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Johnson SS. The Urgent Need to Advance Health Equity: Past and Present. Am J Health Promot 2024; 38:427-447. [PMID: 38418436 DOI: 10.1177/08901171241232057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
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Sherman BW, Stiehl E, Gupta R, Pratap PL. The Importance of Human-centered Design in Equitable Health Promotion Initiatives. Am J Health Promot 2024; 38:443-447. [PMID: 38418437 DOI: 10.1177/08901171241232057f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Affiliation(s)
- Bruce W Sherman
- University of North Carolina-Greensboro, Greensboro, NC, USA
- Case Western Reserve University, Cleveland, OH, USA
| | - Emily Stiehl
- University of Illinois Chicago, Chicago, IL, USA
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Sherman BW, Stiehl E, Wator C, Pratap PL. Why Don't Employees Participate in Well-being Programs? A Research-Informed Systems-Based Model. J Occup Environ Med 2024; 66:156-160. [PMID: 37964600 DOI: 10.1097/jom.0000000000003012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
OBJECTIVE Employee nonparticipation in well-being programs is common, but not well understood. Development of a systems-based framework to characterize reasons for nonparticipation can inform efforts to enhance engagement. METHODS Following literature review and building on previous research, a systems-based model was developed to contextualize participation barriers. RESULTS Well-being program nonparticipation is more frequent among low-wage workers as well as minority subpopulations. Contributors include employer factors, such as inequitable benefits design, and employee factors, such as lack of perceived relevance, barriers to access, and lower prioritization of personal health needs. CONCLUSIONS A systems-based approach to evaluating well-being program nonparticipation can help identify factors contributing to employee nonparticipation and lead to targeted policy and practice changes that encourage greater employee engagement.
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Affiliation(s)
- Bruce W Sherman
- From the University of North Carolina-Greensboro, Greensboro, NC (B.W.S.); Case Western Reserve University, Cleveland, OH (B.W.S.); and University of Illinois at Chicago, Chicago, IL (E.S., C.W., P.L.P.)
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Hammerback K, Strait M, Kohn MJ, Garcia C, Harris JR, Hannon PA. Exploring the Impact of the COVID-19 Pandemic on Employees' Workplace Health Promotion Preferences. Am J Health Promot 2024; 38:238-241. [PMID: 37349879 PMCID: PMC10291210 DOI: 10.1177/08901171231185765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
PURPOSE The COVID-19 pandemic has led to profound changes in the workplace as well as increases in stress, missed preventive care, and other health concerns. There is limited research since the onset of the pandemic on employees' primary health concerns and their willingness to engage with workplace health promotion (WHP) programs to address these needs. We conducted this survey about employees' current health priorities as a first step to exploring whether WHP programs need to evolve to be responsive to employees' needs at this stage of the pandemic. DESIGN National cross-sectional survey. SETTING United States, April 29-May 5, 2022. SUBJECTS 2053 Americans employed part or full time. MEASURES 17-item online survey assessing demographics, health priorities, and impact of the pandemic on health. ANALYSIS Descriptive statistics, SPSS Version 19. RESULTS Employees' most common health concerns included work/life balance and stress (each cited by 55%). Nearly half (46%) said their health or well-being was affected by the pandemic; within this group, the most common concerns were stress (66%), anxiety (61%), sleep (49%), and depression (48%). Almost all (94%) indicated they would be open to receiving support from their employers. CONCLUSION This research is a first step in learning about employees' current health priorities and how they may have changed. WHP researchers and practitioners can determine how their programs align with current priorities. Our future research will explore employees' preferences, heath behaviors, and their current workplace environments in more depth.
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Affiliation(s)
- Kristen Hammerback
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Michelle Strait
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Marlana J. Kohn
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Cinthya Garcia
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Jeffrey R. Harris
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Peggy A. Hannon
- Health Promotion Research Center, Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
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Bleier H, Lützerath J, Schaller A. Organizational facilitators and barriers for participation in workplace health promotion in healthcare: A qualitative interview study among nurses. Front Psychol 2023; 14:1101235. [PMID: 36936007 PMCID: PMC10017985 DOI: 10.3389/fpsyg.2023.1101235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/01/2023] [Indexed: 03/06/2023] Open
Abstract
Background There is evidence for the positive effects of workplace health promotion (WHP) for nurses. Although this highly stressed target group also actively desires WHP, the number of participants is low. Individual reasons play a role in the decision to engage in WHP activities, yet it is interesting to consider which organizational factors a company could address to improve participation. In this regard, the question arises of what organizational factors facilitate participation in WHP activities from the perspective of nurses in inpatient care facility (ICF), outpatient care service (OCS), and acute care hospitals (ACH). Method Sixteen semi-structured interviews were conducted in different care settings between May and September 2021. Questions about everyday working life, WHP activities, and organizational framework conditions were asked. Result The results show that there is a wide range of influencing factors at the organizational level, some overall settings, and others setting-specific. High workload and the fit of WHP activities with shift times were particularly inhibiting overall settings. A negative association with the employer worked as a barrier in ICF and ACH. Conclusion When implementing WHP activities, it can be useful to consider organizational facilitators and barriers to promote sustainable and attractive WHP activities and higher participation rates in the different settings of nursing.
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Affiliation(s)
- Hannah Bleier
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - Jasmin Lützerath
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
- Institute for Workplace Health Promotion, Cologne, Germany
| | - Andrea Schaller
- Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
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Stiehl E, Bales S, Jenkins K, Sherman BW. Unique Barriers to Workplace Health Promotion Programs (WHP) by Wage Category: A Qualitative Assessment of Secondary Data. Am J Health Promot 2022; 36:843-852. [PMID: 35081750 DOI: 10.1177/08901171211069546] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To understand barriers around accessing or using workplace health promotion (WHP) programs among workers in different wage categories. APPROACH We conducted qualitative analysis of responses to three open-ended questions about WHP program participation, collected as part of an existing WHP program evaluation. SETTING A large mid-western university. PARTICIPANTS Of the 20,000 employees emailed an online survey, 3,212 responded (16.1%). The sample was mostly female (75%), white (79%), and comprised of staff members (84%). The average age was 44 years and 67% had annual incomes <$75,001. METHOD We used NVivo-12 Plus and two coders to apply Grounded Theory on the open-ended questions and identify emergent themes. RESULTS Although most respondents were happy with the program, differences across wage categories emerged around time, financial incentives, commute, workload, and organizational policies/support. Employees at all wage levels were enthusiastic about creating a culture of health but needed different supports to do so. For instance, higher-wage workers needed to overcome self-made time constraints, while lower-wage workers needed supervisor support to overcome coverage constraints that prevented participation. CONCLUSION The unique participation challenges experienced by employees in different wage categories provide justification for WHP programs that can better accommodate the participation barriers of all employees. While some programs may simply require more flexible offerings, others may need to train supervisors to support and foster healthy environments.
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Affiliation(s)
- Emily Stiehl
- Health Policy and Administration14681University of Illinois at Chicago
| | | | | | - Bruce W Sherman
- Medicine12304Case Western Reserve University School of Medicine
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Damian AJ, Stinchfield K, Kearney RT. Telehealth and Beyond: Promoting the Mental Well-Being of Children and Adolescents During COVID. Front Pediatr 2022; 10:793167. [PMID: 35237538 PMCID: PMC8882817 DOI: 10.3389/fped.2022.793167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- April Joy Damian
- Weitzman Institute, Community Health Center, Inc., Middletown, CT, United States.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | | | - R Timothy Kearney
- Weitzman Institute, Community Health Center, Inc., Middletown, CT, United States
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Chen Y, Chu H, Wang P. Employee Assistance Programs: A Meta‐Analysis. JOURNAL OF EMPLOYMENT COUNSELING 2021. [DOI: 10.1002/joec.12170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Yin‐Che Chen
- Department of Educational Psychology and Counseling National Tsing Hua University
| | - Hui‐Chuang Chu
- Department of Educational Psychology and Counseling National Tsing Hua University
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Bell A, Barrett N, Lamaro Haintz G. "The Ripple Effect": The influence of social support on participation in a small workplace health promotion program. Health Promot J Austr 2021; 33:470-479. [PMID: 34139036 DOI: 10.1002/hpja.511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 06/16/2021] [Indexed: 11/06/2022] Open
Abstract
ISSUE ADDRESSED Workplaces are key settings for health promotion. There is limited evidence pertaining to workplace health promotion [WHP] in Australian small and medium enterprises [SMEs], particularly in regional areas. This qualitative study explored employee perceptions of a pilot workplace health promotion program, LifeMAP, conducted in a small health service enterprise in regional Victoria 2014-2017, including facilitators of participation and perceived benefits of participation. METHOD Ten LifeMAP participants were recruited using convenience sampling. Individual semi-structured interviews (n = 7) and one focus group (n = 3) were conducted between August and September 2017. Data were analysed inductively and thematically to elicit emergent themes. RESULTS Social support emerged as the overarching theme influencing participation in LifeMAP, and a perceived benefit of participation. Using FitBits® and setting exercise challenges enabled social support to be fostered through role modelling, staff collegiality and community. There may be gendered differences in the experiences of role modelling in WHP. CONCLUSIONS This SME, and others like it, often feature high levels of employee social connectedness, with a strong workplace and community networks. Social support is a critical influence in social connectedness which needs to be considered and incorporated into the design, implementation and evaluation of WHP programs as a means of overcoming WHP recruitment and participation challenges in regional SMEs. SO WHAT?: The identification of social support as a key factor for WHP participation and employee satisfaction is a valuable finding providing insight into how similar programs may be better designed and implemented to enhance WHP program recruitment and retention.
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Affiliation(s)
- Alexandra Bell
- Health Promotion Department, South West Healthcare, Warrnambool, VIC, Australia
| | - Norma Barrett
- School of Health and Social Development, Deakin University, Warrnambool, VIC, Australia
| | - Greer Lamaro Haintz
- Centre for Health through Action on Social Exclusion (CHASE), School of Health and Social Development, Deakin University, Geelong, VIC, Australia
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Certified Nursing Assistants’ Barriers and Facilitators to Accessing and Using Worksite Health Promotion Programs. J Occup Environ Med 2020; 62:943-952. [DOI: 10.1097/jom.0000000000002007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Fetherman DL, McGrane TG, Cebrick-Grossman J. Health Promotion for Small Workplaces: A Community-Based Participatory Research Partnership. Workplace Health Saf 2020; 69:7-14. [PMID: 32812843 DOI: 10.1177/2165079920938298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The majority of U.S. worksites are smaller worksites that often employ low-wage workers. Low-wage workers have limited access to, and participation in, workplace health promotion programs. Community-based participatory research (CBPR) has been identified as a key method to directly engage employers in identifying the health promotion needs of smaller workplaces. This article describes a four-phased process where CBPR was used to tailor a workplace health promotion program to meet the needs of a smaller workplace that employees low-wage workers. Outcomes of this program were measured and reported over time. METHODS The CBPR approach was based on the Social Ecological Model along with two additional health promotion models. Publicly available evidence-based tools were also used for this four-phased process which included the following: (a) initial program assessment, (b) program planning, (c) program implementation, and (d) program evaluation. Key strategies for developing a comprehensive workplace health promotion program guided the process. FINDINGS The workplace's capacity for promoting health among its employees was improved. There were sustainable improvements in the health interventions and organizational supports in place. CONCLUSION/APPLICATION TO PRACTICE A CBPR approach may be a way to build the capacity of smaller workplaces with low-wage employees to address the health promotion needs of their workforces. The use of publicly available strategies and tools which incorporate the social ecological determinants of health is of equal importance.
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van der Put AC, Mandemakers JJ, de Wit JB, van der Lippe T. Worksite health promotion and social inequalities in health. SSM Popul Health 2020; 10:100543. [PMID: 32021901 PMCID: PMC6994707 DOI: 10.1016/j.ssmph.2020.100543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/10/2020] [Accepted: 01/12/2020] [Indexed: 10/31/2022] Open
Abstract
It is well-documented that higher educated employees have better health than the lower educated. The workplace has been put forward as a contributor to this inequality. We extend previous work on workplace characteristics that could influence employee health by asking to what extent workplace health promotion (WHP) can account for the relation between education and health. Two ways in which WHP may relate to health inequalities are addressed: higher educated employees may be more likely to use WHP than lower educated employees and the effect of WHP on health may be stronger for higher educated than for lower educated employees. Using data from the European Sustainable Workforce Survey which contains information on over 11000 employees in 259 organisations, we test whether three types of WHP mediate or moderate the relation between education and health: healthy menus, sports facilities and health checks. We find that higher educated employees are in better health and that use of WHP positively relates to health. Use of healthy menus and sports facilities in the workplace can contribute to increasing health inequalities, as lower educated employees are less likely to make use of these. Health checks could contribute to diminishing health inequalities, as lower educated employees are more likely to use them compared to higher educated employees. The effect of WHP is not contingent on education. We advise stimulating lower educated employees to make more use of WHP, which can contribute to decreasing health inequalities.
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Affiliation(s)
- Anne C. van der Put
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - Jornt J. Mandemakers
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - John B.F. de Wit
- Interdisciplinary Social Science: Public Health, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
| | - Tanja van der Lippe
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH, Utrecht, the Netherlands
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Fink J, Zabawa B, Chopp S. Employee Perceptions of Wellness Programs and Incentives. Am J Health Promot 2020; 34:257-260. [DOI: 10.1177/0890117119887687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To explore, by income level, employee perceptions of an employer offered wellness incentive program. Design: Qualitative and quantitative study that includes a survey with close-ended and open-ended questions. Setting: The study setting was a hospital in Wisconsin. Participants: Participants (n = 105). Measures and Analysis: Quantitative responses were analyzed using descriptive statistics in Qualtrics and logistic regression in Statistical Analysis System. Results: Sixty-three percent participated in the wellness incentivized program because their employer offers them a reward; 52% said they would participate without a reward; 48% feel like they must participate in this year’s program; and 34% feel like they would have to disclose information about their health at or below the current reward level. Conclusion: Income does not have a significant effect on whether employees feel they must participate or disclose health information. However, income has a significant effect on employee’s beliefs about whether or not employers should play an active role in improving the health of their employees.
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Affiliation(s)
- Jennifer Fink
- Department of Health Informatics and Administration, College of Health Sciences, University of Wisconsin Milwaukee, WI, USA
| | - Barbara Zabawa
- Department of Health Informatics and Administration, College of Health Sciences, University of Wisconsin Milwaukee, WI, USA
| | - Sara Chopp
- Department of Health Informatics and Administration, College of Health Sciences, University of Wisconsin Milwaukee, WI, USA
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Hannon PA, Hammerback K, Kohn MJ, Kava CM, Gary Chan KC, Parrish AT, Allen C, Helfrich CD, Mayotte C, Beresford SA, Harris JR. Disseminating Evidence-Based Interventions in Small, Low-Wage Worksites: A Randomized Controlled Trial in King County, Washington (2014-2017). Am J Public Health 2019; 109:1739-1746. [PMID: 31622155 DOI: 10.2105/ajph.2019.305313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To determine whether (1) participating in HealthLinks, and (2) adding wellness committees to HealthLinks increases worksites' evidence-based intervention (EBI) implementation.Methods. We developed HealthLinks to disseminate EBIs to small, low-wage worksites. From 2014 to 2017, we conducted a site-randomized trial in King County, Washington, with 68 small worksites (20-200 employees). We assigned worksites to 1 of 3 arms: HealthLinks, HealthLinks plus wellness committee (HealthLinks+), or delayed control. At baseline, 15 months, and 24 months, we assessed worksites' EBI implementation on a 0% to 100% scale and employees' perceived support for their health behaviors.Results. Postintervention EBI scores in both intervention arms (HealthLinks and HealthLinks+) were significantly higher than in the control arm at 15 months (51%, 51%, and 23%, respectively) and at 24 months (33%, 37%, and 24%, respectively; P < .001). Employees in the intervention arms perceived greater support for their health at 15 and 24 months than did employees in control worksites.Conclusions. HealthLinks is an effective strategy for disseminating EBIs to small worksites in low-wage industries.Public Health Implications. Future research should focus on scaling up HealthLinks, improving EBI maintenance, and measuring impact of these on health behavior.
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Affiliation(s)
- Peggy A Hannon
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Kristen Hammerback
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Marlana J Kohn
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Christine M Kava
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Kwun C Gary Chan
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Amanda T Parrish
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Claire Allen
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Christian D Helfrich
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Caitlin Mayotte
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Shirley A Beresford
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
| | - Jeffrey R Harris
- Peggy A. Hannon, Kristen Hammerback, Marlana J. Kohn, Christine M. Kava, Amanda T. Parrish, Claire Allen, Caitlin Mayotte, and Jeffrey R. Harris are with the Department of Health Services, University of Washington, Seattle. Kwun C. Gary Chan is with the Department of Biostatistics, University of Washington, Seattle. Christian D. Helfrich is with VA Puget Sound Health Care System, Seattle, WA. Shirley A. Beresford is with the Department of Epidemiology, University of Washington, Seattle
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Tabak RG, Strickland JR, Stein RI, Dart H, Colditz GA, Kirk B, Dale AM, Evanoff BA. Development of a scalable weight loss intervention for low-income workers through adaptation of interactive obesity treatment approach (iOTA). BMC Public Health 2018; 18:1265. [PMID: 30445939 PMCID: PMC6240310 DOI: 10.1186/s12889-018-6176-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 11/01/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Describing how and why an evidence-based intervention is adapted for a new population and setting using a formal evaluation and an adaptation framework can inform others seeking to modify evidence-based weight management interventions for different populations or settings. The Working for You intervention was adapted, to fit a workplace environment, from Be Fit Be Well, an evidence-based intervention that targets weight-control and hypertension in patients at an outpatient clinic. Workplace-based efforts that promote diet and activity behavior change among low-income employees have potential to address the obesity epidemic. This paper aims to explicitly describe how Be Fit Be Well was adapted for this new setting and population. METHODS To describe and understand the worksite culture, environment, and policies that support or constrain healthy eating and activity in the target population, we used qualitative and quantitative methods including key informant interviews, focus groups, and a worker survey; these data informed intervention adaptation. We organized the adaptations made to Be Fit Be Well using an adaptation framework from implementation science. RESULTS The adapted intervention, Working for You, maintains the theoretical premise and evidence-base underpinning Be Fit Be Well. However, it was modified in terms of the means of delivery (i.e., rather than using interactive voice response, Working for You employs automated SMS text messaging), defined as a modification to context by the adaptation framework. The adaptation framework also includes modifications to content; in this case the behavioral goals were modified for the target population based on updated science related to weight loss and to target a workplace population (e.g., a goal to avoiding free food at work). CONCLUSIONS If effective, this scalable and relatively inexpensive intervention can be translated to other work settings to reduce obesity and diabetes risk among low-SES workers, a group with a higher prevalence of these conditions. Using a formal evaluation and framework to guide and organize how and why an evidence-based intervention is adapted for a new population and setting can push the field of intervention research forward. TRIAL REGISTRATION ClinicalTrials.gov: NCT02934113 ; Received: October 12, 2016; Updated: November 7, 2017.
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Affiliation(s)
- Rachel G. Tabak
- Prevention Research Center in St. Louis, The Brown School, Washington University in St. Louis, 1 Brookings Dr, St. Louis, MO 63130 USA
| | - Jaime R. Strickland
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Richard I. Stein
- Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8083, St. Louis, MO 63110 USA
| | - Hank Dart
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO 63110 USA
| | - Graham A. Colditz
- Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Department of Surgery, Washington University School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, Campus Box 8100, St. Louis, MO 63110 USA
| | - Bridget Kirk
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Ann Marie Dale
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
| | - Bradley A. Evanoff
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, 4523 Clayton Avenue, Campus Box 8005, St. Louis, MO 63110 USA
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Chigumete TG, Townsend N, Srinivas SC. Facilitating and limiting factors of workplace health promotion at Rhodes University, South Africa. Work 2018; 59:599-606. [PMID: 29733050 DOI: 10.3233/wor-182707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Workplace health promotion programs, when well designed and implemented are beneficial to both employees and their employers. OBJECTIVE To investigate the factors that affect workplace health promotion initiatives intended for support staff at Rhodes University. To explore ways in which future initiatives that aim to reduce the prevalence of non-communicable diseases in the workplace may be improved. METHODS A qualitative study, using semi-structured interviews and focus group discussions with key stakeholders and support staff. All interviews and focus group discussions were voice recorded and then transcribed verbatim. Transcripts were uploaded into NVivo® 10 for coding and thematic analysis. RESULTS Key stakeholders reported that health promotion initiatives have been attempted and were advertised, however the turnout was poor. The support staff in turn, stated that past initiatives were not tailored to their health needs and they lacked context-specificity and cultural sensitivity. They also suggested improvements for future initiatives such as convenient venues and using films and short plays as a means of delivering health information. CONCLUSIONS Based on inputs from key stakeholders and support staff, there are several factors that affect the success of health promotion initiatives in the workplace. Employees, who are the recipients of the planned initiatives, need to be involved in all stages of the planning and implementation.
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Hammerback K, Hannon PA, Parrish AT, Allen C, Kohn MJ, Harris JR. Comparing Strategies for Recruiting Small, Low-Wage Worksites for Community-Based Health Promotion Research. HEALTH EDUCATION & BEHAVIOR 2018; 45:690-696. [PMID: 29658314 DOI: 10.1177/1090198118769360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND HealthLinks is a workplace health promotion program developed in partnership with the American Cancer Society. It delivers a package of evidence-based interventions and implementation support to small worksites in low-wage industries. As part of a randomized, controlled trial of HealthLinks, we studied approaches to recruiting these worksites. AIMS This study aims to guide future recruitment for community-based worksite health promotion interventions by comparing three approaches, including leveraging relationships with community partners. METHOD We recruited 78 small, low-wage worksites in King County, Washington, to participate in the trial via three approaches: phone calls to companies on a purchased list ("cold"), phone calls to a list of eligible companies provided by a health insurer ("lukewarm"), and personal referrals from local health insurers and brokers ("warm"). Eligible and interested worksites received an in-person visit from researchers and completed additional steps to enroll. RESULTS Of the worksites screened and deemed eligible, 32% of the "cold" worksites enrolled in HealthLinks, as did 48% and 60%, respectively, of the "lukewarm" and "warm" worksites. Compared with "warm" worksites, "cold" worksites were twice as likely to be ineligible. DISCUSSION Two distinct factors help explain why "warmer" worksites were more likely to enroll in HealthLinks. First, eligibility was significantly higher among warmer referrals. Second, most of the warm-referred worksites eligible for the study agreed to meet in person with the project team to hear more about the project. CONCLUSIONS "Warmer" recruitment approaches yielded higher recruitment. Leveraging relationships with community partners can help researchers identify and successfully recruit small, low-wage worksites.
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Passey DG, Brown MC, Hammerback K, Harris JR, Hannon PA. Managers’ Support for Employee Wellness Programs: An Integrative Review. Am J Health Promot 2018; 32:1789-1799. [DOI: 10.1177/0890117118764856] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: The aim of this integrative literature review is to synthesize the existing evidence regarding managers’ support for employee wellness programs. Data Source: The search utilized multiple electronic databases and libraries. Study Inclusion and Exclusion Criteria: Inclusion criteria comprised peer-reviewed research published in English, between 1990 and 2016, and examining managers’ support in the context of a worksite intervention. The final sample included 21 articles for analysis. Data Extraction: Two researchers extracted and described results from each of the included articles using a content analysis. Data Synthesis: Two researchers independently rated the quality of the included articles. Researchers synthesized data into a summary table by study design, sample, data collected, key findings, and quality rating. Results: Factors that may influence managers’ support include their organization’s management structure, senior leadership support, their expected roles, training on health topics, and their beliefs and attitudes toward wellness programs and employee health. Managers’ support may influence the organizational culture, employees’ perception of support, and employees’ behaviors. Conclusions: When designing interventions, health promotion practitioners and researchers should consider strategies that target senior, middle, and line managers’ support. Interventions need to include explicit measures of managers’ support as part of the evaluation plan.
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Affiliation(s)
- Deborah G. Passey
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Meagan C. Brown
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Kristen Hammerback
- Health Promotion Research Center, University of Washington, Seattle, WA, USA
| | - Jeffrey R. Harris
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Peggy A. Hannon
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
- Health Promotion Research Center, University of Washington, Seattle, WA, USA
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Supporting the Health of Low Socioeconomic Status Employees: Qualitative Perspectives From Employees and Large Companies. J Occup Environ Med 2018. [PMID: 29538272 DOI: 10.1097/jom.0000000000001318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to identify alignments between wellness offerings low socioeconomic status (SES) employees need and those large companies can provide. METHODS Focus groups (employees); telephone interviews (large companies). Employees were low-SES, insured through their employers, and employed by large Washington State companies. Focus groups covered perceived barriers to healthy behaviors at work and potential support from companies. Interviews focused on priorities for employee health and challenges reaching low-SES employees. RESULTS Seventy-seven employees participated in eight focus groups; 12 companies completed interviews. Employees identified facilitators and barriers to healthier work environments; companies expressed care for employees, concerns about employee obesity, and reluctance to discuss SES. CONCLUSION Our findings combine low-SES employee and large company perspectives and indicate three ways workplaces could most effectively support low-SES employee health: create healthier workplace food environments; prioritize onsite physical activity facilities; use clearer health communications.
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Stiehl E, Shivaprakash N, Thatcher E, Ornelas IJ, Kneipp S, Baron SL, Muramatsu N. Worksite Health Promotion for Low-Wage Workers: A Scoping Literature Review. Am J Health Promot 2018; 32:359-373. [PMID: 28893085 PMCID: PMC5770241 DOI: 10.1177/0890117117728607] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine: (1) What research has been done on health promotion interventions for low-wage workers and (2) what factors are associated with effective low-wage workers' health promotion programs. DATA SOURCE This review includes articles from PubMed and PsychINFO published in or before July 2016. Study Inclusion/Exclusion Criteria: The search yielded 130 unique articles, 35 met the inclusion criteria: (1) being conducted in the United States, (2) including an intervention or empirical data around health promotion among adult low-wage workers, and (3) measuring changes in low-wage worker health. DATA EXTRACTION Central features of the selected studies were extracted, including the theoretical foundation; study design; health promotion intervention content and delivery format; intervention-targeted outcomes; sample characteristics; and work, occupational, and industry characteristics. DATA ANALYSIS Consistent with a scoping review, we used a descriptive, content analysis approach to analyze extracted data. All authors agreed upon emergent themes and 2 authors independently coded data extracted from each article. RESULTS The results suggest that the research on low-wage workers' health promotion is limited, but increasing, and that low-wage workers have limited access to and utilization of worksite health promotion programs. CONCLUSION Workplace health promotion programs could have a positive effect on low-wage workers, but more work is needed to understand how to expand access, what drives participation, and which delivery mechanisms are most effective.
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Affiliation(s)
- Emily Stiehl
- 1 Health Policy and Administration, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Namrata Shivaprakash
- 2 Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Esther Thatcher
- 3 University of Virginia Health System, University Medical Associates Clinic, Charlottesville, VA, USA
| | - India J Ornelas
- 4 Health Services, University of Washington, Seattle, WA, USA
| | - Shawn Kneipp
- 5 Health Care Environments Division, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sherry L Baron
- 6 Queens College, Barry Commoner Center for Health and the Environment, Flushing, NY, USA
| | - Naoko Muramatsu
- 7 School of Public Health and Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Watkins CM, Macy G, Lartey G, Golla V. Kentucky worksite health promotion 2014 survey results. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2016. [DOI: 10.1108/ijwhm-05-2015-0024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to conduct a statewide assessment of worksite health promotion (WHP) programs to identify the number of comprehensive programs and the health needs of worksites in Kentucky.
Design/methodology/approach
A random sample of 1,200 worksites in Kentucky was selected to receive the Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard to collect cross-sectional information on their health promotion practices.
Findings
Few worksites in Kentucky have WHP programs and even fewer have comprehensive programs. More businesses rely on health insurance to treat chronic diseases than WHP programs to reduce chronic diseases. Small companies were less likely than larger companies to have WHP programs and less likely to have intentions of starting a program.
Research limitations/implications
The response rate of 37 percent was a potential threat to external validity. Respondents had to recall activities conducted during the past 12 months, which could have led to recall bias. Response bias was a potential, as many of the respondents were human resources personnel who may not be as familiar with WHP programs in their worksites. Lastly, four sections of the survey had yet to be validated.
Practical implications
WHP programs, if accessible and comprehensive, have the potential to improve the working population’s health status.
Originality/value
Very little information on the availability and effectiveness of health promotion programs at worksites is available. A statewide assessment on WHP programs has never been conducted in Kentucky.
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Allen CL, Hammerback K, Harris JR, Hannon PA, Parrish AT. Feasibility of Workplace Health Promotion for Restaurant Workers, Seattle, 2012. Prev Chronic Dis 2015; 12:E172. [PMID: 26447549 PMCID: PMC4599055 DOI: 10.5888/pcd12.150093] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Restaurant workers are a large population at high risk for tobacco use, physical inactivity, and influenza. They are difficult to reach with health care interventions and may be more accessible through workplaces, yet few studies have explored the feasibility of workplace health promotion in this population. This study sought to identify barriers and facilitators to promotion of tobacco cessation, physical activity, and influenza vaccination in restaurants. Methods Moderators conducted 7 focus groups, 3 with restaurant owners and managers, 2 with English-speaking workers, and 2 with Spanish-speaking workers. All groups were recorded, and recordings were transcribed and uploaded to qualitative-analysis software. Two researchers coded each transcript independently and analyzed codes and quotations for common themes. Results Seventy people from the restaurant industry participated. Barriers to workplace health promotion included smoking-break customs, little interest in physical activity outside of work, and misinformation about influenza vaccinations. Facilitators included creating and enforcing equitable break policies and offering free, on-site influenza vaccinations. Spanish-speakers were particularly amenable to vaccination, despite their perceptions of low levels of management support for health promotion overall. Owners required a strong business case to consider investing in long-term prevention for their employees. Conclusion Tobacco cessation and influenza vaccinations are opportunities for health promotion among restaurant workers, whereas physical activity interventions face greater challenges. Promotion of equitable breaks, limited smoking-break policies, and free, on-site influenza vaccinations could improve health for restaurant workers, who often do not have health insurance. Workplace interventions may be particularly important for Hispanic workers who have additional access barriers.
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Affiliation(s)
- Claire L Allen
- Health Promotion Research Center, University of Washington, Department of Health Services, 1107 NE 45th St, Suite 200, Seattle, WA 98105. Telephone: 206-543-5750.
| | | | - Jeffrey R Harris
- School of Public Health, University of Washington, Seattle, Washington
| | - Peggy A Hannon
- School of Public Health, University of Washington, Seattle, Washington
| | - Amanda T Parrish
- School of Public Health, University of Washington, Seattle, Washington
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