Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

Purpose: To measure the impact of tying adoption of evidence-based worksite health promotion (WHP) interventions to annual organizational strategic objectives, as measured by the Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard (ScoreCard). Design: A prospective cohort study following Johns Hopkins Medicine (JHM) affiliates against industry-specific and large employer benchmarks from 2016-2020. Settings: JHM, the largest private employer in Maryland with facilities in Florida and the District of Columbia. Subjects: Twelve JHM affiliates representing over 40,000 employees. Intervention: A strategic objective was established annually based on the ScoreCard and organizational priorities. Measures: JHM affiliates measured their WHP efforts annually using the ScoreCard. CDC industry-specific and large employer benchmarks were collected for comparison. Analysis: ScoreCard data was assessed annually to measure deviations from CDC benchmarks, determine whether strategic objectives were met, and inform additional annual objectives. Results: JHM demonstrated improvement from 8.9 percentage points above industry-specific and 3.4 percentage points below large employer benchmarks in 2016, to 26.4 percentage points above industry-specific and 21.8 percentage points above large employer benchmarks in 2020. Conclusion: Large employers face unique challenges in implementing WHP programs. Our study suggests embedding health promotion in annual strategic objectives may alleviate these challenges by prioritizing the goal and ensuring adequate resources to be successful. There are however, some limitations on using benchmarking data for comparison.

Organizations often fail to establish a clear awareness of what employees consider fair when implementing changes to employee benefits in the workplace. In 2016, the Johns Hopkins Health System (JHHS) enhanced their tobacco control efforts. In addition to enhanced smoking cessation benefits, employees were offered an increased reduction in their insurance premiums if they were nonsmokers. To qualify for the reduction, employees participated in testing rather than relying on self-reporting as had been done in the past. The shift to testing prompted a concern by some senior management at JHHS who did not want employees to feel they were not trusted. As the program unfolded at JHHS, the four-component model of procedural justice was applied to provide a framework for reviewing the implementation of the new voluntary tobacco testing at JHHS from a fairness lens. The purpose of this article is to illustrate the application of the four-component procedural model of justice to the tobacco testing process at JHHS. As approximately 75% of employees participated in the program, the experience at JHHS can be instructive to other employers who are looking to implement changes in their workplaces and how to minimize unintended consequences with their employees.