The shape up challenge: a community-based worksite exercise competition

Availability of and Participation in Workplace Health Promotion Programs by Sociodemographic, Occupation, and Work Organization Characteristics in US Workers

PURPOSE

To examine how the availability of and participation in workplace health promotion programs (WHPPs) vary as a function of sociodemographic, occupation, and work organization characteristics.

DESIGN

Cross-sectional study.

SETTING

2015 National Health Interview Survey and Occupational Health Supplement.

PARTICIPANTS

The study sample included 17 469 employed adults who completed the WHPP questions.

MEASURES

The 2 dependent outcome measures were availability of WHPPs and participation in these programs when available. Independent variables included occupation and 8 work organization and employment characteristics: company size, hours worked, supervisory responsibility, hourly pay, paid sick leave, health insurance offered by employer, work schedule, and work arrangement.

ANALYSIS

Poisson regression analyses were conducted with SUDAAN 11.0.1.

RESULTS

Overall, 57.8% of 46.6% employees who have WHPPs available reported participating in these programs. This study found that adults who worked ≤20 h/wk, worked regular night shifts, were paid by the hour, or worked for temporary agencies were less likely to participate in WHPPs. Workers who supervised others were 13% more likely to participate than nonsupervisors. Borderline associations were seen for having access to employer-sponsored health insurance and working at a site with <10 employees.

CONCLUSION

Despite the potential for improving physical and mental health, only 58% of US workers participated in WHPPs. Since barriers to WHPP participation (eg, time constraints, lack of awareness, and no perceived need) may vary across occupations and work organization characteristics, employers should tailor WHPPs based on their specific work organization characteristics to maximize participation.

Organizational-level determinants of participation in workplace health promotion programs: a cross-company study

BACKGROUND

Attracted by the expected benefits such as reduced absenteeism and increased productivity, more and more firms decide to implement workplace health promotion programs (WHPPs). However, those programs can only be effective if employees actually participate. This study aims to (1) gain insight into the degree of enrolment rates in such programs across companies and (2) identify organizational level factors that are associated with employee participation. Building on existing theory on organizational drivers of participation in corporate wellness programs, the study's main goal is to investigate which organizational factors determine whether employees enroll in a corporate fitness program or not.

METHODS

A business-to-business fitness platform company provided organizational level data on 61 client firms that have recently implemented a corporate wellness program. The data contained information on the enrolment rate per company and different organizational level variables. The following potential determinants of participation were analyzed: firm size, organizational program support and employee co-payment. A random effects model was used to examine associations between potential determinants and the program enrolment rate.

RESULTS

The average participation is limited (15.37%) but varies highly across companies (range 0.07-100.00%, monthly basis). Looking at the determinants of program enrolment, we find that organizational program support - the degree to which firm leadership encourages participation - positively influences the enrolment rate (β = 0.051 p < 0.001) while employee co-payment - the financial contribution employees have to make to participate - has a negative impact (β = - 0.002, p < 0.001). Furthermore, firm size has a negative relationship with firm enrolment.

CONCLUSIONS

Enrolment rates in WHPPs are limited, as many companies have difficulties to promote participation in WHPPs among employees. Strong organizational program support and low employee co-payment were identified as drivers of employee participation in corporate health programs. Hence, intensifying both social and financial support of employee participation may help to drive enrolment rates. Firm size was found to negatively affect the enrolment rate in WHPPs, implying that larger firms have to account for their size and corresponding complexity when implementing such a program.

Recruitment Rates in Workplace Physical Activity Interventions: Characteristics for Success

Objective.

To conduct a systematic review to assess recruitment rates in workplace physical activity (PA) intervention studies and describe characteristics of studies with high recruitment rates.

Data Source.

Electronic and manual searches were conducted.

Study Inclusion and Exclusion Criteria.

Workplace PA intervention studies that reported the number of employees invited to participate and the number who responded were included.

Data Extraction.

Studies with recruitment rates of ≥ 70% were categorized as high with the remaining studies (< 70%) used as comparison. Key study characteristics were assessed.

Data Synthesis.

An approach called positive deviance was used to identify the extent to which study characteristics were unique to high recruitment rate.

Results.

Seventy-six percent of studies failed to report recruitment rates (n= 30 included for review). Studies with high recruitment rates (n = 8) tended to have longer study duration (mean 1.6 years) and target smaller cohorts of employees (mean n = 199) than comparison studies (3.9 months; n = 1241). For recruitment strategies and intervention components of high studies, involvement of employees was driven by the organization, with PA interventions provided as part of the working day in paid time.

Conclusion.

These findings suggest a potential to improve recruitment through targeting small cohorts of employees, incorporating PA as a long-term strategy, facilitating organizationally driven employee involvement, and providing PA interventions during paid time.

Barriers to participation in a worksite wellness program

The purpose of this research was to determine barriers that prevent participation in an employee wellness program, Wellness Wednesdays: "Eat & Meet" About Healthy Living, conducted at East Carolina University (ECU) in Greenville, North Carolina. All ECU ARAMARK employees (n = 481) over the age of 18 were eligible to participate in the wellness program. Weekly 30 minute classes, taught by a Registered Dietitian, on various nutrition- and health-related topics were conducted for 10-weeks. Five question knowledge quizzes were administered to participants at the end of each class to determine the comprehension of material presented. Qualitative interviews (n = 19) were conducted with employees (participants and non-participants) and the program organizer after the completion of the 10-week program to identify barriers to program participation. A total of 50 (10.4% of the total number of potential participants) ECU ARAMARK employees, managers, and leadership team directors attended Wellness Wednesdays at least once during the 10-week program. Employees, on average, scored 71-100% on the weekly knowledge quizzes administered at the end of each class. The most common barriers to participation reported included (most often to least often reported): insufficient incentives, inconvenient locations, time limitations, not interested in topics presented, undefined reasons, schedule, marketing, health beliefs, and not interested in the program. Results showed that employee wellness programs can be effective in increasing knowledge of employees on nutrition- and health-related topics. However, program planning that addresses identified barriers including insufficient incentives, inconvenient locations, and time limitations may facilitate higher participation in future worksite wellness opportunities.

Determinants of participation in worksite health promotion programmes: a systematic review

Background

The workplace has been identified as a promising setting for health promotion, and many worksite health promotion programmes have been implemented in the past years. Research has mainly focused on the effectiveness of these interventions. For implementation of interventions at a large scale however, information about (determinants of) participation in these programmes is essential. This systematic review investigates initial participation in worksite health promotion programmes, the underlying determinants of participation, and programme characteristics influencing participation levels.

Methods

Studies on characteristics of participants and non-participants in worksite health promotion programmes aimed at physical activity and/or nutrition published from 1988 to 2007 were identified through a structured search in PubMed and Web of Science. Studies were included if a primary preventive worksite health promotion programme on PA and/or nutrition was described, and if quantitative information was present on determinants of participation.

Results

In total, 23 studies were included with 10 studies on educational or counselling programmes, 6 fitness centre interventions, and 7 studies examining determinants of participation in multi-component programmes. Participation levels varied from 10% to 64%, with a median of 33% (95% CI 25–42%). In general, female workers had a higher participation than men (OR = 1.67; 95% CI 1.25–2.27]), but this difference was not observed for interventions consisting of access to fitness centre programmes. For the other demographic, health- and work-related characteristics no consistent effect on participation was found. Pooling of studies showed a higher participation level when an incentive was offered, when the programme consisted of multiple components, or when the programme was aimed at multiple behaviours.

Conclusion

In this systematic review, participation levels in health promotion interventions at the workplace were typically below 50%. Few studies evaluated the influence of health, lifestyle and work-related factors on participation, which hampers the insight in the underlying determinants of initial participation in worksite health promotion. Nevertheless, the present review does provide some strategies that can be adopted in order to increase participation levels. In addition, the review highlights that further insight is essential to develop intervention programmes with the ability to reach many employees, including those who need it most and to increase the generalizability across all workers.

Evaluation of an employer-sponsored pedometer-based physical activity program

This study evaluated a competition-based employer-sponsored physical activity program using pedometers. City employees (N approximately 2,600) formed teams in groups of 10 persons (N = 640). The groups competed against each other over a 12-wk. period with the goal of attaining 10,000 steps per day, per person. Only teams with complete data were included in the formal evaluation. A repeated-measures analysis of variance indicated significant differences in team steps by week of the program, with post hoc comparisons indicating significant differences from baseline step counts evident during Weeks 6-8 but not at the end of the program. These data confirm that competition-based physical activity programs using pedometers may not be an effective means of increasing the long-term physical activity of employees.

Challenges and opportunities for promoting physical activity in the workplace

Although there would appear to be considerable potential for improving the health, productivity and quality of life of the Australian workforce through workplace physical activity (PA) promotion programs, the scientific evidence that such programs are effective is limited. This review appraises the quality of intervention studies conducted since 1997. Most studies included volunteer participants, who were either sufficiently motivated to change their behaviour or already active. Interventions that focused on corporate-fitness type programs and the provision of generic health education programs were not effective in terms of adequate participation rates and sustained behaviour change. The more successful individually-based programs were those which tailored materials to individual needs. The greatest potential for influencing the overall workforce appeared to be programs that included less 'organised' approaches and promoted incidental PA within and around the workplace. Future programs should; incorporate contemporary theories of behaviour and organisational change; emphasise linkages between the workplace and external settings; expand the profile of programs to address workplace culture; and encourage management support for behavioural adjustments to the organisation. There is a need for greater understanding and evaluation of desirable employer-related outcomes, such as reduced absenteeism, job stress and turnover and improved productivity and job satisfaction, coupled with the exploration of how these factors may relate to PA promotion and adoption. Finally, more in-depth evaluation strategies and complete descriptions of intervention programs are required, in order to identify the most effective strategies.

The Working Healthy Project: a worksite health-promotion trial targeting physical activity, diet, and smoking

Worksites are a key channel for delivery of interventions designed to reduce chronic disease among adult populations. Although some evaluations of worksite physical-activity interventions have been conducted, to date very few randomized trials of worksite health promotion have included the goal of increasing physical-activity levels as part of a comprehensive multiple risk factor approach to worksite health promotion. This article presents the results regarding behavior change found among the cohort of 2055 individuals who completed three health-behavior assessments as part of their worksites' participation in The Working Healthy Project (WHP), a multiple risk factor intervention implemented in 26 manufacturing worksites. In this study, a randomized matched-pair design was used. Fifty-one percent (n = 2,761) of the employees who completed the baseline assessment also completed the interim survey. Eighty-three percent of those who completed the interim assessment also completed the final survey. The WHP intervention targeted smoking, nutrition, and physical activity. At baseline, 38% of the sample reported engaging in regular exercise, and subjects reported consuming an average of 2.7 servings of fruits and vegetables per day, 7.9 grams of fiber per 1000 kilocalories, and 35.4% calories from fat per day; 28% of the sample were smokers. By the time of both the interim (intervention midpoint) and final (end of intervention) assessments, participants in the intervention condition had significantly increased their exercise behavior, compared with the control condition. There was also increased consumption of fruits and vegetables and fiber in the intervention condition by the time of the final assessment, compared with the control condition. No differences by condition were found with regard to percentage of calories from fat consumed or smoking cessation. These results suggest that among a cohort of participants in a worksite health promotion study, there were significant health behavior changes across two risk factors over time. These data suggest that further investigation of multiple risk factor worksite health promotion is warranted, particularly with a focus on ways to increase participation in these programs and to diffuse intervention effects throughout the entire workforce.

Worksite physical activity interventions

BACKGROUND

National objectives for public health have targeted worksite as important settings for interventions to increase physical activity. However, expert reviews reveal no scientific consensus about the effectiveness of worksite interventions for increasing physical activity or fitness.

METHODS

We judged the quantity and quality of existing evidence against scientific standards for the internal and external validity of the research design and the validity of measurements. Meta-analytic methods were used to quantify the size of effects expressed as Pearson correlation coefficients (r). Variation in effect was examined in relation to several features of the studies deemed important for implementing successful worksite interventions. Pre-experimental cohort studies were excluded because they are sensitive to secular trends in physical activity.

RESULTS

Twenty-six studies involving nearly 9,000 subjects yielded 45 effects. The mean effect was heterogeneous and small, r = 0.11 (95% CI, -0.20 to 0.40), approximating 1/4 S.D., or an increase in binomial success rate from 50% to 56%. Although effects varied slightly according to some of the study features we examined, effects were heterogeneous within levels of these features. Hence, the moderating variables examined did not explain variation in the effects (P > 0.05). The exception was that effects were smaller in randomized studies compared with studies using quasi-experimental designs (P < 0.05).

CONCLUSIONS

Our results indicate that the typical worksite intervention has yet to demonstrate a statistically significant increase in physical activity or fitness. The few studies that have used an exemplary sample, research design, and outcome measure have also yielded small or no effects. The generally poor scientific quality of the literature on this topic precludes the judgment that interventions at worksites cannot increase physical activity or fitness, but such an increase remains to be demonstrated by studies using valid research designs and measures.