Zielgruppenorientierung und betriebliche Gesundheitsförderung

Background

In research regarding workplace health promotion (WHP), the employees’ perspective has so far been a neglected issue. Thus, employees’ potential opposition towards WHP due to perceived program-related barriers regarding information as well as program design has also received little attention. The latter is the focus of this study.

Methods

Preliminary hypotheses regarding WHP program-related barriers as well as proposals for their reduction were created on the basis of problem-centered interviews. These interviews were conducted with 19 employees in three organizations, four persons in charge of WHP within these organizations, and nine health experts.

Results

From the employees’ perspective, individual criteria such as the perceived utility of the WHP program, social aspects such as the internal acceptance of WHP, and organizational prerequisites such as access conditions potentially create barriers to the implementation and use of WHP programs.

Conclusion

On the individual level, barriers related to program design can be reduced by, for example, stressing certain topics. On the interpersonal level, offering activities with a strong group orientation is a possibility. On the organizational level, creating attractive organizational conditions represents a favorable intervention.     

Workplace health promotion and employee health in Swedish municipal social care organizations

Aim

The aim of this explorative study was to investigate the employers’ management characteristics, their provision of workplace health promotion (WHP) measures, and employee satisfaction with WHP in relation to employee health in Swedish municipal social care organizations.

Subjects and methods

A cross-sectional design was used, and questionnaires were sent to top managers (representing the employer) and employees in a nationwide random sample of 60 of the 290 municipal organizations for the social care of elderly and disabled people in Sweden. The questionnaire data from the 60 managers were linked to aggregated employee data concerning self-rated health and satisfaction with WHP from a representative sample of 8,082 employees in the same organizations. All analyses were performed at the organizational level using independent t-test, Spearman’s rank correlation and multiple linear regression analysis.

Results

In the multivariate analysis, the organizational WHP index (i.e. local WHP projects and WHP coordinators), individual WHP index (i.e. health profile assessment, fitness activities and medical check-up), and the level of employees’ satisfied with WHP were associated with employee health (F?=?9.64, p?<?0.001, adjusted R ²?=?0.48). General organizational and management characteristics were, however, not statistically related to employee health.

Conclusion

The results suggest that the provision of individual-directed and organizational-directed health-specific measures were related to employee health in Swedish municipal social care organizations and, therefore, can be part of a comprehensive approach to address WHP.     

Why do managers allocate resources to workplace health promotion programmes in countries with national health coverage?

There is extensive evidence that worksite health promotion (WHP) programmes reduce healthcare costs and improve employee productivity. In many countries, a large proportion of healthcare costs are borne by the state. While the full benefits of WHP are still created, they are shared between employers and the state, even though the employer bears the full (after-tax) cost. Employers therefore have a lower incentive to implement WHP activity. We know little about the beliefs of managers with decision responsibility for the approval and implementation of WHP programmes in this context. This article reports the results of a study of the attitudes of Canadian senior general managers (GMs) and human resource managers (HRMs) in the auto parts industry in Ontario, Canada towards the consequences of increasing discretionary spending on WHP, using Structural Equation Modelling and the Theory of Planned Behaviour. We identified factors that explain managers' intentions to increase discretionary spending on wellness programmes. While both senior GMs and HRMs are motivated primarily by their beliefs that WHP reduces indirect costs of health failure, GMs were also motivated by their moral responsibility towards employees (but surprisingly HRMs were not). Importantly, HRMs, who usually have responsibility for WHP, felt constrained by a lack of power to commit resources. Most importantly, we found no social expectation that organizations should provide WHP programmes. This has important implications in an environment where the adoption of WHP is very limited and cost containment within the healthcare system is paramount.     

Betriebliche Gesundheitsförderung in der Bundesrepublik Deutschland

The Luxembourg Declaration defines workplace health promotion (WHP) as the combined efforts of employers, employees and society to improve the health and well-being of people at work. WHP aims at encouraging personal development and healthy lifestyle, improving work organisation and the working environment by a wide range of measures, and at promoting active participation of employees in WHP processes. The procedure of WHP is oriented on the Cycle of Business Excellence. This article presents the development, methods, projects, evaluation and quality control of WHP.     

A cultural economy approach to workplace health promotion in Australian small and medium sized workplaces: a critical qualitative study

Workplace health promotion (WHP) is advocated to progress the health and well-being of employees. However, research findings on its uptake and impacts are equivocal, particularly in smaller workplaces. This paper describes managers’ and workers’ responses to a WHP programme in the Australian Capital Territory. Informed by a cultural economy framework, in-depth interviews were conducted with 44 workers and managers from 10 small to medium sized enterprises (SMEs). Examining their availability and acceptability to workers and managers, we found a limited array of health promotion activities were adopted; a caring environment, provision of healthy foods, occasional health checks and health advice. Physical activity programmes during work hours were unlikely to be accepted by managers due to time costs, and workers were reluctant to spend their non-paid time on them. Casual workers were often excluded from WHP activities because their work times did not synchronize with other employees’ hours. This study illuminates how WHP is shaped by a complex of employment regulations that stress individual performance, associated limits on employer and worker time and resources, and organizational, cultural norms and practices regarding healthy work environments. We conclude that SMEs are implementing a limited array of behaviour change initiatives reflecting a particular view of health promotion. While organizational change may expand adoption of health practices during the workday, there are impediments to workers adopting wholesale changes in their health practices given a national culture of long hours, and intense job demands embedded in Australia’s neoliberal employment system.     

Restructuring the multi-professional organization: professional identity and adjustment to change in a public hospital

The present study explored the multiple identities held by health professionals in a large public hospital that was experiencing organizational change that involved the transition from the traditional use of professional hierarchies to the use of new clinical teams. Consistent with predictions from social identity theory and research, the results of an organization-wide survey (N = 615) reveal the protective role of identification with professional departments during change that threatened group status. Professional departments were the preferred target of identification of employees, and employees who preferred this target reported a stronger sense of identification. Also consistent with our predictions, employees who were members of higher status groups reported greater job satisfaction, higher levels of openness to organizational change, and reduced levels of change-related uncertainty. These results were more pronounced for employees who identified with their professional department. Implications for managing multiple identities during organizational transition are discussed.     

Do wearable activity trackers improve employees’ health and increase re-participation in wellness programs?

ObjectiveWorkplace wellness programs are being widely adopted by organizations. However, the potential benefits of the programs are not realized in part because few employees participate in the programs repeatedly. This study aims to examine how activity tracking technology, prize, and communication affect wellness program participants’ perceived health and their willingness to re-participate in future programs.MethodsThis study examines field data obtained from an annual walking challenge program implemented for seven years by a major U.S. university. It uses the partial least squares (PLS) method to test the hypotheses.ResultsActivity tracking technology and prize opportunity have a significant positive effect on perceived health improvement. Perceived health improvement in turn has a significant positive effect on re-participation intention and word-of-mouth (WOM).ConclusionAs wearable activity tracking technology can increase employees’ repeated participation in workplace wellness programs, it should be an integral component of such programs. Organizations should encourage, support, and incentivise employees’ use of the technology.     

Implementation and outcomes of a comprehensive worksite health promotion program

BACKGROUND: This paper reports on the implementation and results of a three-year comprehensive worksite health promotion program called Take care of your health!, delivered at a single branch of a large financial organization with 656 employees at the beginning of the implementation period and 905 at the end. The program included six educational modules delivered over a three-year period. A global health profile was part of the first and last modules. The decision to implement the program coincided with an overall program of organizational renewal. METHODS: The data for this evaluation come from four sources: analysis of changes in employee health profiles between the first and last program sessions (n=270); questionnaires completed by participating employees at the end of the program (n=169); organizational data on employee absenteeism and turnover; and qualitative interviews with company managers (n=9). RESULTS: Employee participation rates in the six modules varied between 39% and 76%. The assessment of health profile changes showed a significant increase in the Global Health Score. Participants were significantly more likely to report more frequent physical activity and better nutritional practices. The proportion of smokers among participants was significantly reduced (p = 0.0147). Also reduced significantly between the two measurements were self-assessment of high stress inside and outside the workplace, stress signs, and feelings of depression. Employees were highly satisfied with the program and felt that it had impacts on their knowledge and capacities to manage their health behaviour. During the same period, absenteeism in the organization declined by 28% and turnover by 54%. From the organization's perspective, program implementation was very successful. CONCLUSIONS: This study's results are in line with previous findings of significant benefits to organizations and employees from worksite health promotion. The close relationship between the program outcomes and the overall process of organizational renewal that it accompanied supports previous arguments that worksite health promotion will be most effective when it promotes overall organizational health.     

Design principles for data- and change-oriented organisational analysis in workplace health promotion

This article focuses on organizational analysis in workplace health promotion (WHP) projects. It shows how this analysis can be designed such that it provides rational data relevant to the further context-specific and goal-oriented planning of WHP and equally supports individual and organizational change processes implied by WHP. Design principles for organizational analysis were developed on the basis of a narrative review of the guiding principles of WHP interventions and organizational change as well as the scientific principles of data collection. Further, the practical experience of WHP consultants who routinely conduct organizational analysis was considered. This resulted in a framework with data-oriented and change-oriented design principles, addressing the following elements of organizational analysis in WHP: planning the overall procedure, data content, data-collection methods and information processing. Overall, the data-oriented design principles aim to produce valid, reliable and representative data, whereas the change-oriented design principles aim to promote motivation, coherence and a capacity for self-analysis. We expect that the simultaneous consideration of data- and change-oriented design principles for organizational analysis will strongly support the WHP process. We finally illustrate the applicability of the design principles to health promotion within a WHP case study.     

Employees attitudes to workplace health promotion programs for cancer prevention

OBJETIVE: We describe a method for feasibility assessment of workplace health promotion (WHP) programs as a necessary prerequisite of any WHP program. METHODS: A total of 167 employees from five workplace communities participated in the study. A questionnaire on the basic components of feasibility (risk factors, attitudes to workplace health promotion interventions, and social-occupational context) was administered. RESULTS: Risk behaviours were common among the employees interviewed. Health promotion in the workplace was favorably viewed by 79% of subjects but reported participation would be lower. Interventions on diet and physical activity received the highest acceptance. Participation would be greatest among local administration employees. CONCLUSIONS: The method demonstrated its utility in obtaining useful data for designing workplace health promotion interventions.     

Social context for workplace health promotion: feasibility considerations in Costa Rica,Finland, Germany,Spain and Sweden

We constructed a simple, flexible procedure that facilitates the pre-assessment of feasibility of workplace health promotion (WHP) programmes. It evaluates cancer hazards, workers' need for hazard reduction, acceptability of WHP, and social context. It was tested and applied in 16 workplace communities and among 1085 employees in industry, construction, transport, services, teaching and municipal works in Costa Rica, Finland, Germany, Spain and Sweden. Social context is inseparable from WHP. It covers workers' organizations and representatives, management, safety committees, occupational health services, health and safety enforcement agencies, general health services, non-government organizations, insurance systems, academic and other institutions, regulatory stipulations pertaining WHP, and material resources. Priorities, risk definitions, attitudes, hazard profiles, motivations and assessment methods were highly contextual. Management preferred passive interventions, helping cover expert costs, participating in planning and granting time. Trade unions, workers' representatives, safety committees and occupational health services appeared to be important operational partners. Occupational health services may however be loaded with curative and screening functions or be non-existent. We advocate participatory, multifaceted WHP based on the needs and empowerment of the workers themselves, integrating occupational and lifestyle hazards. Workforce in irregular and shift work, in agriculture, in small enterprises, in the informal sector, and immigrant, seasonal and temporary workers represent groups in need of particular strategies such as community health promotion. In a more general framework, social context itself may become a target for intervention.     

Peer Reviewed: Establishing Worksite Wellness Programs for North Carolina Government Employees, 2008

Background

State employee health plans sometimes provide worksite wellness programs to reduce the prevalence of chronic diseases among their members, but few offer the comprehensive range of interventions recommended by the Task Force on Community Preventive Services.

Community Context

North Carolina''s State Health Plan for Teachers and State Employees provides health coverage for approximately 665,000 state employees, teachers, retirees, and dependents. Health claims indicate that the prevalence of having at least 1 chronic disease or of being obese is approximately 32% among state employees.

Methods

The State Health Plan created a partnership with North Carolina''s Division of Public Health, Office of State Personnel, and other key state agencies to identify bureaucratic obstacles to providing worksite wellness programs for state employees and to develop a state policy to address them. The Division of Public Health established a model worksite program to guide development of the worksite wellness policy and pilot wellness interventions.

Outcome

The state''s first worksite wellness policy created an employee wellness infrastructure in state government and addressed administrative barriers to allow effective worksite wellness interventions. For example, the policy led to pilot implementation of a subsidized worksite weight management program. Positive results of the program helped generate legislative support to expand the weight management program throughout state government.

Interpretation

Strong interagency partnership is essential to guide worksite wellness policy and program development in state government. State health plans, public health agencies, and personnel agencies each play a role in that partnership.     

Financial impact of a comprehensive multisite workplace health promotion program

INTRODUCTION: The purpose of this study is to determine if the Washoe County School District Wellness Program impacted employee health care costs and rates of absenteeism over a 2-year period. METHODS: Outcome variables included health care costs and absenteeism during 2001-2002. Data were collected on 6246 employees over a 6-year period from 1997-2002. Baseline health claims costs and absenteeism from 1997-2000, age, gender, job classification, and years worked at the school district were treated as covariates. Logistic regression was used to compare 2-year costs and absenteeism rates between nonparticipants and employees who participated for 1 and 2 years. RESULTS: No significant differences in health care costs were found between those who participated in any of the wellness programs and those who did not participate. There was a significant negative association between participation and absenteeism; program participants averaged three fewer missed workdays than those who did not participate in any wellness programs. The decrease in absenteeism translated into a cost savings of 15.60 US dollars for every dollar spent on the program. CONCLUSIONS: After controlling for several confounding variables, wellness program participation was associated with large reductions in employee absenteeism.     

Employee perceived barriers to participation in worksite health promotion

Aim

Many employers offer worksite health promotion (WHP), but a high percentage of the workforce does not participate. As the employees’ perspective regarding potential barriers to participation has received little attention in research so far, improvements in program design are delayed. The aims of the present paper therefore are to investigate perceived barriers to WHP participation from the employees’ point of view, and to construct a barrier typology.

Subject and methods

A quantitative questionnaire was developed on the basis of existing studies and distributed in four Austrian organisations offering comprehensive WHP programs. 237 respondents rated the appreciability of 22 potential barriers to WHP participation. Barrier categories and typologies were defined using principal component analysis (PCA), multiple correspondence analysis (MCA), and regression analysis.

Results

The PCA identified six barrier types: (1) integration into the daily routine; lack of (2) information; an (3) imbalance of benefits and costs; the requirement of too much (4) involvement; (5) interpersonal barriers; and (6) incredibility of the company’s honest commitment. According to the MCA, one group perceives barriers intensively, another hardly, and a third mainly program design related barriers. The regression analysis shows that especially being too busy at work and feeling physically not up to participating in WHP activities are major barriers.

Conclusion

The results provide a comprehensive overview and categorization of barriers to WHP participation perceived by employees in companies offering holistic programs. Moreover, they can be used as guidelines for analysing existing and/or preventing barriers of occurring when designing and implementing WHP programs.     

Ethics orientation as a mediator of organizational integrity in health services organizations

Increasing scrutiny of ethical misconduct by federal and state agencies has prompted health services organizations to adopt codes of ethics and institute legal compliance programs. However, there is little understanding of the impact of ethics programs or the manner in which program elements act to enhance organizational integrity. This study examined the effect of five ethics program elements on organizational integrity and the mediating role played by ethics orientation in this relationship. It found that program elements influence organizational integrity by engendering among employees a values orientation, a compliance orientation, or both. Furthermore, program elements that induced both orientations have a larger impact on integrity. These findings have important implications for health services managers involved in designing and implementing an ethics program.     

Improving knowledge of strategic goals and the impact on organizational commitment

A large health maintenance organization (HMO) in San Diego, California developed a year-long communication plan to increase employee knowledge of the company's strategic goals and enhance organizational commitment. Survey results indicated: Respondents remembered significantly more strategic goals after program implementation. Respondents who had personal involvement in achieving goals remembered significantly more goals than those without involvement. Department meetings and the employee/physician newsletter were identified as primary sources for learning about goals. These findings suggest that organizations may be able to strengthen employee commitment by increasing awareness of the organization's strategic goals and encouraging employees to become personally involved in the achievement of those goals.     

The Symbolic and Material Nature of Physician Identity: Implications for Physician–Patient Communication

This field study considers the implications of the symbolic and material nature of physician identity for communication with patients. In-depth interviews of physicians across multiple organizational contexts reveal that physician identity is a discursive process of situated meaning in which particular configurations of beliefs, values, and actions are constructed within specific contexts. The content of individual physician identity was related to the general environment of medicine and its local medical context. The identities of physicians working in private practice were linked to the economic, legal, and social environment of medicine, whereas physicians working as employees had identities related to working in a setting that buffered the effects of the environment. Specific implications of the symbolic and material nature of physician identity for physician–patient communication are examined. Understanding physician identity is important to health communication scholarship because of the ongoing and central nature of physicians in health-care decision making and delivery.     

Betriebliche Gesundheitsförderung in mittelständischen Unternehmen

Background

Various studies have found the profitability of small and midsize enterprises (SME) to be related to their ability to innovate. Investing in human and social capital can help these companies increase their ability to innovate.

Research question

This study looked at how the level and type of workplace health promotion (WHP) programmes differ among larger, leading SME when they are actively managed by the businesses’ owners and their competitors.

Method

Structured interviews were conducted with six owner-managed enterprises, as well as with four competitors from the chemicals and metal industry.

Results

All businesses offer WHP programmes. Two of the businesses participating in the study have enrolled an employee in an in-house WHP programme. The organizations taking part in the study spend around €83 per employee per year on WHP programmes. By comparison, owner-managed enterprises clearly spend less than their competitors. One weakness stands out: “Controlling” or “active management” of the WHP programmes was found in only two of the businesses taking part in the study. The differences between the owner-controlled businesses and the management-controlled businesses are, on the whole, minor. Innovative potential by the owner-managed businesses is indicated by the fact that they focus much more strongly on the needs of their employees, as well as possess a perceptiveness and responsiveness to certain groups of employees. In conclusion, it is highly recommended that all businesses enroll more staff and more actively manage their WHP programmes.     

The utilization of employee wellness programs by government, business and industry: a strategic evaluation

This study ascertains the extent of use of employee wellness programs by a cross section of organizations in the United States. Nearly one-thousand organizational personnel professionals responded to a mail survey asking if their organization provided specific wellness services within five areas: (1) incentive programs, (2) exercise and fitness programs, (3) health screening and prevention, (4) nutritional aid, and (5) educational programs. Organizations were then categorized using Standard Industrial Classification (SIC) codes. The results are strategically valuable to both users and providers of wellness products, providing bench-mark data which: (1) allows comparisons of wellness offerings among similar organizations and across organizational types, and (2) provides product development and segmentation guidance to hospitals and other providers of wellness products.