Worksite Wellness Program Research Articles

Pharmacist-led motivational interviewing for diabetes medication adherence in a worksite wellness program

ObjectiveThe primary objective was to evaluate the impact of a pharmacist-delivered motivational interviewing (MI) intervention for diabetes medication adherence; the secondary objectives were to assess the changes in clinical outcomes and health-related quality of life (HRQoL). MethodsA quasi-experimental intervention study was conducted with baseline, postintervention, and follow-up data collections. The study duration was 6 months. Pharmacists trained in MI delivered 3 face-to-face encounters using MI-based semistructured conversation tools to address barriers or challenges to medication adherence. A diabetes worksite wellness program (WWP) at a 350-bed regional hospital in the southeastern United States was the setting, and the study participants were WWP employees or dependents (with type 1 diabetes or type 2 diabetes). The primary outcome was a change in self-reported diabetes medication adherence; the secondary outcomes included the changes in clinical indicators (glycated hemoglobin [HbA1c], blood pressure, and depressive symptoms), and HRQoL. The measures included the Medometer, Summary of Diabetes Self-Care Activities–Medication Subscale (SDSCA-MS), Audit of Diabetes-Dependent QoL (ADDQoL-19), and the Short Form–12 (SF-12) health survey. ResultsFifty-three WWP participants enrolled, and 36 completed the full intervention protocol. Medication adherence (through the Medometer) demonstrated statistically significant improvement after the intervention (P = 0.010); the SDSCA-MS score improved, but was not statistically significant. The change in diastolic blood pressure was statistically significant (P = 0.034), but the changes in HbA1c, systolic blood pressure, presence of depressive symptoms, and ADDQoL-19 were not statistically significant. The SF-12 physical component summary (PCS) and mental component summary (MCS) scores were statistically significant: PCS, P = 0.003, and MCS, P = 0.025. ConclusionThe findings from this pilot study support the effectiveness of a pharmacist-delivered, semistructured MI-based intervention for medication adherence in persons with diabetes in a hospital-based WWP. Pharmacists can support patients’ behavior change using MI communication skills to explore salient barriers to medication adherence and to facilitate goal setting to overcome these in encounters aimed at shared clinical and behavioral decision-making.

A Total Worker Health Approach to Skin Exposure Assessment: Experiences from the Firefighter Cancer Initiative.

Increasing scientific evidence suggests that addressing complex, wide-ranging concerns among worker populations should include the integration of traditional occupational safety and health with often siloed worksite wellness programs. The Total Worker Health (TWH) approach developed by the National Institute for Occupational Safety and Health can support skin cancer prevention efforts by integrating organizational-level policies, programs, and practices that strategically merge both skin protection from work-related safety and health hazards with promotion of skin illness prevention efforts. In the firefighter workforce, epidemiologic studies suggest an increased risk of skin cancer despite the use of personal protective equipment during fire incident response. Mechanisms for dermal absorption of carcinogenic compounds such as polycyclic aromatic hydrocarbons have given insight into how these hazardous chemicals can enter the skin and increase cancer risk. Mitigation of carcinogenic exposures requires a TWH approach that merges skin protection and promotion, routine surveillance, skin health assessment, worksite-based interventions, and regular evaluation of program activities. In this commentary, an example of a TWH approach is provided from the Firefighter Cancer Initiative (FCI), a transdisciplinary initiative focused at addressing excess burden of cancer in the firefighter workforce. The FCI builds on the TWH approach through the following components: (i) organizational leadership commitment; (ii) elimination of workplace hazards and promotion of worker well-being; (iii) engagement of workers in program design and delivery; (iv) ensuring confidentiality and privacy in program participation; and (v) integrating systems effectively. Occupational hygienists have strong potential to play a crucial role beyond traditional risk assessment, exposure assessment, and health protection that further includes skin health promotion and integration of related programs into a TWH framework.

Association Between Walking, Sedentary Behavior, and Weight Changes of Female University Employees Who Were Overweight or Obese

Abstract Objectives Increased physical activity and decreased sedentary time are associated with reduced risk of cardiometabolic disease. The aim of this study was to examine the associations between changes in weight, and walking and sitting time of female employees with overweight or obesity enrolled in a university-based worksite wellness program (WWP). Methods This was a secondary analysis of existing data from the WWP. Descriptive statistics, paired sample t-tests, and the Mann-Whitney U test were used to analyze data from 163 female participants. When comparing participants who lost weight and gained weight, the associations between the changes in walking and sitting times from baseline to 26 weeks post-intervention were analyzed. Results Participants’ mean age was 49.16 ± 10.84 years; 46.60% (n = 76) were white, non-Hispanic (n = 76). Of the 64.40% (n = 105) who lost weight, mean weight loss = 4.11 ± 8.44 pounds after 26 weeks. Those who lost weight increased total walking time by 37.79 minutes/week while the weight gain group (n = 54) decreased total walking time by 52.03 minutes/week (P = 0.01). Those who lost weight decreased sitting time by twice as much (–54.4 vs −23.0 minutes/day, P = 0.11) and increased total moderate-vigorous physical activity time by more than 8 times compared to participants who gained weight (+35.0 vs −4.4 minutes/week, P = 0.07). Conclusions In this sample of female university employees who completed 26 weeks of a WWP, those who lost weight had greater increases in walking time and moderate-vigorous physical activity time and decreases in sitting time compared to those who gained weight. The clinical relevance of the results support the need for prospective research with a larger sample size and objective measures of physical activity is needed to explore the clinical effect of reducing sitting time and engaging in higher intensity physical activity on weight change. Funding Sources Rutgers School of Health Professions Department of Clinical and Preventive Nutrition Sciences.

Financial Well-Being Program Development

Background: The impact of financial well-being on health is significant. Research connects individual and organizational well-being to the strength of financial knowledge and sound finance practices among employees. Learning more about financial topics is critical for comprehensive well-being yet few articles exist which describe implementation of such initiatives within organizations.Aim: While traditional worksite wellness programs have emphasized physical activity, stress management and nutrition, an increasingly larger number of organizations want to expand beyond those categories to topics such as community health and financial well-being.Methods: A Midwestern research-intensive university has offered financial well-being programs for faculty and staff over the last three years. A description of the initiative, and each programming effort, is included within this article.Results: Numerous positive, qualitative outcomes have been experienced by program participants.Conclusions: Learn more about the evidence and practical efforts easily implemented within higher education institutions through this description of one university’s program experience and outcomes.

A Model for Developing Comprehensive Initiatives to Improve the Health of the Worksite: The WorkWell KS Strategic Framework.

Background: Worksite wellness programs that target individual employees, rather than worksites, have demonstrated limited long-term success. The purpose of this overview was to describe the theoretical basis for implementing an effective worksite wellness initiative, WorkWell Kansas (WorkWell KS). WorkWell KS is not a traditional worksite wellness initiative, as its goal is to create healthy worksites, rather than target workers. Methods: The WorkWell KS Strategic Framework is based on academic research that identified successful worksite wellness elements that produce sustainably healthy worksites. The curricula were built around the 3-4-80: three modifiable behaviors (tobacco use, poor access to nutritious foods and beverages, and physical inactivity) contribute to at least four chronic diseases (heart disease, type II diabetes, lung disease, and some cancers), which in turn contribute to approximately 80% of the premature deaths in the United States. Findings: To properly address these modifiable behaviors, the WorkWell KS Strategic Framework was developed to guide worksites to first build a solid worksite wellness foundation, which consists of five elements: the wellness committee, exercising leadership, communications, incentives, and data. Once built, worksites are then encouraged to employ a socio-ecological approach to developing a comprehensive, multi-strategy (information, program, benefit design, policy, and environment) intervention, focusing on one health behavior at a time. Conclusions/Application to Practice: The goal of WorkWell KS was to create healthy worksites, which creates environments for employees to practice these healthy behaviors. Worksite wellness committees, occupational health professionals, and others interested in altering health behaviors at worksites have an opportunity to reframe their approach using this framework.

Employees’ Refusals to Participate in an Employer-Sponsored Wellness Program: Barriers and Benefits to Engagement

While worksite wellness programs are generally designed to help employees realize better overall health, some employees may not see them in that light. The current study sought to better understand why employees refuse to participate in a new employer-sponsored wellness program. This study also investigated how participation in the program is related to employees’ self-perceived health, efficacy to be healthier and their perceptions toward their organization providing useful resources to engage in a healthy lifestyle. A survey of more than 1,500 employees at a large Midwest organization was conducted after their annual open-enrollment period. Open-ended responses from participants refusing to participate in the wellness program ( n = 297) indicated privacy considerations as their primary concern. They also thought participation would take too much time, conceptually thought the program was unfair or not useful and felt they were already healthy and not in need of the program. Both participants and nonparticipants had no differences in self-perceived overall health. However, participants had greater self-efficacy, and perceptions that their employer offered useful resources to engage in a healthy lifestyle, than nonparticipants. Recommendations for communicating new wellness programs to employees are discussed.

Make Your Move Experience: A Worksite Wellness Pilot in South Texas.

To describe the implementation of Make Your Move Experience (MYME) between 2015 and 2017. Cross-sectional. Make Your Move Experience is a culturally sensitive worksite wellness program in South Texas designed to encourage sedentary workers to engage in physical activity. In total, 681 individuals from 19 different organizations. UTHealth School of Public Health in Brownsville staff recruited individuals within local organizations to join MYME. At the end of the 3 months, organizations in which employees met MYME goals earned an incentive-bike rack or hydration station-selected to be permanent features of the local environment and facilitate physical activity. Participant self-reported gender, physical activity level prior to joining MYME (beginner or experienced), and weekly miles of biking, walking, or running completed. Mean number of miles biked, walked, and ran each month were compared between (1) beginners and experienced, (2) men and women, and (3) in fall 2016 and spring 2017 using t tests. Beginners initiated physical activity by walking. Men biked more miles than women did (P < .05 all 3 years). Bike riders cycled fewer miles (20.2 miles vs 44.9 miles; P = .03) and walkers covered fewer miles (195.4 miles vs 266.7 miles; P = .04) in fall 2016 compared to spring 2017. Participation in MYME, a culturally appropriate intervention delivered at the worksite, facilitated an increase in physical activity levels among sedentary individuals.

The Business Case for Investing in Place-Based Public Health Initiatives

The Business Case for Investing in Place-Based Public Health Initiatives

Dietary and Lifestyle Behavior Changes from Voluntary Worksite Wellness Programs: A Secondary Data Analysis

Dietary and Lifestyle Behavior Changes from Voluntary Worksite Wellness Programs: A Secondary Data Analysis

Obesity Prevention Worksite Wellness Interventions for Health Care Workers: A Narrative Review.

Background: Health care workers face elevated risk of obesity due to their unique work requirements. The purpose of this systematic review was to present a narrative summary of the characteristics and effectiveness of worksite wellness programs focusing on preventing obesity among health care workers. Method: The databases Medline, CINAHL, Embase, PsycINFO, and PubMed were searched. Experimental and quasi-experimental studies published in English (between 2000 and 2018) that (a) were worksite interventions, (b) had intervention directed toward health care employees, and (c) reported weight-related outcomes were included. We excluded commercial weight loss studies. Two coders extracted data on the following: purpose, key study characteristics, design, type and dosage of intervention, outcome measure(s), attrition rate, and risk of bias. Results: Of the 51 studies included in this review, the majority (75%, n = 38) targeted diet and physical activity behaviors. The majority reported improved weight outcomes in favor of the intervention. Overall, moderate- to high-intensity behavioral strategies, using any mode of intervention delivery (phone, face-to-face, or Internet), delivered by a trained professional were effective in improving weight-related outcomes. Environmental strategies were effective in improving healthier habits. Self-directed strategies worked better for motivated employees. Discussion: Multicomponent interventions offered in health care settings may be successful in improving employee weight. Across study designs, several gaps in the reporting of intervention design, dosage, fidelity, and system-level outcomes were found. Conclusion/Applying research to practice: Occupational health professionals should continue to be creative in developing multicomponent interventions (combining behavioral/educational, environmental, and organizational support) and use evidence guidance frameworks/tools to design an intervention and report dosage outcomes.

Anthropometric and Body Composition Changes over time among Women with Overweight or Obesity who Participated in a Worksite Wellness Program

1. Describe how weight loss is accompanied by changes in WC, %BF, TBW and FFM among females with overweight or obesity who lost weight after participating in a WWP.

Strengthening Linkages Between Public Health and Health Care in Nebraska.

IntroductionEffective collaboration between public health and the health care system is essential for connecting medical and community health–related resources and improving population health. We investigated the linkages between local health departments and primary care clinics in Nebraska.MethodsWe conducted a mixed-method study by using semistructured in-person and telephone interviews and surveys in 2017 and 2018 with directors of 19 Nebraska local health departments. Interviews and surveys assessed activities and programs that health departments implemented or planned with clinics in their jurisdictions. Barriers, benefits, and opportunities for building the linkages were identified.ResultsStrong linkages existed between local health departments and primary care clinics. Linkages focused on the control and prevention of chronic diseases and on traditional public health programs, including screening for cancer and other chronic diseases, vaccinations, worksite wellness programs, home visits, clinic and medication assistance referrals, health message development, electronic health records data analyses, staff education, and improvements in policies and procedures. The most frequently reported barrier was funding, and the most frequently reported benefit was patient behavior change. The opportunity most frequently reported was chronic disease health coaching.ConclusionExtensive linkages exist between Nebraska local health departments and the health care systems in their areas. Additional funding, effective workforce management, community needs assessments, and program evaluation can support joint initiatives to address community health priorities.

Creating a Workplace Culture of Preventive Health: Process and Outcomes of the Colon Cancer\u2013Free Zone at Virginia Cooperative Extension

Colorectal cancer is the third leading cause of cancer death in the USA, yet is highly preventable and detectable at an early stage through screening. Virginia Cooperative Extension (VCE) implemented a worksite colon cancer awareness program to increase colorectal cancer screening rates and preventive lifestyle behaviors among its employees. The Colon Cancer–Free Zone program is designed using best practice principles of worksite health programs and includes information sessions covering the topics of colorectal cancer, screening guidelines, insurance coverage, and preventive lifestyle behaviors. It is conducted in a campaign format that includes a strategic communication strategy targeting relevant screening barriers and facilitators, peer champions, and incentives. The program was implemented with VCE employees statewide utilizing a web-based system for the information sessions, and resulted in broad participation, a significant increase in screening self-efficacy (4.15 ± 0.64 vs 3.81 ± 0.76, ρ = 0.006), changes in diet and physical activity (50% and 40% of participants, respectively), and a 20.6% increase in the employee colorectal cancer screening rate. A Colon Cancer–Free Zone toolkit was developed for use by Extension Agents to implement the program at worksites in their service communities.

Worksite wellness program implementation in county organizations: Exploring strategies for success

Growing research suggests that successful worksite wellness programs (WWPs) can be effective at reducing health costs and improving employee health. While many studies examine factors that contribute to WWP success, these primarily focus on private organizations, or they group public and private organizations together. However, public organizations encounter unique circumstances, generally, so it is important to examine them in their own right when it comes to WWP implementation. This study assesses what factors are important to WWP implementation in county government organizations. Through a conventional content analysis (Hsieh & Shannon, 2005) of interview data collected from 18 county government WWP managers, the results provide support to earlier work regarding strategies for successful WWP implementation. However, the results also add to the literature in several ways. While the importance of leadership support is well-documented, this study finds that marketing and communication strategies, which typically focus on promoting employee participation, can also be used to encourage leadership buy-in. The study also suggests that a dedicated wellness coordinator who has some organizational autonomy to make decisions about the WWP is needed. Further, the study highlights the importance of trust-building as a strategy for WWP development and implementation. Finally, it calls attention to the impact of public perceptions on county governments’ WWPs, an influence unique to county organizations.

Comparison of Two High-Intensity Interval Training Modalities on Cardiometabolic Health in Overweight/Obese Women

High-intensity interval training (HIIT) has been used to reduce risk factors for diabetes, obesity, cardiovascular diseases and metabolic syndrome (MetS). Few studies have compared resistance-HIIT (R-HIIT) to aerobic-HIIT (A-HIIT) in a worksite wellness program designed to reduce risk factors for the MetS. PURPOSE: To compare the effects of A-HIIT and R-HIIT to that of a control group (CON) on physical characteristics, cardiometabolic health, and self-reported well-being in women employees attending a worksite wellness program. METHODS: A total of 48 overweight/obese women possessing one or more MetS risk factors were randomly assigned to one of three groups with 31 women completing all testing and training procedures: A-HIIT (n=10), R-HIIT (n=10), and CON (n=11). A-HIIT and R-HIIT groups trained 3x/wk for 25 minutes in an 8-week program at an average training intensity of 81.0 ±1 %HRmax and 81.9 ±1 %HRmax, respectively. ANCOVA was used to determine differences among groups on all dependent variables at post-testing after adjusting for baseline values. Post-hoc analyses were performed using Bonferroni adjustments. RESULTS: Both A-HIIT (Mdiff = 23.9 m, p= 0.029) and R-HIIT (Mdiff = 23.8 m, p= 0.029) had higher aerobic fitness than CON (Madj = 190.9 m SEM= 6.3) using the 2-minute walk test following training. Only R-HIIT (Mdiff = 45.3 W, p= 0.002) showed increases in upper body power over CON (Madj = 94.9 W SEM= 8.2) while displaying lower fasting insulin (Mdiff= - 5.6 μU/ml, p= 0.036) compared to CON (Madj= 17.4 μU/ml, SEM= 1.4). R-HIIT also showed greater reductions in HOMA2-IR (Mdiff = - 0.7, p= 0.046) than CON (Madj = 2.2, SEM= 0.2). Furthermore, HOMA2-%B was lower in R-HIIT compared to both CON (Madj = 159.3%, SEM= 8.8, Mdiff = - 38.5%, p= 0.017), and A-HIIT (Madj = 172.2%, SEM= 9.4, Mdiff = - 51.4%, p= 0.002). Finally, R-HIIT had significantly higher scores on the physical function domain of Patient Reported Outcome Measurement System (PROMIS®)-57 well-being questionnaire compared to the CON group (Madj = 51.8 SEM= 1.4, Mdiff = 5.7, p= 0.035). CONCLUSIONS: Our study showed that R-HIIT can be considered as part of a risk reducing worksite-wellness strategy for improving physical characteristics, cardiometabolic health, and well-being in women possessing one or more components of the MetS. Supported by UM Citizens Board Grant

Ready to Move: A Unique University Worksite Wellness Initiative

Background: Ready to Move (RTM), a university worksite wellness program, was implemented to get employees moving more and sitting less by combining student health coaching and activity trackers (AT’s).Aim: This article provides program specifics and survey data outcomes to facilitate ideas for university faculty, staff and student collaboration. The intent of the article is to provide an example of how academic classes can contribute to employee worksite wellness programming within a university.Methods: Twelve cohorts (2015 - 2017) comprised of 295 university employees received Fitbit Flex ATs and health coaching from students enrolled in a physical activity (PA) behavioral interventions class during a 10-week program. The employees met with their student coach eight times to learn how to use their AT and set movement goals. Employee’s completed self-reported surveys on average PA days and PA confidence pre/post program.Results: Findings revealed RTM significantly impacted employees average number of PA days and their confidence in ability to sustain PA. Employee qualitative comments revealed RTM instilled the importance of utilizing ATs combined with student engagement made the experience enjoyable and effective.Conclusion: RTM’s combination improved employee movement outcomes and provided additional programming ideas for the employee wellness program at a large Midwestern university.

Determinants of workplace health program participation among non, low, and incentive-achieving participants

The authors used a cross-sectional survey and zero-inflated ordered probit modeling to investigate individual psychosocial-, interpersonal-, organizational-, and community-level determinants distinguishing nonparticipants, low-level participants, and incentive-achieving participants in a single, university-based worksite health program (WHP) that uses insurance premium reductions to incentivize participation. Results from 319 employees suggested two nonparticipant groups. Persons without employer-sponsored insurance, those with negative participation perceptions, and men were more likely to be “never” participants; those who had never met the incentive were potential future participants. Increased confidence was related to incentive achievement; stress was associated with low participation. No interpersonal, organizational, or community factors were significant. When structuring incentives, WHPs should consider determinants of participation, vis-à-vis the incentive.

Knowledge and health promoting lifestyle behaviors about menopause among perimenopausal female teachers

Menopause is a critical period in a woman's life that not only marks the end of reproductive ability, but it also associated with multiple physical, vasomotor, psychological, and sexual complaints Many of the serious complications that women face during menopause are caused by their own poor lifestyles and their lack of knowledge about self-care. The objective of this study was to assess knowledge and health promoting behavior at menopause among perimenopausal female teachers in Dawadmi City. The study applied cross sectional descriptive design with stratified random sampling used to obtain (348) female teachers statistically calculated from the total 3,708 teachers. A structured closed ended questionnaire was used to collect data consisting of three parts: demographic information, questions to assess knowledge of female teachers about the pre-menopausal symptoms and The Health-Promoting Lifestyle Profile II to measures health-promoting behaviors. 58.9% of the subjects had poor knowledge, 30.7% had moderate knowledge and only 10.3% of teachers had Good and Excellent knowledge levels. Total mean score related to Health Promoting Behaviors was 130.05 ± 27.555 which considered medium in general. In general, socio-demographic variable of female teachers did not show significant correlations by using Pearson Chi-Square test and ANOVA test, also, did not show significant correlations for total knowledge level. Total Behaviors level, which also showed significant correlation with age (F = 1.358, p = .028) and weight during last year (F = 1.303, p = .049) categories. In conclusion, iidentifying the knowledge of women about menopause has an essential role in the development of women’s health during menopausal years. Results suggest that participants do not consistently include health-promoting behaviors into their lifestyle, especially physical activity. Therefore, certain policies should be designed and conducted to promote health behavior. Develop a process to promote worksite wellness programs, and to support behavioral changes intended to promote healthy lifestyles.

Developing community relationships to enhance well-being in a worksite wellness program.

Wellness programs traditionally focus on achieving outcomes such as health improvement, lowered health risks, decreased absenteeism, improved morale and decreased health care costs. Many programs emphasize physical wellness with more recent inclusion of social, emotional, and environmental dimensions. That change is referenced as the migration of wellness programs into well-being efforts. Addressing all elements of well-being is critical for effective wellness program delivery. Recognition of the positive impact related to community well-being is growing in the literature. When people connect with others at work and develop positive and effective relationships across boundaries, a culture of health grows within organizations. This paper reviews three community well-being initiatives implemented within one university worksite and describes the effectiveness of such programs in building community well-being.

Abstract P425: V max Prescribed Cardiovascular Exercise Paired With Gross Whole Body Movement Increases High-Density Lipoprotein Cholesterol

Introduction: Previous literature shows an “appeared linear dose-response between activity levels and HDL cholesterol levels” However, long duration physical activity may decrease HDL and LDL cholesterol. Intensity may better dictate the change in cholesterol. Methods: Group 18 of My Unlimited Potential (worksite wellness program for Baptist Health South Florida Employees) performed a preprogram fitness assessment that included resting, testing, and post-test physiological values such as blood pressure and resting HR. Anthropometric measures such as height, weight, 7 and 6 site girth measurements for men and women. Percentage of body fat using Bio electric impedance. The cardiovascular assessment consisted of a V max (Velocity Max) test on the treadmill. The participants received an exercise prescription (ERX) based on the fitness assessment. Group 18 used the speed and grade of the cardiovascular portion of the fitness assessment to create an ERX. During the course of the 12 weeks V max was reassessed every 2 weeks to determine a new intensity for cardiovascular exercise. The exercise protocol during the first 12 weeks consisted of 20 minutes of interval cardiovascular training and 40 minutes of whole body gross movement resistance training two times a week. The length of each high intensity interval was determined by the participant’s own tolerance. Resistance training consisted of whole body gross movements, the use of free weights and a metabolic exercise, at the individuals ERX. Results: Independent sample t-test showed mean improvement of 3.2 points in group 18 when compared to other cohorts (Table 2). Adjusted regression analysis where dependent variable was HDL showed improvement when compared to other groups (Table 3). Discussion: With V max the intensity is given in a clear speed and incline that must be achieved irrelevant of the interval length performed during cardiovascular activity. We have had 18 total cohorts complete 12 weeks. Only group 18 had a significant increase in HDL. Only group 18 followed this protocol.