BackgroundThe evidence surrounding the value of workplace health promotion in positively influencing employees’ health and wellbeing via changes to their health behaviours is growing. The aim of the study was to explore employers’ views on the promotion of workplace health and wellbeing and the factors affecting these views.MethodsUsing a qualitative phenomenological approach, 10 focus groups were conducted with employers selected from a range of industries and geographical locations within Western Australia. The total sample size was 79.ResultsThree factors were identified: employers’ conceptualization of workplace health and wellbeing; employers’ descriptions of (un)healthy workers and perceptions surrounding the importance of healthy workers; and employers’ beliefs around the role the workplace should play in influencing health.ConclusionsProgress may be viable in promoting health and wellbeing if a multifaceted approach is employed taking into account the complex factors influencing employers’ views. This could include an education campaign providing information about what constitutes health and wellbeing beyond the scope of occupational health and safety paradigms along with information on the benefits of workplace health and wellbeing aligned with perceptions relating to healthy and unhealthy workers.

IntroductionWorkplace health promotion programs to prevent overweight and obesity in office-based employees should be evidence-based and comprehensive and should consider behavioral, social, organizational, and environmental factors. The objective of this study was to identify barriers to and enablers of physical activity and nutrition as well as intervention strategies for health promotion in office-based workplaces in the Perth, Western Australia, metropolitan area in 2012.MethodsWe conducted an online survey of 111 employees from 55 organizations. The online survey investigated demographics, individual and workplace characteristics, barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. We used χ2 and Mann–Whitney U statistics to test for differences between age and sex groups for barriers and enablers, intervention-strategy preferences, and physical activity and nutrition behaviors. Stepwise multiple regression analysis determined factors that affect physical activity and nutrition behaviors.ResultsWe identified several factors that affected physical activity and nutrition behaviors, including the most common barriers (“too tired” and “access to unhealthy food”) and enablers (“enjoy physical activity” and “nutrition knowledge”). Intervention-strategy preferences demonstrated employee support for health promotion in the workplace. ConclusionThe findings provide useful insights into employees’ preferences for interventions; they can be used to develop comprehensive programs for evidence-based workplace health promotion that consider environmental and policy influences as well as the individual.

Objective(s) To estimate the impact of various expansion scenarios of the National Bowel Cancer Screening program (NBSCP) on the number of bowel cancer deaths prevented. Impact of the expansion scenarios on colonoscopy demand was also investigated. Design MISCAN-Colon, a well-established, validated computer simulation model for bowel cancer screening, was adjusted to reflect the Australian situation. In July 2013, we simulated the effects of screening over a 50 year period, starting in 2006. The model parameters included participation rates for screening and follow up, cancerous and pre-cancerous lesion identification rates, bowel cancer incidence, mortality and the outcomes of the NBCSP. Five implementation scenarios, based on biennial screening using an immunochemical faecal occult blood test, were developed and modelled. A sensitivity analysis that increased screening participation to 60% was also conducted. Setting/ Participants Australian residents aged 50 to 74 years Main outcome measures Impact and comparison of five implementation scenarios on the number of bowel cancer deaths prevented and demand for colonoscopy. Results In its current state, MISCAN-Colon calculated that the NBCSP should prevent 35,169 bowel cancer deaths in the coming 40 years. Accelerating the expansion of the program to achieve biennial screening by 2020, more than 70,000 deaths would be prevented. If complete implementation of biennial screening resulted in a corresponding increase in participation to 60%, the number of deaths prevented increased across all scenarios. Conclusion(s) The findings strongly support the need for rapid implementation of the National Bowel Cancer Screening Program. Compared to the current situation, achieving biennial screening by 2020 could result in 100% more bowel cancer deaths being prevented (approximately 35,000) in the coming 40 years.

The aim of this study was to qualitatively explore the barriers and enablers to implementing healthy workplace initiatives in a sample of workplaces based in Perth, Western Australia. In-depth interviews were conducted with representatives from 31 organizations representing small, medium and large businesses in the Perth metropolitan area which reported having healthy workplace initiatives. In total, 43 factors were mentioned as influencing the implementation of healthy workplace initiatives. Factors appearing to exert the most influence on the implementation of health promoting initiatives in this sample were culture; support from managers and staff; collaboration with industry providers; financial resources circumstances and the physical environment. These factors appeared to be mutually reinforcing and interconnected. Findings suggest there may be merit in applying an organizational development lens to the implementation of workplace health promotion initiatives as this could assist in leveraging enablers and minimizing barriers.

Although none of the workplaces reported using a formal organizational change model when implementing their healthy workplace initiatives, there did appear to be perceived merit in using the steps in Kotter's model.

There are a number of factors that increase the risk of bowel cancer: age; personal history of colorectal polyps; chronic inflammatory bowel disease; 3-4 increased insulin levels and Type 2 diabetes (for men; weak association for women);5-6 family history of colorectal cancer;7-8 and inherited syndromes (two most common: familial adenomatous polyposis and hereditary non-polyposis colorectal cancer). [9][10] There are also a number of modifiable lifestyle and diet-related factors that influence the risk of bowel cancer. A recent review 11 concluded that the evidence for decreased risk of colorectal cancer is 'convincing' for increased physical activity and 'probable' for consumption of foods containing dietary fibre, garlic, milk and calcium. The evidence for increased risk of colorectal cancer is 'convincing' for greater body fatness and abdominal fatness, and for consumption of red meat, processed meat and 30 g per day of ethanol in alcoholic drinks (by men; 'probable' in women).

Objectives Colorectal cancer (CRC) screening with a faecal immunochemical test (FIT) has been disrupted in many countries during the COVID-19 pandemic. Performing catch-up of missed screens while maintaining regular screening services requires additional colonoscopy capacity that may not be available. This study aimed to compare strategies that clear the screening backlog using limited colonoscopy resources. Methods A range of strategies were simulated using four country-specific CRC natural-history models: Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) and MIcrosimulation SCreening ANalysis for CRC (MISCAN-Colon) (both in the Netherlands), Policy1-Bowel (Australia) and OncoSim (Canada). Strategies assumed a 3-month screening disruption with varying recovery period lengths (6, 12, and 24 months) and varying FIT thresholds for diagnostic colonoscopy. Increasing the FIT threshold reduces the number of referrals to diagnostic colonoscopy. Outcomes for each strategy were colonoscopy demand and excess CRC-related deaths due to the disruption. Results Performing catch-up using the regular FIT threshold in 6, 12 and 24 months could prevent most excess CRC-related deaths, but required 50%, 25% and 12.5% additional colonoscopy demand, respectively. Without exceeding usual colonoscopy demand, up to 60% of excess CRC-related deaths can be prevented by increasing the FIT threshold for 12 or 24 months. Large increases in FIT threshold could lead to additional deaths rather than preventing them. Conclusions Clearing the screening backlog in 24 months could avert most excess CRC-related deaths due to a 3-month disruption but would require a small increase in colonoscopy demand. Increasing the FIT threshold slightly over 24 months could ease the pressure on colonoscopy resources.

Objective: The purpose of this study was to investigate whether making fruit boxes available in the workplace is a successful health promotion strategy. Design: A quasi-experimental study involving three conditions -free fruit, 50c per piece of fruit and $1 per piece of fruit -to investigate the effect of a contribution scheme on employees' fruit purchase/consumption behaviours and willingness to contribute when in the paid conditions. Setting: Perth, Western Australia. Methods: In total, 36 workplaces participated and were randomly assigned to one of the three conditions. The results were analysed using generalised linear modelling. A qualitative follow-up was conducted with workplace representatives 6 weeks after the completion of the trial to investigate how many workplaces implemented the provision of fruit boxes after the trial and the factors influencing the decision to implement fruit boxes. Results: A significant difference in average fruit purchasing/consumption per person was found with respect to condition (p < .001), with businesses in the free condition purchasing/consuming a significantly greater amount of fruit than businesses in the 50c contribution condition or $1 contribution condition. Following the trial, 13 workplaces continued providing their own fruit box, of which 7 were initially in the free condition. Qualitative findings revealed that management support, a receptive culture and sufficient resources were key to the implementation of fruit boxes. Conclusion: Having a fruit box may be a feasible health promotion strategy, and the financial burden of this strategy could be alleviated by asking employees to contribute to the cost of fruit.