DOI QR코드

DOI QR Code

Strategies for Worksite Health Interventions to Employees with Elevated Risk of Chronic Diseases

  • Meng, Lu (Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia) ;
  • Wolff, Marilyn B. (Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia) ;
  • Mattick, Kelly A. (Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia) ;
  • DeJoy, David M. (Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia) ;
  • Wilson, Mark G. (Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia) ;
  • Smith, Matthew Lee (Workplace Health Group, Department of Health Promotion and Behavior, College of Public Health, The University of Georgia)
  • Received : 2016.03.02
  • Accepted : 2016.11.07
  • Published : 2017.06.30

Abstract

Chronic disease rates have become more prevalent in the modern American workforce, which has negative implications for workplace productivity and healthcare costs. Offering workplace health interventions is recognized as an effective strategy to reduce chronic disease progression, absenteeism, and healthcare costs as well as improve population health. This review documents intervention and evaluation strategies used for health promotion programs delivered in workplaces. Using predetermined search terms in five online databases, we identified 1,131 published items from 1995 to 2014. Of these items, 27 peer-reviewed articles met the inclusion criteria; reporting data from completed United States-based workplace interventions that recruited at-risk employees based on their disease or disease-related risk factors. A content rubric was developed and used to catalogue these 27 published field studies. Selected workplace interventions targeted obesity (n = 13), cardiovascular diseases (n = 8), and diabetes (n = 6). Intervention strategies included instructional education/counseling (n = 20), workplace environmental change (n = 6), physical activity (n = 10), use of technology (n = 10), and incentives (n = 13). Self-reported data (n = 21), anthropometric measurements (n = 17), and laboratory tests (n = 14) were used most often in studies with outcome evaluation. This is the first literature review to focus on interventions for employees with elevated risk for chronic diseases. The review has the potential to inform future workplace health interventions by presenting strategies related to implementation and evaluation strategies in workplace settings. These strategies can help determine optimal worksite health programs based on the unique characteristics of work settings and the health risk factors of their employee populations.

Keywords

References

  1. The Employment Situation-October 2015 Bureau of Labor Statistics 2015 [Internet]. [cited 2015 Dec 11]. Available from: http://www.bls.gov/news.release/pdf/empsit.pdf.
  2. Thorp AA, Healy GN, Winkler E, Clark BK, Gardiner PA, Owen N, Dunstan DW. Prolonged sedentary time and physical activity in workplace and non-work contexts: a cross-sectional study of office, customer service and call centre employees. Int J Behav Nutr Phys Act 2012;9:128. https://doi.org/10.1186/1479-5868-9-128
  3. Duncan GE. Exercise, fitness, and cardiovascular disease risk in type 2 diabetes and the metabolic syndrome. Curr Diab Rep 2006;6:29-35. https://doi.org/10.1007/s11892-006-0048-1
  4. Warren TY, Barry V, Hooker SP, Sui X, Church TS, Blair SN. Sedentary behaviors increase risk of cardiovascular disease mortality in men. Med Sci Sports Exerc 2010;42:879-85. https://doi.org/10.1249/MSS.0b013e3181c3aa7e
  5. Beunza JJ, Martinez-Gonzalez MA, Ebrahim S, Bes-Rastrollo M, Nunez J, Martinez JA, Alonso A. Sedentary behaviors and the risk of incident hypertension: the SUN Cohort. Am J Hypertens 2007;20:1156-62.
  6. Kivimaki M, Leino-Arjas P, Luukkonen R, Riihimaki H, Vahtera J, Kirjonen J. Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. Br Med J 2002;325:857-60. https://doi.org/10.1136/bmj.325.7369.857
  7. Bodenheimer T, Chen E, Bennett HD. Confronting the growing burden of chronic disease: can the U.S. health care workforce do the job? Health Aff 2009;28:64-74. https://doi.org/10.1377/hlthaff.28.1.64
  8. Fighting obesity in the workplace: National Center for Chronic Disease Prevention and Health Promotion [Internet]. 2013 [cited 2015 Dec 17]. Available from: http://www.cdc.gov/nationalhealthyworksite/docs/fighting_obesity_in_the_workplace_final_2_8_13.pdf.
  9. Brown H, Roberts J. Exercising choice: the economic determinants of physical activity behaviour of an employed population. Soc Sci Med 2011;73:383-90. https://doi.org/10.1016/j.socscimed.2011.06.001
  10. Finkelstein EA, Brown DS, Wrage LA, Allaire BT, Hoerger TJ. Individual and aggregate years-of-life-lost associated with overweight and obesity. Obesity 2010;18:333-9. https://doi.org/10.1038/oby.2009.253
  11. Kleinman N, Abouzaid S, Andersen L, Wang Z, Powers A. Cohort analysis assessing medical and nonmedical cost associated with obesity in the workplace. J Occup Env Med 2014;56:161-70. https://doi.org/10.1097/JOM.0000000000000099
  12. Goetzel RZ, Pei X, Tabrizi MJ, Henke RM, Kowlessar N, Nelson CF, Metz RD. Ten modifiable health risk factors are linked to more than one-fifth of employer-employee health care spending. Health Aff 2012;31:2474-84. https://doi.org/10.1377/hlthaff.2011.0819
  13. Carnethon M, Whitsel LP, Franklin BA, Kris-Etherton P, Milani R, Pratt CA, Wagner GR. Worksite wellness programs for cardiovascular disease prevention: a policy statement from the American Heart Association. Circulation 2009;120:1725-41. https://doi.org/10.1161/CIRCULATIONAHA.109.192653
  14. Soeren Mattke HL, Caloyeras JP, Huang CY, Van Busum KR, Khodyakov D, Shier V. Workplace Wellness Programs Study Final Report RAND Corporation 2013 [Internet]. [cited 2015 Dec 17]. Available from: http://www.rand.org/content/dam/rand/pubs/research_reports/RR200/RR254/RAND_RR254.sum.pdf.
  15. Mishra S, Barnard ND, Gonzales J, Xu J, Agarwal U, Levin S. Nutrient intake in the GEICO multicenter trial: the effects of a multicomponent worksite intervention. Eur J Clin Nutr 2013;67:1066-71. https://doi.org/10.1038/ejcn.2013.149
  16. White K, Jacques PH. Combined diet and exercise intervention in the workplace: effect on cardiovascular disease risk factors. AAOHN J 2007;55:109-14. https://doi.org/10.1177/216507990705500303
  17. French SA, Harnack LJ, Hannan PJ, Mitchell NR, Gerlach AF, Toomey TL. Worksite environment intervention to prevent obesity among metropolitan transit workers. Prev Med 2010;50:180-5. https://doi.org/10.1016/j.ypmed.2010.01.002
  18. Chapman LS. Meta-evaluation of worksite health promotion economic return studies: 2012 update. Am J Health Promot 2012;26:TAHP1-12.
  19. Bachman KH. Obesity, weight management, and health care costs: a primer. Dis Manag 2007;10:129-37. https://doi.org/10.1089/dis.2007.103643
  20. Aldana SG, Greenlaw RL, Diehl HA, Salberg A, Merrill RM, Ohmine S. The effects of a worksite chronic disease prevention program. J Occup Env Med 2005;47:558-64. https://doi.org/10.1097/01.jom.0000165743.18570.66
  21. Goetzel RZ, Ozminkowski RJ, Bruno JA, Rutter KR, Isaac F, Wang S. The long-term impact of Johnson & Johnson's Health & Wellness Program on employee health risks. J Occup Env Med 2002;44:417-24. https://doi.org/10.1097/00043764-200205000-00010
  22. Goetzel RZ, Henke RM, Tabrizi M, Pelletier KR, Loeppke R, Ballard DW, Grossmeier J, Anderson DR, Yach D, Kelly RK, McCalister T, Serxner S, Selecky C, Shallenberger LG, Fries JF, Baase C, Isaac F, Crighton KA, Wald P, Exum E, Shurney D, Metz RD. Do workplace health promotion (wellness) programs work? J Occup Env Med 2014;56:927-34. https://doi.org/10.1097/JOM.0000000000000276
  23. Burton WN, Connerty CM. Worksite-based diabetes disease management program. Dis Manag 2002;5:1-8. https://doi.org/10.1089/109350702317377528
  24. Groeneveld IF, Proper KI, van der Beek AJ, Hildebrandt VH, van Mechelen W. Lifestyle-focused interventions at the workplace to reduce the risk of cardiovascular disease - a systematic review. Scand J Work Environ Health 2010;36:202-15. https://doi.org/10.5271/sjweh.2891
  25. Caloyeras JP, Liu H, Exum E, Broderick M, Mattke S. Managing manifest diseases, but not health risks, saved PepsiCo money over seven years. Health Aff 2014;33:124-31. https://doi.org/10.1377/hlthaff.2013.0625
  26. Smith ML, Shurtz S. Search and ye shall find: practical literature review techniques for health educators. Health Promot Pract 2012;13:666-9. https://doi.org/10.1177/1524839911432930
  27. John EJ, Vavra T, Farris K, Currie J, Doucette W, Button-Neumann B, Osterhaus M, Kumbera P, Halterman T, Bullock T. Workplace-based cardiovascular risk management by community pharmacists: impact on blood pressure, lipid levels, and weight. Pharmacotherapy 2006;26:1511-7. https://doi.org/10.1592/phco.26.10.1511
  28. Fouad MN, Kiefe CI, Bartolucci AA, Burst NM, Ulene V, Harvey MR. A hypertension control program tailored to unskilled and minority workers. Ethn Dis 1997;7:191-9.
  29. Fries JF, McShane D. Reducing need and demand for medical services in high-risk persons. A health education approach. West J Med 1998;169:201-7.
  30. Aldana S, Barlow M, Smith R, Yanowitz F, Adams T, Loveday L, Merrill RM. A worksite diabetes prevention program: two-year impact on employee health. AAOHN J 2006;54:389-95. https://doi.org/10.1177/216507990605400902
  31. Hughes MC. A lifestyle-based weight management program delivered to employees: examination of health and economic outcomes. J Occup Environ Med 2007;49:1212-7. https://doi.org/10.1097/JOM.0b013e318159489d
  32. Maron DJ, Forbes BL, Groves JR, Dietrich MS, Sells P, DiGenio AG. Health-risk appraisal with or without disease management for worksite cardiovascular risk reduction. J Cardiovasc Nurs 2008;23:513-8. https://doi.org/10.1097/01.JCN.0000338933.81587.b4
  33. Ferdowsian HR, Barnard ND, Hoover VJ, Katcher HI, Levin SM, Green AA, Cohen JL. A multicomponent intervention reduces body weight and cardiovascular risk at a GEICO corporate site. Am J Health Promot 2010;24:384-7. https://doi.org/10.4278/ajhp.081027-QUAN-255
  34. Levin SM, Ferdowsian HR, Hoover VJ, Green AA, Barnard ND. A worksite programme significantly alters nutrient intakes. Public Health Nutr 2010;13:1629-35. https://doi.org/10.1017/S136898000999303X
  35. Merrill RM, Aldana SG, Bowden DE. Employee weight management through health coaching. Eat Weight Disord-St 2010;15:52-9. https://doi.org/10.1007/BF03325280
  36. Touger-Decker R, Denmark R, Bruno M, O'Sullivan-Maillet J, Lasser N. Workplace weight loss program; comparing live and internet methods. J Occup Environ Med 2010;52:1112-8. https://doi.org/10.1097/JOM.0b013e3181f9ee8c
  37. Barham K, West S, Trief P, Morrow C, Wade M, Weinstock RS. Diabetes prevention and control in the workplace: a pilot project for county employees. J Public Health Manag Pract 2011;17:233-41. https://doi.org/10.1097/PHH.0b013e3181fd4cf6
  38. John D, Thompson DL, Raynor H, Bielak K, Rider B, Bassett DR. Treadmill workstations: a worksite physical activity intervention in overweight and obese office workers. J Phys Act Health 2011;8:1034-43. https://doi.org/10.1123/jpah.8.8.1034
  39. Linde J, Jeffery R. Testing a brief self-directed behavioral weight control program. Behav Med 2011;37:47-53. https://doi.org/10.1080/08964289.2011.568992
  40. Mauceri E, Bienkowski C, Hanson KA, Doyle JJ, Jackson J, Bramer S. A Health outcome assessment of the cardio metabolic mission health program at Novartis. J Occup Env Med 2011;53:647-52. https://doi.org/10.1097/JOM.0b013e31821b7ade
  41. Terry PE, Seaverson ELD, Grossmeier J, Anderson DR. Effectiveness of a worksite telephone-based weight management program. Am J Health Promot 2011;25:186-9. https://doi.org/10.4278/ajhp.081112-QUAN-281
  42. Lahiri S, Faghri PD. Cost-effectiveness of a workplace-based incentivized weight loss program. J Occup Env Med 2012;54:371-7. https://doi.org/10.1097/JOM.0b013e318247a394
  43. Malarkey WB, Jarjoura D, Klatt M. Workplace based mindfulness practice and inflammation: a randomized trial. Brain Behav Immun 2013;27:145-54. https://doi.org/10.1016/j.bbi.2012.10.009
  44. Batra P, Das SK, Salinardi T, Robinson L, Saltzman E, Scott T, Pittas AG, Roberts SB. Relationship of cravings with weight loss and hunger. Results from a 6 month worksite weight loss intervention. Appetite 2013;69:1-7. https://doi.org/10.1016/j.appet.2013.05.002
  45. Salinardi TC, Batra P, Roberts SB, Urban LE, Robinson LM, Pittas AG, Lichtenstein AH, Deckersbach T, Saltzman E, Das SK. Lifestyle intervention reduces body weight and improves cardiometabolic risk factors in worksites. Am J Clin Nutr 2013;97:667-76. https://doi.org/10.3945/ajcn.112.046995
  46. Carr LJ, Karvinen K, Peavler M, Smith R, Cangelosi K. Multicomponent intervention to reduce daily sedentary time: a randomised controlled trial. BMJ Open 2013;3:e003261. https://doi.org/10.1136/bmjopen-2013-003261
  47. Koepp GA, Manohar CU, McCrady-Spitzer SK, Ben-Ner A, Hamann DJ, Runge CF, Levine JA. Treadmill desks: a 1-year prospective trial. Obesity 2013;21:705-11. https://doi.org/10.1002/oby.20121
  48. Kullgren JT, Troxel AB, Loewenstein G, Asch DA, Norton LA, Wesby L, Tao Y, Zhu J, Volpp KG. Individual- versus group-based financial incentives for weight loss: a randomized, controlled trial. Ann Intern Med 2013;158:505-14. https://doi.org/10.7326/0003-4819-158-7-201304020-00002
  49. Carpenter KM, Lovejoy JC, Lange JM, Hapgood JE, Zbikowski SM. Outcomes and utilization of a low intensity workplace weight loss program. J Obes 2014;2014:1-7.
  50. Stites SD, Singletary SB, Menasha A, Cooblall C, Hantula D, Axelrod S, Figueredo VM, Phipps EJ. Pre-ordering lunch at work. Results of the what to eat for lunch study. Appetite 2015;84:88-97. https://doi.org/10.1016/j.appet.2014.10.005
  51. Preedy VR. Handbook of anthropometry: physical measures of human form in health and disease. New York: Springer; 2012. p. 168-9.
  52. Framson C. Development and validation of the mindful eating questionnaire. J Am Diet Assoc 2009;109:1439-44. https://doi.org/10.1016/j.jada.2009.05.006
  53. Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 1985;29:71-83. https://doi.org/10.1016/0022-3999(85)90010-8
  54. Lerner D, Amick BC, Rogers WH, Malspeis S, Bungay K, Cynn D. The work limitations questionnaire. Med Care 2001;39:72-85. https://doi.org/10.1097/00005650-200101000-00009
  55. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
  56. Smith KW, McKinlay SM, Thorington BD. The validity of health risk appraisal instruments for assessing coronary heart disease risk. Am J Public Health 1987;77:419-24. https://doi.org/10.2105/AJPH.77.4.419
  57. Kruger J, Yore MM, Bauer DR, Kohl HW. Selected barriers and incentives for worksite health promotion services and policies. Am J Health Promot 2007;21:439-47. https://doi.org/10.4278/0890-1171-21.5.439
  58. Centers for Disease Control and Prevention. 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 2005;54(No. RR-10):11.
  59. Goldgruber J, Ahrens D. Effectiveness of workplace health promotion and primary prevention interventions: a review. J Public Health 2010;18:75-88. https://doi.org/10.1007/s10389-009-0282-5
  60. Anderson LM, Quinn TA, Glanz K, Ramirez G, Kahwati LC, Johnson DB, Buchanan LR, Archer WR, Chattopadhyay S, Kalra GP, Katz DL. The effectiveness of worksite nutrition and physical activity interventions for controlling employee overweight and obesity: a systematic review. Am J Prev Med 2009;37:340-57. https://doi.org/10.1016/j.amepre.2009.07.003
  61. Carr LJ, Bartee RT, Dorozynski C, Broomfield JF, Smith ML, Smith DT. Internetdelivered behavior change program increases physical activity and improves cardiometabolic disease risk factors in sedentary adults: results of a randomized controlled trial. Prev Med 2008;46:431-8. https://doi.org/10.1016/j.ypmed.2007.12.005
  62. Tate DF, Jackvony EH, Wing RR. Effects of internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a Randomized Trial. JAMA 2003;289:1833-6. https://doi.org/10.1001/jama.289.14.1833
  63. Watson T. The New Health Care Imperative: Driving Performance, Connecting to Value. 19th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care [Internet]. 2014 [cited 2015 Dec 17]. Available from: https://www.towerswatson.com/en-US/Insights/IC-Types/Survey-Research-Results/2014/05/full-report-towers-watson-nbgh-2013-2014-employer-survey-on-purchasing-value-in-health-care.
  64. Wilson MG, DeJoy DM, Vandenberg RJ, Richardson HA, McGrath AL. Work characteristics and employee health and well-being: test of a model of healthy work organization. J Occup Organ Psychol 2004;77:565-88. https://doi.org/10.1348/0963179042596522
  65. Ausburn TF, LaCoursiere S, Crouter SE, McKay T. Review of Worksite Weight Management Programs. Workplace Health Saf 2014;62:122-6. https://doi.org/10.1177/216507991406200306
  66. Benedict MA, Arterburn D. Worksite-based weight loss programs: a systematic review of recent literature. Am J Health Promot 2008;22:408-16. https://doi.org/10.4278/ajhp.22.6.408
  67. Gudzune K, Hutfless S, Maruthur N, Wilson R, Segal J. Strategies to prevent weight gain in workplace and college settings: a systematic review. Prev Med 2013;57:268-77. https://doi.org/10.1016/j.ypmed.2013.03.004
  68. Pratt CA, Lemon SC, Fernandez ID, Goetzel R, Beresford SA, French SA, Stevens VJ, Vogt TM, Webber LS. Design characteristics of worksite environmental interventions for obesity prevention. Obesity 2007;15:2171-80. https://doi.org/10.1038/oby.2007.258
  69. Gwin S, Branscum P, Zacharia S, Alshuwaiyer G, Taylor EL, Funk M. Internet-based physical activity interventions at the worksite: a systematic review. Am J Health Stud 2013;28:114-26.

Cited by

  1. Development of a scalable weight loss intervention for low-income workers through adaptation of interactive obesity treatment approach (iOTA) vol.18, pp.1, 2018, https://doi.org/10.1186/s12889-018-6176-0
  2. Building a culture of workplace wellness: Perspectives from Philippine organizations vol.7, pp.2, 2017, https://doi.org/10.5861/ijrsp.2018.3010
  3. Impact of a Translated Disease Self-Management Program on Employee Health and Productivity: Six-Month Findings from a Randomized Controlled Trial vol.15, pp.5, 2018, https://doi.org/10.3390/ijerph15050851
  4. Obstacles and Future Prospects: Considerations on Health Promotion Activities for Older Workers in Europe vol.15, pp.6, 2017, https://doi.org/10.3390/ijerph15061096
  5. Qualitative Exploration of the Feasibility and Acceptability of Workplace-Based Microgrants to Improve Physical Activity : The 10,000 Steps Pedometer Microgrant Scheme vol.60, pp.8, 2018, https://doi.org/10.1097/jom.0000000000001376
  6. Evaluation of a Lifestyle Change Worksite Weight Management Program Across Multiple Employers and Sites vol.60, pp.12, 2018, https://doi.org/10.1097/jom.0000000000001442
  7. Cost-effectiveness and cost-benefit of worksite health promotion programs in Europe: a systematic review vol.29, pp.3, 2019, https://doi.org/10.1093/eurpub/cky269
  8. Effects of a Workplace-Based Virtual-Run Intervention Among University Employees vol.17, pp.8, 2020, https://doi.org/10.3390/ijerph17082745
  9. Impact of Diabetes and Disease Duration on Work Status Among U.S. Older Adults vol.32, pp.5, 2017, https://doi.org/10.1177/0898264318822897
  10. Using nudges to promote physical activity and to reduce sedentary behaviour in the workplace: a scoping review protocol vol.10, pp.11, 2017, https://doi.org/10.1136/bmjopen-2020-038205
  11. Responsive evaluation of stakeholder dialogue as a worksite health promotion intervention to contribute to the reduction of SEP related health inequalities: a study protocol vol.20, pp.None, 2017, https://doi.org/10.1186/s12913-020-5020-2
  12. A systematic review protocol examining workplace interventions that aim to improve employee health and wellbeing in male-dominated industries vol.9, pp.1, 2020, https://doi.org/10.1186/s13643-019-1260-9
  13. Semmelweis Caring University Model Program Based on the Development of a Center of Preventive Services: Health for All Employees at a University Occupational Setting vol.9, pp.None, 2021, https://doi.org/10.3389/fpubh.2021.727668