Worksite Health Promotion Research Articles

The Impact of Perceived Stress and Coping Adequacy on the Health of Nurses: A Pilot Investigation.

Stress and coping abilities influence the health and work performance of nurses. However, little is known about the combined influence of stress perception and perceived coping adequacy and its impact on the health of nurses. This study examined the relationship between stress, coping, and the combined influences of perceived stress and coping abilities on health and work performance. A valid and reliable questionnaire was completed by 120 nurses in a Midwestern hospital in the USA. In general, the nurses were not healthy: 92% had moderate-to-very high stress levels; 78% slept less than 8 hours of sleep per night; 69% did not exercise regularly; 63% consumed less than 5 servings of fruits and vegetables per day; and 22% were classified as binge drinkers. When confronted with workplace stress, 70% of nurses reported that they consumed more junk food and 63% reported that they consumed more food than usual as a way of coping. Nurses in the “high stress/poor coping” group had the poorest health outcomes and highest health risk behaviors compared to those in other groups. The combined variables of perceived stress and perceived coping adequacy influenced the health of nurses. Therefore, worksite health promotion programs for nurses should focus equally on stress reduction, stress management, and the development of healthy coping skills.

Occupation Is Related to Weight and Lifestyle Factors Among Employees at Worksites Involved in a Weight Gain Prevention Study.

To examine the relationship between job type, weight status, and lifestyle factors that are potential contributors to obesity including, diet, physical activity (PA), and perceived stress among employees enrolled in the Working on Wellness project. Randomly selected employees at 24 worksites completed a baseline survey (n = 1700); some also an in-person survey and anthropometric measures (n = 1568). Employees were classified by US labor standards as white collar (n = 1297), blue collar (n = 303), or service worker (n = 92), and 8 unknown. Associations were analyzed using chi-square and general linear model procedures and adjusted for demographics using logistic regression. In unadjusted models, body mass index of service workers was higher than white collar workers; fruit and vegetable intake was higher for service and blue collar than white collar; white collar workers reported highest stress levels in job and life. Nevertheless, in models adjusted for demographics, the only significant difference was for PA (ie, metabolic equivalent [MET]/min/wk), with blue collar workers reporting higher levels of PA than service workers, who reported higher levels than the white collar workers. Future research should further examine the relationship between health and job status to corroborate the results of the current study and to consider designing future worksite health promotion interventions that are tailored by job category.

Changing organizational culture: using the CEO cancer gold standard policy initiatives to promote health and wellness at a school of public health.

BackgroundWorksite wellness initiatives for health promotion and health education have demonstrated effectiveness in improving employee health and wellness. We examined the effects of a multifaceted health promotion campaign on organizational capacity to meet requirements to become CEO Cancer Gold Standard Accredited.MethodsWe conducted an online survey to assess perceived organizational values and support for the five CEO Cancer Gold Standard Pillars for cancer prevention: tobacco cessation; physical activity; nutrition; cancer screening and early detection; and accessing information on cancer clinical trials. Baseline and follow-up surveys were sent 6-months apart to faculty, staff, and students at a school of public health to test the impact of a multifaceted health promotion campaign on perceived organizational change. Descriptive analyses were used to characterize percent improvement. Multivariate logistic regression analyses were used to control for participants’ university status.ResultsThe current organizational culture highly supported tobacco cessation at both time points. Significant improvements (p < .05) from baseline to follow-up were observed for questions measuring organizational values for ‘prevention, screening, and early detection of cancer’ and ‘accessing cancer treatment and clinical trials’.ConclusionsHealth promotion and education efforts using multiple approaches were effective to improve perceived organizational values and support for cancer prevention and early detection, and increase access to information about cancer clinical trials. Future studies are needed to examine broader impacts of implementing worksite health promotion initiatives.

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.

Validation of a New Metric for Assessing the Integration of Health Protection and Health Promotion in a Sample of Small- and Medium-Sized Employer Groups.

To conduct validation analyses for a new measure of the integration of worksite health protection and health promotion approaches developed in earlier research. A survey of small- to medium-sized employers located in the United States was conducted between October 2013 and March 2014 (n = 111). Cronbach α coefficient was used to assess reliability, and Pearson correlation coefficients were used to assess convergent validity. The integration score was positively associated with the measures of occupational safety and health and health promotion activities/policies-supporting its convergent validity (Pearson correlation coefficients of 0.32 to 0.47). Cronbach α coefficient was 0.94, indicating excellent reliability. The integration score seems to be a promising tool for assessing integration of health promotion and health protection. Further work is needed to test its dimensionality and validate its use in other samples.

Integrating health promotion and occupational safety and health in manufacturing worksites: Perspectives of leaders in small-to-medium sized businesses.

Accumulating evidence suggests that worksite interventions integrating worksite health promotion (WHP) and occupational safety and health (OSH) may be more efficacious and have higher participation rates than health promotion programs offered alone. However, dissemination of integrated programs is complicated by lack of tools for implementation - particularly for small and medium-sized businesses (SMBs). The goal of this study is to describe perceptions of acceptability and feasibility of implementing an integrated approach to worker health that coordinates WHP and OSH in SMBs. In September to November 2012, decision-makers for employee health programming within SMBs (< 750 employees) in greater Minneapolis were identified. Fourteen semi-structured interviews were conducted and analyzed to develop an understanding of perceived benefits and barriers, awareness, and capacity for implementing an integrated approach. Worker health was widely valued by participants. They reported strong management support for improving employee health and safety. Most participants indicated that their company was open to making changes in their approach to worker health; however, cost and staffing considerations were frequently perceived as barriers. There are opportunities for implementing integrated worksite health programs in SMBs with existing resources and values. However, challenges to implementation exist, as these worksites may lack the appropriate resources.

Worksite Health Program Promoting Changes in Eating Behavior and Health Attitudes

The aim of the present study was to evaluate the effectiveness of a worksite multicomponent health promotion intervention on eating behavior and attitudes, changes in body weight, and readiness to make eating behavior changes among workers over a 12-month intervention period. A total of 3,095 workers of a logistic company participated in a quasi-experimental comparison group study design. The intervention group received a multicomponent health training. Two of the main elements of the multicomponent intervention were physical exercise training and nutrition counseling/training. During the pilot year, participants completed a survey at baseline and again after 12 months to assess physical activity-, health-, and diet-related factors. Results showed that participants' body weight did not significantly decrease in the intervention group. Mean weight loss in the intervention groups was 0.5 kg (body mass index = 0.1 kg/m(2)). Eating behaviors in the intervention group improved more than in the comparison group. Some positive intervention effects were observed for the cognitive factors (e.g., changes in eating attitudes). Baseline readiness to change eating behavior was significantly improved over time. We demonstrated initial results of a long-term multicomponent worksite health promotion program with regard to changes in body weight, eating behavior, and attitudes. This evaluation of a 12-month pilot study suggests that a worksite health promotion program may lead to improvements in nutritional health behaviors for a number of workers. An investigation of long-term effects of this multicomponent intervention is strongly recommended.

Healthy Team Healthy U: A Prospective Validation of an Evidence-Based Worksite Health Promotion and Wellness Platform

To evaluate the effects of a research-tested, team-based health promotion and wellness program combined with digital technologies and implemented in a diverse worksite setting among hospital, clinic, and university employees. A prospective cohort study of employees completing biometrics and questionnaires before and after the initial 12-session wellness program and its 12-session booster, 1 year later. After both the initial intervention and booster, blood pressure and weight were reduced, with greater reductions among employees with pre-hypertension and hypertension and those with a body mass index ≥25. After both the initial intervention and booster, there was a significant increase in (1) daily intake of fruit and vegetable servings, (2) days/week of ≥30 min of exercise, (3) days/week of strength training, and (4) levels of moderately vigorous and vigorous daily physical activity. Self-reported indices of both depression and work-related stress were reduced, while participants reported increased happiness. Post booster, average sleep quality, and sleep duration increased among higher risk employees reporting ≤6 h of daily sleep. Employees reported receiving encouragement from co-workers to engage in healthful diet and physical activities, and exercised together more, and indicated that they would recommend the program to other employees. Longitudinal analysis revealed the durability of the initial intervention outcomes with further beneficial effects after the booster. A research tested, comprehensive team-based health promotion and wellness program, combined with digital technologies, improved employee health behaviors, mood, sleep, elements of co-worker cohesion, and biometrics among a diverse multi-site workforce. Positive program effects were durable, with enhanced results after the booster.

Do overweight workers profit by workplace health promotion, more than their normal-weight peers? Evaluation of a worksite intervention.

BackgroundWorksite health promotion programs have been identified as strongly effective in decreasing body weight and increasing awareness and change in health behavior. Aim of this study is to determine the effects of a multi-component intervention in workplace health promotion.MethodsIn a controlled study trail, 1,573 workers of a logistics company had the chance to participate in a one year worksite health promotion program. Main elements of the multi-component intervention were physical activity training in combination with nutrition counseling. Employees completed a questionnaire at baseline and then again after twelve month. Main outcome variables were changes in body weight and health behaviors. Secondary outcomes were subjective health indicators.ResultsOur results showed preliminary improvements in physical activity and eating behavior among normal weight and overweight/obesity weight groups. No significant weight reduction could be found, only a minimal reduction of BMI. The reduction was larger in the overweight group. Workers considered overweight or obese showed significantly greater body weight loss and changes in eating behavior than workers with a normal weight status. Workers with obesity/overweight scored their general health status significantly lower than their colleagues with normal weight status. No significant improvements were found for overall perception of health status between baseline and follow-up in the BMI-groups.ConclusionThis 12-month intervention-control study suggests that a well-implemented multi-component workplace health promotion program may support substantial change in health behavior (e.g. nutrition and physical activity). It is indicated that overweight employees may especially profit from such worksite health promotion. An investigation of long-term effects of this multi-component intervention is strongly recommended.

Total Worker Health: Implications for the Occupational Health Nurse.

Total Worker Health™ is defined as a "strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance worker health and well-being." This strategy aligns workplace safety with individual behaviors that support healthy lifestyles. The Patient Protection and Affordable Care Act of 2010 presumes that incentive-oriented worksite health promotion provides a critical pathway to reduce group health costs. Because of their scientific and clinical backgrounds, professional nurses are well qualified to educate and assist individuals with healthy lifestyle choices. Occupational health nurses and patient advocates can shape wellness initiatives that best serve both employees and their employers.

LifeWorks@TURCK

LifeWorks@TURCK

Differences in Participation in University Worksite Health Promotion Programs and Physical Activity Between Faculty, Staff and Administration

Despite the numerous documented benefits of worksite health promotion programs (HPPs), participation rates are traditionally low. These low participation rates are due in part to perceived barriers. Barriers to use of HPPs and exercise have been a well-studied topic within the last two decades. However, fewer studies have focused on barriers to participation in HPPs among university employees. The differences in roles and responsibilities on a university campus warrant a more thorough examination of barriers among job classifications. PURPOSE: The purpose of this study was to examine differences in participation in university health promotion programs (HPPs) among faculty, staff and administration. Further, barriers to participation were examined as well as an analysis of those meeting weekly physical activity (PA) recommendations. METHODS: An electronic survey was sent to all employees at a metropolitan university (n=3603) which inquired about participation in the University HPP, physical activity and perceived barriers to participation. A Chi-square Test of Independence was performed for HPP participation and physical activity amounts between groups, and qualitative themes were identified for perceived barriers. RESULTS: Results (n=308) indicated a difference in participation rates (χ2: p<0.001) among faculty, staff and administration, as well as those meeting PA recommendations between job classifications (χ2: p<0.001). Unique barriers were identified for each job classification. CONCLUSIONS: The results of this study suggest that HPP administrators should recognize the differences in barriers to participation among university employees in order to maximize HPP participation.

Effect of a Worksite Walking Competition on Health-Related Quality of Life Among University Employees

Worksite health promotion programs (WHPPs) aim to improve the health and wellness of employees in an effort to improve health related quality of life (HRQOL). The effect of exercise on improving HRQOL is well documented among clinical populations. However, few studies have examined the effect of WHPPs on HRQOL. The purpose of this study was to investigate the effect of a six-week “Workplace Walk-Off Competition” (WWC) on HRQOL among university employees. One hundred and nine university employees were included in this study (WWC group: n=47, Control group: n=62). All study participants completed the Short Form 12 Question, Version 2 (SF-12v2), a HRQOL questionnaire, before and after the WWC. The SF-12v2 questionnaire determines HRQOL based on two components and reports scores for a physical component summary (PCS) score and a mental component summary (MCS) score. A two-way repeated measures ANOVA was performed on PCS and MCS scores, followed by dependent t-tests for each group. There was no significant difference in PCS or MCS scores between the groups. Further, there were no statistically significant changes in PCS or MCS scores (p&gt;.05) among either group, following the six-week WWC. Although much research deems WHPPs effective for improving many health indicators, this short-term program was not effective in improving PCS and MCS components of HRQOL. KEYWORDS: Quality of Life, Health Promotion, Walking Competition, University Employees

Workplace Health Promotion in Small, Medium-Sized and Large Enterprises of the Health-Care Sector - Frequency, Reasons for the Company Management to Take Action and Barriers to Implementation

The aim of this study was to gain insight into worksite health promotion in small and medium-sized companies compared to large concerns in Middle Franconia. Action in worksite health promotion, obstacles and demand for networks for workplace health promotion were determined. A standardised telephone interview served for collecting data for this cross-sectional study. The interviewee was always the manager or their proxy. 106 companies were contacted. The results of this study were analysed via qualitative and quantitative methods in SPSS(®) 20. It was possible to reach and interview 80 companies, a return rate of 75.5%. More than half the companies (68.8%) implemented at least one activity for worksite health promotion, especially ergonomic measures and measures to promote physical activity. Taking the size of the company into consideration when analysing the results, previous study results are confirmed. With an increasing size of the company, the relative frequency of measures for workplace health promotion rises. The motivation for worksite health promotion ranges from keeping the employees healthy (38.2%) to worksite health promotion as part of the business culture (9.1%). 81.1% of the companies consider their activity in worksite health promotion to be successful. Furthermore, 80.0% of the firms that implemented worksite health promotion were supported by a partner like a health insurance (43.2%). Those companies that did not implement any activities for worksite health promotion, state as a prime reason that they did not think about it as yet (44.0%). Besides, 44.0% of the companies without any worksite health promotion would like to implement measures. 65.5% of the companies that already took action in worksite health promotion and 56.0% of the companies that did not would like to cooperate with other firms in a network for workplace health promotion. Mutual exchange is the most important factor for them. The results of this study show that almost half of the companies that did not implement measures for worksite health promotion as yet would like to take action in this regard. For a bigger establishment of worksite health promotion, networks are predestinated and are best accompanied and supported by external professionals like health insurances, mutual indemnity associations or universities.

Effectiveness of 6 months of tailored text message reminders for obese male participants in a worksite weight loss program: randomized controlled trial.

BackgroundWorksite nutrition and physical activity interventions are important to help overweight and obese employees lose weight, but costs and insufficient sustained motivation prevent the majority of these programs from succeeding. Tailored text messaging in aiding weight management has been effective in several studies, but no studies have evaluated the effect of a tailored text message service on weight loss in a worksite health promotion program.ObjectiveWe studied the efficacy of a tailored text-messaging intervention for obese male participants in a worksite weight loss program of 6 months duration.MethodsThe study was an unblinded, randomized controlled trial. Men with a body mass index greater than 25 kg/m2 were recruited from the Korea District Heating Corporation, the Korea Expressway Corporation, and the Korea Gas Corporation. The participants were identified by nurse managers. Participants were randomly allocated to 1 of the following 2 groups for 24 weeks: (1) intervention group, which received tailored text message reminders every other day plus 4 offline education sessions and brief counseling with monthly weight check by nurses for weight control over 6 months and (2) control group, which received the 4 offline education sessions and brief counseling with monthly weight check by nurses about weight control over 6 months. The primary outcome was the difference in weight loss at 6 months. A mixed-model repeated-measures analysis was performed to evaluate the effect of the intervention group’s weight loss compared with the control group.ResultsA total of 205 obese men were randomized into either the intervention (n=104) or the control group (n=101). At the end of 6 months, the intervention group (n=63) had lost 1.71 kg (95% CI –2.53 to –0.88) and the control group (n=59) had lost 1.56 kg (95% CI –2.45 to –0.66); the difference between the 2 groups was not significant (mean difference –0.15, 95% CI –1.36 to 1.07). At the end of the study, 60% (34/57) of the intervention group rated the message program as helpful for weight control and 46% (26/57) would recommend the text message service to their friends.ConclusionsTailored text message reminders did not have a significant effect on weight loss in obese men as part of a worksite weight loss program.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 39629189; http://www.isrctn.com/ISRCTN39629189?q=39629189&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search (Archived by WebCite at http://www.webcitation.org/6VsFkwJH6).

A worksite intervention to reduce the cardiovascular risk: proposal of a study design easy to integrate within Italian organization of occupational health surveillance.

BackgroundDespite the substantial amount of knowledge on effectiveness of worksite health promotion (WHP) in reducing cardiovascular disease (CVD) risk, WHP programs are not systematically applied in Italy. The aim was to design an intervention easy to integrate within the Italian organization of workplace health surveillance.MethodsWe used the “pretest-posttest design”. Workers were employed in multiple occupations and resident in Veneto region, Italy. Occupational physicians (OPs) performed all examinations, including laboratory evaluation (capillary blood sampling and measure of glycaemia and cholesterolemia with portable devices), during the normal health surveillance at worksite. CVD risk was computed based on sex, age, smoking habit, diabetes, systolic pressure and cholesterol level. After excluding those with <40 years of age, missing consent, CVD diagnosis or current therapy for CVD, missing information, CVD risk <5%, out of 5,536 workers 451 underwent the intervention and 323 male workers were re-examined at 1 year. CVD risk was the most compelling argument for changing lifestyle. The counseling was based on the individual risk factors. Individuals examined at posttest were a small fraction of the whole (6% = 323/5,536). In these workers we computed the ratio pretest/posttest of proportions (such as percent of subjects with cardiovascular risk >5%) as well as the exact McNemar significance probability or the exact test of table symmetry.ResultsCVD risk decreased by 24% (McNemar p = 0.0000) after the intervention; in a sensitivity analysis assuming that all subjects lost to follow-up kept their pretest cardiovascular risk value, the effect (−18%) was still significant (symmetry p < 0.0000). Each prevented CVD case was expected to cost about 5,700 euro.ConclusionsThe present worksite intervention promoted favorable changes of CVD risk that were reasonably priced and consistent across multiple occupations.

Health Behaviors and Overweight in Nursing Home Employees: Contribution of Workplace Stressors and Implications for Worksite Health Promotion.

Background. Many worksite health promotion programs ignore the potential influence of working conditions on unhealthy behaviors. Methods. A study of nursing home employees (56% nursing aides) utilized a standardized questionnaire. We analyzed the cross-sectional associations between workplace stressors and obesity, cigarette smoking, and physical inactivity. Results. Of 1506 respondents, 20% reported exposure to three or more workplace stressors (physical or organizational), such as lifting heavy loads, low decision latitude, low coworker support, regular night work, and physical assault. For each outcome, the prevalence ratio was between 1.5 and 2 for respondents with four or five job stressors. Individuals under age 40 had stronger associations between workplace stressors and smoking and obesity. Conclusions. Workplace stressors were strongly associated with smoking, obesity, and physical inactivity, even among the lowest-status workers. Current working conditions affected younger workers more than older workers. Although this study is cross-sectional, it has other strengths, including the broad range of work stressors studied. Strenuous physical work and psychosocial strain are common among low-wage workers such as nursing home aides. Workplace health promotion programs may be more effective if they include measures to reduce stressful work environment features, so that working conditions support rather than interfere with employee health.

Worksite health promotion programs in college settings

The purpose of this paper is to describe the multifaceted nature and benefits of worksite health promotion programs (WHPPs), with emphasis on the college setting. An assessment of the peer-reviewed literature was conducted of articles published since 2000. Several search engines were accessed and selected key words were used. Most studies examining WHPPs have focused on return on investment and productivity. Research that targets the softer side-benefits of health promotion programs in the workplace is less available. Although the college setting offers some advantages for implementing health promotion programs. They may also have unique challenges due to their large and diverse employee population. There is little research to show the effectiveness and unique challenges of college-based health promotion programs.

The effect of a health promotion intervention for construction workers on work-related outcomes: results from a randomized controlled trial.

The objective of the present study is to investigate the effects of a worksite health promotion intervention on musculoskeletal symptoms, physical functioning, work ability, work-related vitality, work performance, and sickness absence. In a randomized controlled design, 314 construction workers were randomized into an intervention group (n = 162) receiving personal coaching, tailored information, and materials, and a control group (n = 152) receiving usual care. Sickness absence was recorded continuously in company records, and questionnaires were completed before, directly after the 6-month intervention period, and 12 months after baseline measurements. Linear and logistic regression analyses were performed to determine intervention effects. No significant changes at 6 or 12 months of follow-up were observed in musculoskeletal symptoms, physical functioning, work ability, work-related vitality, work performance, and sickness absence as a result of the intervention. This study shows that the intervention was not statistically significantly effective on secondary outcomes. Although the intervention improved physical activity, dietary, and weight-related outcomes, it was not successful in decreasing musculoskeletal symptoms and improving other work-related measures. Presumably, more multifaceted interventions are required to establish significant change in these outcomes.

Nurses’ lifestyle behaviours, health priorities and barriers to living a healthy lifestyle

Introduction: The workplace is a setting with the potential for reaching large numbers of people, with positive impacts on health status. Previous research suggests that nurses have an increased risk for non-communicable diseases (NCDs). Therefore the aim of this study was to determine the health concerns, priorities and barriers to living a healthy lifestyle among nurses and hospital management staff working in public hospitals in theWestern Cape, South Africa. Methods: All the nurses employed at the five participating hospitals were eligible to participate in the research study. Five focus groups were conducted with the day shift (n=36), and seven focus groupswere conductedwith the night shift (n=57) nurses. In addition, 7 key informant interviews were conducted with the Nursing Managers from the hospitals. Guiding questions were used to gain insight into nurses’ health concerns, lifestyle behaviours and current worksite health promotion programmes (WHPPs). Data were analysed using thematic analysis with the Atlas.ti Qualitative Data Analysis Software. Results: Weight gain and living with NCDs such as hypertension were the main health concerns identified by the nurses. The nurses suggested that being overweight had a negative impact on their occupational tasks and requirements. In addition, both management and nurses perceived the hospital as a stressful working environment. Lack of time was the main barrier to healthy eating and regular physical activity. Another barrier that nurses identifiedwas the hospital environment, where for example, the canteen did not offer healthy food options. The most commonly delivered WHPPs includedopportunities for telephone-based counseling and advisory services, and an online employee wellness programme. Wellness days, which included blood glucose, cholesterol, blood pressure and Body Mass Index measures, were also frequently reported. Both day and night shift nurses were interested inWHPP that provided opportunities for physical activity in addition to stress management programmes and support groups. The managerswere interested in interventions thatpromoted teambuilding and addressing cultural diversity. Discussion: Both the risk of NCDs and exposure to infectious disease remains a concern in this working population. Our findings highlight the need for WHPPs in hospitals that support nurses in managing stress and controlling their weight, as well as transforming the work environment to facilitate healthy lifestyles.