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Linnan LA, Vaughn AE, Smith FT, Westgate P, Hales D, Arandia G, Neshteruk C, Willis E, Ward DS. Results of caring and reaching for health (CARE): a cluster-randomized controlled trial assessing a worksite wellness intervention for child care staff. Int J Behav Nutr Phys Act 2020; 17:64. [PMID: 32414381 PMCID: PMC7227251 DOI: 10.1186/s12966-020-00968-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Child care workers are among the lowest paid US workers and experience a wide array of health concerns. The physical and mental demands of their job and the lack of employer-provided health-insurance increase health risks. The Caring and Reaching for Health (CARE) study evaluated a 6-month Healthy Lifestyles intervention targeting child care workers' physical activity (primary outcome), other health behaviors, and their workplace health environment. METHODS Eligible child care centers, defined as being in operation for at least 2 years and employing at least four staff, were enrolled into CARE's cluster-randomized trial. Centers and their child care staff were randomly assigned to either the Healthy Lifestyles (HL) intervention arm or the Healthy Finances (HF) attention control arm using a block randomization approach. Intervention components were delivered through in-person workshops, center-level displays, informational magazines, director coaching, electronic messaging, and an interactive website. Outcome measures were collected during center visits at baseline and immediately post-intervention by trained data collectors blinded to center arm assignment. Workers' physical activity was assessed with accelerometers, worn for 7 days. Secondary outcome measures included biometric assessments of health and fitness, web-based surveys about health behaviors, and an environmental audit of workplace supports for health. Multi-level linear mixed models assessed worker- and center-level changes in these outcomes. RESULTS Participants included 553 child care workers representing 56 centers (HL = 250 staff/28 centers, HF = 303 staff/28 centers). At 6 months, moderate-to-vigorous physical activity declined slightly in both arms (- 1.3 min/day, 95% CI: - 3.0, 0.3 in HL; - 1.9 min/day, 95% CI: - 3.3, - 0.5 in HF), but there was no significant group by time interaction. Several secondary outcomes for other health behaviors and workplace health environment showed improvements in favor of the intervention arm, yet differences did not remain statistically significant after adjustment for multiple comparisons. CONCLUSIONS While the Healthy Lifestyles intervention did not improve health behaviors or the workplace health environment, results confirmed the pressing need to focus on the health of child care workers. Future interventions should focus on prevalent health issues (e.g., weight, stress), include both high-tech and high-touch intervention strategies, and address work conditions or other social determinants of health (e.g. wages) as a means of improving the health of these essential workers. TRIAL REGISTRATION Care2BWell: Worksite Wellness for Child Care (NCT02381938).
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Affiliation(s)
- Laura A Linnan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB 7440, Chapel Hill, North Carolina, 27599-7440, USA.
| | - Amber E Vaughn
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Falon T Smith
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Philip Westgate
- Department of Biostatistics, College of Public Heath, University of Kentucky, Lexington, Kentucky, USA
| | - Derek Hales
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gabriela Arandia
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB 7440, Chapel Hill, North Carolina, 27599-7440, USA
| | - Cody Neshteruk
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erik Willis
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dianne S Ward
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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LAZZERI G, FERRETTI F, POZZA A, DORI F, VOLPE E, GIOVANNINI V, GUSINU R. The Workplace Health Promotion (WHP) programme in an Italian University Hospital. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E243-E249. [PMID: 31650061 PMCID: PMC6797891 DOI: 10.15167/2421-4248/jpmh2019.60.3.1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/31/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Description of the lifestyles of employees of the Siena University Hospital (Azienda Ospedaliera Universitaria Senese: AOUS), as assessed through a Workplace Health Promotion (WHP) project in the two-year period 2017-18; assessment of possible short-term effects of integrated health promotion interventions in the workplace, within the framework of the Tuscany WHP network, as applied in the AOUS and involving about 1,000 workers. METHODS A cross-sectional study and a pre-post evaluation of data collected by means of anonymous questionnaires in two phases: before the beginning of the programme and after 12 months. RESULTS Twelve months after the start of the programme regarding diet (consumption of fruit and vegetables) and physical activity, the positive effects that emerged were not statistically significant. No differences were observed between gender or professional categories. The employees' perception of the programme was satisfactory. CONCLUSIONS Albeit within the methodological limits of the assessment, the results showed that the diffusion of some major risk factors for chronic diseases had not decreased after 12 months' exposure to the programme. However, monitoring of these risk factors needs to be continued over a longer period, in order to detect the appearance of the expected changes in the long term. Moreover, it is essential to continue monitoring by sex and professional category, in order to pick out any differences and, if possible, take remedial actions. Further studies, in collaboration with the pertinent physicians, are desirable, since integrating data collected during health surveillance with a limited set of indicators of general risk factors may help to promptly identify possible health needs among employees.
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Affiliation(s)
- G. LAZZERI
- University Hospital of Siena, Italy
- Department Molecular and Developmental Medicine University of Siena, Italy
| | - F. FERRETTI
- University Hospital of Siena, Italy
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - A. POZZA
- University Hospital of Siena, Italy
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy
| | - F. DORI
- University Hospital of Siena, Italy
| | - E. VOLPE
- University Hospital of Siena, Italy
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Schouw D, Mash R, Kolbe-Alexander T. Transforming the workplace environment to prevent non-communicable chronic diseases: participatory action research in a South African power plant. Glob Health Action 2019; 11:1544336. [PMID: 30474516 PMCID: PMC6263095 DOI: 10.1080/16549716.2018.1544336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: The workplace is an important setting for the prevention of non-communicable diseases (NCDs). Policies for transformation of the workplace environment for occupational health and safety in South Africa have focused more on what to do and less on how to do it. There are no guidelines and little evidence on workplace-based interventions for NCDs. Objective: The aim of this study was to learn how to transform the workplace environment in order to prevent and control cardio-metabolic risk factors for NCDs amongst the workforce at a commercial power plant in Cape Town, South Africa. Methods: The study design utilized participatory action research in the format of a cooperative inquiry group (CIG). The researcher and participants engaged in a cyclical process of planning, action, observation and reflection over a two-year period. The group used outcome mapping to define the vision, mission, boundary partners, outcomes and strategies required. At the end of the inquiry the CIG reached a consensus on their key learning. Results: Substantial change was observed in the boundary partners: catering services (78% of progress markers achieved), sport and physical activities (75%), health and wellness services (66%) and managerial support (65%). Highlights from a 10-point consensus on key learning included the need for: authentic leadership; diverse composition and functioning of the CIG; value of outcome mapping; importance of managerial engagement in personal and organizational change; and making healthy lifestyle an easy choice. Conclusion: Transformation included a multifaceted approach and an engagement with the organization as a living system. Future studies will evaluate changes in the risk profile of the workforce, as well as the costs and consequences for the organization.
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Affiliation(s)
- Darcelle Schouw
- a Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
| | - Robert Mash
- a Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences , Stellenbosch University , Cape Town , South Africa
| | - Tracy Kolbe-Alexander
- b School of Health and Wellbeing , University of Southern Queensland , Ipswich , Australia
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Ablah E, Wilcox EA, Honn A. The Cons of Traditional Worksite Wellness Interventions and a Proposed Model. Public Health Rep 2019; 134:319-323. [PMID: 31021697 PMCID: PMC6598150 DOI: 10.1177/0033354919845683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Elizabeth Ablah
- University of Kansas School of Medicine–Wichita, Wichita, KS, USA
| | | | - Allison Honn
- University of Kansas School of Medicine–Wichita, Wichita, KS, USA
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Arandia G, Vaughn AE, Bateman LA, Ward DS, Linnan LA. Development of a Workplace Intervention for Child Care Staff: Caring and Reaching for Health's (CARE) Healthy Lifestyles Intervention. Health Promot Pract 2018; 21:277-287. [PMID: 30033775 DOI: 10.1177/1524839918786214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Child care staff are among the lowest wage workers, a group at increased risk for a wide array of chronic diseases. To date, the health of child care staff has been largely ignored, and there have been very few interventions designed for child care staff. This article describes the development of the Caring and Reaching for Health (CARE) Healthy Lifestyles intervention, a workplace intervention aimed at improving physical activity and health behaviors among child care staff. Theory and evidence-based behavior change techniques informed the development of intervention components with targets at multiple social ecological levels. Final intervention components included an educational workshop held at a kick-off event, followed by three 8-week campaigns. Intervention components within each campaign included (1) an informational magazine, (2) goal setting and weekly behavior self-monitoring, (3) weekly tailored feedback, (4) e-mail/text prompts, (5) center-level displays that encouraged team-based goals and activities, and (6) coaching for center directors. This multilevel, theory-driven intervention is currently being evaluated as part of a larger randomized controlled trial. Process evaluation efforts will assess the extent to which child care staff participated in, engaged with, and were satisfied with the intervention. Lessons learned will guide future intervention research engaging child care workers.
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Affiliation(s)
- Gabriela Arandia
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber E Vaughn
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lori A Bateman
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dianne S Ward
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura A Linnan
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Kottke TE, Pronk N, Zinkel AR, Isham GJ. Philanthropy and Beyond: Creating Shared Value to Promote Well-Being for Individuals in Their Communities. Perm J 2018; 21:16-188. [PMID: 28488982 DOI: 10.7812/tpp/16-188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Health care organizations can magnify the impact of their community service and other philanthropic activities by implementing programs that create shared value. By definition, shared value is created when an initiative generates benefit for the sponsoring organization while also generating societal and community benefit. Because the programs generate benefit for the sponsoring organizations, the magnitude of any particular initiative is limited only by the market for the benefit and not the resources that are available for philanthropy.In this article we use three initiatives in sectors other than health care to illustrate the concept of shared value. We also present examples of five types of shared value programs that are sponsored by health care organizations: telehealth, worksite health promotion, school-based health centers, green and healthy housing, and clean and green health services. On the basis of the innovativeness of health care organizations that have already implemented programs that create shared value, we conclude that the opportunities for all health care organizations to create positive impact for individuals and communities through similar programs is large, and the limits have yet to be defined.
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Affiliation(s)
- Thomas E Kottke
- Medical Director for Population Health for HealthPartners and a Senior Clinical Investigator for HealthPartners Institute for Education and Research in Minneapolis, MN, and a Professor at the University of Minnesota Medical School in Minneapolis.
| | - Nico Pronk
- Vice President of Health and Care Engagement for HealthPartners in Minneapolis, MN.
| | - Andrew R Zinkel
- Associate Medical Director of HealthPartners in Minneapolis, MN.
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Impact of a Workplace Health Promotion Program on Employees' Blood Pressure in a Public University. PLoS One 2016; 11:e0148307. [PMID: 26840508 PMCID: PMC4739732 DOI: 10.1371/journal.pone.0148307] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 01/15/2016] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Workplace health promotion is important in the prevention of non-communicable diseases among employees. Previous workplace health programs have shown benefits such as lowered disease prevalence, reduced medical costs and improved productivity. This study aims to evaluate the impact of a 6-year workplace health promotion program on employees' blood pressure in a public university. METHODS In this prospective cohort study, we included 1,365 employees enrolled in the university's workplace health promotion program, a program conducted since 2008 and using data from the 2008-2013 follow-up period. Participants were permanent employees aged 35 years and above, with at least one follow up measurements and no change in antihypertensive medication during the study period. Baseline socio-demographic information was collected using a questionnaire while anthropometry measurements and resting blood pressure were collected during annual health screening. Changes in blood pressure over time were analyzed using a linear mixed model. RESULTS The systolic blood pressure in the hypertension subgroup decreased 2.36 mmHg per year (p<0.0001). There was also significant improvement in systolic blood pressure among the participants who were at risk of hypertension (-0.75 mmHg, p<0.001). The diastolic blood pressure among the hypertensive and at risk subgroups improved 1.76 mmHg/year (p<0.001) and 0.56 mmHg/year (p<0.001), respectively. However, there was no change in both systolic and diastolic blood pressure among participants in the healthy subgroup over the 6-year period. CONCLUSION This study shows that continuing participation in workplace health promotion program has the potential to improve blood pressure levels among employees.
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Goldenhar LM, Stafford P. If you've seen one construction worksite stretch and flex program … you've seen one construction worksite stretch and flex program. JOURNAL OF SAFETY RESEARCH 2015; 55:73-79. [PMID: 26683549 DOI: 10.1016/j.jsr.2015.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 05/14/2015] [Accepted: 08/19/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Work-related Musculoskeletal Disorders (WMSD) account for approximately one-third of all injuries in the U.S. construction industry. Many companies have implemented stretch and flex (s/f) programs to reduce WMSD despite a lack of evidence showing effectiveness. METHODS We conducted a mixed-methods study to understand (a) why employers continue devoting resources to s/f programs; (b) how programs vary; and (c) any actual or perceived benefits. RESULTS Nineteen safety and health professionals were interviewed and 133 more (13.3% response rate) completed an on-line survey. Fifty-six percent had implemented an s/f program with the primary goal of reducing WMSDs; though most did not review data to determine goal achievement. Program structure varied in terms of duration, frequency, and type of stretches. There was strong agreement about mandating attendance but not participation, due primarily to liability issues. Cost was a factor when deciding to implement a program but not for sustaining one. The majority had not implemented other ergonomic prevention activities, but many had started conducting daily safety huddles for task and safety planning. Those reporting a reduction in WMSDs agreed that it was not due to the s/f program alone and that other benefits included increased worker camaraderie, communication, and collaboration. CONCLUSION Although there is little to no scientific evidence showing that they work as intended, construction companies continue to implement s/f programs with the goal of reducing WMSDs. Bringing work crews together for s/f activities has prompted employers to also begin conducting daily safety huddles. Although employers may not be able to link reduced WMDS to an s/f program, the ancillary benefits may warrant the time and resources. PRACTICAL APPLICATIONS S/f programs should be only one component of a more comprehensive ergonomics prevention program. Conducting daily safety huddles at the same time also may enhance worker communication, camaraderie, collaboration and improve safety outcomes.
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Affiliation(s)
- Linda M Goldenhar
- CPWR: The Center for Construction Research and Training, 8484 Georgia Ave. Suite 1000, Silver Spring, MD 20910, USA.
| | - Pete Stafford
- CPWR: The Center for Construction Research and Training, 8484 Georgia Ave. Suite 1000, Silver Spring, MD 20910, USA.
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Syamlal G, Jamal A, Mazurek JM. Current Cigarette Smoking Among Workers in Accommodation and Food Services--United States, 2011-2013. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2015. [PMID: 26225478 PMCID: PMC4584835 DOI: 10.15585/mmwr.mm6429a5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Girija Syamlal
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, CDC
- Corresponding author: Girija Syamlal, , 304-285-5827
| | - Ahmed Jamal
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jacek M. Mazurek
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, CDC
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Syamlal G, Mazurek JM, Dube SR. Gender differences in smoking among U.S. working adults. Am J Prev Med 2014; 47:467-75. [PMID: 25049215 PMCID: PMC4542001 DOI: 10.1016/j.amepre.2014.06.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 05/13/2014] [Accepted: 06/10/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cigarette smoking remains a leading cause of morbidity and mortality. Although gender differences in cigarette smoking in the U.S. population have been documented, information on these differences among working adults is limited. PURPOSE To describe the current smoking prevalence by gender among working U.S. adults and examine gender differences in smoking by occupation. METHODS The 2004-2011 National Health Interview Survey data for adults aged ≥18 years that were working in the week prior to the interview (N=132,215) were analyzed in 2013. Current cigarette smokers were those who smoked at least 100 cigarettes in their lifetime and currently smoke every day or some days. RESULTS During 2004-2011, an estimated 22.8% of men workers and 18.3% of women workers were current smokers. Of the current smokers, women workers had higher odds of being an everyday smoker (prevalence OR [POR]=1.17, 95% CI=1.09, 1.26); having poor self-rated emotional health (POR=1.28, 95% CI=1.15, 1.41); and having chronic obstructive pulmonary disease (POR=2.45, 95% CI=2.14, 2.80), heart disease (POR=1.27, 95% CI=1.12, 1.45), and current asthma (POR=2.21, 95% CI=1.96, 2.49) compared with men workers. Women in "supervisors, construction, and extraction" (38.9%) occupations and men in "extraction" (40.5%) occupations had the highest smoking prevalence. CONCLUSION Among working adults, women had lower prevalence of smoking than men, yet women who smoke were more likely than men to have adverse health outcomes, including self-rated poorer physical and emotional health.
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Affiliation(s)
- Girija Syamlal
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia.
| | - Jacek M Mazurek
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Shanta R Dube
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Pomeranz JL. Workplace wellness programs: how regulatory flexibility might undermine success. Am J Public Health 2014; 104:2052-6. [PMID: 25211713 DOI: 10.2105/ajph.2014.302149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The Patient Protection and Affordable Care Act revised the law related to workplace wellness programs, which have become part of the nation's broader health strategy. Health-contingent programs are required to be reasonably designed. However, the regulatory requirements are lax and might undermine program efficacy in terms of both health gains and financial return. I propose a method for the government to support a best-practices approach by considering an accreditation or certification process. Additionally I discuss the need for program evaluation and the potential for employers to be subject to litigation if programs are not carefully implemented.
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Affiliation(s)
- Jennifer L Pomeranz
- Jennifer L. Pomeranz is with the Department of Public Health, Center for Obesity Research and Education, Temple University, Philadelphia, PA
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Abstract
OBJECTIVE To identify and evaluate determinants of fire departments' wellness program adoption. METHODS The Promoting Healthy Lifestyles: Alternative Models' Effects fire service wellness program was offered for free to all medium-sized fire departments in Oregon and Washington. An invitation to participate was mailed to key fire department decision makers (chief, union president, and wellness officer). These key decision makers from 12 sites that adopted the program and 24 matched nonadopting sites were interviewed and results were analyzed to define adoption determinants. RESULTS Three adoption requirements were identified: (1) mailer connection, (2) local firefighter wellness champion, and (3) willing fire chief, whereas a fourth set of organizational factors had little or no impact on adoption including previous and ongoing wellness activities, financial pressures, and resistance to change. CONCLUSIONS Findings identified determinants of medium-sized fire service wellness program adoption.
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Abstract
Occupational health promotion programs with documented efficacy have not penetrated worksites. Establishing an implementation model would allow focusing on mediating aspects to enhance installation and use of evidence-based occupational wellness interventions. The purpose of the study was to implement an established wellness program in fire departments and define predictors of program exposure/dose to outcomes to define a cross-sectional model of translational effectiveness. The study is a prospective observational study among 12 NW fire departments. Data were collected before and following installation, and findings were used to conduct mediation analysis and develop a translational effectiveness model. Worker age was examined for its impact. Leadership, scheduling/competing demands, and tailoring were confirmed as model components, while organizational climate was not a factor. The established model fit data well (χ (2)(9) = 25.57, CFI = 0.99, RMSEA = 0.05, SRMR = 0.03). Older firefighters, nearing retirement, appeared to have influences that both enhanced and hindered participation. Findings can inform implementation of worksite wellness in fire departments, and the prioritized influences and translational model can be validated and manipulated in these and other settings to more efficiently move health promotion science to service.
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Mabry L, Elliot DL, Mackinnon DP, Thoemmes F, Kuehl KS. Understanding the durability of a fire department wellness program. Am J Health Behav 2013; 37:693-702. [PMID: 23985292 DOI: 10.5993/ajhb.37.5.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To understand the influences associated with durability and diffusion of benefits of a fire service wellness program. METHODS Qualitative assessment of group interviews. RESULTS Five years following a controlled worksite wellness trial, behavioral improvements were durable and had diffused to control participants. These findings were associated with firefighters' team orientation, enacted healthy norms and competitiveness regarding the results of annual health assessments. The original intervention trial appeared to initiate individual change that coalesced into group effects. Secondary influences included increasing public awareness about health, newly hired younger firefighters, and a modicum of administrative support. Culture shift was achieved at the workplace. CONCLUSIONS Although the fire service is a unique occupation, these findings suggest general strategies to achieve durable positive health change in other occupational settings.
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Affiliation(s)
- Linda Mabry
- Washington State University Vancouver, Department of Teaching and Learning, Vancouver, WA, USA
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Hui SKA, Engelman KK, Shireman TI, Ellerbeck EF. Adherence to cancer screening guidelines and predictors of improvement among participants in the Kansas State Employee Wellness Program. Prev Chronic Dis 2013; 10:E115. [PMID: 23845176 PMCID: PMC3711498 DOI: 10.5888/pcd10.120212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Employee wellness programs (EWPs) have been used to implement worksite-based cancer prevention and control interventions. However, little is known about whether these programs result in improved adherence to cancer screening guidelines or how participants’ characteristics affect subsequent screening. This study was conducted to describe cancer screening behaviors among participants in a state EWP and identify factors associated with screening adherence among those who were initially nonadherent. Methods We identified employees and their dependents who completed health risk assessments (HRAs) as part of the Kansas state EWP in both 2008 and 2009. We examined baseline rates of adherence to cancer screening guidelines in 2008 and factors associated with adherence in 2009 among participants who were initially nonadherent. Results Of 53,095 eligible participants, 13,222 (25%) participated in the EWP in 2008 and 6,205 (12%) participated in both years. Among the multiyear participants, adherence was high at baseline to screening for breast (92.5%), cervical (91.8%), and colorectal cancer (72.7%). Of participants who were initially nonadherent in 2008, 52.4%, 41.3%, and 33.5%, respectively, became adherent in the following year to breast, cervical, and colorectal cancer screening. Suburban/urban residence and more frequent doctor visits predicted adherence to breast and colorectal cancer screening guidelines. Conclusion The effectiveness of EWPs for increasing cancer screening is limited by low HRA participation rates, high rates of adherence to screening at baseline, and failure of nonadherent participants to get screening. Improving overall adherence to cancer screening guidelines among employees will require efforts to increase HRA participation, stronger interventions for nonadherent participants, and better access to screening for rural employees.
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Affiliation(s)
- Siu-kuen Azor Hui
- Fox Chase Cancer Center, Department of Psychosocial and Behavioral Medicine, 333 Cottman Ave, Young Pavilion 4141, Philadelphia, PA 19111, USA.
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Arena R, Guazzi M, Briggs PD, Cahalin LP, Myers J, Kaminsky LA, Forman DE, Cipriano G, Borghi-Silva A, Babu AS, Lavie CJ. Promoting health and wellness in the workplace: a unique opportunity to establish primary and extended secondary cardiovascular risk reduction programs. Mayo Clin Proc 2013; 88:605-17. [PMID: 23726400 PMCID: PMC7304414 DOI: 10.1016/j.mayocp.2013.03.002] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/04/2013] [Accepted: 03/11/2013] [Indexed: 12/16/2022]
Abstract
Given the burden of cardiovascular disease (CVD), increasing the prevalence of healthy lifestyle choices is a global imperative. Currently, cardiac rehabilitation programs are a primary way that modifiable risk factors are addressed in the secondary prevention setting after a cardiovascular (CV) event/diagnosis. Even so, there is wide consensus that primary prevention of CVD is an effective and worthwhile pursuit. Moreover, continual engagement with individuals who have already been diagnosed as having CVD would be beneficial. Implementing health and wellness programs in the workplace allows for the opportunity to continually engage a group of individuals with the intent of effecting a positive and sustainable change in lifestyle choices. Current evidence indicates that health and wellness programs in the workplace provide numerous benefits with respect to altering CV risk factor profiles in apparently healthy individuals and in those at high risk for or already diagnosed as having CVD. This review presents the current body of evidence demonstrating the efficacy of worksite health and wellness programs and discusses key considerations for the development and implementation of such programs, whose primary intent is to reduce the incidence and prevalence of CVD and to prevent subsequent CV events. Supporting evidence for this review was obtained from PubMed, with no date limitations, using the following search terms: worksite health and wellness, employee health and wellness, employee health risk assessments, and return on investment. The choice of references to include in this review was based on study quality and relevance.
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Affiliation(s)
- Ross Arena
- Division of Physical Therapy, Department of Orthopaedics and Rehabilitation, and the Division of Cardiology, Department of Internal Medicine, University of New Mexico, Albuquerque.
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Rolando L, Byrne DW, McGown PW, Goetzel RZ, Elasy T, Yarbrough MI. Health risk factor modification predicts incidence of diabetes in an employee population: results of an 8-year longitudinal cohort study. J Occup Environ Med 2013; 55:410-5. [PMID: 23532193 PMCID: PMC3903429 DOI: 10.1097/jom.0b013e31827cbaec] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To understand risk factor modification effect on Type 2 diabetes incidence in a workforce population. METHODS Annual health risk assessment data (N = 3125) in years 1 through 4 were used to predict diabetes development in years 5 through 8. RESULTS Employees who reduced their body mass index from 30 or more to less than 30 decreased their chances of developing diabetes (odds ratio = 0.22, 95% confidence interval: 0.05 to 0.93), while those who became obese increased their diabetes risk (odds ratio = 8.85, 95% confidence interval: 2.53 to 31.0). CONCLUSIONS Weight reduction observed over a long period can result in clinically important reductions in diabetes incidence. Workplace health promotion programs may prevent diabetes among workers by encouraging weight loss and adoption of healthy lifestyle habits.
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Affiliation(s)
- Lori Rolando
- Health & Wellness, Division of Administration, Human Resources, Vanderbilt University
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University
| | - Daniel W. Byrne
- Health & Wellness, Division of Administration, Human Resources, Vanderbilt University
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University
- Department of Biostatistics, Vanderbilt University
| | - Paula W. McGown
- Health & Wellness, Division of Administration, Human Resources, Vanderbilt University
| | - Ron Z. Goetzel
- Institute for Health and Productivity Studies, Emory University and Truven Health Analytics
| | - Tom Elasy
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University
| | - Mary I. Yarbrough
- Health & Wellness, Division of Administration, Human Resources, Vanderbilt University
- Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University
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Kuehl KS, Elliot DL, Goldberg L, Moe EL, Perrier E, Smith J. Economic benefit of the PHLAME wellness programme on firefighter injury. Occup Med (Lond) 2013; 63:203-9. [PMID: 23416849 DOI: 10.1093/occmed/kqs232] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Work-related injuries and illness are prevalent and costly. Firefighting is especially hazardous and many firefighters sustain work-related injuries. Workplace health promotion programmes have shown positive return on investment (ROI). Little is known about how similar programmes would impact injury and cost among firefighters. AIMS To evaluate the impact of a workplace health promotion intervention on workers' compensation (WC) claims and medical costs among Oregon fire departments participating in the PHLAME (Promoting Healthy Lifestyles: Alternative Models' Effects) health promotion programme compared with Oregon fire departments not participating in PHLAME. METHODS Data from firefighters from four large urban fire departments in Oregon were evaluated using a retrospective quasi-experimental study design. Outcomes were (i) total annual firefighter WC claims, (ii) total annual incurred medical costs prior to and after implementation of the PHLAME firefighter worksite health promotion programme (iii) and an ROI analysis. RESULTS Data were obtained from 1369 firefighters (mean age of 42 years, 91% white, 93% male). WC claims (P < 0.001) and medical costs (P < 0.01) were significantly lower among PHLAME fire departments compared with Oregon fire departments not participating in the programme. Fire departments participating in the PHLAME TEAM programme demonstrated a positive ROI of 4.61-1.00 (TEAM is used to indicate the 12-session peer-led health promotion programme). CONCLUSIONS Fire department WC claims and medical costs were reduced after implementation of the PHLAME workplace health promotion programme. This is a low cost, team-based, peer-led, wellness programme that may provide a feasible, cost-effective means to reduce firefighter injury and illness rates.
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Affiliation(s)
- K S Kuehl
- Division of Health Promotion and Sports Medicine, Department of Medicine, Oregon Health & Science University, Portland, OR 97239-3098, USA.
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Lopes FM, Peuker AC, Bizarro L. Aplicação de um programa de cessação do tabagismo com rodoviários urbanos. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2013. [DOI: 10.1590/s1414-98932013000200017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O presente relato tem como objetivo descrever a aplicação de um programa de cessação do tabagismo realizado em uma empresa de transporte coletivo urbano que implantou a política do ambiente livre do fumo. Pretende-se contribuir apresentando um modelo de intervenção de abordagem cognitivocomportamental possível de ser implantado no contexto organizacional. Método: o programa foi realizado em três etapas: levantamento no número de fumantes (n=90; 13% do universo total de funcionários), avaliação do nível de dependência de nicotina (n=30; 33% dos fumantes) e realização dos grupos de cessação do tabagismo, dos quais participaram 16 fumantes (18%). Os grupos aconteceram em quatro encontros semanais, com duração de duas horas cada, sendo que, após trinta dias, foi realizado um encontro de manutenção. Resultados: o programa demonstrou boa eficácia, pois, dos 16 fumantes que participaram, 7 atingiram a abstinência e 9 reduziram o consumo. Conclusão: os psicólogos podem ser agentes comprometidos em manter um ambiente livre de fumo e prevenir os efeitos do tabagismo nas organizações utilizando intervenções cognitivo-comportamentais como a descrita.
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Freak-Poli RLA, Wolfe R, Walls H, Backholer K, Peeters A. Participant characteristics associated with greater reductions in waist circumference during a four-month, pedometer-based, workplace health program. BMC Public Health 2011; 11:824. [PMID: 22024045 PMCID: PMC3262156 DOI: 10.1186/1471-2458-11-824] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 10/25/2011] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC) following participation in a four-month, pedometer-based, physical activity, workplace health program. METHODS 762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after) was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models. RESULTS Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a 'high-risk' baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to 'low risk' WC at the end of the program. CONCLUSIONS While employees with 'high-risk' WC at baseline experienced the greatest improvements in WC, the other variables associated with greater WC improvement were generally indicators of better baseline health. These results indicate that employees who started with better health, potentially due to lifestyle or recent behavioural changes, were more likely to respond positively to the program. Future health program initiators should think innovatively to encourage all enrolees along the health spectrum to achieve a successful outcome.
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Affiliation(s)
- Rosanne LA Freak-Poli
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Rory Wolfe
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Helen Walls
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Kathryn Backholer
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
| | - Anna Peeters
- 1Department of Epidemiology & Preventive Medicine, Faculty of Medicine, Nursing & Health Sciences, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, Alfred Hospital, Commercial Road, Melbourne, Victoria 3004, Australia
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Elliot DL, Kerry KS, Moe EL, DeFrancesco CA, Goldberg L, MacKinnon DP, Enders J, Favorite KC. The IGNITE (investigation to guide new insight into translational effectiveness) trial: Protocol for a translational study of an evidenced-based wellness program in fire departments. Implement Sci 2010; 5:73. [PMID: 20932290 PMCID: PMC2959080 DOI: 10.1186/1748-5908-5-73] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 10/08/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worksites are important locations for interventions to promote health. However, occupational programs with documented efficacy often are not used, and those being implemented have not been studied. The research in this report was funded through the American Reinvestment and Recovery Act Challenge Topic 'Pathways for Translational Research,' to define and prioritize determinants that enable and hinder translation of evidenced-based health interventions in well-defined settings. METHODS The IGNITE (investigation to guide new insights for translational effectiveness) trial is a prospective cohort study of a worksite wellness and injury reduction program from adoption to final outcomes among 12 fire departments. It will employ a mixed methods strategy to define a translational model. We will assess decision to adopt, installation, use, and outcomes (reach, individual outcomes, and economic effects) using onsite measurements, surveys, focus groups, and key informant interviews. Quantitative data will be used to define the model and conduct mediation analysis of each translational phase. Qualitative data will expand on, challenge, and confirm survey findings and allow a more thorough understanding and convergent validity by overcoming biases in qualitative and quantitative methods used alone. DISCUSSION Findings will inform worksite wellness in fire departments. The resultant prioritized influences and model of effective translation can be validated and manipulated in these and other settings to more efficiently move science to service.
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Affiliation(s)
- Diane L Elliot
- Division of Health Promotion and Sports Medicine; Department of Medicine; 3181 SW Sam Jackson Park Road CR110; Oregon Health & Science University; Portland, Oregon 97239-3098, USA
| | - Kuehl S Kerry
- Department of Psychology; Arizona State University; Tempe, Arizona 85287-1104, USA
| | - Esther L Moe
- Division of Health Promotion and Sports Medicine; Department of Medicine; 3181 SW Sam Jackson Park Road CR110; Oregon Health & Science University; Portland, Oregon 97239-3098, USA
| | - Carol A DeFrancesco
- Division of Health Promotion and Sports Medicine; Department of Medicine; 3181 SW Sam Jackson Park Road CR110; Oregon Health & Science University; Portland, Oregon 97239-3098, USA
| | - Linn Goldberg
- Division of Health Promotion and Sports Medicine; Department of Medicine; 3181 SW Sam Jackson Park Road CR110; Oregon Health & Science University; Portland, Oregon 97239-3098, USA
| | - David P MacKinnon
- Department of Psychology; Arizona State University; Tempe, Arizona 85287-1104, USA
| | - Jeanne Enders
- School of Business; Portland State University; P.O. Box 751; Portland, Oregon 97207-0751, USA
| | - Kim C Favorite
- Northwest Fire Fighter Fitness Foundation; P.O. Box 55262; Shoreline, Washington 98155-0262, USA
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