Worksite Policies Research Articles

How do employees feel their health is valued? a descriptive case study

PurposeA descriptive case study approach was adopted to examine employees' perceptions of the prevalence and usefulness of wellness programs. Relying on Centers for Disease Control and Prevention Health ScoreCard (CDC HSC), this study aims to assess the prevalence of worksite wellness programs, policies and benefits in general and incorporated employee perspectives to contextualize the CDC HSC wellness assessments.Design/methodology/approachThe authors first compared the CDC HSC assessments to evaluate the effectiveness of wellness programs in 20 select organizations. Follow-up employee interviews (n = 25) were conducted to contextualize the CDC HSC assessments.FindingsA variety of wellness programs are likely to increase employee engagement and participation when organizations adopt a bundling approach to combine wellness policies, incentives and an array of wellness programming opportunities that encourage and incentivize employees’ health promotion behaviors.Research limitations/implicationsFuture researchers might examine health metrics, in terms of dollars, doctor visits or biometrics before and after the implementation of a wellness program or paid wellness coordinator. Because this study interviewed employees and not members of executive leadership or finance and accounting, financial metrics were not available or the focus of this study. The inclusion of leaders and directors of wellness initiatives would offer additional ways for examining the impact of wellness initiatives on employee behaviors on organizational outcomes.Practical implicationsNutrition, weight management and chronic disease management were identified as major challenges impacting the health of employees. Even when organizations reported robust scores in their CDC HSC assessments, employers identified these three areas as critical for sustaining the health and well-being of their employees. Finally, the issue of employee safety was a top priority for all organizations regardless of how they scored on their CDC HSC assessments.Social implicationsThe authors suggest that when high-impact wellness practices are linked to organizational supports in the workplace, these efforts are likely to have more positive effects on both employee outcomes and organizational outcomes. A regular routine of checking on wellness issues can help keep potential problems from going unnoticed. An example of this is a reminder to stretch at a morning meeting or during work hours as a reminder to stay focused on health and well-being.Originality/valueThe authors aggregated the organizational assessments for different wellness interventions and compared the scores (falling above or below) with standardized CDC wellness scores. The incorporation of the CDC scorecard ensured a standardized and evidence-based evaluation of workplace wellness programs. This additional step informed the interview guide and follow-up with employees who offered recommendations for how organizations could enhance their wellness programs and policies.

Fitting and validation of an agent-based model for COVID-19 case forecasting in workplaces and universities.

COVID-19 forecasting models have been critical in guiding decision-making on surveillance testing, social distancing, and vaccination requirements. Beyond influencing public health policies, an accurate COVID-19 forecasting model can impact community spread by enabling employers and university leaders to adapt worksite policies and practices to contain or mitigate outbreaks. While many such models have been developed for COVID-19 forecasting at the national, state, county, or city level, only a few models have been developed for workplaces and universities. Furthermore, COVID-19 forecasting models have rarely been validated against real COVID-19 case data. Here we present the systematic parameter fitting and validation of an agent-based compartment model for the forecasting of daily COVID-19 cases in single-site workplaces and universities with real-world data. Our approaches include manual fitting, where initial model parameters are chosen based on historical data, and automated fitting, where parameters are chosen based on candidate case trajectory simulations that result in best fit to prevalence estimation data. We use a 14-day fitting window and validate our approaches on 7- and 14-day testing windows with real COVID-19 case data from one employer. Our manual and automated fitting approaches accurately predicted COVID-19 case trends and outperformed the baseline model (no parameter fitting) across multiple scenarios, including a rising case trajectory (RMSLE values: 2.627 for baseline, 0.562 for manual fitting, 0.399 for automated fitting) and a decreasing case trajectory (RMSLE values: 1.155 for baseline, 0.537 for manual fitting, 0.778 for automated fitting). Our COVID-19 case forecasting model allows decision-makers at workplaces and universities to proactively respond to case trend forecasts, mitigate outbreaks, and promote safety.

Using CDC's Worksite Health ScoreCard to Evaluate Nutrition and Physical Activity Interventions in Priority Communities in New York State, 2015-2020.

The aim of our study was to evaluate a statewide obesity prevention program, designed to improve two social determinants of health (access to healthy foods and opportunities for physical activity) by changing worksite policies, systems, and environments. We used data on social determinants of health to identify priority communities and funded 25 contractors to recruit and engage worksites in those communities. We employed a pre/post quasi-experimental design and used the Centers for Disease Control and Prevention's Worksite Health ScoreCard to assess implementation of nutrition and physical activity strategies. Contractors collaborated with partners to conduct pre- and postassessments at 313 worksites. Worksites were successful at implementing all except one strategy; implementation doubled for eight strategies and tripled for three. We used weighted scores to incorporate strength of the evidence-base and level of impact into our analysis; increases in strategy implementation were statistically significant in worksites that provided places to purchase food and beverages and in those that did not. Our study revealed several important recommendations for practice. Use available data to prioritize communities experiencing health disparities and identify PSE change strategies to increase access to nutritious foods and physical activity opportunities. Engage with reputable community-based partners from different sectors when designing and implementing programs. Use standardized tools, such as the Worksite Health ScoreCard, to evaluate public health initiatives.

Cracks in the foundation: The experience of care aides in long-term care homes during the COVID-19 pandemic.

BackgroundCare aides (certified nursing assistants, personal support workers) are the largest workforce in long‐term care (LTC) homes (nursing homes). They provide as much as 90% of direct care to residents. Their health and well‐being directly affect both quality of care and quality of life for residents. The aim of this study was to understand the impact of COVID‐19 on care aides working in LTC homes during the first year of the pandemic.MethodsWe conducted semi‐structured interviews with a convenience sample of 52 care aides from 8 LTC homes in Alberta and one in British Columbia, Canada, between January and April 2021. Nursing homes were purposively selected across: (1) ownership model and (2) COVID impact (the rate of COVID infections reported from March to December 2020). Interviews were recorded and analyzed using inductive content analysis.ResultsCare aides were mainly female (94%) and older (74% aged 40 years or older). Most spoke English as an additional language (76%), 54% worked full‐time in LTC homes, and 37% worked multiple positions before “one worksite policies” were implemented. Two themes emerged from our analysis: (1) Care aides experienced mental and emotional distress from enforcing resident isolation, grief related to resident deaths, fear of contracting and spreading COVID‐19, increased workload combined with staffing shortages, and rapidly changing policies. (2) Care aides' resilience was supported by their strong relationships, faith and community, and capacity to maintain positive attitudes.ConclusionsThese findings suggest significant, ongoing adverse effects for care aides in LTC homes from working through the COVID‐19 pandemic. Our data demonstrate the considerable strength of this occupational group. Our results emphasize the urgent need to appropriately and meaningfully support care aides' mental health and well‐being and adequately resource this workforce. We recommend improved policy guidelines and interventions.

Abstract P158: Work-related Exertion And Standing/walking Are Associated With Leisure-time Physical Activity In Latinos

Introduction: Latinos engage in higher levels of occupational physical activity, yet lower levels of leisure-time physical activity (LTPA), than other racial/ethnic groups. Limited research has examined specific work-based activities that contribute to lower LTPA among Latinos. The purpose of our study was to examine associations between frequency of work-related exertion and standing/walking with LTPA among Latinos. Hypothesis: We hypothesized that higher frequency of work-related exertion and standing/walking would be associated with lower levels of LTPA among Latinos. Methods: We used cross-sectional 2015 National Health Interview Survey (NHIS) data on employed Latinos ≥18 years of age (n=3,305). We examined two types of work-based activities: frequency of exertion and frequency of standing/walking. Frequency of exertion was assessed based on reported frequency of engaging in repeated lifting, pulling, pushing, or bending at work. Frequency of standing/walking was assessed based on frequency with which their work involved standing or walking around. Responses to work-based activity items were on a Likert scale (0=never, 1=seldom, 2= sometimes, 3=often, 4=always). LTPA was measured based on minutes of moderate-to-vigorous LTPA aerobic physical activity per week, which were categorized into none (0 min/week), some LTPA (>0 min/week of activity but less than recommendation), and meeting the LTPA guideline (≥150 min of moderate-vigorous activity or ≥75 min of vigorous activity or 150 min of moderate activity/week). Multinomial logistic regression models that accounted for the complex survey design of NHIS were used to estimate the associations between frequency of work-related exertion and standing/walking with LTPA. All models were adjusted for age, sex, education, shift work, and acculturation proxies (nativity, years living in the US). Results: In adjusted models, compared with those who reported never engaging in exertion at work, individuals reporting always exerting themselves at work were significantly less likely to meet the LTPA guideline (Odds Ratio [OR]: 0.68, 95% Confidence Interval [CI]: 0.50-0.94). In addition, compared with those that reported never standing/walking at work, only those who reported that their job seldom involved standing/walking at work were significantly less likely to meet the LTPA guideline (OR: 0.52, 95% CI: 0.30-0.92). Conclusions: In conclusion, these findings suggest that work-related physical activities may contribute to LTPA levels among Latinos, and associations vary based on the type of physical activities performed at work. Future physical activity promotion efforts among Latinos should consider the role of worksite policies to promote wellness.

Abstract PS7-72: Will it work? Opportunities for physicians and employers to assist breast cancer patients in addressing non-medical barriers to care

Abstract Background: Advances in cancer treatments have improved the prognosis for many people and enabled some to work during treatment. Although physicians have conversations with cancer patients about care preferences, conversations often do not include the impact of treatment on the non-medical aspects of patients’ lives. In particular, work disruption has the potential to exacerbate existing hardships and has been proven to be a significant barrier to care and attaining optimal wellbeing. For many patients, returning to work is viewed as a key milestone. This study evaluated the impact of breast cancer on work activities, return-to-work decision-making, and the opportunity for employers to accommodate and support employees with cancer. Methods: A cross-sectional survey of patients served by Patient Advocate Foundation in 2018-2019. Descriptive statistics were calculated using frequencies for categorical variables. Results: Of 677 breast cancer patients surveyed, >6-months of treatment-related work absence was experienced by 53%; 32% utilized FMLA; 32% short-term disability; 40% unpaid leave. One fifth retired early; 23% reduced hours worked; 8% changed careers and 66% discussed treatment impact with HR. Almost two-thirds of employers (60%) made reasonable adjustments to work duties; 68% were supportive during the entire illness. Half (51%) of the patients reported that their provider initiated a conversation about the impact of treatment on their ability to work; 54% considered work impact when deciding on their first treatment; and 53% reported that their treatment ‘always’ or frequently’ reduced their ability to work. Work disruption had a negative impact on monthly income; 68% of patients stating that it had ‘a lot of impact’ and 46% reported lost wages >$750. Survey respondents were 65% Caucasian, 20% African American, and 15% Other or Undisclosed. Nearly half (44%) were <55 years old, and 77% reported income <$48,000. Two thirds (63%) reported full time employment, 73% age <60 years and half reported stage 0-2 (49%) at time of diagnosis; 47% were employer insured. Discussion: Patients with cancer struggle to afford needed medical care alongside daily financial obligations due to rising healthcare costs. It is important for provider care conversation to expand beyond just the decision around clinical care. Employers were reported to be supportive and flexible about return to work and most cancer survivors in this study were satisfied with their employers’ responses to their needs. The large percentage of patients that did not discuss the impact of cancer treatment on work activities may indicate their reluctance to have these conversations with HR and highlight how the threat of reduced financial status may change treatment decisions. Conclusions: Health system-level solutions will require person-centered policies focused on expanding shared decision making by integrating what matters to patients in the context of their lived experience with illness. Care conversations must incorporate all aspects of the patient’s situation and preferences to ensure the alignment of treatment, personal and financial goals. It is imperative that clinicians recognize and discuss the impact of treatment choices on a patient’s ability to work, as employment changes place patients at increased risk for negative financial impact. Similarly, employers should develop and implement worksite wellness policies that encourage (and protect) patients facing changes in health that impact work and support flex scheduling for persons with chronic conditions. The adoption of such policy could minimize the need for extensive time off or loss of job. This in turn could avert lost wages, lost productivity, and early retirement of employees, as well as potentially decreasing the costs associated with employee turnover. Citation Format: Fran Castellow, Kathleen Gallagher, Rebekah Angove. Will it work? Opportunities for physicians and employers to assist breast cancer patients in addressing non-medical barriers to care [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-72.

Abstract P499: 24-month Follow-up Of The ‘Stand And Move At Work’ Sedentary Behavior Intervention: Effects On Workplace Sitting Time

Multicomponent interventions that use sit-stand workstations (SSW) to reduce workplace sitting time have been largely successful. However, the long-term maintenance (i.e., >12 months) of this behavior change is relatively unknown. We aimed to evaluate the 24-month maintenance of reductions in workplace sitting time, along with the effects of introducing the SSW after 12 months of multicomponent intervention only. We used data from Stand and Move at Work, a two-arm multi-site group randomized trial of 24 worksites (12 worksites per arm; N=630, 74% female, 45±11 years of age). Worksites in the STAND+ arm received 12 months of a multilevel (i.e., worksite policy, environmental, and individual-level strategies) intervention to increase light-intensity physical activity, along with a SSW, to increase standing time. Worksites in the MOVE+ arm (i.e., comparator) received the same multilevel intervention but were not provided with the SSW until after the intervention ended at 12 months. Sitting time was assessed for 7 consecutive days using the activPAL3c micro accelerometer at baseline, 12, and 24 months. Results are presented below in table form. In STAND+ , sitting time at 24 months, relative to baseline, was significantly reduced and similar in magnitude of change to what was observed at 12 months. In MOVE+ , sitting time at 24 months (a year after the SSW was introduced), relative to baseline, was significantly reduced but markedly smaller in magnitude of change than observed during the STAND+ active intervention period (i.e., 0 to 12 months). These results support the use of SSW coupled with a multicomponent intervention for optimal and long-term maintenance of reductions in workplace sitting time. Hierarchical regression models were adjusted for worksite clustering, age, sex, and baseline BMI.

Abstract P500: 24-Month Follow-Up of the ‘Stand and Move at Work’ Sedentary Behavior Intervention: Effects on Cardiometabolic Risk in Those With Dysglycemia

Long-term effects of workplace sedentary behavior interventions on cardiometabolic risk are poorly understood. Stand and Move at Work was a multi-site group randomized trial in 24 worksites (N=630, 74% female, 45±11 years of age) of office-based employees in Phoenix, AZ and Minneapolis/St. Paul, MN. Worksites in the STAND+ study arm received 12 months of a multilevel (i.e., worksite policy, environmental, and individual-level strategies) intervention to increase light-intensity physical activity along with a sit-stand workstation (SSW) to increase standing time. Worksites in the MOVE+ study arm received the same multilevel intervention but were not provided the SSW until after the intervention ended at 12 months. The STAND+ arm, but not the MOVE+ arm, had significant reductions in sedentary time over the 12-month intervention. However, 12-month improvements in cardiometabolic risk factors were only observed among a subgroup with dysglycemia (prediabetes or diabetes). Here we report the long-term follow-up of these changes, 12 months after the end of the trial (24 months). Results are shown in the Table. The effects at 12 months were largely sustained at 24 months. Although limited by the small sample size in this subgroup, long-term meaningful and sustained improvement in blood glucose, triglycerides, systolic blood pressure, and weight may be observed from a multilevel workplace sedentary behavior intervention that includes sit-stand workstations.

PhenX: Environment measures for Tobacco Regulatory Research

ObjectiveA Working Group (WG) of tobacco regulatory science experts identified measures for the tobacco environment domain.MethodsThis article describes the methods by which measures were identified, selected, approved and placed in...

Employer-Supported Volunteerism in Rural Worksites.

Employer-supported volunteerism has the potential to benefit employees and ultimately have a positive business impact. Volunteerism has been linked to improved quality of life, reduced morbidity, and higher self-rated health. This study was designed to understand what small, rural worksites are doing with regard to volunteerism, and what their barriers are to such activities. An online survey was distributed to worksites using the social network of a Resource, Conservation, and Development Council, a rural nonprofit entity. Analyses included descriptive statistics, and for qualitative data, review and summary of common themes. Thirty-eight worksites responded, representing a wide range of worksite types. Volunteer activities requiring less time and resources to organize were more commonly employed versus group-based activities. Identified barriers included time, costs, small staffing numbers, perceived employee lack of interest, worksite policies, distance to volunteer sites, language barriers, and lack of awareness of opportunities. Despite a variety of challenges, some forms of employer-supported volunteerism seem feasible even in very small rural worksites. Worksite type, culture, and leadership are likely to be determinants of the extent and nature of employer-supported volunteerism. Strategies to encourage greater volunteerism need to be tailored to the interests and resources of each site. Occupational health nurses should consider incorporating some form of employee volunteerism activities within their health promotion programming, as it is consistent with an overall strategy of enhancing employee well-being. This could lead to positive business impacts such as increased employee engagement, improved recruitment and retention, and improved productivity.

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.

Development of a scalable weight loss intervention for low-income workers through adaptation of interactive obesity treatment approach (iOTA)

BackgroundDescribing how and why an evidence-based intervention is adapted for a new population and setting using a formal evaluation and an adaptation framework can inform others seeking to modify evidence-based weight management interventions for different populations or settings. The Working for You intervention was adapted, to fit a workplace environment, from Be Fit Be Well, an evidence-based intervention that targets weight-control and hypertension in patients at an outpatient clinic. Workplace-based efforts that promote diet and activity behavior change among low-income employees have potential to address the obesity epidemic. This paper aims to explicitly describe how Be Fit Be Well was adapted for this new setting and population.MethodsTo describe and understand the worksite culture, environment, and policies that support or constrain healthy eating and activity in the target population, we used qualitative and quantitative methods including key informant interviews, focus groups, and a worker survey; these data informed intervention adaptation. We organized the adaptations made to Be Fit Be Well using an adaptation framework from implementation science.ResultsThe adapted intervention, Working for You, maintains the theoretical premise and evidence-base underpinning Be Fit Be Well. However, it was modified in terms of the means of delivery (i.e., rather than using interactive voice response, Working for You employs automated SMS text messaging), defined as a modification to context by the adaptation framework. The adaptation framework also includes modifications to content; in this case the behavioral goals were modified for the target population based on updated science related to weight loss and to target a workplace population (e.g., a goal to avoiding free food at work).ConclusionsIf effective, this scalable and relatively inexpensive intervention can be translated to other work settings to reduce obesity and diabetes risk among low-SES workers, a group with a higher prevalence of these conditions. Using a formal evaluation and framework to guide and organize how and why an evidence-based intervention is adapted for a new population and setting can push the field of intervention research forward.Trial registrationClinicalTrials.gov: NCT02934113; Received: October 12, 2016; Updated: November 7, 2017.

A qualitative study of facilitators and barriers to implementing worksite policies that support physical activity

BackgroundPhysical inactivity is associated with several chronic diseases that are costly to society, employers, and individuals. Workplaces are a common location for physical activity (PA) initiatives because of the amount of time individuals who are employed full time spend at work. This research examined a statewide worksite wellness program, the Healthiest Maryland Businesses (HMB) program, to fill an important gap regarding the facilitators for and barriers to implementing workplace policies that support PA.MethodsIndividual telephone interviews were conducted in December 2015 with six HMB Coordinators and their supervisor, and from August through October 2016 with a purposeful sample of 15 businesses of various sizes from across Maryland, to learn about the role of leadership, and successes and challenges of implementing PA programs and policies. The sample of businesses was intentionally selected to capture perspectives from a range of businesses. Interviews were recorded and professionally transcribed. Descriptive coding was used to identify dominant themes that addressed the study aims and research questions.ResultsPA was not described as a priority for several large and small businesses. To garner more support for PA, interviewees emphasized associating PA initiatives with measures the businesses care about, such as health care costs from claims data. Small businesses also described having a need for PA programming yet reported having significant resource constraints. There was a strong interest in developing guidance for implementing PA break policies, which was mentioned as a critical support for workplace PA promotion. More commitment and investment of resources from leadership, and an engaged wellness committee with company representation at all levels and roles, were identified as vital for impactful programs.ConclusionsMost businesses are implementing PA programs with limited policy supports, which was mentioned as a barrier. Successful implementation of workplace wellness programs broadly, and PA initiatives specifically, are achievable through leadership buy-in, employee input, and policy supports, along with highlighting the economic benefits for businesses.

Strengthening tobacco-free worksite policies in India

Strengthening tobacco-free worksite policies in India

Mixed methods analysis of eighteen worksite policies, programs, and environments for physical activity

BackgroundThis study examined whether specific worksite supports for physical activity (PA) were associated with total and domain-specific PA.MethodsA cross-sectional, telephone-based study was conducted in four Missouri, USA, metropolitan areas in 2012 and 2013. Outcome variables included total PA and sub-domains (leisure, work, travel) measured using the International Physical Activity Questionnaire. Logistic regression determined odds of meeting PA recommendations, given access to and use of 18 unique PA worksite supports. A subsample of 119 participants also wore hip accelerometry for seven consecutive days and maintained a wear-time diary. Access to worksite supports were associated with odds of meeting objective moderate and vigorous (MV) PA above 150 min per week.ResultsAmong 2013 survey participants, meeting PA recommendations while performing work-related tasks was significantly associated with several supports (e.g., walking maps, stair prompts), as was meeting recommendations during travel (e.g., flextime for PA, incentives for public transportation, walking/bicycling to work). Access to 11 worksite supports increased odds of meeting PA recommendations through leisure-time PA; five supports were associated with total PA. There were significant differences between access to and use of supports. Using objective MVPA, access to worksite challenges and bike storage were significantly associated with five and three times greater odds of meeting 150 min of MVPA per week, respectively.ConclusionsWorksite wellness plans are increasing across the US and employers are eager for evidence-based supports for increasing PA. This study provides insights into the utility of multiple worksite supports for PA to increase odds that employees meet PA recommendations.

Work-related correlates of occupational sitting in a diverse sample of employees in Midwest metropolitan cities.

The worksite serves as an ideal setting to reduce sedentary time. Yet little research has focused on occupational sitting, and few have considered factors beyond the personal or socio-demographic level. The current study i) examined variation in occupational sitting across different occupations, ii) explored whether worksite level factors (e.g., employer size, worksite supports and policies) may be associated with occupational sitting.Between 2012 and 2013, participants residing in four Missouri metropolitan areas were interviewed via telephone and provided information on socio-demographic characteristics, schedule flexibility, occupation, work related factors, and worksite supports and policies. Occupational sitting was self-reported (daily minutes spent sitting at work), and dichotomized. Occupation-stratified analyses were conducted to identify correlates of occupational sitting using multiple logistic regressions.A total of 1668 participants provided completed data. Those employed in business and office/administrative support spent more daily occupational sitting time (median 330 min) compared to service and blue collar employees (median 30 min). Few worksite supports and policies were sitting specific, yet factors such as having a full-time job, larger employer size, schedule flexibility, and stair prompt signage were associated with occupational sitting. For example, larger employer size was associated with higher occupational sitting in health care, education/professional, and service occupations.Work-related factors, worksite supports and policies are associated with occupational sitting. The pattern of association varies among different occupation groups. This exploratory work adds to the body of research on worksite level correlates of occupational sitting. This may provide information on priority venues for targeting highly sedentary occupation groups.

Evaluating worksite wellness summit among Maui worksites.

CONTEXT:The Maui Worksite Wellness Policy Initiative was evaluated utilizing a baseline and follow-up study to improve the prevalence and awareness of worksite wellness for Maui employers following the Maui Worksite Wellness Summit intervention.AIMS:To evaluate a worksite wellness intervention.SETTINGS AND DESIGN:Worksites that attended the Maui Worksite Wellness Summit with a pre- and post-test design.PARTICIPANTS AND METHODS:Worksite characteristics and worksite wellness components (infrastructure, physical activity, and nutrition) were measured using a Likert-scale survey.STATISTICAL ANALYSIS USED:Repeated measures analysis of variance was used to compare the pre- and post-tests.RESULTS:The baseline sample was comprised of 9 businesses, and the number of full-time employees ranged from 3 to 715; the follow-up sample was comprised of 7 businesses, and the number of full-time employees ranged from 3 to 750. Results indicated that majority (71.43%) of worksites improved their worksite wellness policies, 85.71% improved their infrastructure, 71.43% increased their support for physical activity policies, and 57.14% improved their support for nutrition policies after the Maui worksite wellness summit.CONCLUSIONS:Based on this study, future efforts should comprise of a larger sample, more rigorous methodology, and longer duration.

Evaluation of worksite policies and practices promoting nutrition and physical activity among hospital workers

Purpose – As posited by the ecological model of health, improvements in the nutrition and physical activity environments of worksites may facilitate healthier dietary intakes and physical activity patterns of employees. This cross-sectional study describes current policies and practices targeting these environments in five large Texas-based hospitals employing approximately 40,000 adults. The paper aims to discuss these issues. Design/methodology/approach – The environmental assessment tool survey, an observation tool, was used to assess these policies and practices in August and September 2012. Findings – Results demonstrated major policy and practice deficiencies, including a lack of policies supporting on and offsite employee physical fitness, no healthy catering or healthy meeting policies, minimal subsidizing of healthy food and beverage options, few health-promoting vending services, and no performance objectives related to worksite health improvement. Hospitals having an active employee wellness staff consistently performed better on implementation of policies and practices supporting healthy eating and physical activity. Practical implications – This study supports practice recommendations including engaging executive leadership to prioritize worksite wellness and using policies to create an infrastructure that promotes healthy eating and encourages physical activity among employees. Originality/value – This study is the first to compare and contrast the nutrition and the physical activity environments of large hospitals, allowing for the identification of common environmental barriers and supports across multiple hospital and foodservice systems.

Prevalence of Physical Activity Policies and Environmental Strategies in Communities and Worksites: The Iowa Community Transformation Grant.

This study describes results of community and worksite assessments of physical activity policies and environmental strategies in 26 Iowa counties. Community coalition members completed the Community Health Assessment and Group Evaluation tool. The study explored findings using descriptive statistics and examined rural-urban differences in two of the five assessed sectors: community and worksites. Lower community scores (ie, needing improvement) were found for complete streets, bicycle use, and street calming. Higher scores (ie, identified strengths) were found for land use plans, maintain parks, and sidewalks Americans with Disabilities Act compliant. Worksites scored lower on promote stairwells, encourage non-motorized commuting, and implement activity breaks but higher on subsidize gym membership and provide area for physical activity. No rural-urban differences were found. Results identify opportunities to enhance community and worksite policies and environmental strategies to increase physical activity.

Current Cigarette Smoking Among Workers in Accommodation and Food Services--United States, 2011-2013.

Tobacco use is the leading cause of preventable disease and death in the United States. One of the Healthy People 2020 objectives calls for reducing the proportion of U.S. adults who smoke cigarettes to ≤12% (objective TU-1.1). Despite progress in reducing smoking prevalence over the past several decades, nearly one in five U.S. adults, including millions of workers, still smoke cigarettes. During 2004-2010, nearly one fifth (19.6%) of U.S. working adults aged ≥18 years smoked cigarettes, and of all the industry sectors, current smoking prevalence among the accommodation and food services sector workers (30%) was the highest. CDC analyzed National Health Interview Survey (NHIS) data for 2011-2013 to estimate current cigarette smoking prevalence among adults working in the accommodation and food services sector, and found that these workers had higher cigarette smoking prevalence (25.9%) than all other workers (17.3%). Among workers in accommodation and food services sector, the highest smoking prevalences were observed among males, non-Hispanic whites, those aged 25-44 years, those with a high school diploma or a General Educational Development (GED) certificate and no college education, those with an annual family income <$35,000, those with no health insurance, and those working in the food services and drinking places industry. These results indicate a need to better understand the reasons for higher smoking prevalence observed among accommodation and food services workers (e.g., workplace culture), so that appropriate intervention strategies can be developed and implemented. Evidence suggests that smoke-free worksites and workplace cessation programs, including comprehensive worksite smoke-free policies, health promotion, access to smoking cessation programs, and increasing the cost of tobacco products, can substantially reduce smoking among workers.