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.     

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.     

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.     

Stress prevention and supervisor training]

This article surveys available literature addressing the role of supervisors (corporate administrators) in stress prevention activities within the workplace and describes some desirable training courses. In most successful stress management programs or programs that promote mental health, the provision of training for supervisors has been an important strategy. Several reports have asserted that proper training is an effective method of reducing worksite stress and improving job satisfaction in workers, but few prospective intervention studies investigating the truth of these reports have been made. Additional research is necessary to assess the validity of various training programs. The structure of organizations and employment systems has recently begun to change, and the traditional employee-supervisor relationship is slowly disappearing in some enterprises, so that the role of supervisors with regard to stress management may need to be revised.     

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

Background  

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

A web-based approach to managing stress and mood disorders in the workforce

OBJECTIVE:: To evaluate the effectiveness of a web-based multimedia health promotion program for the workplace, designed to help reduce stress and to prevent depression, anxiety, and substance abuse. METHODS:: Using a randomized controlled trial design, 309 working adults were randomly assigned to the web-based condition or to a wait-list control condition. All participants were assessed on multiple self-reported outcomes at pretest and posttest. RESULTS:: Relative to controls, the web-based group reduced their stress, increased their knowledge of depression and anxiety, developed more positive attitudes toward treatment, and adopted a more healthy approach to alcohol consumption. CONCLUSIONS:: We found that a brief and easily adaptable web-based stress management program can simultaneously reduce worker stress and address stigmatized behavioral health problems by embedding this prevention material into a more positive stress management framework.     

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.     

Occupational mental health promotion: a prevention agenda based on education and treatment. The American Psychological Association/National Institute for Occupational Safety and Health, Health Promotion Panel, 1990 Work and Well-Being Conference

PURPOSE OF THE REVIEW. Psychological disorders are one of the 10 leading work-related diseases and injuries in the United States according to the National Institute for Occupational Safety and Health. This article addresses occupational metal health and preventive stress management in the workplace. The individual and organizational costs are briefly considered with concern for reducing the burden of suffering associated with these problems. SEARCH METHOD. As an American Psychological Association interdisciplinary panel, we searched the psychological, medical, public health, and organizational literature. We selected articles relevant to the problem of psychological disorders in the workplace and to enhancing occupational mental health and preventive stress management. IMPORTANT FINDINGS. The panel proposed a national agenda of education and treatment, combined with a program of evaluation research, for addressing these issues. Target populations are identified, and the need for collaboration among a variety of national constituencies is considered. Advancing occupational mental health and promoting skills in preventive stress management is considered in the context of comprehensive health promotion. MAJOR CONCLUSIONS. The panel concluded that there is a pressing need to: 1) set a 'gold' standard concerning the current state of knowledge in the domains of occupational mental health and stress management; 2) identify Diagnostically Related Groups (DRGs) which are stress-related; 3) establish assessment standards for stress and mental health; 4) set guidelines for reasonable interventions; and 5) establish acceptable post-outcome criteria.     

Employer Role in Integrative Workplace Health Management

The health of the international workforce has been an increasing area of concern for the last two decades. Globalization of the world economy and rapid technological changes continue to change the nature of work and employment practices, exposing employees to new and serious health risks. These challenges are inescapable in any workplace, therefore it is important that employers examine how they can best fulfill their legal and leadership roles to protect and promote the health and well-being of their employees.This paper explores employer roles in employee health in the context of global and local challenges. A strategy is suggested for employers to deal with the multifaceted workplace pressures and health impacts on employees i.e. implementing an integrative holistic model of workplace health management (workplace health management is an approach to workplace health that includes health promotion, disease prevention, safety management and organizational development). Workplace health management has emerged from the latest developments in the settings approach to workplace health promotion.The changing world of work and the implications on employee health in the current climate of globalization and technological changes is also examined. In particular, it highlights mental health issues associated with the emerging epidemic of work stress from increased workplace pressures.The paper reviews the changing conceptions of the role of employers and contemporary approaches to management practices in a range of disciplines, drawing out the common principles and strategies to respond to changes. One essential message which has emerged from the review is that employers need to become change agents and visionary leaders who adopt a proactive, interdisciplinary and integrative system approach to formulate and develop company policies and workplace culture that facilitates employee participation, professional growth and team work.These contemporary management principles and strategies form the basis of the integrative model for workplace health management presented in this paper. In essence, the integrative model of workplace health management uses a participatory problem solving cycle to identify and address the numerous issues associated with health promotion and disease prevention, occupational safety and hazard reduction, and organizational improvement and human resource management. Specifically this involves the employees and employer participating in a needs-based program development and implementation cycle: identifying health priorities and addressing environmental, organizational, occupational and lifestyle determinants of employee health. The paper concludes with an overview of international development of workplace health management and reports on successful examples from European, Western Pacific and Pan American regions.     

Betriebliche Gesundheitsförderung durch Arbeitsgestaltung und Unternehmenskultur

The article discusses worksite health promotion in the sight of work science and work design. Firstly, several conceptual factors of the health-oriented work science and work design are sketched, for example: an integral process-oriented definition of health, the health-oriented objectives of design, the extended stress-strain-concept, a psychological structure model of health-oriented actions, the strategy of participation-oriented design of work, the concept of differentiated and dynamic work design. Secondly, a few results of worksite health promotion by work design are described. Health circles are integrated into planning of a new production centre within the framework of a participation-oriented reorganization project. Another project is dealing with stress observation/evaluation and stress coping at computer-aided mental work.     

Assessing the effects of health promotion in worksites: a review of the stress program evaluations

In a recent issue of Health Education Quarterly, Chen(1) reviewed the evaluations of worksite health promotion programs published in health education journals from 1980 through June 1983. He found few evaluations in the literature that used either quasi-experimental or experimental designs. This paper reviews the evaluations of stress reduction programs in the worksite, most of which were either published outside of health education journals or unpublished. Over one-half of the studies used either experimental or quasi-experimental designs in the evaluations. This suggests that reviews of worksite health promotion program evaluations must encompass journals from a variety of disciplines. Recommendations for improving the evaluations of stress reduction programs in the worksite are included.     

Effects of worksite health promotion interventions on employee diets: a systematic review

Background  

Public health strategies place increasing emphasis on opportunities to promote healthy behaviours within the workplace setting. Previous research has suggested worksite health promotion programmes have positive effects on physical activity and weight loss, yet little is known regarding their effects on dietary behaviour. The aim of this review was to assess the effects of worksite interventions on employee diets.     

Health promotion in the Scottish workplace: a case for moving the goalposts

The workplace provides an important opportunity for health promotion, both in terms of allowing access to a large proportion of the adult population and encouraging developments within the workplace structure to improve health. This paper reports on the findings of a survey of Scottish workplaces carried out in 1996 for the Health Education Board for Scotland to assess the state of health promotion activity in the Scottish workplace setting. The results echo those from previous surveys in that most health promotion effort was centred around health and safety, smoking, and alcohol issues, particularly for the smaller and less well-resourced businesses. Under one-fifth of businesses surveyed addressed areas such as stress and mental health, which are being seen as increasingly important in terms of their contribution to the well-being of the employee and the organization. The main implication of these findings is that it is smaller businesses who potentially have the most to gain from workplace health promotion. In this context, the construction of relevant and sustainable health promotion programmes requires an organizational development perspective in order to encourage such businesses to regard workplace health promotion as part of good business practice.     

Lifestyle, stress and work: Strategies for health promotion

Much work today inhibits positive health practices. To be successful,workplace health promotion strategies must focus on the natureof the work itself, as well as upon the worker. Approaches tolifestyle-change range from changes in legislative policy, asin Norway, to community health education, organizational development,occupational safety and health and, increasingly in the U.S.and Canada, worksite wellness programmes. Contrasts betweenthe European and North American approaches to lifestyle, stressand work are apparent. European efforts are often directed towardsstructural and legislative changes. Unions, rather than topmanagement, have taken the lead. The primary focus has beenupon stressors–toxic chemicals, work design, man-machinesystems. In contrast, North American efforts have generallybeen initiated by senior management, and have focussed on changesin personal health practices such as cigarette smoking, nutrition,exercise, and stress management. These contrasts will blur asmanagement and labour begin to collaborate on the developmentand implementation of comprehensive health promotion programmes.The paper concludes with examples of some successful programmesand recommendations for would-be programme developers.     

A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1995-1998 update (IV)

The fourth in a series of critical reviews, this study examines the clinical and cost outcome evaluations of 10 worksite health promotion programs that were comprehensive, multifactorial, and directed at risk management. The studies, conducted between 1994 and 1998, indicate favorable clinical and cost outcomes and suggest characteristics of worksite interventions that may be critical for effectiveness.     

Betriebliche Gesundheitsförderung im öffentlichen Dienst

Aim

The longitudinal survey analyses the changes in workplace health promotion within the public administration in Hessen and Thüringen between 1999 and 2004.

Methods

A sample of 153 executives was interviewed by telephone.

Results

The results show that the level of workplace health promotion in the questioned departments rose significantly in comparison to 1999. Departments, which conduct workplace health promotion enlarged their scope of measures in the last five years. But on average the performance of workplace heath promotion is still poor. The need of information and consulting in questions about workplace health promotion rose slightly: major topic of interest is mental stress at workplace. The departments expect support particularly from the institutions of the statutory occupational accident insurance, health insurance companies and public occupational safety and health administration. One alarming result is that only 64% of the interviewed departments reported that they realized the statutory analyses of work-related health risks.

Conclusion

The future main focus should lie on prevention and reduction of mental stress at the workplace as well as on an enforced regard on small departments and on the implementation of legal orders.     

The role of diet in the prevention and management of adolescent depression

Summary  Depression in adolescence is associated with a range of negative outcomes and substantial risk for morbidity and mortality across the lifespan. Dietary improvement and supplementation may offer an inexpensive and acceptable adjunct to standard treatment; yet this has, to date, been largely overlooked, owing to lack of evidence and knowledge. This is important, as improving understanding of the role of diet in mental health and promotion of appropriate dietary practices could significantly reduce the personal and social impact of depression in young people. This article sets out to review the existing research literature on associations between diet and mental health in adolescence, in particular, the role of diet in the prevention and management of adolescent depression. A closer examination of associations between obesity and depression is also included, as these two conditions often co-occur. Research into diet and mental health tends to fall into two main categories: population-based observational studies and intervention studies; however, there is very little research evidence specific to adolescents. Potential implications for mental healthcare policy and practice are discussed.     

Gesundheitsförderung im oetrieb — was kann die sportwissenschaft beitragen?

Within the sport science there is currently a surge of interest in the topic sport and health. It is widely acknowledged that physical activity can contribute to the improvement of physical health resources. As a result of these findings, concepts have been developed on how to improve physical health through physical exercise. They have centred on influencing the cardiovascular system, as well as the musculoskeletal system. Apartfrom looking at the physical effects of sporting activities, further investigations have become increasingly concerned with their psychological effects. The concepts for health promotion, developed due to these studies, focused themselves at models such as Antonovsky’s idea of “saluto-genesis”, which were seen as also suitable for use in worksite health promotion. A research project, investigating the problems of transposing those models, identified the typical users of behavioural workplace health promotion programs as persons who already enjoy a marked awareness on health issues. Real risk persons however were hardly achieved. On balance, it is inevitable that workplace health promotion, that contains only behaviour prevention, will remain limited in its effect. Apartfrom the unsatisfactory range of employees attracted by worksite health promotion programs, it was estimated that around only about five to ten per cent of the enterprises offer health promotion. For clarifying the actual spreading representative surveys were conducted at about one thousand private and public sector companies. The results indeed showed that, in many businesses measures of workplace health promotion were yet to be implemented but that health promotion, in the sense of an integrated, interdisciplinary process, existed in only ten to fifteen per cent of the enterprises. In particular small and medium-sized businesses still need more information on the subject of health promotion, accompanied with an intensified support by experts of the health promotion.