Linking Workplace Health Promotion Best Practices and Organizational Financial Performance: Tracking Market Performance of Companies With Highest Scores on the HERO Scorecard

Occupational health literacy and work ability: a moderation analysis including interpersonal and organizational factors in healthy organizations

Introduction

Healthy organizations approach to occupational safety and health should holistically include individual, interpersonal, and organizational levels. There is an empirical research gap in considering different levels in organizations for health promotion in the context of maximizing work ability. This study aims to investigate the association of (1) occupational health literacy (on an individual level), (2) health-oriented leadership (interpersonal level), (3) participation possibilities in health, and (4) values of health in companies (both organizational levels) on work ability. Additionally, we examined the potentially moderating role of health-oriented leadership, participation possibilities in health, and values of health between occupational health literacy and work ability.

Methods

Cross-sectional data were obtained from 828 employers and employees in small and medium-sized enterprises. Self-report measures included occupational health literacy, health-oriented leadership, work ability, participation possibilities in health at work, and values of health in the company. Occupational health literacy comprises two factors: a knowledge-/skill-based approach to occupational health and a willingness/responsibility for occupational health. Participation possibilities in health are measured regarding participatory opportunities and co-creation of health at work. Values of health in the company capture the importance of health in the workplace and the scope for improving employees' health. Data were analyzed using latent regression and latent moderation analyses controlling for age, gender, and educational level.

Results

Occupational health literacy (knowledge-/skill-based), health-oriented leadership, participation possibilities in health, and values of health in companies showed positive associations with work ability. Health-oriented leadership on an interpersonal level was found to moderate the positive relationship between (knowledge-/skill-based) occupational health literacy and work ability. Participation possibilities in health on an organizational level acted as a moderator on the relationship between both occupational health literacy factors and work ability.

Discussion

Individual, interpersonal, and organizational factors play important roles in maintaining work ability in healthy organizations. This study highlights the importance of promoting occupational health literacy among employees and leaders, creating a healthy workplace through health-oriented leadership, and providing participatory opportunities for co-creation in health promotion at work. Future research should further explore these factors' roles in different industries and contexts and how they may be addressed effectively in tailored workplace interventions.

The Role of Wellness Climate in Small Business Health Promotion and Employee Wellbeing

Wellness involves physical, emotional, behavioral, social, and spiritual dimensions. A climate for wellness exists at both the psychological and organizational levels, consisting of individual and shared perceptions of policies, structures, and managerial behavior that support or promote employee wellbeing. This study explored the associations between psychological and organizational wellness climate and the effectiveness of a team health promotion training on employees' perceived physical and mental wellbeing and substance use. Employees from 45 small businesses completed self-report measures of wellness climate, wellbeing, positive unwinding behavior, work-family conflict, job stress, drug use, and alcohol use, assessed before, and one and six months after, attending either of two types of onsite health promotion training. Team Awareness training targeted improvements in the social climate at work. Healthy Choices training targeted individual health behavior. A control group did not receive training until after the study. Businesses were randomly assigned to conditions and data were analyzed using multi-level modeling. Models that included wellness climate as a mediator fit the data significantly better than models without climate as a mediator. Team Awareness participants showed greater improvements in wellness climate and wellbeing compared to the control group. Healthy Choices participants showed no changes in climate and no mediation effects of climate. Health promotion efforts may be enhanced by including wellness climate as a target in program design at multiple levels.

ESG Standards are TBD in Health Promotion: What the ESG Movement can Learn From the Workforce Wellness Movement

Large organizations produce annual shareholder reports that tout their business success, and many also describe their role in doing well by their employees and communities. What if systemic efforts to improve employee and community health were a reporting requirement on par with the reporting of profits, losses and liquidity? This editorial examines the nascent ESG movement and its potential role in sparking systems changes that improve individual and organizational health. ESG is an acronym for the Environmental, Social and Governance (ESG) standards that many investment fund managers are considering as a component of evaluating company performance. Today, assessing investments that factor in health alongside other business success measures is commonplace but, recently, ESG factors have become political fodder. How is it that there is growing acceptance of corporate social responsibility principles among business leaders but a growing opposition to ESG standards by many politicians who otherwise identify as pro-business?

Thriving from Work Questionnaire: Dimensionality, reliability, and validity of the long and short form questionnaires

INTRODUCTION

Thriving from Work is defined as the state of positive mental, physical, and social functioning in which workers' experiences of their work and working conditions enable them to thrive in their overall lives, contributing to their ability to achieve their full potential at work, at home, and in the community. The purpose of this study was to develop a psychometrically-sound questionnaire measuring the positive contribution that work can have on one's well-being both at, and outside of, their work.

METHODS

We used both a qualitative and quantitative approach of item reduction, domain mapping dimensionality testing, development of "long-" and "short-" versions of the questionnaire, reliability, and construct and criterion validity testing. This was established in two independent online samples of US based workers (n = 1550, n = 500).

RESULTS

We developed a bi-factor model 30-item long-form and a uni-factorial 8-item short-version. The long-form measures both the latent construct of Thriving from Work and six domains (psychological/emotional; work-life integration; social; experience of work; basic needs; health). Both long- and short- forms were found to have high empirical reliability (0.93  and 0.87 respectively). The short-form captures 94% of variance of the long-form. Construct and criterion validity were supported. Test-retest reliability was high.

CONCLUSIONS

The Thriving from Work Questionnaire appears to be a valid and reliable measure of work-related well-being in United States workers. Further testing is needed to refine and test the instrument in specific industries, unique worker populations, and across geographic regions.

Association between proximity to COVID-19 and the quality of life of healthcare workers

Background

The coronavirus disease 2019 (COVID-19) affects almost all countries in the world and it impacts every aspect of people’s life-physically, mentally, and socio-economically. There are several research studies examining the impact of this pandemic on health, however, very few studies examining the impact of this pandemic on quality of life. This study aimed to investigate the association between proximity to the COVID-19 and quality of life of healthcare workers and identify factors influencing quality of life.

Methods

A cross-sectional study was conducted among hospital staff in a tertiary hospital in Singapore. Data on demographic, medical history, lifestyle factors, psychosocial factors, and quality of life were collected using online self-administered questionnaire. Quality of life (QoL) was measured by the WHOQOL-BREF questionnaire. Robust linear regression was used to determine factors associated with quality of life.

Results

A total of 1911 participants were included in the analysis. The average age of participants was 38.25 (SD = 11.28) years old. 26.90% of participants had been quarantined, hospitalised, being suspected or diagnosed of having COVID-19 infection and they were found to have the lowest levels of QoL across all four domains (physical, psychological, social, and environmental domains). Participants who were singles or nurses, worked in shifts or worked longer hours, had chronic diseases were likely to have lower QoL scores compared to participants in other categories. Healthy lifestyle, social connectivity, resilience, social and workplace support were associated with higher QoL scores.

Conclusions

In planning of measures which aim to improve QoL of healthcare workers, priority should be given to individuals who have been quarantined, hospitalised, being suspected, or diagnosed of having COVID-19 infection. In addition to the proximity of the COVID, lifestyle and psychosocial factors contribute to QoL of healthcare workers. Hence, multifaceted interventions are needed to improve QoL of healthcare workers.

How Work-Nonwork Conflict Affects Remote Workers' General Health in China: A Self-Regulation Theory Perspective

Difficulty in balancing the demands of work and nonwork has been shown to be associated with lower physical and psychological health. Grounded on the self-regulation theory, we examined the effect of work-nonwork conflict on general health among employees who transitioned to remote work (remote workers), and we tested whether this association was mediated by impaired self-control capacity. The study further examined the perceived boundary control as a moderator of these associations. We collected two waves of questionnaire data with a one-month interval from 461 remote workers, and the results of regression-based analyses revealed that work-nonwork conflict was negatively related to remote workers' general health through increased self-control capacity impairment. In addition, this indirect effect was weaker for remote workers with higher perceived boundary control than those with lower perceived boundary control. These findings expand our understanding of remote workers' work-nonwork conflict and have practical implications for promoting the general health of remote workers who are experiencing work-nonwork conflict.

Productivity loss and productivity loss costs to United States employers due to priority conditions: a systematic review

AIMS

To summarize published studies evaluating productivity loss and productivity loss costs associated with cancer, chronic lung disease, depression, pain, and cardiometabolic disease among US employees.

MATERIALS AND METHODS

A PubMed search from the past 10 years was conducted using the terms productivity, absenteeism, presenteeism, cancer, bronchitis, asthma, chronic obstructive pulmonary disease, depression, pain, heart disease, hypertension, and diabetes (limited to English-language publications and studies of adults aged 19-64). Study endpoints included annual incremental time (work hours lost and Work Productivity and Impairment [WPAI] questionnaire overall work impairment) and monetary estimates of productivity loss. Studies were critically appraised using a modified Oxford Centre for Evidence-Based Medicine (OCEBM) Quality Rating Scheme.

RESULTS

Of 2,037 records identified from the search, 183 studies were included. The most common observed condition leading to productivity loss was pain (24%), followed by cancer (22%), chronic lung disease (17%), cardiometabolic disease (16%), and depression (16%). Nearly three-quarters of the studies (n = 133, 72.7%) were case-control/retrospective cohort studies (OCEBM quality rating 3); the remainder were case series/cross-sectional studies (n = 28, 15.3%; quality rating 4), randomized clinical trials (n = 18, 9.8%; quality rating 1); and controlled trials without randomization/prospective comparative cohort trials (n = 4, 2.2%; quality rating 2). Samples sizes ranged from 18 patients to millions of patients for studies using the Medical Expenditure Panel Survey (MEPS). Most studies found employees lost up to 80 annual incremental work hours; employees with cancer and cardiometabolic disease had the greatest number of work hours lost. Overall percentage work impairment ranged from 10% to 70% and was higher for pain and depression. Annual incremental costs of lost work productivity ranged from $100 to $10,000 and were higher for cancer, pain, and depression.

LIMITATIONS

Study heterogeneity.

CONCLUSIONS

Despite some gaps in evidence for the cost of productivity loss, sufficient data highlight the substantial employer burden of lost productivity among priority conditions.

Corporate social responsibility and workplace health promotion: A systematic review

The complex situation that global society is facing as a result of COVID-19 has highlighted the importance of companies committing to the principles of social responsibility. Among the internal initiatives, those related to the health of workers are, obviously, highly topical. The objective of our research is to provide concise knowledge of the relationship between workplace health promotion (WHP) and corporate social responsibility (CSR) so that the relevant specialized research was gathered in a single document that lays the foundations of its applicability. A systematic review, following the PRISMA method, has been carried out. Twenty-seven articles have been selected from the main scientific databases. Their qualitative analysis concludes that CSR and WHP are linked, have beneficial reciprocal effects, need committed leadership respectful of autonomy and voluntariness, and require the establishment of specific goals within the framework of the organizations' sustainability policies. Future studies should establish the impact of the pandemic on these aspects.

The Evolution from Occupational Health to Healthy Workplaces

Occupational health has evolved as a field over the last 20 years, most significantly over the last 2 years. The COVID-19 pandemic has increased the amount and complexity of challenges for occupational health professionals and at the same time provided a unique opportunity for the field in light of the heightened focus on health at the workplace. Responsibilities have become broader and more multi-faceted including areas such as mental wellbeing and psychosocial risk factors. The pandemic has shown us that the workplace is an essential setting to promote health with a growing number of employers investing in policies and programs for their employees. However, many global health campaigns and large scale national initiatives do not include the workplace setting in their strategy to the detriment of the their effectiveness. In addition to the pressing global health needs, two recent developments have propelled workplace health to the forefront and are asking questions of employers. The Sustainable Development Goals as well as the ESG (Environment, Social, Governance) agenda on behalf of the financial sector are pushing the corporate sector to act responsibly beyond seeking profits and disclose related policies and actions. Healthy workplaces are essential for global development and progress.

Job crafting and employees' general health: the role of work-nonwork facilitation and perceived boundary control

Background

Job crafting is associated with positive work–related outcomes, but its effects on nonwork–related outcomes are unclear. The conservation of resources theory informed the hypotheses that work–nonwork facilitation mediates the relationship between job crafting and general health, and this mediation process is moderated by perceived boundary control.

Methods

Using a two–wave design, 383 employees from a range of work settings completed questionnaires in which they rated job crafting, work–nonwork facilitation, general health and perceived boundary control.

Results

Moderated mediation analysis showed that work–nonwork facilitation mediated the relationship between job crafting and employee general health. Further, perceived boundary control moderated this indirect effect, such that the indirect effect was stronger for employees with high perceived boundary control than those with low perceived boundary control.

Conclusions

This study is an important step forward in understanding the effect of job crafting on nonwork domains, and in clarifying “how” and “when” job crafting might affect employees’ general health. Further, the results have practical implications for fostering employee general health.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13569-z.

Prevalence and correlates of psychological distress and coronavirus anxiety among hospital essential services workers in Singapore

INTRODUCTION

The COVID-19 pandemic has affected almost all populations, with frontline workers experiencing a higher risk of mental health effects compared to other groups. Although there are several research studies focusing on the mental health effects of the pandemic on healthcare workers, there is little research about its impact on workers in outsourced hospital essential services. This study aims to examine the prevalence and correlates of psychological distress and coronavirus anxiety among staff working in 3 outsourced hospital essential services-housekeeping, porter service and maintenance services.

METHODS

A cross-sectional study was conducted among outsourced hospital essential services workers in a tertiary hospital. Data on demographics, medical history, lifestyle factors, psychosocial factors and mental well-being were collected using self-administered questionnaires. Robust logistic regression was used to determine risk factors associated with psychological distress and dysfunctional anxiety related to COVID-19.

RESULTS

A total of 246 hospital essential services workers participated in the study. The prevalence of psychological distress was 24.7%, and dysfunctional anxiety related to COVID-19 was 13.4%. Social support and workplace support were found to be independently associated with a lower risk of psychological distress, and social connectivity was associated with a lower risk of dysfunctional anxiety related to COVID-19.

CONCLUSION

These findings highlight the crucial roles of communities and workplaces in combating the mental health consequences of the pandemic. Public health programmes that aim to tackle the emerging mental health crisis in hospital essential services workers should incorporate strategies to address psychosocial factors, in addition to traditional self-care approaches.

Studying wearable health technology in the workplace using the Behavior Change Wheel: a systematic literature review and content analysis

Wearable Health Technology (WHT) is considered to be fast, feasible, and effective in workplace health promotion programs. This study aims to analyze behavior change strategies applied to WHT products used by employees in health promotion programs. A systematic literature review of WHT in workplace health promotion between 2006 and 2020 was conducted. The Behavior Change Wheel (BCW) was used to undertake the content analysis. We identified 14 articles of WHT in the workplace. First, physical activity and weight management were the most common health issue. Second, using the BCW, we found guidelines, regulation and communication were the most frequently applied policy categories. Third, education, enablement and training were the most common intervention functions. For example, the promoter could provide health education information by WHT. Moreover, encouraging online would motivate employees to improve health behavior. There has been a growing interest in WHT with increasing complexity in research designs and specifications. While using WHT can be an appropriate strategy to adopt as employee health projects, other interventions should be considered, for incentivization and modeling, etc. The results of this study suggest using WHT should take related health behavior theories or variables into consideration to form a comprehensive health promotion programs.

Revisiting the Performance of Firms Recognized for Creating a Healthy Culture

OBJECTIVE

To augment several prior JOEM studies, which associated firms with recognized health and safety programs with outsized firm stock performance.

METHODS

Stock performance of CHAA and C. Everett Koop National Health Award winners are analyzed using standard asset-pricing, risk-adjusted modeling to compare them against benchmark stock portfolios.

RESULTS

While wellness programs are laudable, the firms did not universally outperform a market benchmark over extended periods when controlling for well-established measures of portfolio risk.

CONCLUSIONS

Investors could have also expected to underperform the market based on the excess risk involved with these selected companies. Investors must recognize that adding these award-winning companies to their portfolios also increases the overall riskiness and volatility of their portfolios. The previously documented outsized returns could be the reward for bearing this additional risk.JEL categories: G11, G51, J26, J32.

Cost of Lost Productivity Due to Erectile Dysfunction and Impact of Employer Benefit Exclusion of Penile Prosthesis Implantation Treatment

OBJECTIVE

We examined the cost of lost productivity due to erectile dysfunction (ED) and employer benefit exclusion of penile prosthesis implantation (PPI) among men with employer-sponsored health insurance.

METHODS

A decision-analytic model was developed using administrative claims data, US Bureau of Labor Statistics, and published literature. The economic impact of ED productivity loss and PPI benefit exclusion was reported in 2019 USD.

RESULTS

Men with ED had an additional 282.7 hours/year of work impairment compared to men without ED, resulting in annual incremental costs of $7,270. US employers excluding PPI benefits could lose $9.3 billion/year of work due to additional work impairment from ED.

CONCLUSIONS

Productivity loss due to ED and PPI benefit exclusion have considerable economic impacts on men with ED and their employers. Continuous advocacy for benefit exclusion removal is needed to ensure appropriate patient access.

The Role of Food and Beverage Companies in Transforming Food Systems: Building Resilience at Multiple Scales

Food and beverage companies are increasingly aware of the risks posed by climate change and many are interested in addressing them by building resilience along their supply chains. Financial incentives for environmental, social, and governance criteria further motivate mitigation action by firms. To achieve sustainable outcomes, human and ecological systems must be managed for resilience. The scientific community and food and beverage firms must collaborate in the development of measurable and verifiable indicators that support adaptation and mitigation action along food supply chains. This article identifies 3 areas in which a synergistic progress would set a resilient trajectory toward sustainability: 1) incentives for sustainable intensification, 2) expanded reporting standards, and 3) pre-competitive collaborations. Incremental, clear, and measurable steps can be taken to adapt food supply chains to the pressing challenges imposed by climate change, mitigate further emissions, and bring producers and consumers along in the journey towards planetary health.

Addressing Health-Care System Inequities in the Management of Erectile Dysfunction: A Call to Action

Erectile dysfunction (ED) is a common, burdensome, and costly urologic condition strongly related to all aspects of general health, from physical to mental. ED has profound consequences as it may interfere physical well-being, quality of life (QoL), self-esteem, relationships, self-worth, and productivity. It is therefore important to ensure that all types of effective ED treatments are consistently accessible to patients. While federal and state mandates ensure access to treatment for women’s breast health, female-factor infertility, and gender affirmation to ensure that these individuals do not experience a diminished QoL, there are no comparable mandates for men’s sexual and reproductive health. The burden of ED necessitates a call to action to improve the accessibility of ED treatments. The call to action steps include: (a) coverage for pharmacological, surgical, and other ED treatments should be viewed in the same way as coverage for other health issues, whether male or female and regardless of the stages of treatment, physical dysfunction, or physical changes; (b) American Urological Association (AUA) guidelines for the management of ED should be followed, including implementation of templates in electronic medical records (EMRs) to support adherence to the guidelines; and (c) coverage criteria should explicitly state that the criteria are intended to support gender equity for sexual and reproductive health care and should not be used to prevent men from receiving medically necessary ED treatments. This call to action offers a pathway to support every man who seeks treatment for ED as a medically necessary intervention by removing systemic health-care barriers.

The Group Nurturance Inventory - initial psychometric evaluation using Rasch and factor analysis

BACKGROUND

This paper describes the development and psychometric evaluation of a behavioral assessment instrument primarily intended for use with workgroups in any type of organization. The instrument was developed based on the Nurturing Environments framework which describes four domains important for health, well-being, and productivity; minimizing toxic social interactions, teaching and reinforcing prosocial behaviors, limiting opportunities for problem behaviors, and promoting psychological flexibility. The instrument is freely available to use and adapt under a CC-BY license and intended as a tool that is easy for any group to use and interpret to identify key behaviors to improve their psychosocial work environment.

METHODS

Questionnaire data of perceived frequency of behaviors relevant to nurturance were collected from nine different organizations in Sweden. Data were analyzed using confirmatory factor analysis, Rasch analysis, and correlations to investigate relationships with relevant workplace measures.

RESULTS

The results indicate that the 23-item instrument is usefully divided in two factors, which can be described as risk and protective factors. Toxic social behaviors make up the risk factor, while the protective factor includes prosocial behavior, behaviors that limit problems, and psychological flexibility. Rasch analysis showed that the response categories work as intended for all items, item fit is satisfactory, and there was no significant differential item functioning across age or gender. Targeting indicates that measurement precision is skewed towards lower levels of both factors, while item thresholds are distributed over the range of participant abilities, particularly for the protective factor. A Rasch score table is available for ordinal to interval data transformation.

CONCLUSIONS

This initial analysis shows promising results, while more data is needed to investigate group-level measurement properties and validation against concrete longitudinal outcomes. We provide recommendations for how to work in practice with a group based on their assessment data, and how to optimize the measurement precision further. By using a two-dimensional assessment with ratings of both frequency and perceived importance of behaviors the instrument can help facilitate a participatory group development process. The Group Nurturance Inventory is freely available to use and adapt for both commercial and non-commercial use and could help promote transparent assessment practices in organizational and group development.

Service provider perspectives on implementing the NSW Get Healthy at Work program

Purpose: One approach increasingly used by governments to deliver on public initiatives is to partner with private enterprise through public–private partnerships. This study is a qualitative process evaluation of an Australian state-wide workplace health programme “Get Healthy at Work” from the currently under-researched perspective of the private service providers. Methods: Semi-structured interviews were conducted with nine service providers. Interviews were transcribed and analysed inductively. Results: Service providers reported an alignment of motives and skills between the programme and their organizations as a benefit of the partnership. However, they also described misalignments: between the potential and realized value of the programme to businesses and service providers; the programme cycle and business operational processes; and the capacity building approach and businesses’ expectations of the service.Conclusions: Although several hallmarks of a well-functioning private–public partnership were evident, misalignments of process and expectations challenged sustained partnership involvement by providers. Careful consideration must be given to the ongoing management functioning of cross-sector engagement and partnering in health promotion practice in order to ensure public health goals are being met, but also that the model is mutually sustainable.

Companies That Promote a Culture of Health, Safety, and Wellbeing Outperform in the Marketplace

OBJECTIVE

The objective of this research is to test the hypothesis that companies distinguished by their commitment to their workforce's health, safety, and well-being outperform in the marketplace.

METHODS

To test this, we analyzed the real-world stock market performance of an investment fund of publicly traded companies selected on evidence demonstrating their pursuit of a culture of health, safety, and well-being.

RESULTS

This fund outperformed the market by 2% per year, with a weighted return on equity of 264% compared with the S&P 500 return of 243% over a 10-year period.

CONCLUSIONS

Employers, fund managers, and fund investors would be well served by including strategies that assess a company's commitment to the health, safety, and well-being of their workforce when evaluating investments in their enterprise and portfolios.

Psychometric Properties of Flourishing Scales From a Comprehensive Well-Being Assessment

In this article, we develop a measure of complete well-being. The framework is derived from the theoretical model of human flourishing understood as a state in which all aspects of a human life are favorable. The approach extends beyond psychological well-being and reflects the World Health Organization definition of health that not only considers the health of body and mind but also embraces the wholeness of the person. The Well-Being Assessment (WBA) is a comprehensive instrument designed to assess holistic well-being in six domains: emotional health, physical health, meaning and purpose, character strengths, social connectedness, and financial security. Although each of these domains is distinct, all of them are nearly universally desired, and all but financial security constitute ends in themselves. Data were collected from a representative sample of working adults. A sample of 276 employees participated in the pilot, 2,370 participated in the first wave and 1,209 in the second wave of the survey. The WBA showed a good fitting (40 items, six factors), satisfactory reliability, test-retest correlation, and convergent/discriminant validity in relation to stability over time and relevant health measures, as well as a good fit to the data that were invariant over time, gender, age, education, and marital status. The instrument can be of use for scientists, practitioners, clinicians, public health officials, and patients. Adoption of more holistic measures of well-being that go beyond psychological well-being may help to shift the focus from health deficiencies to health and well-being promotion.

The future of research on work, safety, health and wellbeing: A guiding conceptual framework

Work plays a central role in health. A conceptual model can help frame research priorities and questions to explore determinants of workers' safety, health, and wellbeing. A previous conceptual model focused on the workplace setting to emphasize the role of conditions of work in shaping workers' safety, health and wellbeing. These conditions of work include physical, organizational, and psychosocial factors. This manuscript presents and discusses an updated and expanded conceptual model, placing the workplace and the conditions of work within the broader context of socio-political-economic environments and consequent trends in employment and labor force patterns. Social, political and economic trends, such as growing reliance on technology, climate change, and globalization, have significant implications for workers' day-to-day experiences. These structural forces in turn shape employment and labor patterns, with implications for the availability and quality of jobs; the nature of relationships between employers and workers; and the benefits and protections available to workers. Understanding these patterns will be critical for anticipating the consequences of future changes in the conditions of work, and ultimately help inform decision-making around policies and practices intended to protect and promote worker safety, health, and wellbeing. This model provides a structure for anticipating research needs in response to the changing nature of work, including the formation of research priorities, the need for expanded research methods and measures, and attention to diverse populations of enterprises and workers. This approach anticipates changes in the way work is structured, managed, and experienced by workers and can effectively inform policies and practices needed to protect and promote worker safety, health and wellbeing.

Association between perceived organizational support and COVID-19 vaccination intention: A cross-sectional study

OBJECTIVES

We examined the association between perceived organizational support (POS) and COVID-19 vaccination intention as well as the influence of the implementation of workplace infection prevention measures.

METHODS

We analyzed data from an Internet survey of workers aged 20-65 years conducted in December 2020, during a period of widespread COVID-19 infection in Japan.

RESULTS

Of the 23 846 participants in this survey, 1958 (8%) reported very high POS. In the group with very high POS, 836 (43%) workers wanted the COVID-19 vaccination; in contrast 1382 (36%) workers in the group with very low POS wanted the vaccination. POS was associated with COVID-19 vaccination intention (odds ratio [OR] = 1.11). The OR decreased after additional adjustment for the number of workplace infection control measures (OR = 1.06). In the analysis with POS as a categorical variable, very high POS was associated with COVID-19 vaccination intention (reference: very low POS) (OR = 1.34). The OR decreased after additional adjustment for the number of workplace infection control measures (OR = 1.17). High POS was associated with COVID-19 vaccination intention (OR = 1.17) but not with vaccination intention after additional adjustment for the number of workplace infection control measures (OR = 1.05).

CONCLUSIONS

High POS during the COVID-19 pandemic increased employees' vaccination intention. The relationship between POS and vaccination intention was strongly influenced by implementation of workplace infection prevention measures. Implementing appropriate workplace infection prevention measures in the event of an emerging infectious disease outbreak may influence the vaccination behavior of employees, which may contribute to the acquisition of herd immunity in the community.

Validity and Reliability of the Updated CDC Worksite Health ScoreCard

OBJECTIVE

The aim of this study was to evaluate the reliability and validity of the updated 2019 CDC Worksite Health ScoreCard (CDC ScoreCard), which includes four new modules.

METHODS

We pilot tested the updated instrument at 93 worksites, examining question response concurrence between two representatives from each worksite. We conducted cognitive interviews and site visits to evaluate face validity, and refined the instrument for public distribution.

RESULTS

The mean question concurrence rate was 73.4%. Respondents reported the tool to be useful for assessing current workplace programs and planning future initiatives. On average, 43% of possible interventions included in the CDC ScoreCard were in place at the pilot sites.

CONCLUSION

The updated CDC ScoreCard is a valid and reliable tool for assessing worksite health promotion policies, educational and lifestyle counseling programs, environmental supports, and health benefits.

Implementing movement at the workplace: Approaches to increase physical activity and reduce sedentary behavior in the context of work

The purpose of this article is to highlight approaches to increase movement, physical activity (PA), and cardiorespiratory fitness, and reduce sedentary behavior (SB) in the context of the workplace. A deliberate strategy that will enable the successful promotion of movement at the workplace includes a business plan and rationale, an organizing framework, prioritization of interventions that are known to generate outcomes, and alignment of programmatic solutions with strong program design principles. Recommended principles of design include leadership, relevance, partnership, comprehensiveness, implementation, engagement, communications, being data-driven, and compliance. Specific evidence-based intervention examples are presented in the context of a socio-ecological framework including the individual, group, communications environment, physical environment, and policy domains. Increased movement at the workplace, as a result of promoting PA and reducing SB, generates important health outcomes across physical, mental, social, and economic domains and these benefits extend across the individual and organizational levels.

Workplace Well-Being Factors That Predict Employee Participation, Health and Medical Cost Impact, and Perceived Support

Purpose:

This study tested relationships between health and well-being best practices and 3 types of outcomes.

Design:

A cross-sectional design used data from the HERO Scorecard Benchmark Database.

Setting:

Data were voluntarily provided by employers who submitted web-based survey responses.

Sample:

Analyses were limited to 812 organizations that completed the HERO Scorecard between January 12, 2015 and October 2, 2017.

Measures:

Independent variables included organizational and leadership support, program comprehensiveness, program integration, and incentives. Dependent variables included participation rates, health and medical cost impact, and perceptions of organizational support.

Analysis:

Three structural equation models were developed to investigate the relationships among study variables.

Results:

Model sample size varied based on organizationally reported outcomes. All models fit the data well (comparative fit index > 0.96). Organizational and leadership support was the strongest predictor ( P < .05) of participation (n = 276 organizations), impact (n = 160 organizations), and perceived organizational support (n = 143 organizations). Incentives predicted participation in health assessment and biometric screening ( P < .05). Program comprehensiveness and program integration were not significant predictors ( P > .05) in any of the models.

Conclusion:

Organizational and leadership support practices are essential to produce participation, health and medical cost impact, and perceptions of organizational support. While incentives influence participation, they are likely insufficient to yield downstream outcomes. The overall study design limits the ability to make causal inferences from the data.

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.

The Correlation of a Corporate Culture of Health Assessment Score and Health Care Cost Trend

Objective:

Employers that strive to create a corporate environment that fosters a culture of health often face challenges when trying to determine the impact of improvements on health care cost trends. This study aims to test the stability of the correlation between health care cost trend and corporate health assessment scores (CHAS) using a culture of health measurement tool.

Methods:

Correlation analysis of annual health care cost trend and CHAS on a small group of employers using a proprietary CHAS tool.

Results:

Higher CHAS scores are generally correlated with lower health care cost trend. For employers with several years of CHAS measurements, this correlation remains, although imperfectly.

Conclusion:

As culture of health scores improve, health care costs trends moderate. These findings provide further evidence of the inverse relationship between organizational CHAS performance and health care cost trend.

Building a Culture of Health and Well-Being at Merck

There is increasing evidence that a healthy and safe workforce can provide a competitive business advantage. This article shares the efforts and experience of a large global employer as it builds on existing corporate wellness and safety programs to develop a corporate culture of health and well-being. Starting with a comprehensive review of the current state of employee health and culture, a small team established the business case, aligned strategic partners, created an implementation plan, and engaged the C-Suite. The aim of this article is to provide a case study that others might use to design their blueprint, to gain awareness and to build a culture of health and well-being within their organization.

Development and Validation of the Work-Related Well-Being Index: Analysis of the Federal Employee Viewpoint Survey

OBJECTIVE

To describe development and validation of the work-related well-being (WRWB) index.

METHODS

Principal components analysis was performed using Federal Employee Viewpoint Survey (FEVS) data (N = 392,752) to extract variables representing worker well-being constructs. Confirmatory factor analysis was performed to verify factor structure. To validate the WRWB index, we used multiple regression analysis to examine relationships with burnout associated outcomes.

RESULTS

Principal Components Analysis identified three positive psychology constructs: "Work Positivity", "Co-worker Relationships", and "Work Mastery". An 11 item index explaining 63.5% of variance was achieved. The structural equation model provided a very good fit to the data. Higher WRWB scores were positively associated with all three employee experience measures examined in regression models.

CONCLUSIONS

The new WRWB index shows promise as a valid and widely accessible instrument to assess worker well-being.

Developing community relationships to enhance well-being in a worksite wellness program

BACKGROUND

Wellness programs traditionally focus on achieving outcomes such as health improvement, lowered health risks, decreased absenteeism, improved morale and decreased health care costs. Many programs emphasize physical wellness with more recent inclusion of social, emotional, and environmental dimensions. That change is referenced as the migration of wellness programs into well-being efforts.

OBJECTIVE

Addressing all elements of well-being is critical for effective wellness program delivery.

DESIGN

Recognition of the positive impact related to community well-being is growing in the literature. When people connect with others at work and develop positive and effective relationships across boundaries, a culture of health grows within organizations.

RESULTS AND CONCLUSIONS

This paper reviews three community well-being initiatives implemented within one university worksite and describes the effectiveness of such programs in building community well-being.

Evaluation of Get Healthy at Work, a state-wide workplace health promotion program in Australia

BACKGROUND

Workplace health programs (WHPs) may improve adult health but very little evidence exists on multi-level WHPs implemented at-scale and so the relationship between program implementation factors and outcomes of WHPs are poorly understood. This study evaluated Get Healthy at Work (GHaW), a state-wide government-funded WHP in Australia.

METHODS

A mixed-method design included a longitudinal quasi-experimental survey of businesses registered with GHaW and a comparison group of businesses surveyed over a 12-month period. Semi-structured interviews and focus groups with key contacts and employees of selected intervention group businesses and the service providers of the program were conducted to assess program adoption and adaptation.

RESULTS

Positive business-level changes in workplace culture were observed over time among GHaW businesses compared with the control group. Multilevel regression modelling revealed perceptions that employees were generally healthy (p = 0.045 timeXgroup effect) and that the workplace promoted healthy behaviours (p = 0.004 timeXgroup effect) improved significantly while the control group reported no change in work culture perceptions. Changes in perceptions about work productivity were not observed; however only one third of businesses registered for the program had adopted GHaW during the evaluation period. Qualitative results revealed a number of factors contributing to program adoption: which depended on program delivery (e.g., logistics, technology and communication channels), design features of the program, and organisational factors (primarily business size and previous experience of WHPs).

CONCLUSIONS

Evaluation of program factors is important to improve program delivery and uptake and to ensure greater scalability. GHaW has the potential to improve workplace health culture, which may lead to better health promoting work environments. These results imply that government can play a central role in enabling prioritisation and incentivising health promotion in the workplace.

The Stock Performance of American Companies Investing in a Culture of Health

Purpose:

We investigated the relationship between companies’ efforts to build internal (COH-INT) and external cultures of health (COH-EXT) and their stock performance.

Design:

We administered 2 surveys, which measure companies’ programs, policies, and supports for improving the health of their employees and communities. We then compared the companies’ stock performance to the Standard and Poor’s (S&P) 500 Index from January 2013 through August 2017.

Setting:

United States.

Participants:

Representatives from 17 publicly traded companies who completed the COH-INT survey, of whom 14 also completed the COH-EXT.

Measures:

Culture of health scores were dichotomized into high versus low for both surveys. Stock price data for all companies were gathered from public sources.

Analysis:

We constructed 5 stock portfolios: all 17 companies, high COH-INT, low COH-INT, high COH-EXT, and low COH-EXT companies. We examined total returns for each portfolio compared to the S&P 500.

Results:

High COH-INT companies’ stock price appreciated by 115% compared to the S&P benchmark (+69%), while low COH-INT companies appreciated only 43%. In contrast, high COH-EXT companies underperformed (+44%) when compared to the S&P 500 (+69%) and low COH-EXT companies (+89%).

Conclusion:

This study supports the view that employers’ efforts to build an internal culture of health is a sound business strategy. More research is needed, however, to establish whether a link exists between supporting healthy community initiatives and company stock performance.

The Supervisor's Perceived Role in Employee Well-Being: Results From Mayo Clinic

PURPOSE

Novel approaches are needed to enhance employee well-being and perhaps supervisors can be an effective agent for worksite health promotion. The aim of this study was to examine the supervisor's perceived needs, barriers, and role for influencing employee well-being for incorporation into program development.

DESIGN

Semistructured, qualitative interviews of supervisors.

SETTING

Large, integrated academic health-care organization with over 30 000 employees and 2600 supervisors having access to comprehensive well-being programs and a successful well-being champion network comprised of 600 champions.

PARTICIPANTS

Twenty supervisors representing clinical, research, and administrative units.

METHODS

Semistructured, one-on-one interviews were conducted and audio recorded. Analysis included content log development and open coding by a trained analyst to reveal key themes. More formalized content coding using specialized software for qualitative analyses was also conducted.

RESULTS

Supervisor responses were wide ranging regarding their perceived and desired role in promoting workplace well-being. Barriers from the supervisor perspective included high current workload, ambivalence about promoting wellness, lack of support from leadership, lack of flexibility and control at work, and difficulty accessing on-site resources. They perceived their potential role in well-being as remaining a positive role model and encouraging their staff in wellness activities.

CONCLUSION

Although findings are generated from a small sample size, these qualitative data provide compelling and early insights into building a workplace well-being strategy leveraging an underutilized key stakeholder, the workplace supervisor.

Supporting a Culture of Health in the Workplace: A Review of Evidence-Based Elements

OBJECTIVE

To identify and evaluate the evidence base for culture of health elements.

DATA SOURCE

Multiple databases were systematically searched to identify research studies published between 1990 and 2015 on culture of health elements.

STUDY INCLUSION AND EXCLUSION CRITERIA

Researchers included studies based on the following criteria: (1) conducted in a worksite setting; (2) applied and evaluated 1 or more culture of health elements; and (3) reported 1 or more health or safety factors.

DATA EXTRACTION

Eleven researchers screened the identified studies with abstraction conducted by a primary and secondary reviewer. Of the 1023 articles identified, 10 research reviews and 95 standard studies were eligible and abstracted.

DATA SYNTHESIS

Data synthesis focused on research approach and design as well as culture of health elements evaluated.

RESULTS

The majority of published studies reviewed were identified as quantitative studies (62), whereas fewer were qualitative (27), research reviews (10), or other study approaches. Three of the most frequently studied culture of health elements were built environment (25), policies and procedures (28), and communications (27). Although all studies included a health or safety factor, not all reported a statistically significant outcome.

CONCLUSIONS

A considerable number of cross-sectional studies demonstrated significant and salient correlations between culture of health elements and the health and safety of employees, but more research is needed to examine causality.

Leadership, job crafting, and employee health and performance

Purpose

The purpose of this paper is to integrate the effects of top-down leadership and employees’ bottom-up job crafting behaviors on employee health and performance. The authors expected that employees’ promotion- and prevention-focused job crafting act as intervening mechanisms linking top-down employee-oriented leadership with employee health and performance.

Design/methodology/approach

Multi-source data were collected among n=117 independent employee-leader dyads.

Findings

Promotion-focused job crafting was positively and prevention-focused job crafting was negatively related to employees’ health and performance. Employee-oriented leadership was positively related to promotion-focused job crafting but unrelated to prevention-focused job crafting. Employee-oriented leadership was indirectly related to health and performance through promotion-focused job crafting. Moreover, promotion-focused job crafting had the strongest positive impact on adaptive performance, followed by proactive and then task performance, while prevention-focused job crafting had the strongest negative impact on task performance followed by proactive and then adaptive performance.

Research limitations/implications

Despite the cross-sectional study design, results reveal how employee-oriented leadership is related to employee health and performance through promotion-focused job crafting.

Practical implications

Organizations need employee-oriented leaders, who facilitate promotion-focused job crafting, which helps employees to perform well while staying well.

Originality/value

This study adds to the literatures on job crafting, leadership, and employee health and performance by explicating intervening processes in these relationships. It adds to research on the extended job demands-resources job crafting model by showing, that promotion- and prevention-focused job crafting has different relationships with antecedents (i.e. leadership) and outcomes (i.e. health and performance).

Role and Value of the Corporate Medical Director

: The role of the corporate medical director (CMD) has evolved over the last 300 years since Ramazzini first identified diseases of Italian workers in the early 1700s. Since then, there has been a gradual blurring of the boundaries between private and workplace health concerns. Today's CMD must have intimate knowledge of their corporation's industry and the businesses that they support, particularly the occupational and environmental programs that comply with all local, state, and/or national standards and regulations. Leading companies not only measure compliance with such standards but also may hold programs to their own internal corporate global standards even if these go beyond local government requirements. This document will explore in greater depth the strength and importance that the CMD brings to the business operations to support a healthy, engaged, and high performing workforce. Part 1 describes the role and value of the CMD, while Part 2 provides collective wisdom for the new CMD from current and past highly experienced CMDs.

Philanthropy and Beyond: Creating Shared Value to Promote Well-Being for Individuals in Their Communities

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.

Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: The Consortium Pain Task Force White Paper

Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices.