Worksite health promotion and social inequalities in health

Workplace Health Promotion Programs Targeting Smoking, Nutrition, Physical Activity, and Obesity in Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The workplace has been highlighted as a potential setting to deliver health promotion programs to target modifiable health behaviors that contribute to chronic disease. This review evaluated the effectiveness of interventions implemented within the workplace that targeted either smoking, nutrition, alcohol, physical activity, and/or overweight and obesity in men. A review protocol was prospectively registered through PROSPERO (CRD42021293398). Five electronic bibliographic databases were searched for randomized controlled trials conducted in the workplace assessing chronic disease risk factors in men from January 2010 to August 2021. Eleven studies were included, reporting on overweight and obesity n = 8, physical activity n = 7, nutrition n = 4, alcohol n = 3, smoking n = 3, with eight studies assessing multiple outcomes. Results were mixed. Narrative synthesis highlighted studies reporting improvements to snacking frequency, sugar sweetened beverage consumption, and physical activity (METs and Vo2 max). Meta-analysis highlighted pooled mean decrease in body weight of -0.28 kg up to 3 months; -1.38 kg for >3 months, and pooled mean decrease in body mass index 0.06 kg/m2 up to 3 months; -0.27 kg/m2 for >3 months. Despite the encouraging direction of the relationship, results were not statistically significant (p > .05). Findings underscore the potential of workplace health promotion programs targeting certain chronic disease risk factors in men; however, future research should consider long-term study designs to assess the efficacy of workplace health programs as a solution to the growing burden of global disease.

Cognitive Job Demands and Sports Participation among Young Workers: What Moderates the Relationship?

Cognitive job demands are theoretically and empirically associated with sports participation in various ways. Workers may be overwhelmed by stress and fatigue from their workload and therefore refrain from sports activities, but they can also feel the need to use sports as a way to recover and detach from work. The strategy to which workers adhere can depend on workers' resources that moderate the cognitive job demands and sports participation relationship, such as educational attainment, being a parent, or having worktime and work location control. To test our expectations, we used recent information on sports participation by young working adults from the Netherlands (N = 2032). Using multinomial logistic regression modelling, we found that workers in mentally demanding jobs were more likely to participate in sports more than three times a week. In particular, workers without children reported a higher likelihood of participating in sports more than three times a week when they experienced high cognitive job demands. Among the higher-educated, workers with high cognitive job demands were less likely to participate in sports one to three times a week. We reflect on the academic and policy-related implications of our findings.

Worksite Health Promotion and Work Performance: Both Awareness and Use Matter

OBJECTIVE

This work aimed to study whether being aware of the existence of worksite health promotion (WHP), using it, or both are related to employees' task and contextual performance.

METHODS

Multilevel cross-sectional data came from the European Sustainable Workforce Survey, with data from more than 11,000 employees in 259 organizations. Generalized structural equation modeling was used to examine two types of WHP: healthy menus and sports facilities.

RESULTS

Awareness of healthy menus and sports facilities was positively associated with task and contextual performance. Healthy menus use was related to both higher task and contextual performance, whereas sports facilities use was only associated with contextual performance. The relation of WHP use was stronger for contextual than for task performance.

CONCLUSIONS

Organizations should ensure that employees are aware of the availability of WHP as well as stimulate employees to make use of it.

Worksite health promotion for employees working from home: A vignette experiment examining intentions to participate

This study explores which factors affect employees' intention to participate in worksite health promotion (WHP) when they work from home. Employees increasingly work from home, yet existing WHP is mainly tied to the workplace. We lack knowledge on what might stimulate employees to make use of WHP specifically when they work from home. Drawing on the theory of reasoned action, we studied whether type of activity, duration, if WHP takes place during work time, how often employees work from home (shaping employees' attitude) and colleague participation (social norms) explain employees' intention to participate in WHP when working from home. To do so, we employed a vignette experiment. Results show that employees' intentions are higher for walking and taking breaks than for an online sports class. Moreover, intentions are higher for shorter activities and when participating in WHP can be done during work time. The more colleagues participate, the higher intentions of employees to do so too. By offering WHP for employees at home, employers can promote employees' health even when these are not present in the workplace. Our study provides leads into how employers may create conditions under which employees use WHP when working from home.

Health and wellness in the Australian coal mining industry: An analysis of pre-post findings from the RESHAPE workplace health promotion program

OBJECTIVES

Non-communicable diseases are the leading cause of death worldwide, accounting for 71% of deaths in 2021. The chronic and pervasive nature of these diseases spurs the need for novel treatment approaches, including using the workplace as a front for the promotion and dissemination of health messages and activities. Taking this into consideration, this study aimed to assess the efficacy of a workplace health promotion program that targeted nutrition, physical activity, and obesity outcomes in a New South Wales (NSW) coal mine site.

DESIGN

A 12-week quasi-experimental pre-test-post-test study.

SETTING

A coal mine site in rural NSW, Australia.

PARTICIPANTS

At baseline there were n = 389 participants, with similar numbers at follow-up (n = 420) as well as 61 participants from both timepoints (8.2% repeated measures), with 89% of participants being male.

INTERVENTION

A multicomponent wellness intervention was implemented incorporating aspects of education, goal setting, and competition.

OUTCOMES

Physical activity, nutrition, and weight.

RESULTS

The mean BMI at baseline was 30.01 kg/m2, and at follow-up 29.79 kg/m2 (p = 0.39). At follow-up, participants reported 81% lower odds of engaging in the exercise category 'no moderate physical exercise' (OR = 0.09, p < 0.001), as well as 111% higher odds of meeting physical activity and exercise guidelines (OR = 2.11, p = 0.057). There were no changes to diet outcomes and no association between employment characteristics and participating in physical activity.

CONCLUSIONS

Workplace health promotion programs can be an efficacious strategy in improving physical activity outcomes and marginally improving weight outcomes in those in the mining industry. Further research is needed to determine the true effectiveness of these programs long-term, particularly in an environment as challenging and dynamic as the mining industry.

Quantifying Value of Worksite Well-Being Programs With a Health Equity Lens: It's Time to Raise the Bar

Calls to address workforce health inequities have been met with expanded well-being programming, without an assessment of programming relevance or evaluation of equity-related outcomes. The goal of this commentary is to summarize current practices and gaps in evaluation of well-being programs, provide evidence supporting the need for broader participation in well-being offerings, and make recommendations to incorporate health equity measures into planning and evaluation efforts conducted by both employers and vendors. Data sharing, expanded measurement, more rigorous evaluation methods, and alignment of goals are some of the recommendations to better address health inequities and differential participation among employees.

Responsive evaluation: an innovative evaluation methodology for workplace health promotion interventions

Background: Workplace health promotion (WHP) interventions have limited effects on the health of employees with low socioeconomic position (SEP). This paper argues that this limited effectiveness can be partly explained by the methodology applied to evaluate the intervention, often a randomised controlled trial (RCT). Frequently, the desired outcomes of traditional evaluations may not match employees'-and in particular employees with low SEP-needs and lifeworld. Furthermore, traditional evaluation methodologies do not function well in work settings characterised by change resulting from internal and external developments. Objective: In this communication, responsive evaluation is proposed as an alternative approach to evaluating WHP interventions. Responsive evaluation's potential added value for WHP interventions for employees with low SEP in particular is described, as well as how the methodology differs from RCTs. The paper also elaborates on the different scientific philosophies underpinning the two methodologies as this allows researchers to judge the suitability and quality of responsive evaluation in light of the corresponding criteria for good science.

Workplace wellness programs targeting weight outcomes in men: A scoping review

Workplaces have been identified as a priority setting for the delivery of wellness programs to address risk factors for overweight and obesity. Men in particular may benefit greatly from these types of programs as they are typically harder to engage in health promotion. A scoping review was performed to provide an overview of interventions that have been implemented within the workplace that target weight outcomes in men. A searched of six electronic databases (Medline, Embase, CINAHL, Scopus, Cochrane Database of Systematic Review, and Business Source Ultimate) was conducted from January 2010 to August 2020. Of the 2191 articles identified, 25 were included. The majority took place in North America or Europe (72%). Over half (n = 17, 68%) utilized both a nutrition and physical activity component. Thirteen of the 19 articles (68%) that reported weight as an outcome showed the program to be efficacious in reducing weight. Overall, only seven articles were solely focused on an all-male population. Workplace wellness programs targeting weight outcomes in men have been conducted to some extent, with majority being successful in reducing weight. However, there is a need for more randomized controlled trials (RCTs), long-term follow-up, and male-only programs.

Success factors of health promotion: Evaluation by DEMATEL and M-DEMATEL methods - A case study in a non-profit organization

Proper health knowledge and adequate motivation for health activities are key factors that influence an individual to adopt a healthy behavior. Health promotion positively influences progressive behaviors that seek to advance health potential, to continuously improve one's lifestyle. There are many health promotion indications constantly encouraging people to eat healthier food. Based on the successful experience of a non-profit organization promoting a healthier vegetarian diet, this research identifies the operating factors that lead to the success of health promotion. The formulation and implementation of the health promotion strategy must be combined with the key success factors in order to accomplish the objectives. This study assessed seven factors, evaluated using the proposed method. The proposed Decision Making Trial and Evaluation Laboratory (DEMATEL) method constructs the cause and effect model of health promotion, and places forward suggestions and strategies for improvement based on the evaluation of the results. This research compared the original DEMATEL with a Modified DEMATEL (M-DEMATEL) to identify the success factors of health promotion. According to the results of both methods, "leadership", "communication channel" and "budget" are the most important and influential factors when promoting healthy diets. The results have shown the connection and the difference between the two methods. The main purpose of this research is not to determine which method is the best method, instead, to derive the combined effect of both methods.

Actions Speak Louder Than Words: Workplace Social Relations and Worksite Health Promotion Use

OBJECTIVE

To study whether workplace social relations explain use of worksite health promotion (WHP), by examining colleagues' and team managers' WHP encouragement of a healthy lifestyle, and colleague WHP uptake.

METHODS

Multilevel data came from the second wave of the European Sustainable Workforce Survey (4345 employees of 402 team in 9 countries). Linear probability models were used to test use of two types of WHP: healthy menus and sport facilities.

RESULTS

Employees are more likely to use healthy menus and sport facilities when more colleagues do so too and when colleagues encourage a healthy lifestyle. Surprisingly, encouragement by one's manager plays no role.

CONCLUSIONS

Social contact among colleagues can facilitate WHP use, and WHP initiatives should pay attention to the influential role of colleagues.

The effectiveness of workplace health promotion programs on self-perceived health of employees with a low socioeconomic position: An individual participant data meta-analysis

The aim of the current study was to evaluate whether workplace health promotion programs improve self-perceived health of employees with a low socioeconomic position (SEP), and whether differential effects exist between individuals with a low SEP for gender, marital status or age. Individual participant data from six Dutch intervention studies aiming at promoting healthy behavior and preventing obesity in the work setting, with a total of 1906 participants, were used. The overall intervention effect and interaction effects for gender, marital status and age were evaluated using two-stage meta-analyses with linear mixed regression models. In the first stage effect sizes of each study were estimated, which were pooled in the second stage. Compared to control conditions, workplace health promotion programs did not show an overall improvement in self-perceived health of employees with a low SEP (β0.03 (95%CI: −0.03 to 0.09)). Effects did not differ across gender, marital status and age. Future research could be focused on the determinants of self-perceived health next to health behavior to improve the health of employees with a low SEP.