A health plan perspective on worksite-based health promotion programs

An evaluation of the Just Five program, a flexible digital approach to adult substance use education

Substance use is a steadily worsening crisis, yet there is limited evidence on the effectiveness of brief educational programs related to substance use disorders (SUD). To address this, the Just Five digital program launched in 2019 with six educational lessons about SUD, each five minutes long. Just Five is delivered through various organizations, including employers as part of workplace wellness, health plans that offer it to members, and to community-based organizations and populations they serve. This study evaluated the effectiveness of the program across 10 organizations in the initial launch. A cross-sectional survey was given to Just Five viewers to establish changes in perceived knowledge and attitudes toward SUD. Results were analyzed among the overall sample; a sub-analysis compared results within the three types of organizations taking part. Between December 2019 and September 2021, 2,749 baseline and 397 follow-up surveys were collected. Significant improvements were observed across almost all questions asked, with the largest improvements in respondent confidence to recognize signs of addiction (52.5% baseline; 87.7% follow-up); knowledge about ways to reduce the risk of addiction (54.1% baseline; 86.5% follow-up); and knowledge of how to help someone with addiction (38.7% baseline; 81.7% follow-up). All trends were replicated in sub-analyses. Substance use has severe societal impacts, and there is a need for effective programs that can be quickly implemented across various environments at large scale. Just Five is a potentially effective tool to increase perceived knowledge and improve attitudes toward SUD.

The Workplace Health Promotion (WHP) programme in an Italian University Hospital

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.

Health risk factor modification predicts incidence of diabetes in an employee population: results of an 8-year longitudinal cohort study

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.

Motivating factors for small and midsized businesses to implement worksite health promotion

OBJECTIVE

This study explores the decision-making process, including motivating factors, for small and midsized businesses in the Midwest to implement health promotion initiatives.

METHOD

This a replication of a study conducted in the Pacific Northwest. Semistructured qualitative interviews were conducted with key informants from 12 Midwestern metropolitan employers with fewer than 1,000 employees. Informants were interviewed regarding their companies' policies and practices around workplace health promotion programming adoption and valuation.

RESULTS

Workplace health promotion adoption at these small and midsized businesses was motivated by three goals: to lower health care costs, to address human relations objectives, and to improve productivity. Low upfront cost was the most frequently considered criterion in choosing which workplace health promotion program to offer. Barriers to implementation included lack of employee buy-in, prohibitive costs, and personnel or time constraints. Aids to implementation included employee buy-in and affordability.

CONCLUSIONS

This study suggests that cost considerations predominate in the workplace health promotion decision-making process at small to midsized businesses. Furthermore, employee buy-in cannot be underestimated as a factor in successful program implementation or longevity. Employees, along with executives and human resources management, must be appropriately targeted by health promotion practitioners in workplace health promotion efforts.