Abstract
Background: Many employed Americans suffer from chronic conditions like obesity, diabetes, and cardiovascular diseases. Worksite wellness programs provide opportunities to introduce health promotion strategies. While there is evidence of the effectiveness of workplace health promotion, this is tempered by concern that benefits may be less available to low-wage workers with inflexible working conditions.Objective: The aim was to evaluate a workplace health promotion (WHP) in the long-term care sector (skilled nursing facilities).Methods: Nursing home employees from 18 facilities within a single company were surveyed by a standardized, self-administered questionnaire. A company-sponsored WHP program was offered to the facilities, which were free to take it up or not. We categorized the facilities by level of program adoption. Cross-sectional associations were estimated between program category and prevalence of individual-level worker health indicators, adjusting for center-level working conditions.Results: A total of 1,589 workers in 5 job categories completed the survey. Average levels of psychological demands and social support at work were relatively high. Supervisor support stood out as higher in centers with well-developed WHP programs, compared to centers with no programs. There were no differences among program levels for most health outcomes. Workers in centers with well-developed programs had slightly lower average body mass index and (unexpectedly) slightly lower prevalence of non-smoking and regular aerobic exercise.Conclusions: Only small health benefits were observed from well-developed programs and working conditions did not appear to confound the negative results. This low-intensity, low-resourced workplace health promotion program may have benefited a few individuals but seems to have had only modest influence on average levels of the measured health indicators. Many nursing home employees experience obstacles to health behaviors; approaches that provide more environmental and economic supports for healthy behaviors, such as Total Worker Health®, may yield larger health benefits.
Highlights
Most adults in the United States are employed and spend on average of 8.5 h per day in a work-related activity
Worksite health promotion (WHP) has been recognized as a public health strategy [2] and a number of large US employers offer some type of wellness programming as a part of their employees’ health benefits [3]
body mass index (BMI) was slightly lower among centers with well-developed, emerging, and unknown programs compared with none. This non-experimental study examined the association of a company-sponsored WHP in the long-term care sector with workers’ health indicators, health beliefs and behaviors, and work environment conditions
Summary
Most adults in the United States are employed and spend on average of 8.5 h per day in a work-related activity. WHP programs are typically intended to modify employee health behaviors in order to reduce risk for chronic health conditions. In the United States, the underlying premise of WHP is simple: A healthy workforce can be financially beneficial to the employer by lowering medical health care spending [8, 9]. Employers who initiate such programs are typically motivated by goals such as decreasing absenteeism, increasing job satisfaction, and reducing the cost of group health care coverage [9,10,11,12,13]. While there is evidence of the effectiveness of workplace health promotion, this is tempered by concern that benefits may be less available to low-wage workers with inflexible working conditions
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