Providing worksite health promotion through university-community partnerships. The South Carolina DOT project.

The occupational health nurse for the South Carolina Department of Transportation (SCDOT) collaborated with the Schools of Nursing within the state universities of South Carolina to coordinate individual health screenings for the employees of SCDOT. Personal Wellness Profiles (PWP) by Wellsource, Inc., were used to perform the health screenings and included family and personal histories, and assessment of blood pressure, vision, height, weight, total and high density lipoprotein cholesterol, and blood glucose levels. In addition, hepatitis and tetanus/diphtheria immunizations and influenza vaccines were provided. Each of the 48 county sites was visited twice during the semester by nursing faculty and nursing and public health students. The first visit was to collect assessment data for screening and provide immunizations. The second visit was to provide individualized analyzed data and health counseling. Of the 5,118 SCDOT employees, 3,141 were screened the first year and 2,315 were screened the second year. Of the original 3,141, only 1,549 elected to participate in the rescreening. Although the average population age was 41, 78.3% were rated at high coronary risk because of high blood pressure, high cholesterol and blood sugar levels, excessive weight and stress levels, and sedentary lifestyles.     

The role of health professional at worksite health services in South Africa

The goal of this study was to describe the roles of health care professionals at small and large worksites in South Africa and to compare them with those of similar professionals in other countries. Questionnaires were mailed to 981 individuals listed as responsible for worksites. Respondents were asked to record number of employees at the worksite and indicate what proportion of time was spent by registered nurses and medical practitioners on each of the specified duties. Medical practitioners spent much less time at worksite health services than nurses. Nurses in small worksites worked a 33.6 hour week, while nurses in large worksites worked a 45.4 hour week. Nurses spent more time on administration, particularly in small worksites. This study showed that the nurse may be better suited to the role of administrator of the worksite health service in South Africa because of the longer work week and greater employee contact than the medical practitioner.     

Understanding why some employees ignore worksite health promotion efforts. Refocusing the issue

Corporations are beginning to examine exactly who is responding to health promotion programs offered at the worksite. Most findings indicate that those employees using most of the health care dollars are the least involved in health promoting efforts. When assessing why certain employees choose not to participate, application of a health promotion model will identify direct and indirect factors associated with this choice. Based on factors identified in the health promotion model, wellness programs are designed to fit the employees' level of readiness to adopt healthy behaviors. The three program levels build upon each other to achieve health promotion. The occupational health nurse has the skills necessary to identify this population which continues to live unhealthy lifestyles. The overall goal is to increase their participation in health promotion. This may be achieved by identifying their needs and designing programs accordingly.     

A worksite diabetes prevention program: two-year impact on employee health.

The purpose of this study was to determine the 2-year impact of a worksite-based diabetes prevention program. Thirty-seven pre-diabetic and previously undiagnosed diabetic employees participating in a 12-month worksite diabetes prevention program were included. Weight, body mass index, waist circumference, oral glucose tolerance testing, fasting insulin, blood lipids, and aerobic fitness had improved significantly after 6 months. Much of this improvement continued through 12 months. One year following the intervention, oral glucose tolerance and aerobic fitness had improved significantly. Of the 22 employees remaining in the study through 24 months, more than half had normal results on glucose tolerance testing. Worksite diabetes prevention programs may reduce blood glucose below pre-diabetic and diabetic levels. Improvements in diabetes risk factors persisted for at least 2 years in most of these employees.     

Cholesterol education at the worksite

1. Risk factors for coronary heart disease include age, sex, family history, high cholesterol, blood pressure, smoking, and severe obesity. The last four risk factors can be modified with lifestyle changes. 2. Occupational health nurses who provide primary care to workers can assist employees in detecting and treating their elevated cholesterol. Cholesterol screening at the workplace is an effective means for employees to learn their cholesterol level or monitor their dietary progress in lowering their cholesterol. 3. Employees can modify their eating behaviors by developing the skills to make wise dietary choices. Simple dietary self assessment and self monitoring tools will aid employees in monitoring and evaluating their efforts. 4. To successfully implement a cholesterol education program and counsel employees, occupational health nurses need to increase their knowledge of nutrition, specifically the composition of a diet that will help reduce the risks associated with heart disease.     

Effect of worksite health promotion programs on employee absenteeism. A comparative analysis

Employee absenteeism is an important economic variable that needs to be examined by occupational health nurses when evaluating worksite health promotion programs. Two of the three Blue Cross and Blue Shield Plan studies suggested that their programs acted to contain absenteeism among program participants. The worksite programs that met with success tended to be comprehensive and to have strong management support. Strengths of the three studies included the use of comparison groups and pretest measures of absenteeism in the analyses. Limitations included selection bias, subject dropout over time, limited monitoring of the program process, and the use of an analysis method that did not consider the statistical characteristics of the absenteeism variable.     

Health risk appraisal at the worksite

Employers in the 1990s will need all the help they can get to cut health care costs, while still providing health benefits for their employees. The HRA assessment combined with the nursing intervention at the time of the HRA interpretation can trigger changes in health behavior. Employers want these positive results: healthier employee behaviors and lower health care costs.