Worksite Wellness Program Research Articles

How do employees feel their health is valued? a descriptive case study

PurposeA descriptive case study approach was adopted to examine employees' perceptions of the prevalence and usefulness of wellness programs. Relying on Centers for Disease Control and Prevention Health ScoreCard (CDC HSC), this study aims to assess the prevalence of worksite wellness programs, policies and benefits in general and incorporated employee perspectives to contextualize the CDC HSC wellness assessments.Design/methodology/approachThe authors first compared the CDC HSC assessments to evaluate the effectiveness of wellness programs in 20 select organizations. Follow-up employee interviews (n = 25) were conducted to contextualize the CDC HSC assessments.FindingsA variety of wellness programs are likely to increase employee engagement and participation when organizations adopt a bundling approach to combine wellness policies, incentives and an array of wellness programming opportunities that encourage and incentivize employees’ health promotion behaviors.Research limitations/implicationsFuture researchers might examine health metrics, in terms of dollars, doctor visits or biometrics before and after the implementation of a wellness program or paid wellness coordinator. Because this study interviewed employees and not members of executive leadership or finance and accounting, financial metrics were not available or the focus of this study. The inclusion of leaders and directors of wellness initiatives would offer additional ways for examining the impact of wellness initiatives on employee behaviors on organizational outcomes.Practical implicationsNutrition, weight management and chronic disease management were identified as major challenges impacting the health of employees. Even when organizations reported robust scores in their CDC HSC assessments, employers identified these three areas as critical for sustaining the health and well-being of their employees. Finally, the issue of employee safety was a top priority for all organizations regardless of how they scored on their CDC HSC assessments.Social implicationsThe authors suggest that when high-impact wellness practices are linked to organizational supports in the workplace, these efforts are likely to have more positive effects on both employee outcomes and organizational outcomes. A regular routine of checking on wellness issues can help keep potential problems from going unnoticed. An example of this is a reminder to stretch at a morning meeting or during work hours as a reminder to stay focused on health and well-being.Originality/valueThe authors aggregated the organizational assessments for different wellness interventions and compared the scores (falling above or below) with standardized CDC wellness scores. The incorporation of the CDC scorecard ensured a standardized and evidence-based evaluation of workplace wellness programs. This additional step informed the interview guide and follow-up with employees who offered recommendations for how organizations could enhance their wellness programs and policies.

COVID-19 Implications on Worksite Wellness Programming.

Seven of the top ten leading causes of death in the United States are due to chronic diseases and treating these accounts for 86 percent of our nation's health care costs. The workplace offers an environment to implement chronic disease prevention strategies, such as worksite wellness programs, due to the large amount of time spent at the worksite daily by employees. As a result of COVID-19, many organizations began to change their workdays (i.e., working from home). This research sought to understand what, if any, implications the COVID-19 epidemic had on worksite wellness programming. Semistructured interviews were employed and recorded via Zoom conferencing to gather qualitative data. Four themes were identified: (a) relationship building among remote employees, (b) creativity in how to carry out program components, (c) increased physical activity and work-life balance, and (d) increased knowledge of health issues and mental health resources. Both challenges and successes were reported within themes. The main finding from this research indicates a mostly positive experience for worksite wellness programs during the COVID-19 epidemic. Many organizations have continued nontraditional work environments and the lessons learned from this study can both encourage and provide ideas for how to create and continue a worksite wellness program outside of the normal face-to-face working environment.

Workplace Health Promotion Programs Available to Emergency Medical Services Clinicians in North Carolina

Background Emergency medical services (EMS) clinicians demonstrate a high prevalence of chronic medical conditions that place them at risk for early mortality. Workplace health promotion programs improve health outcomes, but the availably of such programs for EMS clinicians has not been described. We investigate the availability, scope, and participation of workplace health promotion programs available to EMS clinicians in North Carolina (NC). Methods We administered an electronic survey based on the Centers for Disease Control and Prevention Worksite Health ScoreCard to key representatives of EMS agencies within NC that provide primarily transport-capable 9-1-1 response with ground ambulances. We collected information on agency size, rurality, elements of health promotion programs offered, incentives for participation, and participation rate. We calculated descriptive statistics using frequency and percentage for worksite and health promotion program characteristics. We compared the participation rate for agencies who did and did not incentivize participation using Fisher’s exact test. Results Complete responses were received from 69 of 92 agencies (response = 75%) that collectively employ 6679 EMS clinicians [median employees per agency 71 (IQR 50–131)]. Most agencies (88.4%, 61/69) offered at least one element of a worksite health program, but only 13.0% (9/69) offered all elements of a worksite health program. In descending order, the availability of program elements were employee assistance programs (73.9%, 51/69), supportive physical and social environment (66.7%, 46/69), health education (62.3%, 43/69), health risk assessments (52.2%, 36/69), and organization culture of health promotion (20.3%, 14/69). Of agencies with programs, few (11.5%, 7/61) required participation, but most (59.0%, 36/61) offered incentives to participate. Participation rates were <25% among nearly all of the agencies that did not offer incentives, but >50% among most agencies that did offer incentives (p < 0.001). Conclusion While most agencies offer at least one element of a worksite health promotion program, few agencies offer all elements and participation rates are low.

Using experiential learning in undergraduate exercise science to provide university worksite wellness programs

Using experiential learning in undergraduate exercise science to provide university worksite wellness programs

Work related musculoskeletal symptoms; exposures and perception towards physiotherapeutic interventions at work setting in teachers and caregivers of special schools in Pune – a questionnaire based study

Background: Teachers and caregivers at special schools are at a risk of developing work related musculoskeletal disorders (WRMSDs) as they tend to work in awkward postures. It is important to identify musculoskeletal complaints and exposure levels to incorporate work site modifications to reduce risk of developing WRMSDs. Also understanding their perception towards physiotherapy might help in better implementation of worksite wellness programs. Methods: Participants were administered nordic musculoskeletal questionnaire (NMQ), quick exposure check (QEC) questionnaire and a self-designed questionnaire with five domains. Results: Out of the 66 participants, 36 were teachers and 30 were caregivers. Results of NMQ stated that, 20 participants reported to have pain. 50 participants had discomfort in the form of stiffness, fatigue. Assessment via QEC revealed, 39 participants were exposed at a lower level, followed by 22 and 5 who were exposed at moderate and higher level of the risk factors causing WRMSDs respectively. 26 participants were not engaged in regular physical activity. 26 participants had never been explained about safe and ideal ways to handle children with special needs in order to prevent WRMSDs. Conclusions: Musculoskeletal pain was predominantly in the lower back, shoulder/arms, and neck region. Almost 60% of participants were exposed at a lower level to the risk factors leading to WRMSDs. All of the participants stated that they would like to attend a training program by a physiotherapist regarding the same.

667-P: Enrollment Characteristics of Adults Aged 18–44 in the National Diabetes Prevention Program (National DPP)

The Centers for Disease Control and Prevention (CDC) estimates that 96 million adults aged 18 years or older had prediabetes in 2019. Of these, 32.2 million, or 33.5%, were aged 18-44, emphasizing the need for efforts to prevent or delay onset of type 2 diabetes within this population. CDC's National Diabetes Prevention Program (National DPP) is a partnership of public and private organizations collaborating to build a nationwide delivery system for a lifestyle change program (LCP) proven to prevent or delay the onset of type 2 diabetes in adults with prediabetes or at high risk. While the mean age of participants in the LCP is 51 years, 31.6% of the participants enrolled as of October 2022 were in the 18-44 age group. When examining the characteristics of this age group, 52.1% of participants identified as non-Hispanic or Latino White, 18.4% identified as Hispanic or Latino, and 12.9% identified as non-Hispanic or Latino Black or African American. Overall, 71.4% of participants in this group enrolled in an online program and 81% participated through a worksite wellness program. For those who had the opportunity to complete the year-long LCP, the mean number of days spent in the program was 110. By comparison, among 45-64-year-olds, the mean number of days spent in the program was 161, and for those 65 and older, the mean number of days was 210. This is of note because participants who stay in the LCP longer are more likely to meet the risk reduction outcomes. Participants 18-44 met the programmatic risk reduction 5% weight loss goal at a lower rate (18.4%) than participants aged 45-64 (27%) and 65 and over (40.2%). These findings highlight the opportunity to develop strategies focused on supporting this younger adult population to enroll in and complete the LCP. Disclosure M.Bell: None. M.Papalii: None. S.Van aacken: None. E.Ely: None.

Impact of Worksite Wellness Programs on Health-Related Outcomes in White Collar Workers-A Narrative Review

Worksite wellness programs are often implemented to increase work productivity and improve the health in employees however there is very little evidence on how effective these programs are. This review of literature aims to investigate the impact Worksite Wellness Programs have on the physiological and psychological health-related outcomes in white-collar workers. Electronic databases including PubMed Web of Science and CINAHL were screened. Publications between 2010 and 2020 were included. A total of nine studies were reviewed. Six out of nine studies showed positive improvements in physical health characteristics like BMI fat mass waist circumference occupational sitting time and step counts. Four out of nine studies showed significant differences in psychological outcomes like quality of life emotional exhaustion ruminative depression and other stress-related symptoms. No significant changes were found in job satisfaction performance and cognitive function. The study yielded mixed results regarding the impact of wellness programs on health outcomes. There exists strong evidence demonstrating the impact of Worksite wellness programs on major physiological outcomes such as BMI step counts waist circumference sitting time waist-to-hip ratio and blood pressure. Significant reductions in major psychological outcomes such as anxiety and depression were reported.

Dietary, Cooking, and Eating Pattern Outcomes from the Emory Healthy Kitchen Collaborative.

Context: Teaching kitchens are emerging innovative and engaging models for creating lifestyle behavior change. They are increasingly being utilized in workplace settings. Objective: The Emory Healthy Kitchen Collaborative (EHKC) year-long worksite wellness teaching kitchen program sought to improve self-reported health behaviors, including food choices, cooking skills, and mindful eating habits. Study Design and Analysis: This 12-month program included a 10-week didactic and experiential curriculum followed by continued support and access to health coaching. Participant t-tests were used to compare results at different time points. Setting: Emory worksite wellness program Population Studied: Forty benefits-eligible Emory employees aged 18-65, were recruited to participate in the EHKC. Preference was given to employees with elevated body mass index, co-morbid conditions, and high lifestyle change motivation levels. Intervention/Instrument and Outcome Measures: Self-assessment instruments were obtained at baseline, 3-months, 6-months and 12-months. This included the 8-item Starting the Conversation (STC) food frequency instrument, eight questions from a 17-item cooking frequency and confidence questionnaire, and a 28-item mindful eating questionnaire. Results: Between May 30 - June 30, 2019, 40 benefits-eligible Emory employees were enrolled in the EHKC. Dietary eating patterns improved significantly throughout the duration of the program year, as measured by the STC. The largest improvement in STC occurred from baseline to three months (mean: - 2.18, standard deviation: 2.35, p-value: p=0.002). Although cooking frequency and confidence trended towards improvement, there were no significant changes. The mindfulness eating questionnaire improved significantly at 3-months (0.27, 0.32, p<0.001), 6-months (0.23, 0.33, p<0.001), and 12 months (0.33, 0.28, p<0.001), as compared to baseline. Conclusion: The EHKC worksite wellness program provided valuable knowledge and insight into the use of a teaching kitchen as a unique health care delivery model. The program significantly improved participant dietary patterns and mindful eating habits; though did not significantly improve cooking confidence or frequency. Further research is needed to understand long term health consequences and disease risk reduction of the EHKC program.

Rationale for participation in university worksite wellness programs

Objective: To understand the wellness needs of university employees to design more effective and inclusive worksite wellness programs (WWP) for health promotion. Methods: Cross-sectional assessment of university employees’ wellness needs (online survey, n = 639). Results: Employees were most interested in physical activity (PA), nutrition, and lifestyle WWP. Principal barriers to participation were time, scheduling, location, motivation, and confidentiality concerns. Significant correlations exist between having a diagnosed health condition and the likelihood of participating in related programs. 67.1% of past participation was predicted by (1) health status today versus last year, (2) use of university recreational facilities, (3) gender, (4) general health status, (5) PA in the past month, (6) faculty/staff, and (7) age. Conclusions: Our findings contribute to building a road map of how-to better design university WWP based on understanding participation predictors, barriers/facilitators, and the influence of health status/conditions on topics of interest/participation. Tailoring WWP to meet employees’ needs may increase reach, engagement and promote a health culture.

Virtual Reality and Powerpoint Grocery Store Tours: Equally Effective in Improving Self-efficacy in Randomised Control Trial.

Compare computer-based virtual reality (CBVR) and voice-over PowerPoint (PP) grocery store tours (GST) on adult nutrition literacy (NL) and healthful food purchasing self-efficacy (HFPSE). Participants (n = 68) recruited from University worksite wellness program and randomly assigned to CBVR or PP (CBVR = 35; PP = 33). Four-week culinary/nutrition education program. Initial three weeks provided identical education for both groups. Week four implemented GST intervention using CBVR or PP. NL and HFPSE surveys before, after, and three-months post from the start of program. Intent-to-treat (ITT) analysis with RMANOVA (95% confidence intervals [CI] and effect sizes) to examine change in NL and HFPSE between CBVR and PP groups over 4-week intervention and 3-month retention period. 43 of 68 participants [CBVR (n = 19) and PP (n = 24)] were included in analyses. Both groups significantly improved HFPSE over time (P<.001, CBVR = 46.23% PP = 33.34%), but there were no differences between groups (P = .21) or group by time interaction (P = .31). NL did not change for either group (P = .83, CBVR = 1.11%; PP = .12%) nor were there differences between groups (P = .07). CBVR and PP GST significantly improved and maintained higher HFPSE scores.

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.

Incidence and Risk for Hypertension among Regular Medical Examination Attendee Cohort in an Automobile Industry. A Cox- Regression Analysis Model.

Introduction:With nearly 1,612,505 industrial workers in Karnataka, controlling hypertension among them is necessary to reduce subsequent non-communicable diseases (NCDs). However, information on prevalence, incidence, and risk for hypertension among industrial workers is limited.Objectives:To estimate the prevalence, incidence proportion, incidence rate, and risk for hypertension among annual medical examination [AME] attendee cohort between 2010 and 2014 in an automobile industry in India.Materials and Methods:Longitudinal record analysis (cohort approach) of 640 regular AME attendees between 2010 and 2014 was performed to estimate incidence and incidence rates. Cox regression was conducted to estimate the risk for hypertension in the study period. Necessary permission and ethics clearance was obtained.Results and Conclusion:The prevalence of hypertension significantly increased from 8.8% in 2010 to 26.6% in 2014. The small increase in mean blood pressure (BP) resulted in large increases in the prevalence of hypertension. The incidence rate increased from 6.5 per 1000 person-months of observation in 2012 to 14.5 in 2014. No significant risk for hypertension was observed for the work department and type of plant. Results indicate a rising burden of hypertension with no specific risks associated with different work departments or types of plants. AME data is a utility value to monitor hypertension trends among employees and evaluate the effectiveness of worksite health programs to reduce hypertension.

Adoption and Implementation Barriers for Worksite Health Programs in the United States.

Worksite health promotion programs have been identified as having the potential to mitigate chronic health risks. In the most recent 2017 U.S. CDC survey of workplace health promotion, respondents identified several perceived barriers related to program adoption and implementation. The analysis indicates that challenges negatively associated with having worksite program were lack of senior management support (OR = 0.50, 95% CI: 0.32–0.78), lack of qualified vendors (OR = 0.56, 95% CI: 0.4–0.79), lack of qualified personnel (OR = 0.56, 95% CI: 0.35–0.73), and cost (OR = 0.58, 95% CI: 0.39–0.88). Challenges associated with having a program were lack of employee interest (OR = 2.09, 95% CI = 1.44–3.03), lack of space (OR = 1.76, 95% CI: 1.26–2.48), and demonstrating program results (OR = 2.09, 95% CI = 1.44–3.03). These findings can provide insights to policy makers, insurers, and employers seeking to implement workplace-based health promotion initiatives.

Discover Wellness: A Worksite Wellness Program for Higher Education

Sixty percent of adults in the United States suffer from chronic disease. Worksite wellness programs that target at-risk populations have positive health benefits. Discover Wellness: Find a Healthier You (DW) is a worksite wellness program intended to improve the higher education employee health by providing an opportunity for participants to learn and practice healthy behaviors. The purpose of this study was to evaluate DW program impact on employee behavior change to reduce chronic disease risk. This study employed a pretest-posttest quasi-experimental design that assessed self-efficacy and health behaviors of employees of a state university in the northeast United States. Participants experienced significant improvement in stress (t23 = -31.602, p &lt; 0.001), nutrition (t21 = -36.313, p &lt; 0.001), physical activity (t22 = -34.380, p &lt; 0.001), and sleep (t23 = -18.450, p &lt; 0.001). Additionally, anecdotes from participants revealed themes of comradery and reflection on health behaviors.

Effectiveness of workplace wellness programmes for dietary habits, overweight, and cardiometabolic health: a systematic review and meta-analysis

SummaryBackgroundThe workplace offers a unique opportunity for effective health promotion. We aimed to comprehensively study the effectiveness of multicomponent worksite wellness programmes for improving diet and cardiometabolic risk factors.MethodsWe did a systematic literature review and meta-analysis, following PRISMA guidelines. We searched PubMed-MEDLINE, Embase, the Cochrane Library, Web of Science, and Education Resources Information Center, from Jan 1, 1990, to June 30, 2020, for studies with controlled evaluation designs that assessed multicomponent workplace wellness programmes. Investigators independently appraised the evidence and extracted the data. Outcomes were dietary factors, anthropometric measures, and cardiometabolic risk factors. Pooled effects were calculated by inverse-variance random-effects meta-analysis. Potential sources of heterogeneity and study biases were evaluated.FindingsFrom 10 169 abstracts reviewed, 121 studies (82 [68%] randomised controlled trials and 39 [32%] quasi-experimental interventions) met the eligibility criteria. Most studies were done in North America (57 [47%]), and Europe, Australia, or New Zealand (36 [30%]). The median number of participants was 413·0 (IQR 124·0–904·0), and median duration of intervention was 9·0 months (4·5–18·0). Workplace wellness programmes improved fruit and vegetable consumption (0·27 servings per day [95% CI 0·16 to 0·37]), fruit consumption (0·20 servings per day [0·11 to 0·28]), body-mass index (−0·22 kg/m2 [−0·28 to −0·17]), waist circumference (−1·47 cm [−1·96 to −0·98]), systolic blood pressure (−2·03 mm Hg [−3·16 to −0·89]), and LDL cholesterol (−5·18 mg/dL [−7·83 to −2·53]), and to a lesser extent improved total fat intake (−1·18% of daily energy intake [−1·78 to −0·58]), saturated fat intake (−0·70% of daily energy [−1·22 to −0·18]), bodyweight (−0·92 kg [−1·11 to −0·72]), diastolic blood pressure (−1·11 mm Hg [−1·78 to −0·44]), fasting blood glucose (−1·81 mg/dL [−3·33 to −0·28]), HDL cholesterol (1·11 mg/dL [0·48 to 1·74]), and triglycerides (−5·38 mg/dL [−9·18 to −1·59]). No significant benefits were observed for intake of vegetables (0·03 servings per day [95% CI −0·04 to 0·10]), fibre (0·26 g per day [−0·15 to 0·67]), polyunsaturated fat (−0·23% of daily energy [−0·59 to 0·13]), or for body fat (−0·80% [−1·80 to 0·21]), waist-to-hip ratio (−0·00 ratio [−0·01 to 0·00]), or lean mass (1·01 kg [−0·82 to 2·83]). Heterogeneity values ranged from 46·9% to 91·5%. Between-study differences in outcomes were not significantly explained by study design, location, population, or similar factors in heterogeneity analyses.InterpretationWorkplace wellness programmes are associated with improvements in specific dietary, anthropometric, and cardiometabolic risk indicators. The heterogeneity identified in study designs and results should be considered when using these programmes as strategies to improve cardiometabolic health.

P50 Exploring the Experiences of Registered Dietitian Nutritionists (RDNs) who Educate Through Cooking and Food Preparation

<h3>Background</h3> Registered Dietitian Nutritionists (RDNs) often provide guidance on preparing healthy meals. Although food science and culinary skills are addressed in coursework to become a RDN, those involved in nutrition education do not universally incorporate hands-on cooking in their practice. Cooking skills, knowledge and confidence have declined among the public, while rates of obesity and chronic disease are on the rise. RDNs can play a central role in teaching essential cooking skills and food-related knowledge. This calls for exploration on the perspectives and characteristics of RDNs drawn to culinary education. Few studies have investigated the personal experiences and viewpoints of RDNs involved in teaching the public how to cook. <h3>Objective</h3> To explore the perspectives of RDNs who teach cooking and food preparation, to better understand their experiences learning to cook and teaching others. Cooking-related knowledge/skills perceived as lacking among the public and necessary to perform their role are compared with competencies outlined by the Academy of Nutrition and Dietetics' Food and Culinary Professionals (FCP) Dietetic Practice Group. <h3>Study Design, Setting and Participants</h3> The research design is cross-sectional and qualitative. Face-to-face semi-structured interviews are conducted remotely via Microsoft Teams. A convenience sample is recruited from community settings, including private practice, worksite wellness, supermarkets, Expanded Food and Nutrition Education Program, and SNAP-Ed. <h3>Analysis</h3> Interviews are recorded, transcripts are coded, and recurring themes are summarized. <h3>Results</h3> Analysis of pilot data (n = 14) on experiences learning to cook indicate cooking at home with parents while growing up, food science coursework, and personal interest in cooking. Emerging themes mirrored several FCP competencies, including communication skills, knife skills, ingredient substitution, time management, meal planning and food safety. <h3>Conclusion</h3> This pilot study examines the perspectives of RDNs who teach hands-on cooking, thereby providing insights on the competencies needed to teach others and best serve the public. Our findings merit research with a larger sample to further compare with FCP competencies, and potentially inform dietetics education programs preparing students for careers as RDNs.

SHAREABLE RESOURCE

Grace T. DeSimone, B.A., ACSM-CPT, ACSM-GEI,is the national group fitness director for Optum. She and her group fitness teams manage group exercise classes in worksite wellness programs across the country. She is the editor for ACSM’s Resource Manual for Group Exercise Instructors (2011) and is the 2016 IDEA Health & Fitness Association Program Director of the Year. She holds a Bachelor of Arts degree in Dance from Hunter College, City University of New York, NY, and is an ACSM Certified Group Exercise Instructor® and an ACSM Certified Personal Trainer®.

Dietary and behavior changes following RDN-led corporate wellness counseling: A secondary analysis.

Worksite wellness programs have the ability to activate health promotion and stimulate behavior change. To measure longitudinal associations between visits with a Registered Dietitian Nutritionist (RDN), as part of worksite wellness programs, on dietary and lifestyle behavior changes. The study sample included 1,123 employees with 77 different worksite wellness programs across the United States from March to December 2017. Hierarchical linear modeling was used to evaluate the associations of RDN visits with behavior changes. The mean BMI at baseline was 33.48, indicating over half of all employees are considered obese. Employees who attended more than one visit showed an increase in whole grain consumption and corresponding weight loss (t-ratio = 2.41, p = 0.02). Age played a significant factor in the rise of systolic blood pressure; employees who attended more visits showed an increase in whole grain consumption and corresponding blood pressure (t-ratio = -2.11, p = 0.04). RDNs as part of worksite wellness programs, can contribute to improvements in lifestyle behavior changes. These data highlight the need for nutrition intervention at the workplace. Research on nutrition-focused worksite wellness programs is needed to assess the long-term health outcomes related to dietary and lifestyle behavior changes.

Development and validation of a diabetes risk score among two populations

The purpose of this study was to assess the validity of a practical diabetes risk score amongst two heterogenous populations, a working population and a non-working population. Study population 1 (n = 2,089) participated in a large-scale screening program offered to retired workers to discover previously undetected/incipient chronic illness. Study population 2 (n = 3,293) was part of a Colorado worksite wellness program health risk assessment. We assessed the relationship between a continuous diabetes risk score at baseline and development of diabetes in the future using logistic regression. Receiver operating curves and sensitivity/specificity of the models were calculated. Across both study populations, we observed that participants with diabetes at follow-up had higher diabetes risk scores at baseline than participants who did not have diabetes at follow-up. On average, the odds ratio of developing diabetes in the future was 1.38 (95% CI: 1.26–1.50, p < 0.0001) for study population 1 and 1.68 (95% CI: 1.45–1.95, p-value < 0.0001) for study population 2. These findings indicate that the diabetes risk score may be generalizable to diverse individuals, and thus potentially a population level diabetes screening tool. Minimally-invasive diabetes risk scores can aid in the identification of sub-populations of individuals at risk for diabetes.

A Corporate Wellness Program and Nursing Home Employees' Health.

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.