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

A policy ethnography study of a Singapore regional health system on its governance adaptations and associated challenges as a project organisation to implement Healthier Singapore

Objectives

Project organisations reflect a modern and non-bureaucratic form of organising public-sector activities, which promises innovation, entrepreneurship, and order and control to bring about change. This study seeks to investigate the project organisation Singapore Health Services (SingHealth) Region Health System (RHS)'s approach to implementing the Healthier Singapore (HSG) strategy, including models of governance and perceptions of RHS leads, identify the challenges facing the RHS, and to draw insights into the conditions necessary for using project organisation as a policy tool in policy implementation.

Study design

We adopted a policy ethnography approach to answering the research question.

Methods

The approach involved: (1) non-participant observation with fieldnotes taken during meetings, events, programme activities, and conferences concerning SingHealth and HSG implementation; (2) analysis of 52 organisational documents; and (3) interviews with 21 senior SingHealth leaders from the RHS Executive Committee, involved in envisioning and overseeing the production of RHS projects to align with the HSG strategy (March to September 2022).

Results

Evidence demonstrates the presence of multiple governance and interactive governance in HSG implementation, including legitimising the RHS as the project organisation; engaging the private corporations; incorporating the citizens; and working with non-governmental organisations. However, the RHS faced many challenges, ranging from governance, workforce, financing, IT infrastructure and care models, problem definition, primary care and legacy issues, knowledge management, and being pandemic-informed in its delivery.

Conclusion

The RHS will need to address these challenges through the necessary constitutive, directive, and operational actions, and interactive governance to enhance its institutional capacity to implement the HSG Strategy.

The Validity and Reliability of the Workplace Culture of Health Scale-Short Form

OBJECTIVE

A positive workplace culture of health can have significant benefits for both employees and organizations. The objective of this study was to test the validity and reliability of the Workplace Culture of Health (COH) Scale-Short Form.

METHODS

We conducted a confirmatory factor analysis on data collected from a sample of 12,907 employees across 14 organizations. We examined the construct validity of the 14-item short-form version of the Workplace COH scale and assessed its reliability using internal consistency measures.

RESULTS

Our confirmatory factor analysis demonstrated that the Workplace COH Scale-Short Form had strong model fit, indicating good construct validity. In addition, we found that all constructs had strong internal consistency reliability.

CONCLUSIONS

Findings suggest that the Workplace COH Scale-Short Form is a valid and reliable way to practically assess workplace culture of health from the employee perspective.

[A cross-sectional study of physical activity promotion projects and organizational factors in the workplace]

OBJECTIVE

The benefits of physical activity are well-recognized but physical activity promotion projects (PAPP) are not well implemented in workplaces, resulting in an evidence-practice gap. This study identified the organizational factors associated with PAPP in the workplace in Japan.

METHODS

A self-administered questionnaire survey was postal mailed to 3,266 listed companies (with ≥ 50 employees) in Japan. The items surveyed included the presence or absence of PAPP and 29 organizational factors. Organizational factors were also extracted from interviews with corporate health managers. The Consolidated Framework for Implementation Research (CFIR) was applied. Multiple logistic regression analysis was conducted with the presence or absence of PAPP as the objective variable, each quartile group (Q1-Q4) of the total number of relevant organizational factors as the explanatory variable, and the basic workplace attributes as the covariate.

RESULTS

The analysis covered 301 workplaces. Of these, 98 (32.6%) had implemented PAPP. The adjusted odds ratio for PAPP for each group based on Q1 was 1.88 (0.62-5.70) for Q2, 3.38 (1.21-9.43) for Q3, and 29.69 (9.95-88.59) for Q4. The association between each organizational factor and PAPP was high for the constructs in the 'inner setting' of the CFIR. The observed adjusted odds ratios for these items were: 'there is a precedent for PAPP' 12.50 (6.42-24.34), 'there is a budget for the health department' 10.36 (5.24-20.47), 'understanding of the health department manager' 8.41 (4.43-15.99), 'understanding of workplace management' 7.63 (4.16-14.02), 'employee 7.31 (3.42-15.64), and 'requests from employees' 7.31 (3.42-15.64).

CONCLUSION

There was a quantity-response relationship between the number of applicable organizational factors and PAPP. It has been suggested that the expansion of organizational factors may lead to PAPP. In particular, the creation of an internal atmosphere and the promotion of understanding among the people concerned may be useful.

Quality changes in workplace health promotion over time: an extended validation of quality criteria from a longitudinal perspective

Aim

The quality of workplace health promotion (WHP) is essential for the successful deployment of financial and human resources. The aim of this paper is to evaluate the measurement quality of a WHP instrument with 15 quality criteria over time. In addition, it examines whether the quality of WHP in the enterprises concerned changed over time and whether typical developments can be identified. Finally, the role of company parameters such as size and implementation phase are analysed in relation to how WHP develops over time.

Subjects and methods

Evaluations of the quality of WHP collected between 2014 and 2021 were available at two and three measurement points for 570 and 279 enterprises, respectively. To assess the longitudinal measurement structure, confirmatory factor analyses were carried out followed by structural equation modelling to analyse causality. Cluster analysis was used to identify typical developments, and differences in company parameters were analysed with MANOVA.

Results

The results prove that the 15 quality criteria can be used to evaluate the quality of WHP in enterprises in a valid and reliable manner, both cross-sectionally and longitudinally. The quality of WHP in the enterprises concerned remained relatively stable over approximately 12 years. The cluster solution revealed three different developments characterized by increasing, stable or decreasing quality.

Conclusion

Measurements using a quality evaluation system permit a good assessment of WHP in enterprises. WHP quality also depends on company parameters; here more support should be provided to motivate enterprises in the long run, particularly in the sustainability phase.

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.

Association of Workplace Culture of Health and Employee Emotional Wellbeing

The study aimed to examine associations between workplace culture of health and employee work engagement, stress, and depression. Employees (n = 6235) across 16 companies voluntarily completed the Workplace Culture of Health (COH) Scale and provided data including stress, depression, and biometrics through health risk assessments and screening. We used linear regression analysis with COH scores as the independent variable to predict work engagement, stress, and depression. We included age, gender, job class, organization, and biometrics as covariates in the models. The models showed that total COH scores were a significant predictor of employee work engagement (b = 0.75, p < 0.001), stress (b = -0.08, p < 0.001), and depression (b = 0.08, p < 0.001). Job class was also a significant predictor of work engagement (b = 2.18, p < 0.001), stress (b = 0.95, p < 0.001), and depression (b = 1.03, p = 0.02). Gender was a predictor of stress (b = -0.32, p < 0.001). Overall, findings indicate a strong workplace culture of health is associated with higher work engagement and lower employee stress and depression independent of individual health status. Measuring cultural wellbeing supportiveness can help inform implementation plans for companies to improve the emotional wellbeing of their employees.

[Evaluation index for a healthy workplace culture in health and productivity management]

OBJECTIVES

This study aimed to establish a healthy workplace culture, rather than simply enhancing the content of intervention programs, aimed toward reducing health risks and maintaining and increasing productivity. Previous studies have found that the higher the awareness of employees' subjective evaluation of support for their health, the smaller is the health risk and problem of presenteeism. In health and productivity management, it is necessary to make evaluations from the employees' perspective. This study created an index of healthy workplace culture from the employees' perspective and examined its usefulness as an evaluation index for health and productivity management.

METHODS

A questionnaire survey was conducted using 20 indicators derived from a literature review of the workplace culture of health. The survey was conducted among 50 organizations that were certified as excellent healthcare corporations in 2019. A questionnaire was distributed to 886 employees in 25 cooperating organizations, and responses were received from 435 employees.

RESULTS

The analysis was performed among employees at 43 large and 263 small and medium-sized organizations, and 123 organizations with unknown certification status. Comparison by size showed that the following were significantly better in large organizations: policy on maintaining and promoting health, procedures for handling health issues, program and support for returning to work after a long absence, program and support for improving mental health, and places to consult with employees about health and safety issues. However, the following were significantly better in small and medium-sized organizations: feedback on health issues from supervisors to employees and provision of useful information about health promotion. Organizations with unknown certification status showed significantly worse results for all items. It was evident with all indicators that a strong workplace culture of health resulted in reduced health risks and diminished presenteeism.

CONCLUSIONS

The validity of the index developed in this study demands future verification. However, the index allows the degree of the workplace culture of health to be assessed and may be beneficial in health and productivity management for evaluation from the employees' perspective.

Development of occupational health culture scale: A study based on miners and construction workers

Culture is an essential influence on effectiveness of workplace health promotion, which can promote occupational health protection behavior. The aim of this research was to develop and validate an occupational health culture scale available to Chinese workers. Occupational health culture scale (OHCS) was developed based on elements of health culture and safety culture in workplace. Nine techniques steps of scale development were used, including a 15-member expert group, 10 workers for cognitive interview, and 1,119 questionnaires (from 710 miners and 409 construction workers) for formal investigation. Welch's variance analysis, independent samples t-test, Kruskal-Wallis test, Spearman correlation analysis was employed, respectively, to verified nine hypotheses about impact relationship on OHCS score. After the analysis reliability and validity, the final scale consisted of 21 items in five domains: leadership support, co-workers support, values, policy and norms, employee involvement, physical environment. Moreover, respirable dust concentration from individual sampler had the largest negative correlation coefficient on OHCS score, -0.469 (p < 0.01). The development of an occupational health culture among Chinese workers is necessary for the sustainability of human resources and the implementation of corporate responsibility.

Organizational support and perceived environment impact on quality of care and job satisfaction: a study with Pakistani nurses

Purpose

Referring to the theory of organizational empowerment, the purpose of this study is to examine the relationship of organizational support and perceived environment on quality of care and job satisfaction, with organizational commitment as a mediator for the first variable.

Design/methodology/approach

This study employed a cross-sectional research design and data was collected from seven private and public sector hospitals in Pakistan, involving 352 nurses on a voluntary basis through a self-administered survey.

Findings

The results showed that organizational commitment mediates the relationship between organizational support and job satisfaction with the quality of care. Moreover, the perceived environment has an impact on job satisfaction and quality of care.

Originality/value

Healthcare service quality seems strictly dependent on the perceived quality of care and job satisfaction among healthcare workers. Theoretical and practical implications for policymakers and HR management are discussed.

Framing well-being in a college campus setting

This investigatory study sought to explore the range and variation of well-being initiatives on a select cross-section of college campuses across the United States and in Canada. This whitepaper seeks to highlight innovative practices that may inspire institutions to consider new ways of promoting well-being for both students and employees. In this whitepaper, we report findings from 10 participating higher education institutions across three major categories: student-serving programs, employee-serving programs, and hybrid programs. The qualitative data collected from key stakeholder interviews and focus groups were analyzed for trends between and across institutions. Importantly, the results of this study are intended to be hypothesis-generating as opposed to hypothesis-testing. In an effort to describe the state of the field with respect to both common and innovative practices the findings have generated additional questions for further research. Several themes emerged from this study: (1) Campuses have not adopted a universally-accepted definition of well-being; (2) While many institutions are using iterations of the wellness wheel and its various dimensions (e.g. physical, emotional, intellectual, social, spiritual, financial) to guide their efforts, there is not a dominant model for structuring or measuring well-being initiatives on campus; (3) There appears to be a systematic shift from use of the term "wellness" to "well-being"; (4) While many institutions are still utilizing traditional health education practices, there appears to be a movement toward more systemic, environmental approaches to well- being, including structural, organizational, and financial strategies, in addition to a range of policy initiatives; (5) There is a range of engagement in well-being initiatives, with significant variance based on institutional philosophy; and (6) Many institutions are designing well-being initiatives that address health disparities-particularly among underrepresented or marginalized populations.

Resilient performance in healthcare during the COVID-19 pandemic (ResCOV): study protocol for a multilevel grounded theory study on adaptations, working conditions, ethics and patient safety

INTRODUCTION

Since early 2020, the COVID-19 pandemic has challenged societies and revealed the built-in fragility and dependencies in complex adaptive systems, such as healthcare. The pandemic has placed healthcare providers and systems under unprecedented amounts of strain with potential consequences that have not yet been fully elucidated. This multilevel project aims to explore resilient performance with the purpose of improving the understanding of how healthcare has adapted during the pandemic's rampage, the processes involved and the consequences on working conditions, ethics and patient safety.

METHODS

An emerging explorative multilevel design based on grounded theory methodology is applied. Open and theoretical sampling is performed. Empirical data are gathered over time from written narratives and qualitative interviews with staff with different positions in healthcare organisations in two Swedish regions. The participants' first-person stories are complemented with data from the healthcare organisations' internal documents and national and international official documents.

ANALYSIS

Experiences and expressions of resilient performance at different system levels and times, existing influencing risk and success factors at the microlevels, mesolevels and macrolevels and inter-relationships and consequences in different healthcare contexts, are explored using constant comparative analysis. Finally, the data are complemented with the current literature to develop a substantive theory of resilient performance during the pandemic.

ETHICS AND DISSEMINATION

This project is ethically approved and recognises the ongoing strain on the healthcare system when gathering data. The ongoing pandemic provides unique possibilities to study system-wide adaptive capacity across different system levels and times, which can create an important basis for designing interventions focusing on preparedness to manage current and future challenges in healthcare. Feedback is provided to the settings to enable pressing improvements. The findings will also be disseminated through scientific journals and conferences.

Cardiovascular Health Research in the Workplace: A Workshop Report

Heart disease and stroke are the first and fifth leading causes of death in the United States, respectively. Employers have a unique opportunity to promote cardiovascular health, because >60% of US adults are employed, and most spend half of their waking hours at work. Despite the scope of the opportunity, <1 in 5 businesses implement evidence-based, comprehensive workplace health programs, policies, and practices. Integrated, systems-based workplace health approaches that harness data science and technology may have the potential to reach more employees and be cost-effective for employers. To evaluate the role of the workplace in promoting cardiovascular health across the lifespan, the National Heart, Lung, and Blood Institute, the National Institute for Occupational Safety and Health, and the American Heart Association convened a workshop on March 7, 2019, to share best practices, and to discuss current evidence and knowledge gaps, practical application, and dissemination of the evidence, and the need for innovation in workplace health research and practice. This report presents the broad themes discussed at the workshop and considerations for promoting worker cardiovascular health, including opportunities for future research.

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.

Workplace-based opportunities to support child care workers' health and safety

Child care workers earn among the lowest wages in the United States and they struggle with many health issues. The purpose of this study was to describe workplace supports for nutrition, physical activity, other health behaviors (e.g., smoking cessation, stress management), and occupational health and safety available to child care workers, and thereby inform the development of future workplace-based interventions to improve worker well-being. Between 2015 and 2016, 74 North Carolina child care centers (and directors), participating in a larger randomized controlled trial, completed a Workplace Health and Safety Assessment (interview and observation) measuring four domains: Infrastructure, Organizational Policies and Procedures, Programs and Promotions, and Internal Physical Environment. This study used baseline data to report means and standard deviations. Participating child care centers employed, on average, 12.7 ± 8.4 employees. Total scores from the Workplace Health and Safety Assessment averaged 41.3 ± 12.6 out of a possible 154, demonstrating many missed opportunities for supporting health/safety. More specifically, centers scored on average 9.5 ± 3.9 on Infrastructure (35% of potential points), 11.1 ± 3.9 on Organizational Policies and Procedures (32% of potential), 7.6 ± 5.4 on Programs and Promotions (12% of potential), and 13.1 ± 2.2 on Internal Physical Environment (49% of potential). The most frequent supports available were for occupational health and safety issues, while fewer supports were available for physical activity and other health behaviors. Child care workers could benefit greatly from more comprehensive workplace health and safety interventions; however, strategies must overcome centers' limited capacity and resources.

Examining the Impact of Wellness Champions on the Effectiveness of a Workplace Health and Well-Being Program

PURPOSE

To evaluate the impact of Desire2Move (D2M) implementation fidelity by Wellness Champions on program effectiveness.

DESIGN

Cross-sectional.

SETTING

Years 1, 3, and 5 of D2M; an annual peer support health and well-being initiative for university employees.

PARTICIPANTS

D2M participants included 422 employees from 28 teams; however, only 144 provided survey data (34.1% response rate).

INTERVENTION

During the 8-week program, departments competed as teams to accumulate the greatest average physical activity (PA) minutes. Each team selected a Wellness Champion who delivered program information. Each team member recorded PA minutes with MapMyFitness.

MEASURES

An electronic survey assessed program implementation fidelity and program satisfaction.

ANALYSIS

Median split (median [Mdn] = 21.2) categorized teams into "high" (n = 14; Mdn = 24.0, range = 21.4-25.0) and "low" (n = 14; Mdn = 19.4, range = 14.3-21.0) implementation groups. Independent samples t tests evaluated differences between groups on program satisfaction and team program average PA minutes.

RESULTS

Groups were significantly different for program satisfaction, t(26) = -2.76, P = .011, and team program average PA minutes, t(26) = -2.40, P = .024. The "high" implementation group reported greater program satisfaction (mean [M] = 12.6, standard deviation [SD] = 1.8) and team program average PA minutes (M = 2104.4, SD = 807.4) than the "low" implementation group (program satisfaction M = 11.1, SD = 1.1; team program average minutes M = 1340.8, SD = 875.8).

CONCLUSION

Wellness Champions positively impacted employee PA participation and program satisfaction.

Employee wellness on the frontline: an interactional psychology perspective

Purpose

Employee wellness is vital to creating high-quality employee–customer interactions, yet frontline service workers (FLSWs) do not typically engage in, or benefit from, wellness initiatives. This paper aims to conceptually model the interactive influences of organizational and employee factors in influencing FLSW involvement in wellness programs and provides suggestions on how service organizations can enhance wellness behaviors and outcomes.

Design/methodology/approach

This paper builds upon classical and contemporary management theories to identify important gaps in knowledge about how employees and firms engage with wellness. Interactive psychology, emphasizing multidirectional interaction between person (employee) and situation (organization) wellness orientation, is introduced.

Findings

The paper develops a model that can be used to assess organizational wellness program effectiveness by emphasizing the interaction of employee and organizational wellness orientation. The model illustrates that wellness effectiveness relies equally on employee agency through an active wellness orientation matched with the organizational wellness orientation.

Originality/value

This paper questions the dominant approaches to assessing the effectiveness of workplace wellness initiatives, arguing for a more humanistic and agentic perspective rather than traditional organizationally centered fiscal measures.

Adjudicating Traditional Wellness

There is no consensus definition for “traditional wellness” but in worksite health promotion, it usually means the wellness program is a health assessment and/or health screening offering followed by some educational programs, usually in the physical health domain. Using the term traditional wellness may belie an unawareness about or lack of appreciation for the quality improvement principles that are as applicable to the health of a profession as they are to the growth of an organization. This editorial examines how the use of the term traditional wellness is a reflection on our professional zeitgeist. Five ideas that attempt to explain misunderstandings about differing approaches to worksite health promotion are offered along with 5 ways we may be able to make peace with traditional wellness.

Commentary on the Study: “What Do Workplace Wellness Programs Do? Evidence From the Illinois Workplace Wellness Study”

Recently, several high-profile randomized clinical trials conducted with employees at the University of Illinois and BJ’s Wholesale Club have questioned the value of workplace health and well-being programs. This commentary focuses on the latest research published in The Quarterly Journal of Economics by authors Jones, Molitor, and Reif who evaluated the iThrive wellness program. The commentary challenges the study’s main finding that wellness programs (in general) do not work. Several perspectives are explored including whether the evaluated programs are well-designed, sufficiently potent, and appropriate candidates for randomized trials. The article also asks what role employers can or should play in improving the health and well-being of Americans given recent troubling statistics showing a decline in life expectancy and an increase in health risks.

Exploring and Developing the Workplace Health Culture Scale in Taiwan

Background: The aim of this study was to develop and validate the workplace health culture scale.

Methods: This paper collected and re-organized current definitions about health culture from literature and created the domains and items to develop a new tool. Six enterprises and 2,431 participants were recruited from northern Taiwan for validity test.

Results: We found the workplace health culture scale had appropriate reliability and validity, including a good model fit for the 25-item scale.

Conclusions: Workplace health culture might be an important domain to the work of WHP. More validity and reliability studies about WHCS in wider industries and the correlation between WHCS and other WHP indicators are needed.

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.

A Brief Measure of Organizational Wellness Climate: Initial Validation and Focus on Small Businesses and Substance Misuse

OBJECTIVE

Organizations with fewer than 100 employees comprise most businesses in the United States. Since small businesses lack comparable resources, they may benefit from a simple valid tool for broadly assessing positive wellness climate, especially because climate contributes to employee wellbeing.

METHODS

Using an ethnically and occupationally diverse sample of 45 businesses (n = 1512), the current study developed and tested a brief self-report measure of organizational wellness climate.

RESULTS

Confirmatory factor analysis shows that a 9-item measure has good model fit (RMSEA = 0.06, CFI = 0.91), inter-item consistency of 0.74, and mean Rwg(j) of 0.87. The new measure is significantly positively correlated with physical health and wellbeing, and negatively correlated with substance use behavior.

CONCLUSIONS

Findings indicate that a 9-item measure has good reliability, construct, and criterion validity. Implications for practical use of the measure are discussed.

Untangling Truth, Facts, and Opinions: Why Simple Tenets of Science Have Become Uneasy

TIME magazine selected “The Guardians and the War on Truth” as their 2018 “Person of the Year.” Journalists everywhere urge us to remember writer Jamal Khashoggi’s murder as a harsh testament to the risks of speaking truth to power. But Khashoggi was a perceived threat to a totalitarian government, surely truth is more respected in America, right? Suggest that to the Columbia University School of Law who built a “silencing science tracker” to document “government attempts to restrict or prohibit scientific research, education or discussion.” In this editorial, I argue that researchers who publish their scientific findings in peer-reviewed journals must also embrace the role of “guardians” against the growing assaults on science. In an era where the majority of Americans get their health information via social media, our challenge as scientists is to transcend our basic calling as truth seekers and truth tellers. Closely aligned with this truth guardian’s work in health promotion is the True Health Initiative, a cohort of renowned scientists dedicated to offering “clarity over confusion”; they “work to spread the fundamental evidence and consensus-based truths about lifestyle as medicine.” When purveyors of falsehoods have such unfettered channels as they do today, my hope for scientists and for this journal is that we grow our ambitions relating to curating facts, authoritative dissemination, and persuasive communications alongside our usual work of learning and teaching.