case (4 sites), longitudinal (7 years) and interpretive study method was used. The interpretation framework considered that the implementation and sustainability of HPPW in companies are the result of organizational learning in health promotion, determined by the strategies of individuals in a position of control who shape the decisional processes related to these programmes. RESULTS After seven years of observation, two of the four sites had continued their HPPW, although these programmes were no longer applied within these companies. The health promotion organizational learning processes in both sites were defined according to targeted organizational purposes set by the decision-makers who supported HPPW. However, these gains were largely lost when HPPW were no longer retained as a component of their organizational development strategy. DISCUSSION The organizational conditions that are conducive to HPPW are difficult to put together and sustain in companies like those in our study. Businesses implement these programmes mainly for the organizational benefits they expect to reap in the short term, whereas improvement in the health of workers in the longer term is not a priority.
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Affiliation(s)
- Angèle Bilodeau
- Direction de santé publique, Agence de développement de réseaux locaux de services de santé et de services sociaux de Montréal, Montréal, Québec.
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Abstract
BACKGROUND The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation. OBJECTIVES To categorize workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking or to reduce tobacco consumption. SEARCH STRATEGY We searched the Cochrane Tobacco Addiction Group Specialized Register in October 2004, MEDLINE (1966 - October 2004), EMBASE (1985 - October 2004) and PsycINFO (to October 2004). We searched abstracts from international conferences on tobacco and we checked the bibliographies of identified studies and reviews for additional references. SELECTION CRITERIA We categorized interventions into two groups: a) Interventions aimed at the individual to promote smoking cessation and b) interventions aimed at the workplace as a whole. We applied different inclusion criteria for the different types of study. For interventions aimed at helping individuals to stop smoking, we included only randomized controlled trials allocating individuals, workplaces or companies to intervention or control conditions. For studies of smoking restrictions and bans in the workplace, we also included controlled trials with baseline and post-intervention outcomes and interrupted times series studies. DATA COLLECTION AND ANALYSIS Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the study was abstracted by one author and checked by two others. Because of heterogeneity in the design and content of the included studies, we did not attempt formal meta-analysis, and evaluated the studies using qualitative narrative synthesis. MAIN RESULTS Workplace interventions aimed at helping individuals to stop smoking included ten studies of group therapy, seven studies of individual counselling, nine studies of self-help materials and five studies of nicotine replacement therapy. The results were consistent with those found in other settings. Group programmes, individual counselling and nicotine replacement therapy increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective.Workplace interventions aimed at the workforce as a whole included 14 studies of tobacco bans, two studies of social support, four studies of environmental support, five studies of incentives, and eight studies of comprehensive (multi-component) programmes. Tobacco bans decreased cigarette consumption during the working day but their effect on total consumption was less certain. We failed to detect an increase in quit rates from adding social and environmental support to these programmes. There was a lack of evidence that comprehensive programmes reduced the prevalence of smoking. Competitions and incentives increased attempts to stop smoking, though there was less evidence that they increased the rate of actual quitting. AUTHORS' CONCLUSIONS We found: 1. Strong evidence that interventions directed towards individual smokers increase the likelihood of quitting smoking. These include advice from a health professional, individual and group counselling and pharmacological treatment to overcome nicotine addiction. Self-help interventions are less effective. All these interventions are effective whether offered in the workplace or elsewhere. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low. 2. Limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer. 3. Consistent evidence that workplace tobacco policies and bans can decrease cigarette consumption during the working day by smokers and exposure of non-smoking employees to environmental tobacco smoke at work, but conflicting evidence about whether they decrease prevalence of smoking or overall consumption of tobacco by smokers. 4. A lack of evidence that comprehensive approaches reduce the prevalence of smoking, despite the strong theoretical rationale for their use. 5. A lack of evidence about the cost-effectiveness of workplace programmes.
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Pechter E, Davis LK, Tumpowsky C, Flattery J, Harrison R, Reinisch F, Reilly MJ, Rosenman KD, Schill DP, Valiante D, Filios M. Work-related asthma among health care workers: surveillance data from California, Massachusetts, Michigan, and New Jersey, 1993-1997. Am J Ind Med 2005; 47:265-75. [PMID: 15712261 DOI: 10.1002/ajim.20138] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Asthma morbidity has increased, posing a public health burden. Work-related asthma (WRA) accounts for a significant proportion of adult asthma that causes serious personal and economic consequences. METHODS Cases were identified using physician reports and hospital discharge data, as part of four state-based surveillance systems. We used structured interviews to confirm cases and identify occupations and exposures associated with WRA. RESULTS Health care workers (HCWs) accounted for 16% (n = 305) of the 1,879 confirmed WRA cases, but only 8% of the states' workforce. Cases primarily were employed in hospitals and were nurses. The most commonly reported exposures were cleaning products, latex, and poor air quality. CONCLUSIONS Health care workers are at risk for work-related asthma. Health care providers need to recognize this risk of WRA, as early diagnosis will decrease the morbidity associated with WRA. Careful product purchasing and facility maintenance by health care institutions will decrease the risk.
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Affiliation(s)
- Elise Pechter
- Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, Massachusetts 02108, USA.
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