Workplace health promotion and safety in state and territorial health departments in the United States: a national mixed-methods study of activity, capacity, and growth opportunities

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

Introduction

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

Methods

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

Results

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

Conclusion

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

Safety-Management Practices and the Occurrence of Occupational Accidents: Assessing the Mediating Role of Safety Compliance

This study examines the impact of critical safety-management practices on the occurrence of occupational accidents by means of safety compliance in Malaysia’s oil and gas industry. This study employed a cross-sectional design, in which data were collected from oil and gas downstream operations in five states within Malaysia using the convenience-sampling technique. The valid data of 280 responses were analyzed with Smart-PLS, and the structural-equation-modeling technique was applied. The study’s outcome revealed that safety-management practices (i.e., safety training, workers’ involvement, safety communication and feedback, management commitment to safety, safety-promotion policies, and safety rules and procedures) were significantly associated with occupational accidents via safety compliance. Thus, this study is helpful for practitioners and researchers to understand the importance of safety-management practices in reducing occupational accidents.

Partnerships to expand worksite wellness programs - A qualitative analysis of state and local health department perspectives

Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the U. S. Because the central mission of state and local health departments (HDs) is to protect, promote, and improve population health, these agencies are well-positioned to address risk behaviors for chronic disease. HD-employer partnerships could enhance worksite wellness programming, but few studies have explored this topic. Building upon previously published findings, the purpose of this qualitative study was to describe the context and environment for HDs' delivery of worksite wellness programs, including interest, barriers, facilitators, and decision-making processes. We conducted 12 interviews with directors of state chronic disease programs, 21 interviews with local directors, and three focus groups with local staff. We performed a thematic analysis of the data. Key themes include the following: (1) worksite wellness programs delivered by HDs were diverse in topic and scope and delivered both internally (at the HD for their agency) and externally (for other employers); (2) decisions made about chronic disease prevention were largely driven by funding priorities, with federal, state, and local entities playing roles in the decision-making process; and (3) HDs expressed potential interest in worksite wellness program delivery, dependent upon staff capacity, available funding, and employer buy-in. Our results suggest that funding should be increased for and reallocated towards chronic disease prevention, including worksite wellness. To overcome HD barriers to program delivery, key funders and stakeholders should prioritize and communicate the importance of worksite wellness.

Local Health Departments' Capacity for Workplace Health Promotion Programs to Prevent Chronic Disease: Comparison of Rural, Micropolitan, and Urban Contexts

OBJECTIVE

To examine local health department (LHD) contexts, capacity for, and interest in partnering with employers on workplace health promotion programs (WHPPs) for chronic disease prevention.

DESIGN

Qualitative interviews with LHD directors.

SETTING

LHDs from 21 counties in 10 states.

PARTICIPANTS

Twenty-one LHD directors.

MAIN OUTCOME MEASURESS

Experiences and perceptions of existing partnerships, decision making, funding, data needs, and organizational capacity for WHPP partnerships with employers.

RESULTS

We identified 3 themes: (1) LHDs see the value of partnering with employers but lack the capacity to do so effectively; (2) while LHDs base priorities on community need, funding ultimately drives decision making; and (3) rural, micropolitan, and urban LHDs differ in their readiness and capacity to work with employers.

CONCLUSIONS

Understanding LHDs' partnership capacity and context is essential to the successful implementation of WHPP partnerships with employers. Expanding these partnerships may require additional financial investments, particularly among rural LHDs.

Education and Training to Build Capacity in Total Worker Health®: Proposed Competencies for an Emerging Field

Objective:

Establishment of core competencies for education and training of professionals entering the emerging field of Total Worker Health®.

Methods:

Compilation and distillation of information obtained over a 5-year period from Total Worker Health symposia, workshops, and academic offerings, plus contributions from key stakeholders regarding education and training needs.

Results:

A proposed set of Total Worker Health competencies aligns under six broad domains: Subject Matter Expertize; Advocacy and Engagement; Program Planning, Implementation and Evaluation; Communications and Dissemination; Leadership and Management; and Partnership Building and Coordination.

Conclusions:

Proposed set of core competencies will help standardize education and training for professionals being trained in Total Worker Health. It serves as an invitation for further input from stakeholders in academia, business, labor, and government.

Using a Social Capital Framework to Explore a Broker's Role in Small Employer Wellness Program Uptake and Implementation

PURPOSE

Small employers, while motivated to implement wellness programs, often lack knowledge and resources to do so. As a result, these firms rely on external decision-making support from insurance brokers. The objective of this study was to analyze brokers' familiarity with wellness programs and to characterize their role and interactions with small employers.

DESIGN

Using a newly developed common interview guide (20 questions), protocol and analysis plan, 20 interviews were conducted with health insurance brokers in Illinois, Minnesota, North Carolina and Washington in 2016 and 2017. In addition to exploring patterns of broker interactions and familiarity by segment, we propose a framework to conceptualize the broker-client relationship using social capital theory and the RE-AIM model.

METHODS

Interviews were transcribed, summarized and a common codebook was established using DeDoose. Themes were identified following multi-rater coding and structured within the framework.

RESULTS

Participating brokers reported having a high to moderate familiarity with wellness programs (65%) and a majority (80%) indicated that they have previously advised their small business clients on the availability and features of them. Further, we find that brokers may help eliminate barriers to resources and act as a connector to wellness opportunities within their professional network.

CONCLUSION

New initiatives to promote small employer wellness programs can benefit from examining the influence of brokers on the decision-making process. When engaged and supported with resources, brokers may be effective champions for employer wellness programs.