The Productivity Dilemma in Workplace Health Promotion.
Ontology highlight
ABSTRACT: Worksite-based programs to improve workforce health and well-being (Workplace Health Promotion (WHP)) have been advanced as conduits for improved worker productivity and decreased health care costs. There has been a countervailing health economics contention that return on investment (ROI) does not merit preventive health investment. METHODS/PROCEDURES: Pertinent studies were reviewed and results reconsidered. A simple economic model is presented based on conventional and alternate assumptions used in cost benefit analysis (CBA), such as discounting and negative value. The issues are presented in the format of 3 conceptual dilemmas.In some occupations such as nursing, the utility of patient survival and staff health is undervalued. WHP may miss important components of work related health risk. Altering assumptions on discounting and eliminating the drag of negative value radically change the CBA value.Simple monetization of a work life and calculation of return on workforce health investment as a simple alternate opportunity involve highly selective interpretations of productivity and utility.
Project description:Despite the potential health benefits of workplace health promotion for employees in sheltered workplaces, participation is often limited. The aim of this study was (i) to understand this limited participation, and (ii) to find opportunities for adapting workplace health promotion, such that it better meets the needs of the target population. A responsive process evaluation of an extensive multi-component workplace health promotion program targeting lifestyle behaviors, financial behaviors, literacy and citizenship, was performed in a large, sheltered workplace in the Netherlands (>3500 employees). To understand the limited participation, interviews with employees (n = 8), supervisors (n = 7) and managers (n = 2), and 10 participant observations were performed. To find opportunities for improving workplace health promotion in the sheltered workplace, 7 dialogs with employees were performed (n = 30). The interview data on the barriers for participation were evaluated through the lens of care ethics, as this allowed to understand the role of various stakeholders in the limited participation, as well as the indirect role of the institutional context. Findings showed that participation in workplace health promotion could increase if it is organized in a way that it encourages employees to work on health together, allow to tailor activities to different needs and capabilities of employees, and connects activities to employees' daily lives. A strength of this study is that the responsive process evaluation focused both on barriers for participation, as well as on opportunities to increase participation.
Project description:PurposeThis study examined the relationship between employee outcomes and employer implementation of evidence-based interventions (EBIs) for chronic disease prevention.DesignCross-sectional samples collected at 3 time points in a cluster-randomized, controlled trial of a workplace health promotion program to promote 12 EBIs.SettingKing County, WA.SampleEmployees of 63 small, low-wage workplaces.MeasuresEmployer EBI implementation; 3 types of employee outcomes: perceived implementation of EBIs; perceived employer support for health; and health-related behaviors, perceived stress, depression risk, and presenteeism.AnalysisIntent-to-treat and correlation analyses using generalized estimating equations. We tested bivariate associations along potential paths from EBI implementation, through perceived EBI implementation and perceived support for health, to several employee health-related outcomes.ResultsThe intent-to-treat analysis found similar employee health-related behaviors in intervention and control workplaces at 15 and 24 months. Workplaces implemented varying combinations of EBIs, however, and bivariate associations were significant for 4 of the 6 indicators of physical activity and healthy eating, as well as perceived stress, depression risk, and presenteeism. We did not find significant positive associations for cancer screening and tobacco cessation.ConclusionOur findings support broader dissemination of EBIs for physical activity and healthy eating, as well as more focus on improving employer support for employee health. They also suggest we need better interventions for cancer screening and tobacco cessation.
Project description:The complex situation that global society is facing as a result of COVID-19 has highlighted the importance of companies committing to the principles of social responsibility. Among the internal initiatives, those related to the health of workers are, obviously, highly topical. The objective of our research is to provide concise knowledge of the relationship between workplace health promotion (WHP) and corporate social responsibility (CSR) so that the relevant specialized research was gathered in a single document that lays the foundations of its applicability. A systematic review, following the PRISMA method, has been carried out. Twenty-seven articles have been selected from the main scientific databases. Their qualitative analysis concludes that CSR and WHP are linked, have beneficial reciprocal effects, need committed leadership respectful of autonomy and voluntariness, and require the establishment of specific goals within the framework of the organizations' sustainability policies. Future studies should establish the impact of the pandemic on these aspects.
Project description:Research has shown that workplace health promotion (WHP) efforts can positively affect employees' health risk accumulation. However, earlier literature has provided insights of health risk changes in the short-term. This prospective longitudinal quasi-experimental study investigated trends in health risks of a comprehensive, eight-year WHP program (n = 523-651). Health risk data were collected from health risk assessments in 2010-2011, 2013-2014, and 2016-2017, applying both a questionnaire and biometric screenings. Health risk changes were investigated for three different time-periods, 2010-2013, 2014-2017, and 2010-2017, using descriptive analyses, t-tests, and the Wilcoxon Signed Rank and McNemar's test, where appropriate. Overall health risk transitions were assessed according to low-, moderate-, and high-risk categories. Trend analyses observed 50-60% prevalence for low-, 30-35% for moderate-, and 9-11% high-risk levels across the eight years. In the overall health risk transitions of the three time-periods, 66-73% of participants stayed at the same risk level, 13-15% of participants improved, and 12-21% had deteriorated risk level across the three intervention periods. Our findings appear to indicate that the multiyear WHP program was effective in maintaining low and moderate risk levels, but fell short of reducing the total number of health risks at the population level.
Project description:This study aimed to investigate the association between mental health and comprehensive workplace health promotion (WHP) delivered to an entire state public service workforce (~28,000 employees) over a three-year period. Government departments in a state public service were supported to design and deliver a comprehensive, multi-component health promotion program, Healthy@Work, which targeted modifiable health risks including unhealthy lifestyles and stress. Repeated cross-sectional surveys compared self-reported psychological distress (Kessler-10; K10) at commencement (N = 3406) and after 3 years (N = 3228). WHP availability and participation over time was assessed, and associations between the K10 and exposure to programs estimated. Analyses were repeated for a cohort subgroup (N = 580). Data were weighted for non-response. Participation in any mental health and lifestyle programs approximately doubled after 3 years. Both male and female employees with poorer mental health participated more often over time. Women's psychological distress decreased over time but this change was only partially attributable to participation in WHP, and only to lifestyle interventions. Average psychological distress did not change over time for men. Unexpectedly, program components directly targeting mental health were not associated with distress for either men or women. Cohort results corroborated findings. Healthy@Work was successful in increasing participation across a range of program types, including for men and women with poorer mental health. A small positive association of participation in lifestyle programs with mental health was observed for women but not men. The lack of association of mental health programs may have reflected program quality, its universality of application or other contextual factors.
Project description:IntroductionEngaging in health-enhancing physical activity (HEPA) can reduce the risk of developing chronic diseases, which is particularly important for office workers with sedentary lifestyles. Therefore, time- and location-independent interventions for increasing HEPA are necessary.MethodsTo achieve long-term changes in HEPA, interventions can be based on physical activity-related health competence (PAHCO). 48 office workers (83% female, 50 ± 8 years) completed an intervention consisting of bi-weekly exercise videos for 5 weeks, supplemented by PAHCO and anatomical education. The participants' HEPA levels were measured using the Physical Activity, Exercise, and Sport Questionnaire (Bewegungs- und Sportaktivität Fragebogen; BSA-F)and a physical activity diary, with follow-up measurements at 3 months.ResultsThere was a significant increase in PAHCO (p = 0.002), especially in control competence (p < 0.001), after the intervention and at follow-up. The other sub-competences also increased, but not significantly. HEPA decreased after the intervention and at follow-up, but the decrease was not statistically significant.DiscussionPAHCO increases after the end of the intervention, especially through the sub-competence of control competence. The other two sub-competences also improved, but not significantly. Participating in the study had no impact on HEPA as an outcome of the PAHCO model. Our study provides preliminary evidence that PAHCO can be enhanced through digital, time- and location-independent interventions. Future research should utilize a randomized controlled design to be able to causally attribute the effects of PA interventions in office workers to the intervention and objective measurements for HEPA should be employed.
Project description:Background: Workplace health promotion (WHP) interventions have limited effects on the health of employees with low socioeconomic position (SEP). This paper argues that this limited effectiveness can be partly explained by the methodology applied to evaluate the intervention, often a randomised controlled trial (RCT). Frequently, the desired outcomes of traditional evaluations may not match employees'-and in particular employees with low SEP-needs and lifeworld. Furthermore, traditional evaluation methodologies do not function well in work settings characterised by change resulting from internal and external developments. Objective: In this communication, responsive evaluation is proposed as an alternative approach to evaluating WHP interventions. Responsive evaluation's potential added value for WHP interventions for employees with low SEP in particular is described, as well as how the methodology differs from RCTs. The paper also elaborates on the different scientific philosophies underpinning the two methodologies as this allows researchers to judge the suitability and quality of responsive evaluation in light of the corresponding criteria for good science.
Project description:BackgroundMobile applications (apps) have started to be used for workplace health promotion (WHP). However, the factors that lead to the usage of apps in the workplace from the end-user perspective remain unclear.MethodsTo investigate the research gap, the study evaluates a model for the adoption of WHP apps by combining the theory of planned behavior, the health belief model, and the technology acceptance model. A self-administered questionnaire with validated scales among 354 participants was used to evaluate the proposed model for WHP.ResultsAlthough the study indicated a limited overall model fit, interesting aspects were derived. In particular, the study demonstrated that normative belief (especially), perceived usefulness, and attitudinal belief play important roles in the intention to use WHP apps.ConclusionThe study is among the first to validate the theoretical models of mHealth adoption for WHP. Moreover, it shows that not only normative belief but also adjustment to several target groups is a necessary factor to be considered in the development and implementation of an app for WHP.
Project description:IntroductionHealth literacy and numeracy are linked to obesity and dietary behaviors. This study investigates whether the effect of a workplace behavioral intervention to prevent weight gain and improve diet differed by employee health literacy and numeracy.MethodsChooseWell 365 was an RCT of hospital employees testing a 12-month intervention using nudges and feedback to promote healthier choices, building on existing cafeteria traffic light labels (e.g., green=healthy, red=unhealthy). Health literacy and numeracy were measured with the Newest Vital Sign (range=0-6) and General Numeracy Scale (range=0-3). Mixed-effects linear models examined if intervention effects on cafeteria purchases, diet quality (Healthy Eating Index 2015, range=0-100), and weight change over 24 months differed by higher versus lower health literacy or numeracy. Data were collected in 2016-2020 and analyzed in 2020-2021.ResultsIn 12 months, 510 participants completed the Newest Vital Sign and General Numerancy Scale; 36.7% had Newest Vital Sign<6 (lower health literacy) and 31.6% had General Numerancy Scale<2 (lower numeracy). Intervention participants increased healthy purchases over 24 months compared with controls in both higher and lower health literacy and numeracy groups. At 12 months, Healthy Eating Index 2015 scores increased in intervention versus control participants with lower health literacy (5.5 points, 95% CI=1.51, 9.54) but not in those with higher health literacy (p-interaction=0.040). BMI did not differ by health literacy or numeracy.ConclusionsA behavioral intervention improved cafeteria food choices of hospital employees of varying health literacy and numeracy levels and improved diet quality among employees with lower health literacy, suggesting this group also improved food choices outside of work.