Stakeholder Perspectives on Workplace Health Promotion: A Qualitative Study of Midsized Employers in Low-Wage Industries

Abstract

Purpose.

Study goals were to (1) describe stakeholder perceptions of workplace health promotion (WHP) appropriateness, (2) describe barriers and facilitators to implementing WHP, (3) learn the extent to which WHP programs are offered to workers' spouses and partners and assess attitudes toward including partners in WHP programs, and (4) describe willingness to collaborate with nonprofit agencies to offer WHP.

Design.

Five 1.5-hour focus groups.

Setting.

The focus groups were conducted with representatives of midsized (100–999 workers) workplaces in the Seattle metropolitan area, Washington state.

Subjects.

Thirty-four human resources professionals in charge of WHP programs and policies from five low-wage industries: accommodation/food services, manufacturing, health care/social assistance, education, and retail trade.

Measures.

A semistructured discussion guide.

Analysis.

Qualitative analysis of focus group transcripts using grounded theory to identify themes.

Results.

Most participants viewed WHP as appropriate, but many expressed reservations about intruding in workers' personal lives. Barriers to implementing WHP included cost, time, logistical challenges, and unsupportive culture. Participants saw value in extending WHP programs to workers' partners, but were unsure how to do so. Most were willing to work with nonprofit agencies to offer WHP.

Conclusion.

Midsized, low-wage employers face significant barriers to implementing WHP; to reach these employers and their workers, nonprofit agencies and WHP vendors need to offer WHP programs that are inexpensive, turnkey, and easy to adapt.

Keywords

Workplace Fitness/Physical Activity Nutrition Smoking Control Adults Skill Building/Behavior Change Health Promotion Prevention Research Manuscript format: research Research purpose: descriptive Study design: qualitative Outcome measure: behavioral Setting: workplace Health focus: fitness/physical activity,nutrition,smoking control,weight control Strategy: skill building/behavior change,policy,culture change Target population age: adults Target population circumstances: education/income level

References

Task Force on Community Preventive Services. Guide to community preventive services. Available at: www.thecommunityguide.org. Accessed May 5, 2011.

Task Force on Community Preventive Services. Interventions to promote seasonal influenza vaccinations among non-healthcare workers: Task Force finding & rational statement. Available at: www.thecommunityguide.org/worksite/RRflunon-hcw.html. Accessed August 4, 2011.

Hopkins

Razi

Leeks

. Smokefree policies to reduce tobacco use. A systematic review. Am J Prev Med. 2010;38(suppl 2):S275–S289.

Katz

O'Connell

Yeh

. Public health strategies for preventing and controlling overweight and obesity in school and worksite settings: A report on recommendations of the Task Force on Community Preventive Services. MMWR Recomm Rep. 2005;54(RR-10):1–12.

Anderson

Quinn

Glanz

. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: A systematic review. Am J Prev Med. 2009;37:340–357.

Task Force on Community Preventive Services. Recommendations to increase physical activity in communities. Am J Prev Med. 2002;22(suppl 4):67–72.

Soler

Leeks

Buchanan

. Point-of-decision prompts to increase stair use. A systematic review update. Am J Prev Med. 2010;38(suppl 2):S292–S300.

Baron

Rimer

Coates

. Client-directed interventions to increase community access to breast, cervical, and colorectal cancer screening a systematic review. Am J Prev Med. 2008;35(suppl 1):S56–S66.

Bondi

Harris

Atkins

. Employer coverage of clinical preventive services in the United States. Am J Health Promot. 2006;20:214–222.

10.

Linnan

Bowling

Childress

. Results of the 2004 National Worksite Health Promotion Survey. Am J Public Health. 2008;98:1503–1509.

11.

Henke

Goetzel

McHugh

Isaac

. Recent experience in health promotion at Johnson & Johnson: Lower health spending, strong return on investment. Health Aff (Millwood). 2011;30:490–499.

12.

Goetzel

Roemer

Pei

. Second-year results of an obesity prevention program at the Dow Chemical Company. J Occup Environ Med. 2010;52:291–302.

13.

Naydeck

Pearson

Ozminkowski

. The impact of the Highmark employee wellness programs on 4-year healthcare costs. J Occup Environ Med. 2008;50:146–156.

14.

Short

Goetzel

Young

. Measuring changes in lipid and blood glucose values in the health and wellness program of Prudential Financial, Inc. J Occup Environ Med. 2010;52:797–806.

15.

Beresford

Locke

Bishop

. Worksite study promoting activity and changes in eating (PACE): Design and baseline results. Obesity (Silver Spring). 2007;15(suppl 1):4S–15S.

16.

Beresford

Thompson

Bishop

. Long-term fruit and vegetable change in worksites: Seattle 5 a Day follow-up. Am J Health Behav. 2010;34:707–720.

17.

Hunt

Barbeau

Lederman

. Process evaluation results from the Healthy Directions–Small Business study. Health Educ Behav. 2007;34:90–107.

18.

Sorensen

Barbeau

Stoddard

. Tools for health: The efficacy of a tailored intervention targeted for construction laborers. Cancer Causes Control. 2007;18:51–59.

19.

Harris

Huang

Hannon

Williams

. Low-SES workers: Health risks and how to reach them. J Occup Environ Med. 2011;53:132–138.

20.

McDonnell

Bryant

Harris

. The private partners of public health: Public-private alliances for public good. Prev Chronic Dis. 2009;6:A69.

21.

Huang

Hannon

Williams

Harris

. Workers' health risk behaviors by state, demographic characteristics, and health insurance status. Prev Chronic Dis. 2011;8:A12.

22.

Hughes

Hannon

Harris

Patrick

. Health behaviors of employed and insured adults in the United States, 2004–2005. Am J Health Promot. 2010;24:315–323.

23.

Linnan

Birken

. Small businesses, worksite wellness, and public health: A time for action. N C Med J. 2006;67:433–437.

24.

Thompson

Hannon

Bishop

. Factors related to participatory employee advisory boards in small, blue-collar worksites. Am J Health Promot. 2005;19:430–437.

25.

Barbeau

Hartman

Quinn

. Methods for recruiting white, black, and Hispanic working-class women and men to a study of physical and social hazards at work: The United for Health study. Int J Health Serv. 2007;37:127–144.

26.

Lassen

Bruselius-Jensen

Sommer

. Factors influencing participation rates and employees' attitudes toward promoting healthy eating at blue-collar worksites. Health Educ Res. 2007;22:727–736.

27.

Sorensen

Barbeau

Stoddard

. Promoting behavior change among working-class, multiethnic workers: Results of the healthy directions—small business study. Am J Public Health. 2005;95:1389–1395.

28.

Claxton

DiJulio

Whitmore

. Health benefits in 2010: Premiums rise modestly, workers pay more toward coverage. Health Aff (Millwood). 2010;29:1942–1950.

29.

Gabel

Whitmore

Pickreign

. Obesity and the workplace: Current programs and attitudes among employers and employees. Health Aff (Millwood). 2009;28:46–56.

30.

Hughes

Patrick

Hannon

. Understanding the decision-making process for health promotion programming at small to midsized businesses. Health Promot Pract. 2011;12:512–521.

31.

Tong

Sainsbury

Craig

. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–357.

32.

National industry-specific occupational employment and wage estimates, May 2008. Available at: http://www.bls.gov/oes/current/oessrci.htm. Accessed September 15, 2008.

33.

Phipps

Madison

Pomerantz

Klein

. Identifying and assessing interests and concerns of priority populations for work-site programs to promote physical activity. Health Promot Pract. 2010;11:71–78.

34.

Hunt

Stoddard

Kaphingst

Sorensen

. Characteristics of participants in a cancer prevention intervention designed for multiethnic workers in small manufacturing worksites. Am J Health Promot. 2007;22:33–37.

35.

Green

Cheadle

Pellegrini

Harris

. Active for Life: A work-based physical activity program. Prev Chronic Dis. 2007;4:A63.

36.

American Cancer Society. Active for Life. Available at: http://www.acsworkplacesolutions.com/activeforlife.asp. Accessed October 26, 2011.

37.

American Heart Association. The Fit-Friendly Companies recognition program. Available at: http://www.heart.org/idc/groups/heart-public/@wcm/@wsa/documents/downloadable/ucm_432828.pdf. Accessed October 26, 2011.

38.

American Cancer Society. Workplace solutions assessment. Available at: http://www.acsworkplacesolutions.com/wpassessment.asp. Accessed October 26, 2011.

39.

Harris

Cross

Hannon

. Employer adoption of evidence-based chronic disease prevention practices: A pilot study. Prev Chronic Dis. 2008;5:A92.