Background Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet.Objective The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity.Methods Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests.Results Retention rates were good for both groups—85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F1,415 = 7.104, P = .008) and Dietary Stage of Change (F1,408 = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F2,203 = 5.270, P = .003), Attitudes Toward a Healthful Diet (F2,204 = 2.585, P = .045), and Dietary Stage of Change (F2,200 = 4.627, P = .005). No significant differences were found between the two groups on measures of stress or physical activity, although t tests of pretest-posttest changes indicated that both groups improved on several of these measures. The Web-based group gave significantly higher ratings to the program materials than the print group on all health topics and in their overall evaluation (F1,410 = 9.808, P = .002).Conclusions The Web-based program was more effective than print materials in producing improvements in the areas of diet and nutrition but was not more effective in reducing stress or increasing physical activity. The higher ratings given to the Web-based program suggest that workers preferred it to the print materials. Both groups showed numerous pretest-posttest improvements in all health topics, although such improvements might be attributable in part to a Hawthorne effect. Results suggest that a multimedia Web-based program can be a promising means of delivering health promotion material to the workforce, particularly in the area of diet and nutrition.

A program designed to prevent alcohol misuse among working adults was developed and presented in four sessions to employees of a medium-sized printing company. The Working People program, based on a social-learning model, was field-tested with 108 employees in the context of a quasi-experimental design. Members of the Program Group (n = 38) and two Comparison Groups (n = 26 and 44) were assessed before and after the program on a questionnaire containing measures of alcohol consumption, attitudes and intentions regarding alcohol use, problem consequences of alcohol use, and health beliefs. Program effects were demonstrated on alcohol consumption, motivation to reduce consumption, and problem consequences of drinking. No effects were found on health beliefs or self-efficacy to reduce drinking. Although the findings are qualified by the self-selected nature of the samples, the results suggest that alcohol consumption can be reduced among adults who participate in this type of worksite program.

The majority of heavy drinkers and users of illicit drugs are employed adults, yet there is a dearth of sophisticated substance abuse prevention efforts in the workplace. This article reviews the approaches to worksite-based substance abuse prevention and presents the results of a field test of a prevention program aimed at the individual worker. Based on these findings and other theoretical perspectives from the literature, an expanded conceptual model for workplace substance abuse prevention is presented.

For the past dozen years, our research team has been developing and testing substance abuse prevention programs and materials for the workplace, typically cast in a health promotion framework and rooted in social cognitive theory (Cook & Youngblood, 1990; Cook, Back, & Trudeau, 1996a, 199613). Our efforts have been based on the belief that workers' attitudes toward and practices involving alcohol and other drugs ( AODs) can be shaped by interventions that are congruent with prevailing psychological theories of behavior change and that health promotion programs in the workplace are a logical and appropriate vehicle for substance abuse prevention programs. Although the authors view these interventions as entirely compatible with sociocultural perspectives (as reflected in the work 97

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