Do working characteristics influence the participation at health measures? Findings from a trial phase of workplace health promotion

Uptake of Voluntary Occupational Health Care—Assessments of German Occupational Health Physicians and Employees

Workers’ health surveillance is considered essential for employees’ health and protection against hazardous working conditions. It is one part of occupational health care and thus one of four pillars of holistic workplace health management. In Germany, employers are obliged to provide mandatory and voluntary occupational health care (OHC) to employees, dependent on the defined occupational hazards. However, employees are not obliged to make use of voluntary OHC. No empirical information is available about the uptake of voluntary OHC by employees and the influencing factors in Germany. Thus, we carried out an explorative multi-perspective study with qualitative and quantitative elements to get insights from the view of occupational health physicians (OHPs) and employees. We conducted a survey among OHPs based on prior statements from two focus group discussions. A multivariate logistic regression analysis was performed to detect enablers and barriers regarding employee uptake of the offered voluntary OHC. We used extended qualitative methods among employees instead of an analogous survey. In total, 460 OHPs participated in the survey (response rate 29.1%), and 25 employees took part in interviews. Most of the employees had not heard the term voluntary OHC before, and only a few remembered respective occupational health care after explanatory request. In total, 78% of the OHPs assessed that employees always/mostly take up voluntary OHC. The most important attributed reason for non-uptake was that employees see no need for occupational health care when they feel healthy. The most important enabler for the perceived high uptake of voluntary OHC in the regression analysis was a positive attitude of the OHP toward voluntary OHC. While OHPs perceived that voluntary OHC was accepted by a majority of employees, this was not confirmed by the interviews with selected employees. This could indicate that the OHP respondents overestimated the amount of uptake. Since it became clear that employees are often unfamiliar with the terminology itself, we see a need for more and better information regarding the objectives and content of occupational health care to improve this important pillar of workplace health management.

A German Model Project for Workplace Health Promotion-Flow of Communication, Information, and Reasons for Non-Participation in the Offered Measures

BACKGROUND

Workplace health promotion (WHP) as a part of workplace health management (WHM) was strengthened in German legislature with the Prevention Act of 2015. However, smaller enterprises often do not offer WHM or WHP. Accordingly, a model-project for improving the uptake and implementation, particularly in micro-, small, and medium-sized enterprises (MSMEs) was carried out. The aim of the study was to determine reasons for non-participation in WHP offers and analyze communication issues, both from the employee's and employer's perspective.

METHODS

In total, 21 managers or persons responsible for WHP participated in the first online survey between March and April 2020, and 156 employees responded to the second online survey between June and October 2021. The importance of barriers and communication issues was investigated. Based on a principal component analysis on non-participation, differences regarding sociodemographic variables were analyzed.

RESULTS

Most employees knew about the offered measures and that the measures were cost free. There was no significant association between having communicated the offers to the employees and considering them suitable for their needs. Most of the managers or persons responsible for WHP rated the measures as sufficiently varied and allowed staff to take part during working-time. Reasons for non-participation from the managers' point of view were travel time to the location of the offers, lack of time, and a missing fit between offers and employees' needs. From the employees' point of view, workload (including working time) was the main barrier to participation.

CONCLUSIONS

For the practical implementation of model projects in MSMEs, special attention should be paid to ensuring opportunity to participate, which may be easier with in-house offers.

How Managers Perceive and (Do Not) Participate in Health Promotion Measures-Results from a Cross-Sectional Mixed-Methods Survey in a Large ICT Company

Managers often face stress and high work demands. Yet they have received limited attention as targets of workplace health promotion measures (HPMs). This study’s primary objective (1) is to examine managers’ self-reported participation in HPMs and factors associated with HPM participation. The secondary objective (2) is to examine managers’ perceptions of their working conditions. A cross-sectional mixed-methods online survey was conducted with a nonrandom sample of 179 managers in a large German ICT company. Stepwise logistic regression and qualitative content analysis were used for data analysis. Quantitative findings revealed that 57.9% of managers had not participated in HPMs yet. “Workload relief through digital tools” resulted as a significant predictor of managers’ previous HPM participation (OR: 2.84, 95% CI: 1.42–5.66). In qualitative findings, workload, time, lack of knowledge, and lack of demand were reported as participation barriers (1). Managers reported that work facility traits, workload, social support, and corporate culture should be improved to make their working conditions more health-promoting (2). These findings suggest that providing adequate organizational working conditions may help improve managers’ HPM participation rates and their perception of health-promoting work.