Worksite Health Promotion Activities Research Articles

Performance Against WELCOA's Worksite Health Promotion Benchmarks Across Years Among Selected US Organizations.

The purpose of this study was to quantify the performance of organizations' worksite health promotion (WHP) activities against the benchmarking criteria included in the Well Workplace Checklist (WWC). The Wellness Council of America (WELCOA) developed a tool to assess WHP with its 100-item WWC, which represents WELCOA's 7 performance benchmarks. Workplaces. This study includes a convenience sample of organizations who completed the checklist from 2008 to 2015. The sample size was 4643 entries from US organizations. The WWC includes demographic questions, general questions about WHP programs, and scales to measure the performance against the WELCOA 7 benchmarks. Descriptive analyses of WWC items were completed separately for each year of the study period. The majority of the organizations represented each year were multisite, multishift, medium- to large-sized companies mostly in the services industry. Despite yearly changes in participating organizations, results across the WELCOA 7 benchmark scores were consistent year to year. Across all years, benchmarks that organizations performed the lowest were senior-level support, data collection, and programming; wellness teams and supportive environments were the highest scoring benchmarks. In an era marked with economic swings and health-care reform, it appears that organizations are staying consistent in their performance across these benchmarks. The WWC could be useful for organizations, practitioners, and researchers in assessing the quality of WHP programs.

Participants’ Perceptions of Worksite Health-Promotion Educational Activities

ABSTRACTAdults spend a significant amount of time at work making the worksite a convenient venue for participation in health-promotion activities. This research project examined participants’ perceptions of gaining knowledge and changing health behavior practices as a result of knowledge gained through participation in health-promotion activities provided at the worksite. The worksite health-promotion activities were offered as a result of an innovative collaboration effort between nursing faculty in an academic setting and a community partner in the private sector. The findings demonstrate that participation in health-promotion activities at the worksite can result in increased knowledge and changes in health behavior practices as a result of knowledge gained.

Organizational Characteristics Influence Implementation of Worksite Health Protection and Promotion Programs: Evidence From Smaller Businesses.

We explored associations between organizational factors (size, sector, leadership support, and organizational capacity) and implementation of occupational safety and health (OSH) and worksite health promotion (WHP) programs in smaller businesses. We conducted a web-based survey of human resource managers of 117 smaller businesses (<750 employees) and analyzed factors associated with implementation of OSH and WHP among these sites using multivariate analyses. Implementation of OSH, but not WHP activities, was related to industry sector (P = 0.003). Leadership support was positively associated with OSH activities (P < 0.001), but negatively associated with WHP implementation. Organizational capacity (budgets, staffing, and committee involvement) was associated with implementation of both OSH and WHP. Size was related to neither. Leadership support and specifically allocated resources reflecting that support are important factors for implementing OSH and WHP in smaller organizations.

Employee perceived barriers to participation in worksite health promotion

Many employers offer worksite health promotion (WHP), but a high percentage of the workforce does not participate. As the employees’ perspective regarding potential barriers to participation has received little attention in research so far, improvements in program design are delayed. The aims of the present paper therefore are to investigate perceived barriers to WHP participation from the employees’ point of view, and to construct a barrier typology. A quantitative questionnaire was developed on the basis of existing studies and distributed in four Austrian organisations offering comprehensive WHP programs. 237 respondents rated the appreciability of 22 potential barriers to WHP participation. Barrier categories and typologies were defined using principal component analysis (PCA), multiple correspondence analysis (MCA), and regression analysis. The PCA identified six barrier types: (1) integration into the daily routine; lack of (2) information; an (3) imbalance of benefits and costs; the requirement of too much (4) involvement; (5) interpersonal barriers; and (6) incredibility of the company’s honest commitment. According to the MCA, one group perceives barriers intensively, another hardly, and a third mainly program design related barriers. The regression analysis shows that especially being too busy at work and feeling physically not up to participating in WHP activities are major barriers. The results provide a comprehensive overview and categorization of barriers to WHP participation perceived by employees in companies offering holistic programs. Moreover, they can be used as guidelines for analysing existing and/or preventing barriers of occurring when designing and implementing WHP programs.

Worksite Health Promotion

Although the significant majority of employers offer health promotion programs, for most companies the size and impact of existing programs is minor. Recent research has yielded substantial data in support of worksite health promotion activities, from both medical and economic perspectives. Yet despite this compelling information, corporations have been slow to incorporate more substantial health promotion activities. Employers must come to see that an investment in employee health promotion programs is an investment in their workforce, likely their greatest asset. The impact of health promotion programs needs to be viewed not simply in the context of a business operations cost. In the face of rapidly escalating healthcare costs, successful health promotion programs have the potential to reduce those expenditures as well as enhance employee performance, resulting in improved business productivity. To be effective, worksite health promotion programs must be implemented in a systematic manner. To gain senior management support, education regarding the principles of health and productivity is critical. Program selection and implementation must be carefully planned, reflecting the health promotion interests, needs, culture and resources of the organization. Objective, easily measurable parameters of program quality and outcome must be identified prior to program implementation, in order to assess program effectiveness, from both employee health and business productivity perspectives. Collaborative data review through regular reporting can identify program strengths and weaknesses, leading to corrective modifications.

Health behavior, quality of work life, and organizational effectiveness in the lumber industry.

A major incentive for work-site health promotion activities has been the promise of increased company profitability. Some critics have challenged the economic argument based on distal outcomes such as increased employee longevity and less morbidity later in life. The purpose of this study was to examine the relationships between employee health behavior, quality of work life, and proximal organizationally valued outcomes. Data were collected from a stratified random sample of employees working at Pacific Lumber Company (N = 146), the largest single-site lumber mill in California. Although employee sleep patterns predicted health care utilization and psychological well-being, for the most part employee health behaviors were not strong predictors of proximal organizational effectiveness factors. However, quality-of-work-life factors significantly predicted organizational commitment, absenteeism, and tardiness frequency. The findings suggest the value of improving the system of work in which employees are embedded as part of comprehensive work-site health promotion efforts.

Durability and Diffusion of the Nutrition Intervention in the Working Well Trial: For the Working Well Research Group

Background.The Working Well Trial (WWT) emphasized employee participation in the planning and implementation of the health promotion intervention. These participatory strategies were intended to promote institutionalization of the health promotion program and thereby encourage maintenance of the intervention activities. We used data from 107 worksites in the WWT to test whether the nutrition intervention activities were maintained after the research program (i.e., durability) or were adopted by control sites (i.e., diffusion).Methods.At baseline, upon the completion of the 2-year intervention, and 2 years later, we conducted organization surveys regarding worksite health promotion activities. A nutrition activity score from 0 to 3 was calculated based on availability of nutrition-related programs, self-help manuals or guides, and videos, tapes, brochures, or posters.Results.From baseline to the end of the intervention, there was a significant increase in the nutrition activity score in intervention worksites compared with the controls (P< 0.001). However, 2 years later, there was no difference between intervention and control worksites. In addition, there was no significant increase in the nutrition activity score in control site 2 years after they received the intervention protocols and materials.Conclusions.Research is needed to develop and test worksite-based interventions to promote institutionalization, durability, and diffusion.

Worksite Health and Safety Climate: Scale Development and Effects of a Health Promotion Intervention

Background.Environmental influences on health and health behavior have an important place in research on worksite health promotion. We tested the validity and internal consistency of a new measure of organizational health and safety climate that was used in a large randomized trial of a worksite cancer prevention program (the Working Well Trial). The resulting scales then were applied to assess intervention effects.Method.This study uses data from a subset of 40 worksites in the Working Well Trial. Employees at 20 natural gas pipeline worksites and 20 rural electrical cooperatives completed a cross-sectional questionnaire at baseline and 3-year follow-up.Results.A factor analysis of this self-report instrument produced a two-factor solution. The resulting health and safety climate scales had good internal consistency (Cronbach's α = 0.74 and 0.82, respectively) and concurrent validity. The health climate scale was correlated more highly with organizational measures that were indicative of a supportive health climate than those indicating supportive safety climate, while the reverse was true of the safety climate scale. Changes in health climate were associated with the number of smoking and smokeless tobacco programs offered at the worksites at the time of the 3-year follow-up (r= 0.46 and 0.42, respectively). The scales were not correlated with most employee health behaviors. The health climate scores increased at intervention worksites, compared with scores at control worksites (F[1,36] = 7.57,P= 0.009).Conclusions.The health and safety climate scales developed for this study provide useful instruments for measuring organizational change related to worksite health promotion activities. The Working Well Intervention resulted in a significant improvement in worksite health climate.

Creating Healthful Work Environments for Ethnically Diverse Employees Working in Small and Medium-Sized Businesses

ABSTRACT Worksite size is a strong indicator of worksite health promotion (WHP) and employee assistance (EAP) activity. While the majority of WHP and EAP services are provided to employees working in large organizations, the majority of the work force is employed in worksites with fewer than 50 employees (Fielding, 1991). One of the main findings of the 1992 National Survey of WHP Activities was the identification of a pressing need to understand how to formulate effective strategies for providing comprehen-

Self-insurance and worksite alcohol programs: an econometric analysis.

The worksite is an important point of access for alcohol treatment and prevention, but not all firms are likely to find offering alcohol programs profitable. This study attempts to identify at a conceptual and empirical level factors that are important determinants of the profitability of worksite alcohol programs. A central question considered in the empirical analysis is whether firms' decisions about worksite alcohol programs are related to how employee group health insurance is provided. The data used are from the 1992 National Survey of Worksite Health Promotion Activities (N = 1,389-1,412). The econometric analysis focuses on measures of whether the surveyed firms offer Employee Assistance Programs (EAPs), individual counseling, group classes and resource materials regarding alcohol and other substance abuse. Holding other factors constant, the probability that a self-insured firm offers an EAP is estimated to be 59%, compared to 51% for a firm that purchases market group health insurance for its employees. Unionized worksites and larger worksites are also found to be more likely to offer worksite alcohol programs, compared to nonunionized smaller worksites. Worksites with younger work-forces are less likely than those with older employees to offer alcohol programs. The empirical results are consistent with the conceptual framework from labor economics, since self-insurance is expected to increase firms' demand for worksite alcohol programs while large worksite is expected to reduce the average program cost. The role of union status and workforce age suggests it is important to consider workers' preferences for the programs as fringe benefits. The results also suggest that the national trend towards self-insurance may be leading to more prevention and treatment of worker alcohol-related problems.

Getting smarter and maybe wiser.

This issue contains the second part of an important series of reviews of worksite health promotion activities. These reviews provide the most extensive synthesis to date of the research literature on the health impact of workplace health promotion efforts. The editors are to be congratulated for requiting a very thorough approach to reviewing relevant literature, including references for each of five important heahh promotion components: policy, employee education, family education, manager/supervisor training, and corporate community support. They also make the important observation that it is difficult to interpret the results of interventions that are not based on a well-explicated theory. An important innovation in this series is consistent rules of evidence so that the relative strength of evidence can be compared for interventions used to reduce the same and different risk factors. Encouragement can be taken from the fact that for the majority of risks considered, the quality of the research methodology is considered suggestive, indicative, acceptable, or conclusive. Health professionals toiling in the difficult vineyards of worksite health promotion can take heart that there is a growing body of literature suggesting that their determined efforts can bear fruit. Before running off to trumpet the good news, however, let us take stock of where we are. There are still painfully few randomized intervention

Effect of organization-level variables on differential employee participation in 10 federal worksite health promotion programs.

Guided by a conceptual model, the authors used both qualitative data (e.g., individual interviews, focus groups) and quantitative data from an employee survey (N = 3,388) in 10 federal agencies to investigate whether organization context and implementation process affected participation in worksite health promotion and disease prevention (HPDP) activities among demographic subgroups. Overall, employees on average participated in fewer than two agency-supported health-related activities per year (17% in fitness, 40% in health risk assessment activities). Employees participated more where coworkers endorsed such programs. Minority employees and employees in lower level positions were more likely to participate in fitness activities when organizations had a more comprehensive program structure, engaged in more marketing strategies, gave time off to employees to participate, or had on-site facilities. Management support for the program was related to participation by employees who were male, white, and had upper level positions. The data supported the proposed model; also confirmed was two predicted relationships between model constructs, which provided a better understanding of differential participation by employee groups.

Application of Core Function Concepts to Local Health Department Occupational Safety and Health Activities

To illustrate how core function concepts might be useful in evaluation of specific local health department (LHD) programs, we analyzed preliminary results from a national questionnaire survey of LHD occupational safety and health (OSH) activities during 1992-1993 in categories corresponding to the three core functions: assessment, policy development, and assurance. Overall, 2,079 (71%) LHDs returned completed questionnaires. With regard to the first core function (assessment), the state health department was the most frequent source of data used by the respondent LHDs (47%) to assess worker health and occupational hazards. Concerning the second core function category (policy development), 5% of LHDs had conducted an appraisal in the past three years to summarize the OSH needs of their communities. With regard to the third core function category (assurance), 23% of LHDs directly provided worksite health promotion activities for workers in their communities. We conclude that core function concepts can be a useful adjunct in evaluation of specific LHD programs. Additional research is needed to further refine and improve core function indicators providing insights into specific LHD programs, as well as into overall LHD performance.

1992 National Survey of Worksite Health Promotion Activities: summary. US Department of Health and Human Services Public Health Service.

1992 National Survey of Worksite Health Promotion Activities: summary. US Department of Health and Human Services Public Health Service.

Worksite health promotion in four Midwest cities

A survey of worksite health promotion activities in nine areas of health was conducted in four Midwest cities--Winona and St. Cloud, MN; Eau Claire, WI and Sioux Falls, SD to determine how many worksites are involved in these activities; how many different kinds of programs they offer; and whether or not worksite involvement is growing in these areas of health. All worksites with over 100 employees were surveyed with a completion rate of 96% for eligible worksites. Comparing program offerings at worksites with such offerings by other community providers, we find worksites provide 40% of the total of such programs to adults. They tend to operate most programs independently of other community providers. Exercise and smoking cessation programs are most commonly offered. Worksites in the four communities significantly differed in the number of exercise program options offered and in the prevalence of worksite involvement in home, personal and drivers' safety programs. Compared to national survey results, worksites in these Midwest cities show a lower level of participation in heart disease and cancer screening activities. There is a high rate of dropout among current providers of heart disease screening activities and few nonproviders are initiating programs. Program initiation among nonproviders is highest in smoking cessation, weight loss and nutrition. Program growth among current providers is high in the areas of chemical dependency, exercise and personal, home and drivers' safety.

Synergism in Work Site Adoption of Employee Assistance Programs and Health Promotion Activities

As workplaces increasingly adopt proactive programs directed toward employee health issues, the interrelation between different programs becomes an important issue. Of interest here is the "synergy" in patterns of program adoption between employee assistance programs (EAPs) and health promotion activities (HPAs). We utilize the 1985 National Survey of Worksite Health Promotion Activities (N = 1358) for analyses of the dual presence of EAPs and HPAs, and in multivariate analyses we consider factors affecting such dual presence. The data suggest that synergy occurs, with EAP adoption appearing to influence HPA adoption to a greater extent than the reverse. In multivariate analyses, synergy is confirmed by the finding that, among a variety of relevant organizational characteristics, EAP presence and HPA presence are the best predictors of each other's presence. The analyses also indicate that there is minimal commonality in program ingredients across organizations reporting the presence of HPAs. Implications of the data for the future development of these two programming strategies are discussed.

Work site stress management: national survey results.

The National Survey of Work Site Health Promotion Activities established baseline data on the frequency of nine types of health promotion activity at private work sites with more than 50 employees in the United States. Stress management activities were provided at 26.6% of work sites. Types of activities at those work sites with some stress management activity included group counseling (58.5%), individual counseling (39.3%), follow-up counseling (25.9%), special events (11.5%), providing information about stress (80.7%), providing a place to relax (64.8%), and making organizational changes to reduce employee stress (81.2%). Frequency of activities varied by industry type and by region of the country. Incidence of most types of activities did not increase as work site size increased, although the likelihood of having any of these activities did increase with work site size. Stress management activities were more likely to be present at work sites with a medical staff or health educator. An increase in output, productivity, or quality was the most frequently cited benefit (46.5%). Negative effects were reported at 2.6% of the work sites. Other health promotion activities found at the work sites surveyed included smoking cessation (61.8%), treatment and control of high blood pressure (36.7%), and weight control (34.7%). Employee Assistance Programs were responsible for stress management at 62% of the work sites with an Employee Assistance Program.

Frequency of Health Risk Assessment Activities at U.S. Worksites

Data from the National Survey of Worksite Health Promotion Activities include information about health risk assessment (HRA) activities available at private sector worksites in the United States. HRA activities were found at 29.5% of all worksites. Of those worksites, 24% provided HRA questionnaires and 77.4% provided periodic health/physical examinations. Screening tests provided as part of the health/physical exams included blood pressure screening (55.4%), cancer screening (19.5%), blood tests for cholesterol (28.3%) and sugar (39%), and tests of physical fitness (15.1%). In most cases, the frequency increased as worksite size increased, regional variations were small, and there was significant variation among different industry types. HRA activities were overrepresented at worksites where the majority of workers were women, over 30 years of age, not blue collar, and not represented by a union. On-site health personnel increased the likelihood of the presence of HRA activities. At 85% of the worksites with HRA activities all permanent employees were eligible. The full costs of screening were paid by 87.9% of the worksites, activities were held on company time at 74.5%, and time off to participate was available at 78.2% of worksites. The most commonly mentioned benefit of HRA activities was improved employee health (47.1%). Other health promotion activities frequently found in association with HRA activities were smoking cessation (54.1%), care and prevention of back pain (50.8%), and stress management (49.6%).

Frequency of worksite health promotion activities.

The first National Survey of Worksite Health Promotion Activities surveyed a random sample of all private sector worksites with 50 or more employees, stratified by number of employers, geographic location, and type of industry. The 1,358 completed interviews constituted a response rate of 83.1 per cent. Of responding worksites 65.5 per cent had one or more areas of health promotion activity with slightly more than 50 per cent of activities initiated within the previous five years. Overall prevalence by type of activity included health risk assessment (29.5 per cent), smoking cessation (35.6 per cent), blood pressure control and treatment (16.5 per cent), exercise/fitness (22.1 per cent), weight control (14.7 per cent), nutrition education (16.8 per cent), stress management (26.6 per cent), back problem prevention and care (28.5 per cent), and off-the-job accident prevention (19.8 per cent). Mean number of activities across all worksites was 2.1 and for worksites with activities, 3.2. Activity frequency increased with worksite size, was highest in the western region (2.34) and lowest in the northeast (1.96), and varied considerably by industry type. The majority of worksites paid the entire cost of these activities.

Worksite Health Promotion

Recent years have seen a rapid growth in the number of worksite health promotion programs being offered. While the potential benefits to employers of such programs are many, a variety of issues influence to what extent these benefits are obtained. This article identifies several such issues in the form of questions which need to be addressed by organizations engaged in health promotion activities. Questions relating to program needs and objectives identification, program introduction strategies, costs, legal issues, and ethical considerations are discussed. It is suggested that continued growth and success in worksite health promotion activities is in part dependent upon thoughtful consideration of such questions.