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.     

The relationship between sociodemographic characteristics and recruitment, retention, and health improvements in a worksite health promotion program

BACKGROUND. Recruitment, retention, and success in a worksite health promotion program was examined among various demographic groups of employees (n = 11,830) of the Dallas, Texas Independent School District. METHODS. Enrolled employees (n = 3,873) were given a health screen consisting of health habit assessment, measurement of clinical variables, physical fitness testing, and a medical examination. RESULTS. Thirty-three percent of employees were successfully recruited into the program. Recruitment rates were virtually identical for men and women (32% and 33%, respectively), but varied across ethnic, age, and education groups. Blacks, younger employees, and noncollege graduates were less likely to be recruited. Sixty-nine percent of the employees were retained in the program, as defined by participation in the second screen, and women were more likely to be retained than men (71% versus 64%, respectively). Retention rates throughout the 10-week program were higher for whites and Hispanics, and were virtually identical for each age group and education level. Overall, participants in the program showed an improvement in physical fitness and general well-being, lost weight, and smoked less. These changes were relatively consistent across the various demographic groups. DISCUSSION. Data suggest demographic characteristics are related to recruitment and retention in a health promotion program.     

Increasing low income employee participation in a worksite health promotion program: a comparison of three common strategies

The relative effectiveness of three common strategies to increaseparticipation in worksite health promotion programs was assessed.The interventions, designed for low income employees, were (1)written information, (2) written information and an informationalmeeting, and (3) written information, an information meetingand a group contest. Thirty teams of low income employees wererandomly allocated to receive one of the three interventions.Participation was measured at baseline and at follow-up. Teamparticipation did not vary by strategy but individual participationwas more likely for those offered the contest than for thoseprovided only written information or written information anda meeting. Even under the most intensive recruitment condition,however, few teams and housekeepers participated in the healthpromotion program. Interviews were conducted with housekeepersto obtain reasons for participation and non-participation, andto identify suggestions for facilitating participation.     

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.     

Using theory to understand the multiple determinants of low participation in worksite health promotion programs.

Low participation at the employee or worksite level limits the potential public health impact of worksite-based interventions. Ecological models suggest that multiple levels of influence operate to determine participation patterns in worksite health promotion programs. Most investigations into the determinants of low participation study the intrapersonal, interpersonal, and institutional influences on employee participation. Community- and policy-level influences have not received attention, nor has consideration been given to worksite-level participation issues. The purpose of this article is to discuss one macrosocial theoretical perspective--political economy of health--that may guide practitioners and researchers interested in addressing the community- and policy-level determinants of participation in worksite health promotion programs. The authors argue that using theory to investigate the full spectrum of determinants offers a more complete range of intervention and research options for maximizing employee and worksite levels of participation.     

Issues related to participation in worksite health promotion: a preliminary study

PURPOSE. The purpose of this study was to identify characteristics associated with participation in worksite-based health promotion activities. DESIGN. Follow-up interviews were used to identify demographic, attitudinal, and behavioral differences among three employee groups. Reasons employees chose not to participate in health promotion activities were also explored. SETTING. All respondents were employed at a large midwestern university and were eligible to participate in free onsite health fairs and health promotion programs. SUBJECTS. A stratified random sample of 89 nonparticipants, health fair participants, and behavior change program participants was interviewed. MEASURES. The interview was comprised of questions related to demographic information, personal health habits, physical activity, perceived health status, perceived self-efficacy, worksite norms, health promoting lifestyle factors, and knowledge about health promotion activities. RESULTS. ANOVA and chi-squared comparisons revealed few group differences. Graduate students and employees with advanced degrees were most likely to take part in health fairs. Behavior change program participants were older, clerical-technical staff members, and women. Faculty members were least likely to participate. A lack of time was the most often cited reason for nonparticipation. CONCLUSIONS. The study was retrospective and the analyses limited due to low statistical power. The results suggest that different groups of employees are attracted to different types of health promotion activities.     

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.     

Incidence and reasons for medical referral in a worksite health promotion program

Abstract The purpose of this study was to examine incidence and reasons for medical referral as a result of screening performed in a worksite health promotion program. Screening consisted of a medical history questionnaire, blood lipid profile, a submaximal treadmill stress test to 85% of age-predicted maximal heart rate, and other fitness measures. Overall, 11.5% of participants were referred to their personal physician for medical reasons following testing. Males (rate = 23.3%) were significantly more likely to be referred than females (rate = 8.8%). No significant difference was found in the percent of male (89.3%) or female (78.5%) referrals who were subsequently cleared to actively participate in the worksite program by their personal physician. These findings have important practical applications for worksite health promotion programs that conduct health screening.     

A psychosocial-approached health promotion program at a Japanese worksite

This study examined trends of sickness absence before and after a psychosocial-approached health promotion program (HPP) at a Japanese worksite. The subjects were 1029 male employees working at a manufacturing company from April 1991 to March 1999. The HPP was performed from April 1995 to decrease sickness absence through helping to improve all employees' lifestyles according to a psychosocial approach incorporating six characteristics: 1) concept based on the population strategy, 2) use of a health risk appraisal (HRA), 3) setting easy lifestyle targets, 4) praising the employees' personal lifestyle initiatives, 5) supported (sponsored) by the management, 6) award of subsidiary payments. Sickness absence was considered to be consecutive days calculated by medical certification and company records. Absences due to musculoskeletal diseases and total diseases decreased, when comparing four-year periods before and after the program's introduction. In this report we show that trends of sickness absence changed after the introduction of the psychosocial-approached health promotion program.     

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.     

The cardiovascular health impact of an incentive worksite health promotion program

PURPOSE: We examined the cardiovascular health profiles of benefit-eligible hospital employees who participated in an incentive screen program for 4 years. We also determined if cardiovascular health changes differed between participants (CHAP) who enrolled in structured follow-up risk reduction programs (CHAPplus) compared with those who chose less formal options (CHAPonly). METHODS: CHAP consisted of cardiovascular screens, results counseling, and encouragement to participate in education and behavioral support programs. After adjusting for gender, medication use, and baseline levels of adiposity and physical activity, cardiovascular health changes were tested with repeated-measures analysis of covariance (ANCOVA) among CHAP participants and by CHAP type. RESULTS: CHAP 4-year members (n = 278) were generally healthy and mostly women (87%) with an average age of 40.6 +/- .5 years at baseline. Despite increases in overall (p = .034) and central adiposity (p = .001), cardiovascular health improvements were found for the total cholesterol/high-density lipoprotein ratio (TCHOL/HDL; p = .007), low-density lipoprotein (p = .009), and blood glucose (p = .018) among 4-year CHAP members. CHAPonly employees showed greater improvements in most cardiovascular health indicators than CHAPplus participants, although these differences did not achieve statistical significance. DISCUSSION: Cardiovascular health improvements were associated with long-term participation in a hospital worksite incentive screen program. The cardiovascular health benefits tended to be greatest for CHAP employees who chose informal follow-up risk reduction options (CHAPonly) than those who enrolled in structured programs (CHAPplus).     

Planning worksite health promotion programs: models, methods, and design implications

As the field of Worksite Health Promotion and Wellness matures, greater pressure is being place on programs that produce mitigation of health risks, improved employee productivity and increased levels of economic return. To achieve these expected results and to successfully contend with the challenges of today's workplace and work force it will likely become even more critical to carefully plan both new and existing programs each year. A model for the planning and development of worksite programs is presented and discussed along with a variety of design implications for different population segments.