Purpose: To provide a nationally representative snapshot of workplace health promotion (WHP) and protection practices among United States worksites. Design: Cross-sectional, self-report Workplace Health in America (WHA) Survey between November 2016 and September 2017. Setting: National. Participants: Random sample of US worksites with ≥10 employees, stratified by region, size, and North American Industrial Classification System sector. Measures: Workplace health promotion programs, program administration, evidence-based strategies, health screenings, disease management, incentives, work-life policies, implementation barriers, and occupational safety and health (OSH). Analysis: Descriptive statistics, t tests, and logistic regression. Results: Among eligible worksites, 10.1% (n = 3109) responded, 2843 retained in final sample, and 46.1% offered some type of WHP program. The proportion of comparable worksites with comprehensive programs (as defined in Healthy People 2010) rose from 6.9% in 2004 to 17.1% in 2017 (P < .001). Occupational safety and health programs were more prevalent than WHP programs, and 83.5% of all worksites had an individual responsible for employee safety, while only 72.2% of those with a WHP program had an individual responsible for it. Smaller worksites were less likely than larger to offer most programs. Conclusion: The prevalence of WHP programs has increased but remains low across most health programs; few worksites have comprehensive programs. Smaller worksites have persistent deficits and require targeted approaches; integrated OSH and WHP efforts may help. Ongoing monitoring using the WHA Survey benchmarks OSH and WHP in US worksites, updates estimates from previous surveys, and identifies gaps in research and practice.

No abstract

Agency for Healthcare Research and Quality.

Purpose: We investigated the impact of elements of a workplace culture of health (COH) on employees’ perceptions of employer support for health and lifestyle risk. Design: We used 2013 and 2015 survey data from the National Healthy Worksite Program, a Centers for Disease Control and Prevention (CDC)-led initiative to help workplaces implement health-promoting interventions. Setting: Forty-one employers completed the CDC Worksite Health Scorecard to document organizational changes. Participants: Eight hundred twenty-five employees provided data to evaluate changes in their health and attitudes. Measures: We defined elements of a COH as environmental, policy, and programmatic supports; leadership and coworker support; employee engagement (motivational interventions); and strategic communication. Outcomes included scores of employees’ perceptions of employer support for health and lifestyle risk derived from self-reported physical activity, nutrition, and tobacco use. Analysis: We estimated effects using multilevel regression models. Results: At the employee level and across time, regression coefficients show positive associations between leadership support, coworker support, employee engagement, and perceived support for health (P < .05). Coefficients suggest a marginally significant negative association between lifestyle risk and the presence of environmental and policy supports (P < .10) and significant associations with leadership support in 2015 only (P < .05). Conclusion: Relational elements of COH (leadership and coworker support) tend to be associated with perceived support for health, while workplace elements (environmental and policy supports) are more associated with lifestyle risk. Employers need to confront relational and workplace elements together to build a COH.

No abstract

Purpose: Centers for Disease Control and Prevention (CDC) initiated the Work@Health Program to teach employers how to improve worker health using evidence-based strategies. Program goals included (1) determining the best way(s) to deliver employer training, (2) increasing employers’ knowledge of workplace health promotion (WHP), and (3) increasing the number of evidence-based WHP interventions at employers’ worksites. This study is one of the few to examine the effectiveness of a program designed to train employers how to implement WHP programs. Design: Pre- and posttest design. Setting: Training via 1 of 3 formats hands-on, online, or blended. Participants: Two hundred six individual participants from 173 employers of all sizes. Intervention: Eight-module training curriculum to guide participants through building an evidence-based WHP program, followed by 6 to 10 months of technical assistance. Measures: The CDC Worksite Health ScoreCard and knowledge, attitudes, and behavior survey. Analysis: Descriptive statistics, paired t tests, and mixed linear models. Results: Participants’ posttraining mean knowledge scores were significantly greater than the pretraining scores (61.1 vs 53.2, P < .001). A year after training, employers had significantly increased the number of evidence-based interventions in place (47.7 vs 35.5, P < .001). Employers’ improvements did not significantly differ among the 3 training delivery formats. Conclusion: The Work@Health Program provided employers with knowledge to implement WHP interventions. The training and technical assistance provided structure, practical guidance, and tools to assess needs and select, implement, and evaluate interventions.

Small- and mid-sized employers are less likely to have expertise, capacity, or resources to implement workplace health promotion programs, compared with large employers. In response, the Centers for Disease Control and Prevention developed the Work@Health® employer training program to determine the best way to deliver skill-based training to employers of all sizes. The core curriculum was designed to increase employers’ knowledge of the design, implementation, and evaluation of workplace health strategies. The first arm of the program was direct employer training. In this article, we describe the results of the second arm—the program’s train-the-trainer (T3) component, which was designed to prepare new certified trainers to provide core workplace health training to other employers. Of the 103 participants who began the T3 program, 87 fully completed it and delivered the Work@Health core training to 233 other employers. Key indicators of T3 participants’ knowledge and attitudes significantly improved after training. The curriculum delivered through the T3 model has the potential to increase the health promotion capacity of employers across the nation, as well as organizations that work with employers, such as health departments and business coalitions.

The results and analyses discussed in this book are based on research supported by the Young Adults in the Workplace (YIW) initiative, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). A great number of colleagues, researchers, and federal staff were invaluable in the development and implementation of our work. We are indebted to our YIW workplace partners, who implemented the programs described in these chapters, and to the grantees who contributed the framework, evaluation, and positive energy to explore with us new methods in substance abuse prevention for a younger workforce. Organizational leaders and frontline managers provided the critical support needed to obtain employee participation and worked to frame and implement the new ideas through health/wellness and traditional drug-free workplace programs. Special thanks goes to the YIW Steering Committee, reviewers, and production staff who contributed a great deal to the content, organization, and readability of the book.