Worksite Health Research Articles

Economic Evaluation of an Intervention Promoting Adoption of Occupational Sun Protection Policies.

Economic evaluation of an intervention promoting adoption of occupational sun protection actions by Colorado public sector employers. Randomized controlled trial with 2-year follow-up conducted during 2010 to 2013. Thirty-three intervention and 30 attention-control worksites in final economic sample. Twenty-four-month intervention of personal contacts, training, and materials. Intervention delivery micro-costed. Costs of implemented actions from employer self-report. Twenty-four-month intervention costs: $121,789, 51.8% incurred by project staff (per-worksite mean=$1,732). Worksite costs: $58,631 (mean = $1,777). Per-employee costs: $118 project staff, $56 worksites. Materials cost: $5990 (mean = $181). Intervention worksites implemented 72 nontraining sun protection actions post-Sun Safe Workplaces (SSW) (mean = 2.18). Control worksites implemented 39 actions (mean = 1.30). Total costs to intervention worksites of implementing the 72 post-SSW actions: $90,645 (mean = $2,747). Control worksite costs: $66,467 (mean = $2,216). Per-employee implementation costs are comparable to other worksite health interventions. SSW expanded adoption of sun protection actions at a reasonable per-employee cost.

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.

Gender Differences in Self-perception of Health at a Wellness Center.

Objective: Understanding gender differences in self-perception of health (SPH) and self-efficacy can inform the design of tailored programs to improve health behaviors. We aimed to assess gender-specific differences in SPH and self-efficacy for maintaining wellness habits at a work-place wellness center. Methods: A workplace wellness center member survey was conducted in 2016. Information about SPH and self-efficacy to maintain wellness habits was assessed. Data were analyzed to assess gender differences in SPH and self-efficacy. Results: The survey was completed by 2784 members (mean age, 49.2 years; 68.2% women). SPH was similar between genders despite more men reporting health problems such as hypertension, diabetes, high cholesterol, and cigarette smoking. Women had higher self-efficacy about maintaining healthy diet, but the difference was not clinically meaningful. Women had lower self-efficacy in their ability to maintain physical activity. Conclusions: In this large cohort of worksite wellness center members, men and women had similar self-perception of health despite higher disease burden among men. Women had lower self-efficacy in their ability to maintain physical activity level but similar self-efficacy for maintaining healthy diet. These differences may inform the design of tailored wellness programs to meet the needs of both genders.

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

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

Innovative recruitment strategies for a comprehensive worksite wellness initiative.

Recruiting for wellness initiatives is challenging. WorkWell KS, a statewide worksite wellness initiative, offers unique worksite recruitment strategies that may serve as lessons. From 2012 to 2018, WorkWell KS utilized champions, well-connected local leaders, to recruit worksites. A total of 784 worksites were recruited for at least one WorkWell KS workshop. A survey of champions requested identification of strategies, barriers and facilitators for successful recruitment and continued engagement. Forty-three champions reported on recruitment experiences. Sixty-three percent of respondents attributed recruitment success to having funding to complete their work. Face-to-face meetings was the most commonly reported successful strategy. Eighty-six percent of respondents reported that improving employee health was motivation for worksites to participate. Champions with a significant funding incentive for worksites commonly indicated that funding was a motivating factor. The most commonly selected factor for continued engagement was having a worksite staff member with wellness in their job description (67% of respondents). Forty-nine percent of respondents reported worksites' lack of time as a barrier to participation. The WorkWell KS initiative has implemented innovative recruitment methods that leverage well-connected leaders to recruit worksites to participate in a comprehensive worksite wellness initiative. Future worksite-based initiatives may benefit from adopting recruitment strategies presented here.

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.

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.

Workplace Health Promotion Is Growing Up but Confusion Remains About What Constitutes a Comprehensive Approach.

Professionals interested in advancing best practices in worksite wellness have been calling for more organizational and environmental approaches that will advance a culture of health. We seem to be getting the message across because a recent national survey shows that "supportive social and physical environment" is one of the 5 elements used to define a comprehensive program that has increased the most from 29.2% naming this as part of their approach in 2004 to 56% of companies in 2017. Yet 2 worksite health promotion studies that garnered media attention this past year offer telling examples of what occurs when researchers conflate or confuse the effectiveness of a health education program with a socioecological approach. I would suggest we replace the term "comprehensive programs" with "socioecological approach" or a "culture of health approach" or, at least, "a comprehensive approach," anything but continued use of the oxymoronic term "comprehensive program."

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

Impact of a Fruit and Vegetable Prescription Program on Diet Quality and Cardio-Metabolic Risk Factors in Healthy Adults in a Worksite Setting: A Randomized Controlled Trial (OR16-07-19)

ObjectivesCommunity- and clinic-based fruit and vegetable “prescription” (FVRx) programs, which include nutrition education and subsidies to reduce the cost of fruits and vegetables have improved dietary intake and some clinical outcomes, such as hemoglobin A1c (HbA1c) and blood pressure. However, few if any studies have investigated the impact of an FVRx program in a worksite setting. The purpose of this study was to determine the effects of a worksite FVRx program on diet quality, body mass index (BMI), waist circumference, blood lipid concentrations, hemoglobin A1c (HbA1c), and blood pressure. MethodsIn the first of two planned cohorts, we randomized healthy adults employed at a community hospital in southern Connecticut to receive either the FVRx program for 10 weeks (n = 20) or standard worksite wellness offerings (n = 20). Each week, intervention participants received a 45-minute cooking and nutrition education session held during the workday and a voucher valuing $15–25, depending on household size, that could be redeemed for fruit and vegetable purchases at a local grocery store. Outcome measures were assessed at baseline and at the end of the intervention. ResultsCompared to the control group, participants in the FVRx group significantly increased their HEI-2010 score for vegetable intake (0.91 ± 1.41 vs. 0.02 ± 1.18, P < 0.05) and reduced their HE-2010 score for empty calories (−4.61 ± 4.82 vs. −0.75 ± 3.20, P < 0.01). There were no between-group differences in other HEI-2010 components, body composition, HbA1c blood lipids, or blood pressure. However, the FVRx group did improve their overall HEI-2010 score from baseline (7.85 ± 10.82, P < 0.05) whereas the control group did not (3.57 ± 9.51, P > 0.05). ConclusionsIn this interim analysis, we demonstrated potential benefits of a worksite FVRx program on intake of vegetables and empty calories. Changes in anthropometric or biochemical measures were not observed immediately post-intervention, but this may be due to enrollment of a low-risk population or length of time needed to influence those measures. That the intervention nevertheless improved dietary intake suggests that it may be valuable for prevention of diet-related disease in healthy adults. Funding SourcesCenters for Disease Control and Prevention, Prevention Research Centers Program 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.

Innovation to Create a Healthy and Sustainable Food System: A Science Advisory From the American Heart Association.

Current dietary intakes of North Americans are inconsistent with the Dietary Guidelines for Americans. This occurs in the context of a food system that precludes healthy foods as the default choices. To develop a food system that is both healthy and sustainable requires innovation. This science advisory from the American Heart Association describes both innovative approaches to developing a healthy and sustainable food system and the current evidence base for the associations between these approaches and positive changes in dietary behaviors, dietary intakes, and when available, health outcomes. Innovation can occur through policy, private sector, public health, medical, community, or individual-level approaches and could ignite and further public-private partnerships. New product innovations, reformulations, taxes, incentives, product placement/choice architecture, innovative marketing practices, menu and product labeling, worksite wellness initiatives, community campaigns, nutrition prescriptions, mobile health technologies, and gaming offer potential benefits. Some innovations have been observed to increase the purchasing of healthy foods or have increased diversity in food choices, but there remains limited evidence linking these innovations with health outcomes. The demonstration of evidence-based improvements in health outcomes is challenging for any preventive interventions, especially those related to diet, because of competing lifestyle and environmental risk factors that are difficult to quantify. A key next step in creating a healthier and more sustainable food system is to build innovative system-level approaches that improve individual behaviors, strengthen industry and community efforts, and align policies with evidence-based recommendations. To enable healthier food choices and favorably impact cardiovascular health, immediate action is needed to promote favorable innovation at all levels of the food system.

The Cons of Traditional Worksite Wellness Interventions and a Proposed Model.

The Cons of Traditional Worksite Wellness Interventions and a Proposed Model.

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.

Association of Single and Multiple Medical Conditions with Work Status among Adults in the United States.

BackgroundThe purpose of this study was to comprehensively examine the association of a multitude of individual medical conditions, as well as multimorbidity, on work status among a national sample of U.S. adults.MethodsThe present study included 7 cycles (1999–2012) from the National Health and Nutrition Examination Survey (N = 28,119).ResultsIn total, 26 medical conditions increased the odds of not working. Multimorbidity as well as having prevalent medical condition(s) within each of the Cumulative Index Rating Scale Morbidity Classes were associated with increased odds of not working. Few medical conditions were associated with higher odds of working part-time (vs. full-time) or unemployment (vs. working).ConclusionThese findings underscore the importance of instating comprehensive worksite wellness health promotion policies, as well as providing individuals with resources to preserve and enhance personal health.