Worksite Health Promotion Research Articles

Precision prevention in worksite health-A scoping review on research trends and gaps.

To map the current state of precision prevention research in the workplace setting, specifically to study contexts and characteristics, and to analyze the precision prevention approach in the stages of risk assessment/data monitoring, data analytics, and the health promotion interventions implemented. Six international databases were searched for studies published between January 2010 and May 2023, using the term "precision prevention" or its synonyms in the context of worksite health promotion. After screening 3,249 articles, 129 studies were reviewed. Around three-quarters of the studies addressed an intervention (95/129, 74%). Only 14% (18/129) of the articles primarily focused on risk assessment and data monitoring, and 12% of the articles (16/129) mainly included data analytics studies. Most of the studies focused on behavioral outcomes (61/160, 38%), followed by psychological (37/160, 23%) and physiological (31/160, 19%) outcomes of health (multiple answers were possible). In terms of study designs, randomized controlled trials were used in more than a third of all studies (39%), followed by cross-sectional studies (18%), while newer designs (e.g., just-in-time-adaptive-interventions) are currently rarely used. The main data analyses of all studies were regression analyses (44% with analyses of variance or linear mixed models), whereas machine learning methods (e.g., Algorithms, Markov Models) were conducted only in 8% of the articles. Although there is a growing number of precision prevention studies in the workplace, there are still research gaps in applying new data analysis methods (e.g., machine learning) and implementing innovative study designs. In the future, it is desirable to take a holistic approach to precision prevention in the workplace that encompasses all the stages of precision prevention (risk assessment/data monitoring, data analytics and interventions) and links them together as a cycle.

The Physical Activity Paradox: Implications for Worksite Health Promotion Programming and Considerations for the Conditions of Work

The Physical Activity Paradox: Implications for Worksite Health Promotion Programming and Considerations for the Conditions of Work

The Importance of Comprehensive Evaluations for Worksite Health Promotion Programs.

The Importance of Comprehensive Evaluations for Worksite Health Promotion Programs.

Perceived Factors Influencing Blue-Collar Workers' Participation in Worksite Health Promotion Programs in Freight Transport: A Qualitative Investigation Using the TDF and COM-B.

Blue-collar workers in the freight transport industry report a high risk of developing chronic diseases, partly due to an unhealthy lifestyle. Worksite health promotion programs (WHPPs) may be able to promote a healthier lifestyle, but participation among blue-collar workers in these programs is generally lower than among other workers. The current study aimed to further examine factors that can explain participation of blue-collar workers in these programs. A pragmatic, qualitative study was conducted, and semi-structured interviews were held with 32 blue-collar workers in freight transport in the Netherlands (94% men, 81% driver, mean age 48 (SD = 11)). The interview guide was based on the Theoretical Domains Framework (TDF) and Capability-Opportunity-Motivation-Behavior (COM-B) model, and was used to assess perceived determinants that influence participation. A combination of framework analysis and thematic analysis was conducted, which yielded the following nine main themes: (i) not being aware of WHPPs on offer, (ii) no clear picture of what to expect, (iii) (not) giving priority to health, (iv) expecting feedback and practical support, (v) being open and ready to change, (vi) preferring to be self-dependent, (vii) being offered a practical, fun and joint WHPP, (viii) having an employer who cares, thinks along and facilitates participation, and (ix) working and living in an environment in which a healthy lifestyle is not the norm. With these insights we were able to formulate recommendations to enhance the participation of blue-collar workers in WHPPs.

Do worksite health promotion programs (WHPP) influence presenteeism among employees? A systematic review1.

Worksite health promotion programs (WHPP) aiming to reduce presenteeism are rapidly increasing. However, program-efficacy seems impaired by lack of conceptual understanding and theoretical frameworks related to presenteeism. To study (1) the concept of presenteeism, (2) the causes of the phenomenon and (3) which WHPP affect presenteeism. We followed the PRISMA 2020 guidelines for mapping relevant literature in seven databases. The main search-terms were "worksite", "WHPP", "presenteeism", "employee productivity" and "interventions". Reviews and review of reviews were included and analysed according to research questions and ecological theory. Of 2196 studies identified, 14 reviews were included, comprising 1390 single studies. Conceptually, presenteeism was poorly defined, mostly related to productivity/performance limitations due to ill health. Factors causing presenteeism addressed individual health or lifestyle (78%), and, to a lesser extent work and organisational factors (management/job stress) (22%). Forty-five highly diverse WHPP were identified, about 90% focusing health outcomes. 22/45 WHPP affected presenteeism/productivity positively. Multi-component WHPP implemented at multi levels accounted for 55%. Single-component programs, implemented at individual level, were mostly targeting health-risk subgroups. No specific WHPP seems preferable. Methodological quality seems highly associated with worksite intervention-efficacy. Increased telework opportunities due to COVID-19 experiences has affected working conditions worldwide, for better and worse, requiring adaptions at employee, management, organisational and socio-cultural levels. Our results showed high program diversity, several adaptable to future needs (e.g., digital solutions), however hampered by narrow focus on individual health. Future research should focus on theory-based high quality multilevel WHPP comprising contextual, work, and organisational factors.

Reach and effectiveness of a worksite health promotion program combining a preventive medical examination with motivational interviewing; a quasi-experimental study among workers in low socioeconomic position

BackgroundThis study aimed to evaluate individual characteristics associated with participation and effectiveness of a worksite health promotion program with motivational interviewing targeting health and health behaviour among Dutch workers in low socioeconomic position.MethodsIn a production company and a hospital, 838 workers were invited for a Preventive Medical Examination and subsequent coaching with motivational interviewing up to 7 sessions within 6 months. Follow-up information was collected after 6 months. Characteristics associated with participation in coaching were assessed with logistic regression models. The effectiveness of coaching on body mass index (BMI), bodyweight, self-rated health, vigorous physical activity, smoking, alcohol intake, fruit- and vegetable consumption, work ability, and sickness absence was evaluated with linear regression models and on participation in health promotion activities with logistic regression analysis. The analyses on effectiveness were performed without and with propensity score adjustment.ResultsOf the 838 invited workers, 313 workers participated in the Preventive Medical Examination and follow-up data were available for 176 workers, of whom 100 workers with increased cardiovascular risk attended coaching. The majority of workers with obesity (73%), overweight (60%), and unhealthy behaviours (58%-69%) at baseline participated in motivational interviewing. Males, workers with overweight or obesity, workers at the production company, workers with insufficient vigorous physical activity, and workers with a low educational level were most likely to participate in coaching. Coaching with motivational interviewing after the Preventive Medical Examination was associated with a 4.74 times higher likelihood [95% confidence interval (CI): 1.99;11.32] to participate in health promotion activities and 10.9% (95%CI: 0.6;21.3) more persons who quit smoking compared to workers without coaching. No statistically significant effects were observed on BMI, bodyweight, health, health behaviour, work ability and sickness absence.ConclusionsThe program combining a Preventive Medical Examination with follow-up coaching reached – as intended – workers with obesity or overweight, those with a low education and with unhealthy behaviours. Adding coaching with motivational interviewing to a Preventive Medical Examination contributed to higher participation in health promotion activities and an increase in smoking cessation after 6 months among workers with a lower socioeconomic position, but was not effective on other outcomes.Trial registrationThe study was registered retrospectively in the Netherlands Trial Register as NL8178 on 22/11/2019.

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.

Worksite Health Promotion and Work Performance: Both Awareness and Use Matter.

This work aimed to study whether being aware of the existence of worksite health promotion (WHP), using it, or both are related to employees' task and contextual performance. Multilevel cross-sectional data came from the European Sustainable Workforce Survey, with data from more than 11,000 employees in 259 organizations. Generalized structural equation modeling was used to examine two types of WHP: healthy menus and sports facilities. Awareness of healthy menus and sports facilities was positively associated with task and contextual performance. Healthy menus use was related to both higher task and contextual performance, whereas sports facilities use was only associated with contextual performance. The relation of WHP use was stronger for contextual than for task performance. Organizations should ensure that employees are aware of the availability of WHP as well as stimulate employees to make use of it.

Factors associated with blue-collar workers' participation in Worksite Health Promotion Programs: a scoping literature review.

A growing number of employers implement worksite health promotion programs (WHPPs). In particular, blue-collar workers may benefit from these WHPPs. However, they are less likely than other workers to participate and little is known about which factors affect their participation. The aim of this scoping literature review is to produce an overview of studies on factors associated with blue-collar workers' participation in WHPPs. Five databases were searched: BSU, PsycINFO, Medline, Web of Science and CINAHL. The review included peer-reviewed empirical studies on determinants associated with blue-collar workers' participation in WHPPs. Factors were extracted and categorized. Similar determinants were clustered and the direction of the associations was further examined. Nineteen papers describing 11 qualitative and 4 quantitative studies met the eligibility criteria. Seventy-seven determinants were analyzed (in quantitative studies) or reported (in qualitative studies). In most studies, only participant characteristics were investigated. Participation may be enhanced by addressing needs, tailoring from a broad range of activities, offering group activities, requiring little effort and commitment at the start, using incentives, leading by example and combining WHPPs with occupational safety interventions. WHPPs seem to be able to reach blue-collar workers, but it remains particularly challenging to reach shift workers and those who do not yet experience health complaints.

An Evaluation and Validation of the Discover Wellness Worksite Health Promotion Program Across Three Locations Web Appendix

An Evaluation and Validation of the Discover Wellness Worksite Health Promotion Program Across Three Locations Web Appendix

An Evaluation and Validation of the Discover Wellness Worksite Health Promotion Program Across Three Locations

An Evaluation and Validation of the Discover Wellness Worksite Health Promotion Program Across Three Locations

Implementing Change Using Best Practice Program Design Principles

Nico P. Pronk, Ph.D., FACSM, FAWHP,is president of the HealthPartners Institute and chief science officer at HealthPartners in Minneapolis, MN. Dr. Pronk is an affiliate full professor of Health Policy and Management at the University of Minnesota School of Public Health and a visiting scientist at the Harvard University T.H. Chan School of Public Health. He is a past president of the International Association for Worksite Health Promotion (IAWHP), coauthor of the IAWHP Online Certificate Course, editor of ACSM's Worksite Health Handbook, 2nd edition, and associate editor for ACSM's Health & Fitness Journal®. Joel B. Spoonheim, MUP,is the senior director of Worksite Health & Population Well-Being for HealthPartners. As part of an integrated health plan and care delivery system, the department delivers in-person care, virtual care, and well-being improvement solutions in new ways to make health care simpler and more affordable. Joel's teams serve customers ranging from small to Fortune 500 employers, individual consumers, Medicare and Medicaid populations, and individual patients. DisclosureThe authors declare no conflict of interest and do not have any financial disclosures.

Worksite health promotion for employees working from home: A vignette experiment examining intentions to participate.

This study explores which factors affect employees' intention to participate in worksite health promotion (WHP) when they work from home. Employees increasingly work from home, yet existing WHP is mainly tied to the workplace. We lack knowledge on what might stimulate employees to make use of WHP specifically when they work from home. Drawing on the theory of reasoned action, we studied whether type of activity, duration, if WHP takes place during work time, how often employees work from home (shaping employees' attitude) and colleague participation (social norms) explain employees' intention to participate in WHP when working from home. To do so, we employed a vignette experiment. Results show that employees' intentions are higher for walking and taking breaks than for an online sports class. Moreover, intentions are higher for shorter activities and when participating in WHP can be done during work time. The more colleagues participate, the higher intentions of employees to do so too. By offering WHP for employees at home, employers can promote employees' health even when these are not present in the workplace. Our study provides leads into how employers may create conditions under which employees use WHP when working from home.

Organizational health literacy and health promotion in health care settings: Results from Germany

Abstract Introduction Health care organizations (HCO) are increasingly required to provide health literate structures and processes to strengthen organizational health literacy (OHL). So far, little is known about the extent of OHL in HCO in Germany. Aims are therefore 1) to examine the level of OHL in health care organizations, and 2) to investigate the impact of organizations level of health prevention and workplace health promotion on the level of OHL. Methods Analyses are based on a nationwide cross-sectional study (online survey) among management staff (N = 564) in HCO (hospitals, nursing homes, facilities for disabled people). OHL was measured by the German version of the ‘Health literate health care organization 10 item questionnaire’ (HLHO-10). Health prevention and workplace health promotion were operationalized by the “Worksite Health Promotion Capacity Instrument’ (WHPCI). Uni- and bivariate analyses were carried out, on an item-basis and as an index (median-split). Results Regarding OHL, 55.1 % of the health care organizations reported below-average levels of OHL. On an item-basis, the highest below-average levels were given for the standard ‘communication’ (59.1 %) and the ‘provision of information to patients/residents via various media’ (57.4 %). Regarding the level of health prevention (51.8 %) and the existence of workplace health promotion structures (55.7 %), more than half of HCO reported a below-average level. In addition, results showed that HCO that indicate a below-average level of prevention and few structures of workplace health promotion also revealed a below-average level of OHL. Conclusions There is need to strengthen OHL in German HCO. Key messages • HCO are required to strengthen HLO, particular in communication and participatory approaches. • A higher level of prevention and workplace health promotion on HCO can contribute to the implementation of OHL initiatives.

Changes in Fruit and Vegetable Consumption and Leisure Time Physical Exercise after a Citizen Science-Based Worksite Health Promotion Program for Blue-Collar Workers.

Blue-collar workers have, on average, poorer health than white-collar workers. Existing worksite health promotion programs (WHPPs) are often not successful among blue-collar workers. This study evaluates the effect of the Citizen Science-based WHPP on the targeted lifestyle behaviors among construction workers. The data of 114 participants were retrieved from questionnaires before (T0) and after (T1) the WHPP. Outcome measures were mean and categorical changes in daily fruit and vegetable intake and weekly leisure time physical exercise. Changes were tested using Wilcoxon signed rank tests and McNemar tests. No statistically significant changes were found between T0 and T1. In total, 73.7% of the participants felt involved in the WHPP. Changes in the outcome measures were not significantly different between subgroups based on age, nor in subgroups based on feelings of involvedness. The low intensity of the developed program could be an explanation for this lack of significant change. Future studies using the Citizen Science approach in an occupational setting should aim at developing a more intensified program and should test its effectiveness by comparing changes in a (randomized) controlled trial.

Assessment of Fitness, Health, and Well-Being in the Occupational Setting: A Pragmatic Approach

Apply It! After reading this article, worksite health promotion and health and fitness professionals will: • Understand the purpose of conducting assessments and the health and safety implications when a worker is not able to perform his or her job optimally physically or mentally. • Appreciate how to recognize and manage the risks involved in conducting the assessments. • Know how to apply the practical guidance on which assessments to use and how to implement them on-site or remotely.

Health education using the theory of planned behavior to modify ergonomic posture in hospital computer users: a randomized controlled trial.

Work-related musculoskeletal disorders are prevalent in those who use computers, and education using ergonomic principles may be helpful to prevent such conditions. The present study sought to identify how an educational intervention based on the theory of planned behavior (TPB) may be effective for adopting healthy ergonomic postures. A convenience sample of 162 computer users working in a hospital setting in Iran were randomly assigned to intervention or control groups. The intervention group (n = 81) received six weekly educational sessions based on TPB principles, whereas the control group received no intervention during the study period. Both groups were assessed at baseline and 3 months after the intervention using a TPB questionnaire, rapid office strain assessment (ROSA), and Nordic musculoskeletal questionnaire. Data were analyzed using the independent/paired Student's t test, chi-square, and analysis of covariance. All TPB constructs in the intervention group improved from baseline to follow-up, indicating considerable progress compared to the control group (p < 0.001). More than 60% of intervention and control groups were categorized as high risk at baseline in terms of ergonomic posture measured by ROSA. This percentage was reduced to 21% for intervention group and increased to 65% in the control group at follow-up. Symptom relief was obtained for wrist/hands, lower back, neck, shoulders and upper back in the intervention group (all p < 0.05). The number of affected areas also significantly decreased in the intervention group compared to the control group three months after the intervention. Educational programs based on TPB principles may be helpful in correcting ergonomic postures among computer users. Such interventions are recommended for worksite health promotion in that they may prevent the development of musculoskeletal disorders in staff.

Thriving on Job Demands? Exploring Associations between Goal Uncertainty, Anxiety, and Job Autonomy for Employees with Metabolic Syndrome

Anxiety disorders are among the most common distressing diseases worldwide and have been the focus of increasing attention by companies, as they are associated with impaired work performance, higher absenteeism, and greater health-related costs. The risk of disease is particularly pronounced in individuals with metabolic syndrome and unfavorable working conditions. Nevertheless, empirical knowledge on interactions of metabolic syndrome, job characteristics, and psychiatric morbidity is still sparse. This cross-sectional study included survey data from 176 company employees with diagnosed metabolic syndrome to examine associations between anxiety and job-related factors, namely goal uncertainty and job autonomy. Descriptive data analysis along with Spearman’s rank correlation analysis were performed. Study hypotheses were tested using moderated hierarchical multiple regression analyses. Results extend worksite health promotion literature by demonstrating a slightly U-shaped relation between goal uncertainty and anxiety (β=.16, p≤.05). While moderate levels of goal uncertainty contributed to well-being in terms of low anxiety severity, low and high goal uncertainty were associated with more severe anxiety. This highlights the need to consider differentiated stressor conceptualizations in research on antecedents of employees’ well-being. However, job autonomy showed neither a direct nor a moderating effect on anxiety.

The economic impact of workplace physical activity interventions in Europe: a systematic review of available evidence

PurposeThere is growing interest in the economic impact of workplace physical activity interventions, but the evidence is still lacking — especially in Europe. Although, some evidence on the return on investment (ROI) is found in literature, the included studies may not be applicable to the Europe situation. Therefore, the objective of this study was to review current evidence on the economic impact of workplace physical activity interventions in European countries.Design/methodology/approachA systematic review on the economic impact of worksite health promotion programs aiming at increasing physical activity was conducted. Five electronic databases (MEDLINE (Ovid), MEDLINE (PubMed), EMBASE, NHS-EED and Emerald Insights) were searched for relevant studies published between 2000 and 2020.FindingsA total of 953 abstracts were screened, and 28 were reviewed, 11 of which met all inclusion criteria. The studies varied substantially in sample size, intervention type, duration and frequency of follow-up measurements, valuation methods and assessed economic outcomes. There is inconclusive evidence for decreasing absenteeism, positive net benefit (NB) and positive ROI. No evidence was found to indicate an effect on self-assessed productivity or job satisfaction.Originality/valueThis study is the first try to take the different working conditions from Europe into consideration. The authors found that working conditions could have some impact on the valuation of absenteeism costs and thereof on the ROI. Further, this study provides insight into how to deploy effective and efficient workplace physical activity interventions, based on a standardized and validated methodology and program scope.

The Second Side of the Coin-Resilience, Meaningfulness and Joyful Moments in Home Health Care Workers during the COVID-19 Pandemic.

Nursing literature predominantly focuses on job demands but is scarce for resources related to nurses’ work. In the face of the COVID-19 pandemic, resources that can buffer the health-impairing effects of increased demands gain importance. The aim of this study is to explore resilience, meaning of work and joyful moments in home health care workers in South Germany during the pandemic. Resilience and meaning of work were measured quantitatively; moments of joy were investigated qualitatively by audio diaries and analyzed with qualitative content analysis. In all, 115 home health care workers (mean age = 47.83 ± 11.72; 81.75% female) filled in the questionnaires and 237 diary entries were made by 23 persons (mean age = 46.70 ± 10.40; 91.30% female). The mean scores of resilience (5.52 ± 1.04; 1–7) and meaning of work (4.10 ± 0.92; 1–5) showed high levels, with significantly higher values in females. Home care workers experienced joyful moments 334 times in 60 different types in the categories of social relationships, work content, work organization, work environment and self-care. A deeper understanding of resilience, meaning of work and joyful moments provides a basis for the development of worksite health promotion programs that address both demands and resources in home health care workers.