Abstract

Background: The American Heart Association’s Workplace Health Achievement Index (WHAI) uses a data-driven, quality improvement approach to assist companies in evaluating the quality of their current workplace health policies and promote a culture of healthy living in the workplace. Objective: The objective of this study was to use the WHAI to: 1) describe changes in adoption of workplace health strategies and employee health over time, 2) assess longitudinal differences in performance between smaller (<250 employees) and larger companies (250+ employees), and 3) identify the most and least adopted strategies among smaller and larger companies. Methods: The WHAI score is derived from 55 structure and process (SP) measures across 7 best-practice domains and performance metrics based on employee Life’s Simple 7 (LS7) data. The initial data collection period was Feb 1 – Mar 31, 2016 and the follow-up round of data collection occurred Apr 1 – Mar 31, 2017. Data were stratified according to smaller (n=26) vs. larger (n=119) company size. SP measure frequencies were tabulated to identify the most and least frequently adopted strategies by company size. Differences were assessed using Kruskal-Wallis rank sum tests and Chi-Square tests as appropriate. Results: From 2016-2017, company enrollment increased 49%, from 667 to 992. An estimated 82% (812 of 992) completed all 55 SP questions, an increase of 240% from the previous year. In addition, 36% (297 of 825) companies submitted employee health data, up from 15% to 37%. The median WHAI score increased from 89 to 197 points (p<0.01; max points = 217), with larger companies achieving a greater increase (120 vs. 104; p<0.05). Regarding improvements to SP scores, smaller companies did not significantly improve (p= 0.10) whereas larger companies did (p<0.01). In 2017, the median Heart Health Score (range: 0-10 points) was 7.49, 7.20 for smaller and 7.74 for larger companies (p=<.01). Larger companies 82% (482 of 589) were more likely than smaller companies 59% (120 of 204) to provide adequate tobacco cessation coverage (p<0.01). Conversely, compared to larger companies (75%, 441 of 589), managers at smaller companies (82%, 167 of 204) were more likely to allow employees time off during the day to engage in physical activity (p<0.05). Implications: WHAI enrollment and reporting of employee health data improved over time., Tthis may reflect quality improvement efforts, the larger sample size, or a combination of both. While total scores increased overall, smaller companies did not significantly improve their SP scores. Results indicate there are differences in workplace health strategies adopted among smaller and larger companies. Customized resources and technical assistance may help each group to efficiently address the specific gaps identified through the WHAI.

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