Impact of a Health Promotion Program on Employee Health Risks and Work Productivity

Internet self-efficacy moderates the association of information technology ability with successful ageing among older employees in three African samples

The literature suggests that two distinct competencies [i.e., information technology ability (ITA), and internet self-efficacy] are necessary for the effective use of information technologies for successful ageing, but no study has examined the association of these skills on successful ageing and its domains (i.e., illness avoidance, functioning, and engagement with life). This study investigated whether Internet Self-Efficacy (ISE) moderates the potential association of ITA with successful ageing. The study adopted a cross-sectional design based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist and includes measures against confounding and common methods bias. The participants were 1186 older workers aged 50 years or older in three African countries (Kenya = 350; Nigeria = 260; Ghana = 576). The minimum sample size necessary was calculated, and data were analysed with hierarchical linear regression analysis. After controlling for the covariates, ITA and ISE had a positive association with successful ageing as well as illness avoidance, functioning, and engagement with life in the whole sample. ITA was also positively associated with successful ageing and its domains in Kenya and Ghana. The associations of ITA with successful ageing and its domains were positively moderated by ISE in the whole sample and within each of the three samples. Higher ITA can be associated with successful ageing among working older adults, and ITA positively influences successful ageing at different levels of ISE. Older adults with high ITA are more likely to avoid illness at a higher ISE.

What works to promote staff health in prison settings: a systematic review

PURPOSE

Given epidemiological data highlighting poor health outcomes for prison staff and correctional workers, this systematic review aims to understand what health promotion interventions, delivered in prison settings, are effective for prison staff health.

DESIGN/METHODOLOGY/APPROACH

A systematic review was undertaken, with search parameters encompassing papers published over a ten-year period (2013-2023). Health promotion programmes; well-being programmes; and occupational health interventions to support prison staff health as part of a targeted approach or as part of a whole-prison approach were included in the review.

FINDINGS

The review identified 354 studies, of which 157 were duplicates and 187 did not meet the inclusion criteria. This left ten studies in the review from five countries. Reducing the impact of tobacco smoke was the commonly cited intervention, with four studies focusing on smoke-free prison legislation, but other studies focused on stress reduction for staff and supporting holistic health. The papers were of poor methodological quality, with the exception of three included studies that had robust designs. Most studies showed limited or no impact of interventions to support prison staff health, the exception being policy interventions to reduce second-hand smoke exposure.

ORIGINALITY/VALUE

Prison staff have poor health outcomes and yet limited attention has been paid to interventions to support their health. This review suggests a number of considerations for future policy and practice and direction for further research to improve prison staff health.

Do worksite health promotion programs (WHPP) influence presenteeism among employees? A systematic review1

BACKGROUND

Worksite health promotion programs (WHPP) aiming to reduce presenteeism are rapidly increasing. However, program-efficacy seems impaired by lack of conceptual understanding and theoretical frameworks related to presenteeism.

OBJECTIVES

To study (1) the concept of presenteeism, (2) the causes of the phenomenon and (3) which WHPP affect presenteeism.

METHODS

We followed the PRISMA 2020 guidelines for mapping relevant literature in seven databases. The main search-terms were "worksite", "WHPP", "presenteeism", "employee productivity" and "interventions". Reviews and review of reviews were included and analysed according to research questions and ecological theory.

RESULTS

Of 2196 studies identified, 14 reviews were included, comprising 1390 single studies. Conceptually, presenteeism was poorly defined, mostly related to productivity/performance limitations due to ill health. Factors causing presenteeism addressed individual health or lifestyle (78%), and, to a lesser extent work and organisational factors (management/job stress) (22%). Forty-five highly diverse WHPP were identified, about 90% focusing health outcomes. 22/45 WHPP affected presenteeism/productivity positively. Multi-component WHPP implemented at multi levels accounted for 55%. Single-component programs, implemented at individual level, were mostly targeting health-risk subgroups. No specific WHPP seems preferable. Methodological quality seems highly associated with worksite intervention-efficacy.

CONCLUSION

Increased telework opportunities due to COVID-19 experiences has affected working conditions worldwide, for better and worse, requiring adaptions at employee, management, organisational and socio-cultural levels. Our results showed high program diversity, several adaptable to future needs (e.g., digital solutions), however hampered by narrow focus on individual health. Future research should focus on theory-based high quality multilevel WHPP comprising contextual, work, and organisational factors.

Implementation and evaluation of a multi-level mental health promotion intervention for the workplace (MENTUPP): study protocol for a cluster randomised controlled trial

BACKGROUND

Well-organised and managed workplaces can be a source of wellbeing. The construction, healthcare and information and communication technology sectors are characterised by work-related stressors (e.g. high workloads, tight deadlines) which are associated with poorer mental health and wellbeing. The MENTUPP intervention is a flexibly delivered, multi-level approach to supporting small- and medium-sized enterprises (SMEs) in creating mentally healthy workplaces. The online intervention is tailored to each sector and designed to support employees and leaders dealing with mental health difficulties (e.g. stress), clinical level anxiety and depression, and combatting mental health-related stigma. This paper presents the protocol for the cluster randomised controlled trial (cRCT) of the MENTUPP intervention in eight European countries and Australia.

METHODS

Each intervention country will aim to recruit at least two SMEs in each of the three sectors. The design of the cRCT is based on the experiences of a pilot study and guided by a Theory of Change process that describes how the intervention is assumed to work. SMEs will be randomly assigned to the intervention or control conditions. The aim of the cRCT is to assess whether the MENTUPP intervention is effective in improving mental health and wellbeing (primary outcome) and reducing stigma, depression and suicidal behaviour (secondary outcome) in employees. The study will also involve a process and economic evaluation.

CONCLUSIONS

At present, there is no known multi-level, tailored, flexible and accessible workplace-based intervention for the prevention of non-clinical and clinical symptoms of depression, anxiety and burnout, and the promotion of mental wellbeing. The results of this study will provide a comprehensive overview of the implementation and effectiveness of such an intervention in a variety of contexts, languages and cultures leading to the overall goal of delivering an evidence-based intervention for mental health in the workplace.

TRIAL REGISTRATION

Please refer to Item 2a and registration ISRCTN14104664. Registered on 12th July 2022.

Leading wellness in healthcare: A qualitative study of leadership practices for wellness in hospital settings

Ways of dealing with workplace stress and enhancing healthcare workers wellness are sought globally. The aim of this study was to explore healthcare leaders' practice in relation to the implementation of a workplace wellness program called SEED in the context of multiple crises (bushfires and COVID-19) affecting a local health district in New South Wales, Australia. Practice theory informed interviews (n = 23), focus groups (n = 2) and co-analysis reflexive discussions (n = 2) that were conducted with thirteen leaders and twenty healthcare workers. A pragmatic approach to program implementation for healthcare workers' wellness explored the process and actions that resulted from leadership practice in an inductive thematic analysis. Preliminary themes were presented in the co-analysis sessions to ensure the lived experiences of the SEED program were reflected and co-interpretation of the data was included in the analysis. Three key themes were identified. 1) Leading change-implementing a wellness program required leaders to try something new and be determined to make change happen. 2) Permission for wellness-implicit and explicit permission from leaders to engage in wellness activities during worktime was required. 3) Role-modelling wellness-leaders viewed SEED as a way to demonstrate leadership in supporting and caring for healthcare workers. SEED provided a platform for leaders who participated to demonstrate their leadership practices in supporting wellness activities. Leadership practices are critical to the implementation of healthcare wellness programs. The implementation of SEED at a time of unprecedented crisis gave leaders and healthcare workers opportunities to experience something new including leadership that was courageous, responsive and authentic. The study highlighted the need for workplace wellness programs to intentionally include leaders rather than only expect them to implement them. The practices documented in this study provide guidance to others developing, implementing and researching workplace wellness programs.

Changes in office workers' lived experiences of their own eating habits since working from home due to the COVID-19 pandemic: An interpretative phenomenological analysis

In response to the unprecedented circumstances of the COVID-19 pandemic, there has been little insight into how office workers perceived their own eating behaviour in relation to their new home working environment. The sedentary nature of office-based jobs means that it is crucial that workers in these occupations engage in health behaviours that are beneficial to them. The present study aimed to explore how office workers perceive changes to their own eating behaviour since the transition to working from home (WFH) as a consequence of the pandemic. Semi-structured interviews were conducted with six volunteer office workers who previously worked in an office environment and who are now WFH. Data were analysed using interpretative phenomenological analysis, allowing the researcher to explore each account and understand their lived experiences. There were five superordinate themes: Healthy eating; time constraints; escaping the office; social cognitions; and food indulgence. Increased snacking behaviour since WFH was a major challenge, which was particularly potent during times of elevated stress. Furthermore, quality of nutrition since WFH appeared to coincide with the participants' wellbeing, such that this was reported as being worst at times of low wellbeing. Future studies must focus on developing strategies to improve the eating behaviours and the general wellbeing of office workers as they continue to WFH. These findings can then be utilised for the development of health promoting behaviours.

[Health care workers: the importance of adapted physical activities]

Adapted physical activities (APA) in the workplace improve workers' health. Paradoxically, APA remains marginal in the very places where improving health is the central objective of health care workers, namely clinics and hospitals. Promoting physical activity in the workplace is a twofold challenge. Not only does PA improve the health and well-being of caregivers, but it also allows them to be more effective in their daily work with patients.

Work-related stressors and coping behaviors among leaders in small and medium-sized IT and technological services enterprises

BACKGROUND

Occupational health interventions for leaders are underrepresented in small and medium-sized enterprises (SMEs). When creating and developing effective occupational health interventions, identification of the specific needs of the target group is regarded as an essential step before planning an intervention. Therefore, the aim of this study was (1) to examine the subjectively experienced work-related stressors of leaders in small and medium-sized IT and technological services enterprises, (2) to explore coping behaviors leaders use to deal with the experienced work-related stressors, (3) to investigate resources supporting the coping process and (4) to identify potentially self-perceived consequences resulting from the experienced stressors.

METHODS

Ten semi-structured interviews with leaders in small and medium-sized IT and technological services enterprises were conducted. The interviews were transcribed and analyzed with content-structuring qualitative content analysis in accordance to Kuckartz.

RESULTS

Leaders in small and medium-sized IT and technological services enterprises experience various stressors caused by work organization as well as industry-related stressors and other work-related stressors. To address the experienced stressors, leaders apply problem focused coping behaviors (e.g. performing changes on structural and personal level), emotional focused coping behaviors (e.g. balancing activities, cognitive restructuring) as well as the utilization of social support. Helpful resources for the coping process include organizational, social and personal resources. As a result of the experienced work-related stressors, interviewees stated to experience different health impairments, negative effects on work quality as well as neglect of leisure activities and lack of time for family and friends.

CONCLUSION

The identified experienced work-related stressors, applied coping behaviors, utilized resources and emerging consequences underpin the urgent need for the development and performance of health-oriented leadership interventions for leaders in small and medium- sized IT and technological services. The results of this study can be used when designing a target-oriented intervention for the examined target group.

Work Ability and Well-Being Management and Its Barriers and Facilitators in Multinational Organizations: A Scoping Review

The aim of this scoping review was to identify effective workplace programs for work ability and well-being management and its barriers and facilitators in multinational organizations. The PubMed, Embase, and Web of Science databases were searched from 1974 through February 2023 to identify quantitative and qualitative studies on the management of work ability and well-being, and related outcomes including presenteeism, absenteeism, productivity loss, and healthy practices, conducted in a multinational organization or company. The titles and abstracts of over 11,000 publications were screened, and 10 studies fulfilling the inclusion criteria were included in the review. The management of work ability and well-being in multinational companies requires leadership support and commitment, effective communication, employee health awareness and engagement, comprehensive personalized health risk and condition assessments, and the management of risk factors and occupational and non-occupational health conditions. Financial constraints, high workloads, competing priorities, a lack of effective communication, a lack of worksite managers’ motivation, employees’ language barriers, high worksite managers’ turnover, and a decline in the support of senior managers are considered as barriers, and the presence of existing participatory practices is considered as a facilitator of participation in workplace health and well-being interventions in multinational companies. This review suggests that the management of work ability and well-being in multinational companies should go beyond health promotion and include comprehensive personalized health risk and health condition assessments and management.

A scoping review of digital workplace wellness interventions in low- and middle-income countries

INTRODUCTION

Digital technology-based interventions have gained popularity over the last two decades, due to the ease with which they are scalable and low in implementation cost. Multicomponent health promotion programmes, with significant digital components, are increasingly being deployed in the workplace to assess and promote employees' health behaviours and reduce risk of chronic diseases. However, little is known about workplace digital health interventions in low- and middle- income countries (LMICs).

METHODS

Various combinations of keywords related to "digital health", "intervention", "workplace" and "developing country" were applied in Ovid MEDLINE, EMBASE, CINAHL Plus, PsycINFO, Scopus and Cochrane Library for peer-reviewed articles in English language. Manual searches were performed to supplement the database search. The screening process was conducted in two phases and a narrative synthesis to summarise the data. The review protocol was written prior to undertaking the review (OSF Registry:10.17605/OSF.IO/QPR9J).

RESULTS

The search strategy identified 10,298 publications, of which 24 were included. Included studies employed the following study designs: randomized-controlled trials (RCTs) (n = 12), quasi-experimental (n = 4), pilot studies (n = 4), pre-post studies (n = 2) and cohort studies (n = 2). Most of the studies reported positive feedback of the use of digital wellness interventions in workplace settings.

CONCLUSIONS

This review is the first to map and describe the impact of digital wellness interventions in the workplace in LMICs. Only a small number of studies met the inclusion criteria. Modest evidence was found that digital workplace wellness interventions were feasible, cost-effective, and acceptable. However, long-term, and consistent effects were not found, and further studies are needed to provide more evidence. This scoping review identified multiple digital health interventions in LMIC workplace settings and highlighted a few important research gaps.

Preconception Health in the Workplace: An Opportunity to Support Equitable Access to Education

Preconception health is a key determinant of pregnancy and offspring outcomes, but challenges reaching people during preconception are frequently cited by health professionals. This article highlights the workplace as an important setting for promoting equitable access to preconception health-related information and education to support optimal well-being before pregnancy. Workplaces can support equitable access to education and knowledge for preconception health: (1) due to the high engagement of reproductive-age women in the workforce and (2) by reaching vulnerable or high-risk population groups who may otherwise face barriers to accessing preconception health information. Literature that explicitly investigates workplace delivery of preconception health promotion programs is scarce. However, workplace health promotion more broadly is associated with improved corporate competitiveness, productivity, and strengthened employee-employer relationships. Workplace health promotion activities may also address social determinants of health and improve employee well-being outcomes. The opportunity for workplaces to benefit from an increase in the bottom line makes workplace health promotion programs more attractive, but organizational support and stakeholder engagement are needed to facilitate the design and delivery of successful workplace preconception health education programs. Such programs have the potential to facilitate health gains for women and their families.

Let’s Get Physical: Physical Activity as a Team Intervention at Work

The purpose of this article is to conceptualize a novel theoretical occurrence—team physical activity (PA)—and its relevance for researchers and organizations. By building a testable model of the consequences and contingencies of team PA, we integrate the science of teamwork with the scholarly domain of employee health and well-being. Hence, we clarify the construct of team PA, present a three-dimensional typology, and outline a model drawing on neuroscience, positive organizational behavior, and teams research. Our propositions and subsequent discussion proffer an outline of potential benefits for organizations when they increase the utility and frequency of team PA. We also suggest ways in which researchers can advance scholarship in this area.

STAR-VITAL, a Four Year Comprehensive Workplace Health Promotion Program: Study Design

Background: Premature death, chronic disease, and productivity loss can be reduced with the help of programs that promote a healthy lifestyle. Workplace health promotion programs have been shown to be an efficient way of improving employee health. These can also benefit employers by improving retention, reducing worker turnover, and lowering healthcare costs. In Slovenia, a workplace health promotion program called “STAR-VITAL—Joint Measures for the Vitality of Older Workers” targeting small- and medium-sized enterprises has been ongoing since September 2017. We hypothesize that this workplace health promotion program will yield long-term health changes for the included employees and employers. Methods/Design: The manuscript presents a workplace health promotion program design that introduces some novel approaches and solutions to workplace health promotion program implementation. It also introduces a measurement of their effects that address the problem of low participation rates and the effectiveness of workplace health promotion programs, as follows: (1) the multifaceted and individualised approach to implementation, (2) customer relationship management (CRM) -based interaction management with program participants, and (3) impact evaluation based on employee health and labour market data observing both intermediate outcomes and the final outcomes based on national micro administrative data. Discussion: Although the novel approaches introduced with the STAR-VITAL program proved to be effective during the COVID-19 pandemic, they deserve the attention of scholars and practitioners. Further research is called for to further explore the potential of CRM in health promotion contexts, the effectiveness of multifaceted and individualised workplace health promotion program interventions, and micro administrative data-based impact evaluations. Conclusions: The STAR-VITAL program introduces several new approaches addressing the problem of low participation rates and the effectiveness of WHPPs. Further research is called for to discover and explore the potential of those novel approaches.

The economic impact of workplace physical activity interventions in Europe: a systematic review of available evidence

Purpose

There is growing interest in the economic impact of workplace physical activity interventions, but the evidence is still lacking — especially in Europe. Although, some evidence on the return on investment (ROI) is found in literature, the included studies may not be applicable to the Europe situation. Therefore, the objective of this study was to review current evidence on the economic impact of workplace physical activity interventions in European countries.

Design/methodology/approach

A systematic review on the economic impact of worksite health promotion programs aiming at increasing physical activity was conducted. Five electronic databases (MEDLINE (Ovid), MEDLINE (PubMed), EMBASE, NHS-EED and Emerald Insights) were searched for relevant studies published between 2000 and 2020.

Findings

A total of 953 abstracts were screened, and 28 were reviewed, 11 of which met all inclusion criteria. The studies varied substantially in sample size, intervention type, duration and frequency of follow-up measurements, valuation methods and assessed economic outcomes. There is inconclusive evidence for decreasing absenteeism, positive net benefit (NB) and positive ROI. No evidence was found to indicate an effect on self-assessed productivity or job satisfaction.

Originality/value

This study is the first try to take the different working conditions from Europe into consideration. The authors found that working conditions could have some impact on the valuation of absenteeism costs and thereof on the ROI. Further, this study provides insight into how to deploy effective and efficient workplace physical activity interventions, based on a standardized and validated methodology and program scope.

The asymmetric experience of gains and losses in job security on health

Is workers' health more sensitive to losses than gains in job security? I address this question using the 1999 rise in the French Delalande tax as a quasi-natural experiment. The tax design allows to separately identify the causal impact of exogenous gains and losses in job security on workers' health. Difference-in-differences estimation results show that a greater job insecurity reduces significantly self-reported health. At the same time, more job security does not translate into a higher level of self-reported health.

Internal Corporate Social Responsibility for Sustainability

The recent attention paid to internal corporate social responsibility (ICSR) observed in the academic literature has been paralleled by an increased focus thereof in management, to achieve the United Nations (UN) Sustainable Development Goals (SDGs). A bibliometric examination of the literature on ICSR and a complementary content analysis with ATLAS.ti revealed that the topic was largely neglected until 2014 but has now reached a consolidation stage. The main contribution of this paper was to conceptualize ICSR within the current theoretical paradigm of sustainability. The obtained results demonstrate that sustainable management requires attention to internal practices such as employee well-being and engagement. We anticipate that very soon, organizations will be directly involved in the SDG agenda through ICSR.

Students' perceptions and experiences in a health promotion course using interactive learning

There is lack of studies that describe the experience of studying a health promotion course using an interactive approach and students' perceptions about this method of teaching. The purpose of this study is to describe students’ experiences and perceptions about health promotion course using an interactive learning approach. A descriptive qualitative design was used among 16 undergraduate university students at a governmental university. Four main themes emerged from the data analysis including: (1) fruitfulness and satisfying experience of interactive learning, (2) interactive learning versus traditional learning, (3) barriers to interactive learning, and (4) suggestions to enhance interactive learning. Students reflected positive attitudes toward interactive learning. Interactive learning helped students to be engaged in learning process physically and cognitively. Students mentioned several advantages of learning health promotion course using interactive learning, including, enhancing understanding, sharing ideas and opinions, promoting self-esteem and self-confidence, keeping their minds active and attentive, and improving interpersonal communication. Updated and contemporary learning strategies and methods should be introduced for enhancing interactive learning courses.

Urban-rural differences in the impacts of multiple chronic disease on functional limitations and work productivity among Chinese adults

BACKGROUND

Chronic disease multimorbidity has become a major challenge for health systems. While a lot of research has evaluated the direct economic burden of multimorbidity on health care utilization and cost, little attention has been given to the impacts on work productivity and functional limitations, as indirect indicators of disease burden.

OBJECTIVES

This study aims to examine the prevalence of multimorbidity among Chinese adults and its impact on functional disability and work productivity. It also investigates urban-rural differences in these relationships.

METHOD

This study utilized the data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015, including 11,176 participants aged 45 years and older. Multivariable logistic regression models were used to estimate the effect of multimorbidity on functional disability (i.e. ADL: activities of daily life; IADL: instrumental activities of daily life), and work productivity loss due to health problems. Negative binomial regression models were used to assess the association of multimorbidity with sickness absences from agricultural work and employed non-agricultural work.

RESULTS

68.8% of total participants in CHARLS had multimorbidity in China in 2015. Rural residents with multimorbidity reported higher proportions of physical functions and days of sick leave than urban residents. Multimorbidity was positively associated with ADL limitation (odds ratio 1.924, 95% CI 1.656-2.236), IADL limitation (1.522, 1.326-1.748), limited work due to health problems (1.868, 1.601-2.178) and days of sick leave (for agricultural work, incidence rate ratio 1.676, 95% CI 1.390-2.020; for employed non-agricultural work, 2.418, 1.245-4.696). For the rural group, the impact of multimorbidity on functional limitations and work productivity loss (except for early retirement), was less than the urban group.

CONCLUSIONS

Multimorbidity poses significant challenges for functional health and work productivity These have significant negative economic consequences for individuals, the Chinese health system and the society.

Whole Health Action Management: A Randomized Controlled Trial of a Peer-Led Health Promotion Intervention

OBJECTIVE

Adults with serious mental illness have high rates of general medical comorbidity and encounter challenges in dealing with multiple health conditions. Chronic illness self-management programs may help them more effectively cope with comorbid illnesses, especially when instructors are certified peer specialists. This study assessed the longitudinal effectiveness of a peer-delivered health promotion program.

METHODS

Community mental health program clients in Georgia and Illinois with serious mental illness and health impairments were randomly assigned to receive either Whole Health Action Management (WHAM), a medical illness self-management program led by peer specialists, or care as usual, resulting in a sample of N=139 (WHAM N=68, control N=71). Assessments were conducted at study baseline and at 3 and 6 months. Generalized estimating equations were used to examine change over time in the primary outcome of patient activation and secondary outcomes of general health, hope, and employment.

RESULTS

Longitudinal analysis indicated that compared with control participants, WHAM participants demonstrated significantly greater improvement over time in patient activation for health care. Intervention participants also demonstrated greater improvement in their self-assessed general health, overall hopefulness, and paid employment. Reactions to the WHAM program were positive, with 97% reporting being very or somewhat satisfied, and almost two-thirds (63%) reporting that their health was better than before they joined the program.

CONCLUSIONS

The WHAM program improved patient activation, perceived general medical health, hopefulness, and likelihood of paid employment among people with serious mental illness and co-occurring medical conditions. Results suggest that peer-delivered health self-management education is effective and well received by participants.

Toward Effective Work Accommodations for Depression: Examining the Relationship Between Different Combinations of Depression Symptoms and Work Productivity Losses

OBJECTIVE

Heterogeneity of depression experiences has led to suggestions that interventions focus on depression symptom combinations rather than depression severity alone. Our analyses explore the question, "What is the relationship between different combinations of depression symptoms and work productivity losses?"

METHODS

These analyses use a population-based sample of 2219 working adults. Using the PHQ-8 items, cluster analysis methods were used to identify depression symptom clusters. The Work Limitations Questionnaire's four work productivity loss dimensions were regressed on the identified depression symptoms clusters.

RESULTS

The symptoms clusters of workers with mild to moderate depression had significant but similar work productivity losses. However, the symptom combinations within these clusters of workers varied.

CONCLUSION

To create effective work accommodations, attention should focus on the combinations of depression symptoms and specific job characteristics rather than severity alone.

Built environment for physical activity-An urban barometer, surveillance, and monitoring

The Lancet Commission on Obesity (LCO), also known as the "syndemic commission," states that radical changes are required to harness the common drivers of "obesity, undernutrition, and climate change." Urban design, land use, and the built environment are few such drivers. Holding individuals responsible for obesity detracts from the obesogenic built environments. Pedestrian priority and dignity, wide pavements with tree canopies, water fountains with potable water, benches for the elderly at regular intervals, access to open-green spaces within 0.5-km radius and playgrounds in schools are required. Facilities for physical activity at worksite, prioritization of staircases and ramps in building construction, redistribution of land use, and access to quality, adequate capacity, comfortable, and well-networked public transport, which are elderly and differently abled sensitive with universal design are some of the interventions that require urgent implementation and monitoring. An urban barometer consisting of valid relevant indicators aligned to the sustainable development goals (SDGs), UN-Habitat-3 and healthy cities, should be considered a basic human right and ought to be mounted for purposes of surveillance and monitoring. A "Framework Convention on Built Environment and Physical Activity" needs to be taken up by WHO and the UN for uptake and implementation by member countries.

Reasons for Engagement: SME Owner-Manager Motivations for Engaging in a Workplace Mental Health and Wellbeing Intervention

OBJECTIVE

Small-to-medium enterprises (SMEs) require specialized attention regarding workplace mental health (WMH), but can be challenging to engage in WMH promotion interventions. This cross-sectional study analyzed self-reported motivations of SME owner/managers who engaged in a WMH promotion intervention specifically designed for SMEs.

METHODS

Data from 297 SME owner/managers was thematically coded before conducting multinominal logistical regression analyses to determine reasons for engagement based on a series of predictors, including owner/manager psychological distress, recent experience of a stressful work event, and business confidence.

RESULTS

Owner/manager psychological distress, experience of a recent stressful workplace, and low 12-month business confidence incident were important predictors of engagement.

CONCLUSION

The findings provide important insights into the uptake of a WMH promotion intervention, which can inform the design and future recruitment strategies for WMH promotion interventions within the SME sector.

Activate Your Health, a 3-year, multi-site, workplace healthy lifestyle promotion program: study design

Background

Workplace Health Promotion Programs (WHPP) have been shown to be an efficient way of improving workers’ health. These programs can be incorporated in the worker’s daily schedule and improve their productivity at work. Improving employees’ health also benefits the employers by increasing their return on investment and lowering healthcare costs. The Activate Your Health program, created by Capsana in 2015, is a WHPP targeting multiple lifestyle habits for a three-year period. This WHPP includes tailored web-based interventions and the support of different health professionals throughout the years. We hypothesize that this approach will yield long-term lifestyle changes. The objective of the current paper is to describe the Activate Your Health program’s design.

Methods/design

Eleven companies are taking part in this WHPP and had to choose among five different options of this program and all their employees were encouraged to participate. Each option differs by the number and type of interventions included. The limited option, which is considered the control group, only consists in completing a questionnaire regarding their health status, lifestyle habits and behaviors. On the other end, the extensive option receives a combination of multiple interventions: online menus, health challenges, support in creating a healthy work environment, coaching by health professionals (nurse, nutritionist, and kinesiologist), health screening and flexibility assessment, online resources, social health platform, and activity tracking. The remaining options are in between these options and vary by the amount of intervention. Baseline data are already gathered; two other data collection periods will take place after one and 2 years into the program. The primary outcomes of the current program are physical activity and fitness measures, nutritional data, smoking habits, stress and intention to change.

Discussion

The Activate Your Health program will allow us to compare which combinations of interventions are the most effective. It is expected that the extensive option will be the most advantageous to improve lifestyle habits. The results will indicate the strength and weakness of each intervention and how it could be improved.

Trial registration

Clinicaltrails.gov, registration number: NCT02933385 (updated on the 26th of March 2019, initially registered on the 5th of October 2016).

Health literacy of commercial industry managers: an exploratory qualitative study in Germany

Managers have been neglected in health literacy research. There still is little known about the health-literacy status and needs of commercial industry managers. This article reduces the existing knowledge gap by presenting findings of an exploratory qualitative study. We conducted 23 separate semi-structured interviews of managers from all management levels (low, middle and top) and experts in the field of health management and/or personnel management. The qualitative interviews were analysed according to Mayring's content analytic approach using MAXQDA. The findings indicate that managers do have considerable information levels about existing health topics and relevant problems but have difficulties of discernment as to which sources of information can be activated or accessed in a timely fashion due to work and information overload. Even those who devise strategies often fail in implementing health-literate behavior. Experts and managers had fairly consistent views on the importance of health literacy among managers. Most agreed that mental health was neglected and that company conditions were important in influencing the ability to act in a way that promoted health literacy. The findings also show that strengthening of managerial self-perception, self-regulation and self-control, raising awareness and ability to take personal responsibility for one's own health, developing skills in handling large amounts of information and fostering open and trusting communication are all essential.

Feasibility and acceptability of strategies to address mental health and mental ill-health in the Australian coal mining industry

Background

To evaluate the feasibility, acceptability and effectiveness of implementing a peer-based, multi-component mental health program in the Australian coal mining industry.

Methods

The multicomponent program included MATES in mining (a peer-based mental health and suicide prevention program) and supervisor training. Eight Australian coal mines participated in the research, with four mines receiving the mental health program. Primary outcome variables including mental health stigma, help-seeking behaviour and perception of the workplace commitment to mental health were measured prior to program implementation, and then again 10 months following using a paper based survey. Process evaluation of the mental health program was measured using a pre-test/post-test survey.

Results

MATES in mining 1275 miners participated in the MATES general awareness and connector training. Participants were more confident that they could identify a workmate experiencing mental ill-health; help a workmate, family member or themselves identify where to get support and were more willing to start a conversation with a workmate about their mental health. Supervisor training 117 supervisors completed the supervisor training and were subsequently more confident that they could: identify someone experiencing mental ill-health in the workplace; identify and recommend support services to a person experiencing mental ill-health; and have an effective conversation about performance issues that may be due to mental ill-health.

Conclusions

Our findings show evidence to support the use of peer-based mental health programs in the mining industry, and for male-dominated industry more broadly.

Wellness programme at the workplace promotes dietary change and improves health indicators in a longitudinal retrospective study

OBJECTIVE

To determine the effectiveness of a workplace wellness programme intervention in improving participants' behaviour towards choosing a healthy diet and the correlation with health indicators.

DESIGN

A retrospective cohort study.

SETTING

Wellness programme in the Midwest, USA.

SUBJECTS

Employees (n 12 636) who participated in a wellness programme for three consecutive years during years 2004 to 2013 and who completed web-based health risk questionnaires. The wellness programme included annual health screening, laboratory measures, health risk questionnaire and personalized health-care programme. Participants' food group intakes, BMI and health indicators were compared between the first and last year of participation. McNemar's non-parametric test was used for paired nominal data. Pearson correlations were computed for paired food and health indicator measurements. Correlations between dietary intake and BMI, cholesterol and TAG were computed using Pearson correlations and McNemar's test.

RESULTS

There were negative correlations between intakes of fruits, vegetables, grains, dairy, healthy eating pattern and health outcome indicators such as BMI and TAG levels. Additionally, the percentage of employees who increased their consumption of fruits (16·88 v. 12·08 %, P<0·001), vegetables (15·20 v. 11·44 %, P<0·001) and dark green leafy vegetables (12·03 v. 7·27 %, P 0·001) was significantly higher than the percentage of participants who decreased their intake of these food groups during the third-year follow-up.

CONCLUSIONS

The wellness programme improved some health indicator parameters and had a positive impact on increasing participants' intakes of fruits, vegetables and whole grains at the third year of follow-up.

Accounting for employee health: The productivity cost of leading health risks

BACKGROUND

"Workplace health promotion and protection" broadly refers to an integrated approach to workplace health and safety initiatives. There are substantial benefits to adopting such an approach, including the potential for: improvements to individual employees' health and well-being; increased productivity; and reduced safety risks and expenses. Yet many employers remain reluctant to shift from traditional safety initiatives and spending. This paper aims to demonstrate the value of investing in an integrated health promotion and protection approach by calculating the productivity costs associated with 11 modifiable health risks and 14 chronic conditions in an Australian mining company.

METHOD

Eight hundred and ninety-seven employees participated in a self-report health survey aimed at investigating employee health behaviours, health conditions and productivity.

RESULTS

Overall, modifiable health risks and chronic health conditions were calculated to contribute to an estimated $22.15 million (AUD) and $7.95 million (AUD) in lost productivity per 1000 employees per annum, respectively. Although employee stress was identified as the third highest prevalence health risk across the employee sample (at 42%), it accounted for the highest financial burden.

CONCLUSION

Employee health plays a vital role in the profitability, productivity, and safety outcomes of an organisation. For modifiable health risks and chronic conditions, ailments that affected cognition resulted in the highest financial burden (ie, stress and migraine headaches). SO WHAT?: These findings make a strong financial and business case for the integration of preventative health and safety initiatives, with particular emphasis on modifiable health risk behaviours.

"It's not an Obvious Issue, Is It?" Office-Based Employees' Perceptions of Prolonged Sitting at Work: A Qualitative Study

OBJECTIVE

Current UK workplace health promotion guidance recommends that employers minimize sedentary behaviors, but understanding the issues relating to prolonged workplace sitting has received little empirical attention. This study aimed to explore employees' perceptions of sitting time.

METHODS

Participants at a small to medium-sized UK company were invited to join one of five focus groups. A framework analysis approach was used.

RESULTS

Self-reported mean estimate of occupational sitting time was 6.4 hours/day with a mean estimate of leisure time sitting 6.5 hours/nonwork days. The study highlighted employees' lack of appreciation of the health risks associated with sedentary behavior.

CONCLUSION

This study has highlighted that in addition to personal determinants, the workplace environment and organizational culture have a key role in supporting employees' potential adoption of healthier sitting behavior in the workplace.

Cost and Return on Investment of a Work-Family Intervention in the Extended Care Industry: Evidence From the Work, Family, and Health Network

OBJECTIVE

To estimate the cost and return on investment (ROI) of an intervention targeting work-family conflict (WFC) in the extended care industry.

METHODS

Costs to deliver the intervention during a group-randomized controlled trial were estimated, and data on organizational costs-presenteeism, health care costs, voluntary termination, and sick time-were collected from interviews and administrative data. Generalized linear models were used to estimate the intervention's impact on organizational costs. Combined, these results produced ROI estimates. A cluster-robust confidence interval (CI) was estimated around the ROI estimate.

RESULTS

The per-participant cost of the intervention was $767. The ROI was -1.54 (95% CI: -4.31 to 2.18). The intervention was associated with a $668 reduction in health care costs (P < 0.05).

CONCLUSIONS

This paper builds upon and expands prior ROI estimation methods to a new setting.

The impact of digital health interventions on health-related outcomes in the workplace: A systematic review

BACKGROUND

The impact of employee health on productivity in the workplace is generally evidenced through absenteeism and presenteeism. Multicomponent worksite health programmes, with significant online elements, have gained in popularity over the last two decades, due in part to their scalability and low cost of implementation. However, little is known about the impact of digital-only interventions on health-related outcomes in employee groups. The aim of this systematic review was to assess the impact of pure digital health interventions in the workplace on health-related outcomes.

METHODS

Multiple databases, including MEDLINE, EMBASE, PubMed and PsycINFO, were used to review the literature using PRISMA guidelines.

RESULTS

Of 1345 records screened, 22 randomized controlled trial studies were found to be eligible. Although there was a high level of heterogeneity across these studies, significant improvements were found for a broad range of outcomes such as sleep, mental health, sedentary behaviours and physical activity levels. Standardized measures were not always used to quantify intervention impact. All but one study resulted in at least one significantly improved health-related outcome, but attrition rates ranged widely, suggesting sustaining engagement was an issue. Risk of bias assessment was low for one-third of the studies and unclear for the remaining ones.

CONCLUSIONS

This review found modest evidence that digital-only interventions have a positive impact on health-related outcomes in the workplace. High heterogeneity impacted the ability to confirm what interventions might work best for which health outcomes, although less complex health outcomes appeared to be more likely to be impacted. A focus on engagement along with the use of standardized measures and reporting of active intervention components would be helpful in future evaluations.

A global survey on occupational health services in selected international commission on occupational health (ICOH) member countries

BACKGROUND

The United Nations General Assembly (UNGA), the International Labour Organization (ILO), the World Health Organization (WHO), the International Commission on Occupational Health (ICOH), and the European Union (EU) have encouraged countries to organize occupational health services (OHS) for all working people irrespective of the sector of economy, size of enterprise or mode of employment of the worker. The objective of this study was to survey the status of OHS in a sample of countries from all continents.

METHODS

A questionnaire focusing on the main aspects of OHS was developed on the basis of ILO Convention No. 161 and several other questionnaire surveys used in various target groups of OHS. The questionnaire was sent to 58 key informants: ICOH National Secretaries.

RESULTS

A total of 49 National Secretaries responded (response rate 84.5%), from countries that employ 70% of the total world labour force. The majority of the respondent countries, 67%, had drawn up an OHS policy and implement it with the help of national occupational safety and health (OSH) authorities, institutes of occupational health or respective bodies, universities, and professional associations. Multidisciplinary expert OHS resources were available in the majority (82%) of countries, but varied widely in quantitative terms. The average OHS coverage of workers was 24.8%, with wide variation between countries. In over two thirds (69%) of the countries, the content of services was mixed, consisting of preventive and curative services, and in 29% preventive only. OHS financing was organized according to a mixed model among 63% and by employers only among 33% of the respondents.

CONCLUSIONS

The majority of countries have drawn up policies, strategies and programmes for OHS. The infrastructures and institutional and human resources for the implementation of strategies, however, remain insufficient in the majority of countries (implementation gap). Qualitatively, the content and multidisciplinary nature of OHS corresponds to international guidance, but the coverage, comprehensiveness and content of services remain largely incomplete due to a lack of infrastructure and shortage of multiprofessional human resources (capacity gap). The estimated coverage of services in the study group was low; only a quarter of the total employed population (coverage gap).

An analysis of healthy workplace accreditation and health promotion efforts based on employees' perspectives

This study was conducted to analyze the effects of health promotion efforts in relation to a workplace accreditation program and differing workplace sizes. The research population for the study consisted of 966 employees working at a total of 84 different worksites located in Taipei, Taiwan. The survey instructions used were developed by the European Network for Workplace Health Promotion (WHP). The results indicate that accredited workplaces have better WHP quality than nonaccredited workplaces (p < .001) and commonly implement health promotion measures related to specific health issues. It is recommended that the government provide more health-related resources in workplaces, especially those of small and medium companies.

Stress Prevention@Work: a study protocol for the evaluation of a multifaceted integral stress prevention strategy to prevent employee stress in a healthcare organization: a cluster controlled trial

Background

Adequate implementation of work-related stress management interventions can reduce or prevent work-related stress and sick leave in organizations. We developed a multifaceted integral stress-prevention strategy for organizations from several sectors that includes a digital platform and collaborative learning network. The digital platform contains a stepwise protocol to implement work-related stress-management interventions. It includes stress screeners, interventions and intervention providers to facilitate access to and the selection of matching work-related stress-management interventions. The collaborative learning network, including stakeholders from various organizations, plans meetings focussing on an exchange of experiences and good practices among organizations for the implementation of stress prevention measures. This paper describes the design of an integral stress-prevention strategy, Stress Prevention@Work, and the protocol for the evaluation of: 1) the effects of the strategy on perceived stress and work-related outcomes, and 2) the barriers and facilitators for implementation of the strategy.

Methods

The effectiveness of Stress Prevention@Work will be evaluated in a cluster controlled trial, in a large healthcare organization in the Netherlands, at six and 12 months. An independent researcher will match teams on working conditions and size and allocate the teams to the intervention or control group. Teams in the intervention group will be offered Stress Prevention@Work. For each intervention team, one employee is responsible for applying the strategy within his/her team using the digital platform and visiting the collaborative learning network. Using a waiting list design, the control group will be given access to the strategy after 12 months. The primary outcome is the employees’ perceived stress measured by the stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21). Secondary outcome measures are job demands, job resources and the number of preventive stress measures implemented at the team level. Alongside the trial, a process evaluation, including barriers and facilitators of the implementation of Stress Prevention@Work, will be conducted in one healthcare organisation.

Discussion

If Stress Prevention@Work is found to be effective in one healthcare organisation, further implementation on a broader scale might lead to increased productivity and decreased stress and sick leave in other organizations. Results are expected in 2018.

Trial registration

NTR5527. Registered 7 Dec 2015.

Employer and Promoter Perspectives on the Quality of Health Promotion Within the Healthy Workplace Accreditation

OBJECTIVES

To explore the employers' and promoters' perspective of health promotion quality according to the healthy workplace accreditation.

METHODS

We assessed the perspectives of 85 employers and 81 health promoters regarding the quality of health promotion at their workplaces. The method of measurement referenced the European Network for Workplace Health Promotion (ENWHP) quality criteria.

RESULTS

In the large workplaces, the accredited corporation employers had a higher impression (P < 0.001) of all criteria. The small-medium accredited workplace employers had a slightly higher perspective than non-accredited ones. Nevertheless, there were no differences between the perspectives of health promoters from different sized workplaces with or without accreditation (P > 0.05).

CONCLUSIONS

It seems that employers' perspectives of healthy workplace accreditation surpassed employers from non-accredited workplaces. Specifically, large accredited corporations could share their successful experiences to encourage a more involved workplace in small-medium workplaces.

A global, cross cultural study examining the relationship between employee health risk status and work performance metrics

Background

Health risk assessments (HRA) are used by many organisations as a basis for developing relevant and targeted employee health and well-being interventions. However, many HRA’s have a western-centric focus and therefore it is unclear whether the results can be directly extrapolated to those from non-western countries. More information regarding the differences in the associations between country status and health risks is needed along with a more global perspective of employee health risk factors and well-being overall. Therefore we aimed to i) quantify and compare associations for a number of health risk factors based on country status, and then ii) explore which characteristics can aid better prediction of well-being levels and in turn workplace productivity globally.

Methods

Online employee HRA data collected from 254 multi-national companies, for the years 2013 through 2016 was analysed (n = 117,274). Multiple linear regression models were fitted, adjusting for age and gender, to quantify associations between country status and health risk factors. Separate regression models were used to assess the prediction of well-being measures related to productivity.

Results

On average, the developing countries were comprised of younger individuals with lower obesity rates and markedly higher job satisfaction compared to their developed country counterparts. However, they also reported higher levels of anxiety and depression, a greater number of health risks and lower job effectiveness. Assessment of key factors related to productivity found that region of residency was the biggest predictor of presenteeism and poor pain management was the biggest predictor of absenteeism.

Conclusions

Clear differences in health risks exist between employees from developed and developing countries and these should be considered when addressing well-being and productivity in the global workforce.

Electronic supplementary material

The online version of this article (doi:10.1186/s40557-017-0172-1) contains supplementary material, which is available to authorized users.

Perceived workplace health support is associated with employee productivity

PURPOSE

To examine the relationship between perceived workplace health support and employee productivity.

DESIGN

A quantitative cross-sectional study.

SETTING

Washington State agencies.

SUBJECTS

A total of 3528 employees from six state agencies were included in this analysis.

MEASURES

Perceived workplace health support was assessed by two questions that queried respondents on how often they felt supported by the workplace for healthy living and physical activity. The Work Productivity and Activity Impairment Questionnaire was used to measure health-related absenteeism and presenteeism in the past 7 days.

ANALYSIS

Multivariate linear regression was used to estimate the mean differences in productivity by levels of perceived health support.

RESULTS

Most participants were between 45 and 64 years of age and were predominantly non-Hispanic white. Presenteeism varied significantly by the level of perceived workplace health support, with those who felt least supported having higher presenteeism than those who felt most supported. The difference in presenteeism by perceived workplace support remained significant in models adjusting for sociodemographic and health characteristics (mean difference: 7.1% for support for healthy living, 95% confidence interval: 3.7%, 10.4%; 4.3% for support for physical activity, 95% confidence interval: 1.7%, 6.8%). Absenteeism was not associated with perceived workplace health support.

CONCLUSION

Higher perceived workplace health support is independently associated with higher work productivity. Employers may see productivity benefit from wellness programs through improved perceptions of workplace health support.

The relationship between return on investment and quality of study methodology in workplace health promotion programs

OBJECTIVE

To determine the relationship between return on investment (ROI) and quality of study methodology in workplace health promotion programs.

DATA SOURCE

Data were obtained through a systematic literature search of National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Database (HTA), Cost Effectiveness Analysis (CEA) Registry, EconLit, PubMed, Embase, Wiley, and Scopus.

STUDY INCLUSION AND EXCLUSION CRITERIA

Included were articles written in English or German reporting cost(s) and benefit(s) and single or multicomponent health promotion programs on working adults. Return-to-work and workplace injury prevention studies were excluded.

DATA EXTRACTION

Methodological quality was graded using British Medical Journal Economic Evaluation Working Party checklist. Economic outcomes were presented as ROI.

DATA SYNTHESIS

ROI was calculated as ROI = (benefits - costs of program)/costs of program. Results were weighted by study size and combined using meta-analysis techniques. Sensitivity analysis was performed using two additional methodological quality checklists. The influences of quality score and important study characteristics on ROI were explored.

RESULTS

Fifty-one studies (61 intervention arms) published between 1984 and 2012 included 261,901 participants and 122,242 controls from nine industry types across 12 countries. Methodological quality scores were highly correlated between checklists (r = .84-.93). Methodological quality improved over time. Overall weighted ROI [mean ± standard deviation (confidence interval)] was 1.38 ± 1.97 (1.38-1.39), which indicated a 138% return on investment. When accounting for methodological quality, an inverse relationship to ROI was found. High-quality studies (n = 18) had a smaller mean ROI, 0.26 ± 1.74 (.23-.30), compared to moderate (n = 16) 0.90 ± 1.25 (.90-.91) and low-quality (n = 27) 2.32 ± 2.14 (2.30-2.33) studies. Randomized control trials (RCTs) (n = 12) exhibited negative ROI, -0.22 ± 2.41(-.27 to -.16). Financial returns become increasingly positive across quasi-experimental, nonexperimental, and modeled studies: 1.12 ± 2.16 (1.11-1.14), 1.61 ± 0.91 (1.56-1.65), and 2.05 ± 0.88 (2.04-2.06), respectively.

CONCLUSION

Overall, mean weighted ROI in workplace health promotion demonstrated a positive ROI. Higher methodological quality studies provided evidence of smaller financial returns. Methodological quality and study design are important determinants.

Policy, environment, and worksite fitness program participation among financial enterprise employees in Taiwan

BACKGROUND/OBJECTIVE

This study explored the intertwined effects between the policies and regulations of the companies and personal background on participation in the physical fitness programs and leisure-time activities in financial enterprises.

METHODS

A total of 823 employees were selected as the sample with the multilevel stratification random-sampling technique. The response rate was 52.0%. Data were analyzed with descriptive statistics and hierarchical linear logistic regression.

RESULTS

Thirty-two percent and 39% of the employees participated in the physical fitness programs and leisure-time activities, respectively. The factors affecting participation were categorized into intrapersonal factors, interpersonal processes, and primary groups, as well as institutional factors. In the interpersonal processes and primary groups level, higher family social support, more equipment in health promotion was associated with more participation in the programs. With the influence from the institutional level, it was found that health promotion policy amplified the relationship between employees' age and participation, but attenuated the relationship between education level and participation. Health promotion equipment in the institutes attenuated the relationship between colleague social support, family social support, and education level with program participation. Physical activity equipment in the community attenuated the relationship between family social support and program participation.

CONCLUSION

The influential factors of social support and worksite environment could predict the employees' participation in the physical fitness programs and leisure-time physical activities. Health promotion policy and equipment attenuated the negative effects of nonparticipation as well as amplified the positive effects of participation.