Non-participation in initial and repeated health risk appraisals - a drop-out analysis based on a health project

Impact of workforce characteristics and monetary incentives on uptake of health and wellbeing initiatives in the United Kingdom

There are economic and social benefits associated with promoting the health and wellbeing (HWB) of workers. The workplace is an important setting for HWB promotion, however, small and medium size enterprises (SMEs) are less likely to offer these programmes. Uptake is also uneven across demographic groups, contributing to inequalities outcomes. This study investigates if uptake of HWB promotion programmes in SMEs differs by employee demographics and if these factors interact with the effectiveness of organisational-level monetary incentives to improve uptake. In a secondary analysis of quantitative data from a cluster-randomised controlled trial, multilevel logistic regression models were fitted to examine the relationship between the outcome (uptake of HWB initiatives) and employee demographics (age, gender, ethnicity, education level). Models included interactions between the trial arm (monetary incentive or control) and employee demographics. Results showed that employees in the incentive arm had similar uptake of HWB initiatives compared to the control (adjusted OR 1.11, CI 0.72, 1.70, p = 0.64). In tests of the demographic factors, employees 55+ years had 56% lower odds of uptake (CI 0.25, 0.76, p = 0.003) compared to employees aged 17 to 24 years and these results were robust to treating age as a continuous variable. There were no statistically significant interactions between the incentive and the other employee demographic groups for the uptake of HWB initiatives. Organisational-level monetary incentives do not appear to differ in their effectiveness according to employee demographics, although some sub-groups appeared under-represented in the trial including ethnic minorities and those with education below degree-level. Older workers in SMEs may be less likely to engage in workplace HWB initiatives and could be targeted in terms of workplace HWB implementation, policy, and research.

In or out of reach? Long-term trends in the reach of health assessments in the Swedish occupational setting

OBJECTIVES

This study aimed to investigate the reach of a large-scale health assessment delivered by the occupational health service in Sweden for almost 30 years.

METHODS

A total of 418 286 individuals who participated in a health assessment (Health Profile Assessment, HPA) between 1995-2021 were included. A comparative sample was obtained from Statistics Sweden, comprising the entire working population for each year (4 962 127-6 011 829 unique individuals per time period). Sociodemographic and work organization characteristics were compared between the HPA and comparative population for six different periods. Under- and overrepresented groups in the private and public sectors were identified using the most recent data (2015-2021).

RESULTS

With negative per cent indicating underrepresentation, the most notable changes over time in representation in the HPA population compared to the comparative were observed for women (-1.2% to -12.8%), private sector employees (-9.4% to 14.9%), individuals with ≥3 years of employment (14.5% to 0.9%), in personal care (0.8% to -8.8%) and manufacturing (0.7% to 6.4%) occupations. Consistently overrepresented groups (median representation across periods) included individuals who had a single income source (6.3%) and were middle-aged (10.8%), born in Sweden (5.9%), associate professionals (8.7%), and employed in companies with high operating profit (17.9%) and low staff turnover (14.3%). Conversely, individuals with low income (-34.0%) and employed in small companies/organizations (-10.9%) were consistently underrepresented. Middle-aged women in education occupations were most underrepresented in the public sector, while in the private sector, it was young women in service and shop sales occupations.

CONCLUSIONS

This health assessment has reached many professionals, including hard-to-reach groups, but did not fully represents the Swedish workforce throughout the years.

Barrier profiles in workplace health promotion in Germany

Workplace health promotion (WHP) is often faced with low-participation rates despite high relevance. This limits the potential for creating positive effects for the organization and its staff. Therefore, we investigated the barriers perceived by employees themselves using a representative sample (regarding age, gender and education) in Germany. Data were collected using a quantitative online questionnaire and then analyzed regarding underlying patterns. We found that there are different barrier types, and their importance differs depending on demographic criteria of the participants and the organizations they work for. These results can help organizations to reduce participation barriers to WHP for their staff.

Which factors influence the frequency of participation in longitudinal cohort studies? - An analysis of demographics, social factors, and medical preconditions in participants of the health effects in high level exposure to polychlorinated biphenyls (HELPcB) cohort

The continuous drop out of participants in longitudinal studies is a trend that may be observed in nearly all fields of medical research. A reduced participation rate might compromise the power of statistical analysis as well as lead to an attrition bias of the study. The aim of this analysis was to identify influencing factors on participation frequency in the monitoring program Health Effects in High Level Exposure to polychlorinated biphenyls (HELPcB) study, a cohort investigation of occupationally polychlorinated biphenyls (PCB) exposed individuals. The HELPcB study was initiated in 2010 and consisted of 7 study visits. At the last cross-section in 2019, less than one third of the included patients still actively participated. As possible influencing factors on study participation frequency, demographic, social, and medical characteristics of the participants were examined. In addition, a logistic regression model to predict study participation behavior was calculated. An overall higher frequency of participation was observed, if participants joined the program together with relatives or friends and had a higher age. For PCB plasma levels, an exceedance of the biological reference value (BAR) and further factors, such as (1) professional qualification, (2) later inclusion, (3) type of participant and (4) occupational-related disease notification, significant differences in the participation frequency were observed in the univariate analysis. Only age and joined study participation remained significant in the multivariate logistic regression. In conclusion, it was possible to identify several social and occupational-related factors that influence the frequency of participation of study attendees.