Comparison of participation in federal worksite and community health promotion programs

The extent to which employees rely on the worksite exclusively for health promotion programs was examined in a cross-sectional study of 10 federal worksites. Responses were received from 3,403 of the 5,757 employees surveyed (59%). Fewer than 10% of employees exclusively used agency programs for physical fitness, nutrition, substance abuse, smoking cessation, and support group meetings. A higher percentage participated in health risk assessment (27%), health and disease risk education activities (17%), medical care services (23%), personal safety and first aid training 26%, and stress management programs (17%) only at the worksite. Men were more likely than women to participate exclusively in workplace programs.     

Health promotion programs in small worksites: results of a national survey

PURPOSE: This study documents the prevalence of workplace health promotion activities at small worksites with 15 to 99 employees. DESIGN: A random sample of U.S. worksites stratified by size and industry (n = 3628) was drawn using American Business Lists. MEASURES: Each worksite was surveyed using a computer-assisted telephone interview system to document activities related to health promotion and related programs, worksite policies regarding health and safety, health insurance, and philanthropic activities. SUBJECTS: Participation varied by industry and size, with an overall response rate for eligible worksites of 78% for a total sample of 2680 worksites. DATA ANALYSIS: Data were analyzed using SUDAAN statistical software. RESULTS: Approximately 25% of worksites with 15 to 99 employees offered health promotion programs to their employees, compared with 44% of worksites with 100+ employees. As with the larger worksites, the most common programs for worksites with 15 to 99 employees were those related to occupational safety and health, back injury prevention, and CPR. The majority of worksites in both size categories had alcohol, illegal drug, smoking, and occupant protection policies. The majority of both small and large worksites also offered group health insurance to their employees (92% and 98%, respectively), with many of the worksites also extending benefits to family members and dependents (approximately 80% for both business sizes). CONCLUSIONS: The results indicated that small worksites are providing programs to their employees, with a primary focus on job-related hazards. Small worksites also have formal policies regarding alcohol, drug use, smoking, and seatbelt use and offer health insurance to their employees at a rate only slightly lower than that of large worksites.     

Prevalence of hypercholesterolemia in a national worksite sample.

We conducted a screening for serum cholesterol levels at 41 locations of a large manufacturing company to determine baseline serum cholesterol levels in a workplace population. Locations were based on volunteerism. We conducted screenings at the worksite with individuals voluntarily participating on company time. Fifty percent of eligible employees participated in the screening. Using National Cholesterol Education Program guidelines, we identified 17.6% of employees as hypercholesterolemic (greater than or equal to 240 mg/dL), and another 30.2% were at borderline high risk. Total serum cholesterol increased with age and was higher in men than in women. Total cholesterol was significantly associated with age, sex, marital status, and education, but not with occupational status.     

Prevalence and factors related to Canadian workplace health programs

BACKGROUND: This study documented the prevalence and factors related to workplace health programs in Canada, including Employee Assistance Programs (EAPs), drug testing programs, and Health Promotion Programs (HPPs). METHODS: A representative sample of 565 Human Resources Managers at worksites with 100 or more employees across Canada completed a questionnaire on the worksite characteristics and the types of programs at their workplace (response rate = 79.8%). RESULTS: EAPs were established in 67.8% of sampled worksites (95% CI: 63.9%-71.7%). The proportion of worksites with EAPs varied significantly across work sectors (p<0.001) but not across regions of Canada. Worksites with EAPs had significantly (p<0.001) fewer visible minorities and had more unionized employees (p<0.001) than worksites without EAPs. For drug-testing programs, about 10.3% of Canadian worksites have them (95% CI: 7.8%-12.8%). Significant differences were noted across regions (p<0.001) with Alberta most likely to have such programs (25.4%) and Ontario least likely (4.6%). Also, safety-sensitive worksites and those with United States ownership were significantly (p<0.05) more likely to have drug testing. The most common type of HPP was fitness programs (29.4%) and the least common was day/elder care programs (5.5%). Fitness programs were most common in the Eastern provinces and least common in Quebec. CONCLUSIONS: Overall, Canadian worksites favour a health promotion and treatment approach over a deterrence approach for addressing health and substance use issues in the workplace. Workplace health programs were related to several factors that have created an uneven system of health promotion, treatment and deterrence in Canadian worksites.     

Socioeconomic status, workplace characteristics and plasma fibrinogen level of Japanese male employees

OBJECTIVES: This study examined the relationships between workplace characteristics and plasma fibrinogen level and assessed the possibility of socioeconomic differences in plasma fibrinogen level being accounted for by workplace characteristics. METHODS: Cross-sectional questionnaire data from 4343 Japanese male employees were examined with Karasek's demand-control model, as was sedentary job and overtime work. RESULTS: Less overtime work, a less sedentary job, and to a less extent, lower job control and low worksite support were related to increased plasma fibrinogen levels. Adjusting for employment grade strongly attenuated or eliminated these relationships. The association of job demands or job strain with plasma fibrinogen level was weak. High plasma fibrinogen in lower socioeconomic groups remained largely unchanged after adjustment for workplace characteristics. CONCLUSIONS: Workplace characteristics are not significantly related to the plasma fibrinogen levels of male Japanese employees after adjustment for socioeconomic status, and they do not explain socioeconomic differences in plasma fibrinogen levels among these employees.     

The effects of workplace flexibility on health behaviors: a cross-sectional and longitudinal analysis

OBJECTIVE: To examine the cross-sectional and longitudinal associations between workplace flexibility and health behaviors, and estimate the potential importance of flexibility for effective worksite health promotion programs. METHOD: Cross-sectional and longitudinal health risk appraisal data were obtained from US based employees of a multinational pharmaceutical company (n = 3193). Examined health behaviors were hours of sleep, physical activity frequency, health education seminar attendance, frequency of practicing personal resilience techniques, and self-appraised lifestyle. Self-reported flexibility in the workplace was the primary independent variable. RESULTS: Each health behavior, except regular attendance in health education seminars, was positively related to perceived flexibility in cross-sectional analyses. Sleep and self-appraised lifestyle were significantly related to changes in perceived flexibility over time. CONCLUSIONS: Workplace flexibility may contribute to positive lifestyle behaviors, and may play an important role in effective worksite health promotion programs.     

Physical activity promotion as a strategic corporate priority to improve worker health and business performance

BackgroundThe increasingly sedentary nature of work and its impact on health and productivity indicators demands the promotion of physical activity at the worksite.PurposeThis paper aims to present considerations for broad-scale application of corporate strategies designed to promote physical activity among employees and their families through employer-sponsored initiatives.ApproachThe benefits of physical activity are multifold, including health and wellbeing and productivity related outcomes. The workplace setting may be leveraged to promote physical activity levels through frequent and sustained exposures to effective interventions that reach employees and, indirectly, their families. Furthermore, employers represent a powerful stakeholder group that should leverage its influence on health policy initiatives designed to create supportive environments inside the workplace as well as the broader community. Specific principles, recommendations for action, and considerations for the prioritization of initiatives are provided based on essential elements for comprehensive programs and health policy initiatives and in the context of a social–ecological model and supportive research.ConclusionsPhysical activity promotion at the worksite should be an integrated initiative that measurably improves worker health and enhances business performance.     

Worksite health promotion programs in the U.S.: factors associated with availability and participation

PURPOSE: To examine how the availability of and participation in worksite health promotion programs varies as a function of individual (e.g., age), organizational (e.g., occupation), and health (e.g., high blood pressure) characteristics. Availability of worksite programs was also compared to that reported in two previous national surveys of private companies. DESIGN: Data analyzed were from the 1994 National Health Interview Survey (NHIS), a national cross-sectional probability sample of the U.S. civilian population. SUBJECTS: Five thousand two hundred nineteen NHIS respondents met the inclusion criteria of (1) being currently employed in a company of at least 50 employees, and (2) completing the NHIS section on worksite health promotion. MEASURES: Employees indicated the availability of, and their participation in, 33 different types of worksite programs. National Health Interview Survey data were also available regarding general health, blood pressure, body mass index, and medical conditions. RESULTS: Smoking cessation programs had the highest mean availability (43%), followed by health education programs (31%) and screening tests (31%). Overall, availability of worksite programs appeared comparable to that reported in a recent national survey. Participation ranged from 32% for health education programs to 5% for smoking cessation programs. Compared to availability, participation depended less on individual and organizational characteristics. Healthy employees were not consistently more likely to participate in worksite health promotion programs than nonhealthy employees. CONCLUSIONS: Although availability of worksite health promotion programs remains high, participation by employees in specific types of programs can vary widely. Attempts to increase participation should look beyond individual, health, and organizational variables, to specific features of the work environment that encourage involvement in health promotion activities.     

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

PURPOSE: To assess organizational and employee participation during three community-wide worksite exercise competitions in two communities. DESIGN: A one-group, posttest-only design was used. Lack of controls, exercise baseline, and the short-term nature of the interventions were limitations. SETTING: The Minnesota Heart Health Program conducted annual exercise campaigns between 1982 and 1989 within three intervention communities to reduce behavioral risk for cardiovascular disease. The Shape Up Challenge was a worksite exercise competition designed, in conjunction with other campaign activities, to increase levels of physical activity. SUBJECTS: A total of 119 participating companies in two Minnesota communities, and 17,626 employees within these worksites, composed the subjects in this study. INTERVENTION: Eligible worksites were invited to participate in a month-long competition during which employees recorded minutes spent daily in aerobic activities. Incentives were established to promote intragroup cooperation and intergroup competition. Companies competed for awards that were based on average minutes of exercise per employee versus per participant. MEASURES: Numbers of companies recruited and participating, campaign activities, minutes of exercise, and costs were recorded on implementation logs. Companies completed surveys describing business type, number and sex of employees, existing health promotion programs, and perceived benefits of participation. RESULTS: Of the 365 companies invited to participate, 33% participated (range 15% to 50%). Participating companies were more likely than nonparticipating companies to offer other health promotion programs and perceived greater benefits from participation. Women and smaller companies had significantly greater participation rates than men and larger companies. Average employee participation rates ranged from as high as 84% in smaller organizations to as low as 16% as organization size increased. CONCLUSIONS: Community-based worksite exercise competitions appear to be a viable strategy for promoting employee exercise, particularly in smaller companies. Group-based contingencies applied in natural work units may facilitate employee participation. Further research is needed to assess the relative efficacy of this approach, compare alternative incentives, and identify strategies to enhance exercise maintenance after the intervention has ceased.     

Female employee participation in a worksite mammography screening program.

We conducted a survey of 1,184 women 35 years of age or older who were employees of a company in Los Angeles County, California, to determine why some women participated in a worksite mammography screening program whereas others did not. Of the 111 who accepted a mammogram, 90 responded to the survey; of the 1,073 who declined mammography, 620 responded. The women were predominantly white, were well educated, and had health insurance. Of the 111 women who received mammograms, one was diagnosed with carcinoma. Seventy-three percent of the respondents to the survey 40 years of age or older who declined mammograms had already fulfilled American Cancer Society (ACS) guidelines for mammography screening at the time of the program. Women who accepted a mammogram were more likely to have had at least one previous mammogram than were women who had not met ACS guidelines yet who declined screening. We conclude that many female employees who are white, are well educated, and have health insurance may not participate in a worksite mammography screening program because they have been screened elsewhere. Companies providing worksite mammography screening should target education to women who have not met ACS guidelines, especially those who have never had a mammogram.     

Effectiveness of crime prevention through environmental design in reducing criminal activity in liquor stores: a pilot study

Liquor store employees experience disproportionately higher rates of workplace injury death than employees in any other retail setting. However, efforts to introduce workplace violence prevention programs into liquor stores have been minimal. This study examines the effectiveness of a Crime Prevention Through Environmental Design intervention in reducing criminal activity in Santa Monica, California liquor stores. Nine stores enrolling in the study received an individualized intervention safety plan; the remaining 13 served as a comparison group. Mixed-effects Poisson regression was used to examine intervention effectiveness. The largest reductions in criminal activity occurred for robbery and shoplifting outcomes. We conclude that the Crime Prevention Through Environmental Design program reduced crime and injury in liquor stores and educated small businesses about the risks associated with retail violence and the countermeasures that can be taken.     

Workplace smoking policies in Taiwan and their association with employees' smoking behaviours

BACKGROUND: The implementation of worksite smoking policies has shown significant effects on reducing employees' smoking consumption and protecting non-smoking workers. However, there are no data about workplace smoking policies in Taiwan. The purpose of this study was to document the status of worksite smoking policies in Taiwan and its potential impact on employees' smoking behaviours. METHODS: A two-stage investigation was conducted. The first stage was to examine the current status of workplace smoking policies and the second was to evaluate the relationship between workplace smoking policies and employees' smoking behaviours. After two follow-ups in each stage, 264 companies and 1141 employees returned their questionnaires. RESULTS: Workplace smoking policies were associated with types of businesses and size of workplaces. Only approximately half of manufacturing and service companies have implemented a prohibitive smoking policy. Large facilities (>750 employees) were more likely to implement a prohibitive policy (57%). Employees in workplaces with a prohibitive policy had lower prevalence of smoking and cigarette consumption, and less exposure to passive smoking. Although most smokers agreed with banning smoking in their work environment, no difference in interest in participating in cessation programs was found. CONCLUSIONS: Significant associations were found between workplace smoking policies and employees' smoking behaviours. Results of the study provide basic information for designing more refined smoking policies in the workplace in Taiwan.     

Broadening the scope of worksite stress programs: a guiding framework

Abstract Worksite stress programs have proliferated in recent years. A large proportion of these programs focus on helping individual employees learn about stress and develop better coping skills. Few programs attempt to reduce the stressful aspects of the job or the organizational context. In order to facilitate the development of a broader array of stress reduction programs, the authors provide: 1) a conceptual framework upon which worksite stress programs should be based, 2) a guide to the variety of decision points in the program development process, 3) an exploration of the reasons why a broader range of stress programs have not heretofore been developed, and 4) suggestions for creating a context amenable to innovative worksite stress programs.     

The impact of worksite-based safety belt programs: a review of the literature

PURPOSE: The purpose of this paper is to provide a literature review of the research that examines the effectiveness of worksite intervention programs designed to increase the use of safety belts by employees. SEARCH METHODS: The literature search, which identified 14 research studies on worksite safety belt programs conducted between 1968 and 1994, originated as part of a larger review on the health impact of worksite health promotion programs that was conducted by the Centers for Disease Control and Prevention (CDC). In addition, the authors conducted an additional search in an effort to validate the CDC search, but found no additional research articles. SUMMARY OF IMPORTANT FINDINGS: The literature specific to the effectiveness of safety belt programs is limited to only 14 studies. The safety belt intervention most commonly evaluated used behavioral modification principles involving incentives. These and other interventions demonstrated effective increases in seat belt utilization that, upon withdrawal of the intervention, achieved a recidivism rate above baseline levels. However, the vast majority of studies failed to incorporate control groups into their research design, which caused significant threats to internal validity. Thus, a summary of findings is only suggestive at best. MAJOR CONCLUSIONS: Based on the literature, there appears to be an insufficient number of quality research studies from which to derive a clear view of the impact of worksite safety belt programs. While the evidence is suggestive of a positive impact on safety belt use, there is a clear need for new, well-designed research initiatives on the effectiveness of theory-based safety belt intervention programs.     

Selected barriers and incentives for worksite health promotion services and policies

PURPOSE: To assess employees'attitudes toward potential barriers to and incentives for their likely use of worksite health promotion services. METHODS: Data from the 2004 HealthStyles Survey, a volunteer mail survey, were used to examine selected barriers to, incentives for, and potential use of worksite health promotion programs among adults employed full-time or part-time outside the home (n = 2337). RESULTS: Respondents were 72.7% white and 52.1 % female; 36.5 % were college graduates, 30.7% had a body mass index of at least 30, and 35.6% were regularly active. The most common reported barriers to use of worksite services were no time during the workday (42.5 %) and no time before or after work (39.4%). More than 70% of employees responded that the following incentives would promote their interest in participating in a free worksite wellness program: convenient time, convenient location, and employer-provided paid time off during the workday. Preferred health promotion services reported by respondents were fitness centers (80.6%), weight loss programs (67.1 %), and on-site exercise classes (55.2 %). Policy practices of paid time to exercise at work and healthy vending or cafeteria food choices were preferred by almost 80% of employees. CONCLUSIONS: These HealthStyles Survey data, in combination with needs data from an employer's own workforce, may help employers design wellness programs to include features that attract employees.     

Organizational characteristics of small metal-fabricating businesses in Minnesota

Small U.S. businesses are underserved in terms of occupational health and safety (OHS) services. Little is known about organizational factors influencing OHS in these establishments. Machine guarding was quantitatively evaluated in 40 small businesses. Checklists were used to develop safety scores. Organizational information such as number of employees, unionization, and number of machines was obtained. Experience modification rates, annual sales, and credit ratings were also obtained. Safety scores were divided into terciles. Businesses with safety scores in the top third were unionized, had effective safety committees, and had been operational for more than 30 years. Interventions and policies targeted toward development and implementation of safety committees are needed to improve OHS in this cohort. Financial capability had no bearing on ability of a small business to mount an OHS programs. Non-unionized small businesses may be more vulnerable to occupational injuries.     

Impact of Bipolar Disorder on Employers

Among the typical employer’s workforce, there are employees with various physical and psychological conditions that may affect their healthcare costs and productivity. One such condition, bipolar disorder, is especially costly. Despite many available treatments, a large portion of bipolar disorder-related costs are not related to direct healthcare expenditures, but rather are indirect expenditures related to lost productivity. Thus, ensuring that employees who exhibit symptoms of bipolar disorder receive a timely and correct diagnosis followed by appropriate treatment may prove cost effective. To accomplish this, employer-sponsored health plans should have adequate resources to provide treatment to employees and dependents with bipolar disorder and use evidence-based guidelines to treat the disorder. Increasing awareness of bipolar disorder through education and training in the workplace or the establishment of employee assistance programs may help link those with the disorder to treatment. The provision of reasonable workplace accommodations to employees with bipolar disorder may increase productivity, resulting in additional savings. The coordination of all health plan programs and related services provided to employees is an important consideration. By becoming knowledgeable about bipolar disorder and its treatments, employers can better work with insurers, health management vendors, and intermediary organizations to provide worksite and health plan programs to assist their affected employees.     

National machine guarding program: Part 2. Safety management in small metal fabrication enterprises

Background

Small manufacturing businesses often lack important safety programs. Many reasons have been set forth on why this has remained a persistent problem.

Methods

The National Machine Guarding Program (NMGP) was a nationwide intervention conducted in partnership with two workers' compensation insurers. Insurance safety consultants collected baseline data in 221 business using a 33‐question safety management audit. Audits were completed during an interview with the business owner or manager.

Results

Most measures of safety management improved with an increasing number of employees. This trend was particularly strong for lockout/tagout. However, size was only significant for businesses without a safety committee. Establishments with a safety committee scored higher (55% vs. 36%) on the safety management audit compared with those lacking a committee (P < 0.0001).

Conclusions

Critical safety management programs were frequently absent. A safety committee appears to be a more important factor than business size in accounting for differences in outcome measures. Am. J. Ind. Med. 58:1184–1193, 2015. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.     

Association of the health-promoting workplace with trade unionism and other industrial factors

PURPOSE: The study examines associations of five healthy workplace attributes with trade unionism and nine other industrial and sociodemographic factors. The aims were to illustrate the measurement of workplace health promotion indicators in Western Australia and to identify associations leading to a better understanding of determinants of the healthy workplace. DESIGN: Personal and telephone cross-sectional surveys were performed using population-based sampling frames. The overall response rate was 72%. SETTING: Workplaces in Western Australia. SUBJECTS: Random samples of household respondents aged 16 to 69 years in 1992 (n = 1310) and 1994 (n = 1113). MEASURES: Measures of association between healthy workplace attributes and trade unionism were adjusted for workplace location, size, sector, and industrial classification. RESULTS: Trade unionism was strongly associated with healthy catering practices (adjusted OR 2.05; 95% CI 1.30 to 3.23), sun protection practices (2.66; 1.69 to 4.17), disability access (1.47; 1.10 to 1.95), and worksite health promotion programs (2.56; 2.07 to 3.17). A weak and nonsignificant association was observed with restrictive smoking policies (1.21; .95 to 1.55). Generally, healthy workplace attributes were reported less often by respondents working in rural locations, in the private sector, and at small worksites. There was no consistent relationship with sociodemographic factors, including an index of social disadvantage, but members of blue-collar occupations experienced a low prevalence of restrictive smoking policies. CONCLUSIONS: The study raises the hypothesis, but cannot confirm, that trade unions could provide a means for employees to pursue the creation of a health-promoting workplace. Small business represents an excellent target for health promotion activities.