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Background: Evidence-based interventions (EBIs) for tobacco control can be implemented in worksite settings to reduce tobacco use. Small worksites are less likely to adopt tobacco control EBIs than large worksites. The purpose of this qualitative study was to 1) explore factors that impact small employers' decisions to offer tobacco control EBIs, and 2) understand employees' perceptions of tobacco control at small worksites., Methods: Working with staff from small worksites (20-250 employees), we analyzed data from 12 semi-structured interviews with employers (via key informants) and four focus groups with employees. We recruited employers and employees through a purchased business list and market research company, respectively. Interview and focus group topics included perceptions of worksite tobacco control; internal and external forces shaping worksite tobacco control implementation; and perceived worksite support for cessation. We conducted thematic data analysis., Results: Key themes from the employer interviews included: the local environment played an important role in implementation of tobacco control EBIs; tobacco control was perceived as important but not a priority; and tobacco control decisions were driven by worksite culture. Key themes from the employee focus groups included: perceived employer support for tobacco cessation was limited although there was interest from employees; employees who currently used tobacco were stigmatized for their behavior; and incentives and coaching were considered ideal tobacco control EBIs., Conclusions: Tobacco control has not been prioritized at small worksites, despite employees welcoming additional cessation support. This study contributes important information on contextual factors and employee preferences that could be targeted to improve tobacco control EBI implementation. Worksites should implement comprehensive tobacco-free policies, minimize stigma when promoting cessation, establish equitable break policies, and involve employees in decision-making related to tobacco control., (© 2022. The Author(s).)

Purpose: This study examined the relationship between employee outcomes and employer implementation of evidence-based interventions (EBIs) for chronic disease prevention., Design: Cross-sectional samples collected at 3 time points in a cluster-randomized, controlled trial of a workplace health promotion program to promote 12 EBIs., Setting: King County, WA., Sample: Employees of 63 small, low-wage workplaces., Measures: Employer EBI implementation; 3 types of employee outcomes: perceived implementation of EBIs; perceived employer support for health; and health-related behaviors, perceived stress, depression risk, and presenteeism., Analysis: Intent-to-treat and correlation analyses using generalized estimating equations. We tested bivariate associations along potential paths from EBI implementation, through perceived EBI implementation and perceived support for health, to several employee health-related outcomes., Results: The intent-to-treat analysis found similar employee health-related behaviors in intervention and control workplaces at 15 and 24 months. Workplaces implemented varying combinations of EBIs, however, and bivariate associations were significant for 4 of the 6 indicators of physical activity and healthy eating, as well as perceived stress, depression risk, and presenteeism. We did not find significant positive associations for cancer screening and tobacco cessation., Conclusion: Our findings support broader dissemination of EBIs for physical activity and healthy eating, as well as more focus on improving employer support for employee health. They also suggest we need better interventions for cancer screening and tobacco cessation.

Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the U. S. Because the central mission of state and local health departments (HDs) is to protect, promote, and improve population health, these agencies are well-positioned to address risk behaviors for chronic disease. HD-employer partnerships could enhance worksite wellness programming, but few studies have explored this topic. Building upon previously published findings, the purpose of this qualitative study was to describe the context and environment for HDs' delivery of worksite wellness programs, including interest, barriers, facilitators, and decision-making processes. We conducted 12 interviews with directors of state chronic disease programs, 21 interviews with local directors, and three focus groups with local staff. We performed a thematic analysis of the data. Key themes include the following: (1) worksite wellness programs delivered by HDs were diverse in topic and scope and delivered both internally (at the HD for their agency) and externally (for other employers); (2) decisions made about chronic disease prevention were largely driven by funding priorities, with federal, state, and local entities playing roles in the decision-making process; and (3) HDs expressed potential interest in worksite wellness program delivery, dependent upon staff capacity, available funding, and employer buy-in. Our results suggest that funding should be increased for and reallocated towards chronic disease prevention, including worksite wellness. To overcome HD barriers to program delivery, key funders and stakeholders should prioritize and communicate the importance of worksite wellness.

Objective: To contribute to a broader understanding of effective implementation strategies to help managers engage employees in workplace wellness., Methods: We beta-tested an online training at four Washington state agencies (two test, two control). We administered a post-training evaluation, re-administered an online manager survey and conducted additional interviews with wellness leads., Results: Training participation rate was high. The two test agencies experienced a significant increase in the percentage of managers who: agreed that they received training on employee wellness; agreed their agency's culture supports employee wellness; and encouraged their employees to participate in wellness activities. Approximately 80% of managers who received the training agreed they could apply information learned to support employee wellness., Conclusions: If proven effective, the training could be administered at a low cost and disseminated to improve employee health., Competing Interests: The authors report no conflict of interest., (Copyright © 2021 American College of Occupational and Environmental Medicine.)

Objective: To examine local health department (LHD) contexts, capacity for, and interest in partnering with employers on workplace health promotion programs (WHPPs) for chronic disease prevention., Design: Qualitative interviews with LHD directors., Setting: LHDs from 21 counties in 10 states., Participants: Twenty-one LHD directors., Main Outcome Measuress: Experiences and perceptions of existing partnerships, decision making, funding, data needs, and organizational capacity for WHPP partnerships with employers., Results: We identified 3 themes: (1) LHDs see the value of partnering with employers but lack the capacity to do so effectively; (2) while LHDs base priorities on community need, funding ultimately drives decision making; and (3) rural, micropolitan, and urban LHDs differ in their readiness and capacity to work with employers., Conclusions: Understanding LHDs' partnership capacity and context is essential to the successful implementation of WHPP partnerships with employers. Expanding these partnerships may require additional financial investments, particularly among rural LHDs., Competing Interests: The authors of this article report no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Context: Worksites can serve as community sites for local health jurisdictions (LHJs) to assist with implementation of evidence-based interventions (EBIs) to prevent and control chronic diseases., Objective: To assess the feasibility and effectiveness of using LHJ staff to disseminate Connect to Wellness (CtW), an effective dissemination package for increasing implementation of EBIs for chronic disease control by small worksites., Design: Single-arm, multisite intervention trial, with measurement at baseline, after 6 months of intervention, and after a maintenance period of 6 months., Setting: Six geographically dispersed counties in Washington State. Target worksites had 20 to 250 employees., Participants: Nine staff members from 6 LHJs delivered CtW to 35 worksites., Intervention: Connect to Wellness seeks to increase worksites' implementation of 14 EBIs classified as communication, policy, or program approaches to increasing 4 behaviors: cancer screening, healthy eating, physical activity, and tobacco cessation., Main Outcome Measure: Evidence-based intervention implementation measured on a scale from 0% to 100%., Results: Participating worksites showed a significant increase (P < .001, t test) in total mean implementation scores from baseline (33%) to 6-month follow-up (47%). Increases in implementation for communications, policy, healthy eating, and tobacco EBIs were statistically significant at 6 months and maintained at 12 months. Increased implementation at 6 months of a group physical activity program was not sustained after the program became unavailable, and total implementation scores at 12 months (38%) showed little change from baseline., Conclusions: Local health jurisdiction-delivered CtW increased worksites' implementation of EBIs at 6 months, and increased implementation in communication, policy, healthy eating, and tobacco was maintained at 12 months. This package, delivered by LHJ staff working part-time on CtW, was nearly as successful as prior delivery by staff working full-time on CtW., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc.)

Purpose: To examine the reliability and validity of a brief measure (the Workplace Support for Health [WSH] scale) to assess employees' perceived support for a healthy lifestyle., Design: Repeated cross-sectional surveys., Setting: We collected employer- and employee-level survey data from small, low-wage workplaces in King County, WA enrolled in a randomized controlled trial., Sample: We analyzed data from 68 workplaces that had 2,820 and 2,640 employees complete surveys at baseline and 15 months, respectively., Measures: The WSH scale consisted of five items. To assess validity, we examined associations between the WSH scale and employer implementation of evidence-based interventions for health promotion, employee self-rated health, and job satisfaction., Analysis: We performed an exploratory factor analysis to assess the unidimensionality of the WSH scale items, and produced Cronbach's alpha coefficients to examine scale reliability. We ran regression models using generalized estimating equations to examine validity., Results: The factor analysis indicated one factor, which accounted for 59% of the total variance in the workplace support for health items. The scale had good reliability at baseline (α = 0.82) and 15 months (α = 0.83). Employer evidence-based intervention implementation was positively associated with WSH. WSH was also associated with higher self-rated health and job satisfaction. These associations indicate good concurrent validity., Conclusion: The WSH scale is a reliable and valid measure of perceived workplace support for health. Employers can use the scale to identify gaps in support and create a plan for improvement.

Purpose: To construct a wellness committee (WC) implementation index and determine whether this index was associated with evidence-based intervention implementation in a workplace health promotion program., Design: Secondary data analysis of the HealthLinks randomized controlled trial., Setting: Small businesses assigned to the HealthLinks plus WC study arm., Sample: Small businesses (20-200 employees, n = 23) from 6 low-wage industries in King County, Washington., Measures: Wellness committee implementation index (0%-100%) and evidence-based intervention implementation (0%-100%)., Analysis: We used descriptive and bivariate statistics to describe worksites' organizational characteristics. For the primary analyses, we used generalized estimating equations with robust standard errors to assess the association between WC implementation index and evidence-based intervention implementation over time., Results: Average WC implementation index scores were 60% at 15 months and 38% at 24 months. Evidence-based intervention scores among worksites with WCs were 27% points higher at 15 months (64% vs 37%, P < .001) and 36% points higher at 24 months (55% vs 18%, P < .001). Higher WC implementation index scores were positively associated with evidence-based intervention implementation scores over time ( P < .001)., Conclusion: Wellness committees may play an essential role in supporting evidence-based intervention implementation among small businesses. Furthermore, the degree to which these WCs are engaged and have leadership support, a set plan or goals, and multilevel participation may influence evidence-based intervention implementation and maintenance over time.

Objectives. To determine whether (1) participating in HealthLinks , and (2) adding wellness committees to HealthLinks increases worksites' evidence-based intervention (EBI) implementation. Methods. We developed HealthLinks to disseminate EBIs to small, low-wage worksites. From 2014 to 2017, we conducted a site-randomized trial in King County, Washington, with 68 small worksites (20-200 employees). We assigned worksites to 1 of 3 arms: HealthLinks , HealthLinks plus wellness committee ( HealthLinks+ ), or delayed control. At baseline, 15 months, and 24 months, we assessed worksites' EBI implementation on a 0% to 100% scale and employees' perceived support for their health behaviors. Results. Postintervention EBI scores in both intervention arms ( HealthLinks and HealthLinks+ ) were significantly higher than in the control arm at 15 months (51%, 51%, and 23%, respectively) and at 24 months (33%, 37%, and 24%, respectively; P  < .001). Employees in the intervention arms perceived greater support for their health at 15 and 24 months than did employees in control worksites. Conclusions. HealthLinks is an effective strategy for disseminating EBIs to small worksites in low-wage industries. Public Health Implications. Future research should focus on scaling up HealthLinks , improving EBI maintenance, and measuring impact of these on health behavior.

Objective: The aim of this integrative literature review is to synthesize the existing evidence regarding managers' support for employee wellness programs., Data Source: The search utilized multiple electronic databases and libraries., Study Inclusion and Exclusion Criteria: Inclusion criteria comprised peer-reviewed research published in English, between 1990 and 2016, and examining managers' support in the context of a worksite intervention. The final sample included 21 articles for analysis., Data Extraction: Two researchers extracted and described results from each of the included articles using a content analysis., Data Synthesis: Two researchers independently rated the quality of the included articles. Researchers synthesized data into a summary table by study design, sample, data collected, key findings, and quality rating., Results: Factors that may influence managers' support include their organization's management structure, senior leadership support, their expected roles, training on health topics, and their beliefs and attitudes toward wellness programs and employee health. Managers' support may influence the organizational culture, employees' perception of support, and employees' behaviors., Conclusions: When designing interventions, health promotion practitioners and researchers should consider strategies that target senior, middle, and line managers' support. Interventions need to include explicit measures of managers' support as part of the evaluation plan.

Purpose: The purpose of this study is to evaluate managers' barriers and facilitators to supporting employee participation in the Washington State Wellness program., Design: Exploratory sequential mixed methods., Setting: Four Washington State agencies located in Olympia and Tumwater, Washington., Participants: State employees in management positions (executive, middle, and line), whose job includes supervision of subordinates and responsibility for the performance and conduct of a subunit or group., Methods: We interviewed 23 managers and then used the results to create a survey that was fielded to all managers at the 4 agencies. The survey response rate was 65% (n = 607/935)., Analysis: We used qualitative coding techniques to analyze interview transcripts and descriptive statistics to summarize survey data. We used the Total Worker Health framework to organize our findings and conclusions., Results: Managers support the wellness program, but they also face challenges with accommodating employees' participation due to workload, scheduling inflexibility, and self-efficacy to discuss wellness with direct reports. About half the managers receive support from the manager above them, and most have not received training on the wellness program., Conclusion: Our findings point to several strategies that can strengthen managers' role in supporting the wellness program: the provision of training, targeted messages, formal expectations, and encouragement (from the manager above) to support employees' participation.

Background: HealthLinks is a workplace health promotion program developed in partnership with the American Cancer Society. It delivers a package of evidence-based interventions and implementation support to small worksites in low-wage industries. As part of a randomized, controlled trial of HealthLinks, we studied approaches to recruiting these worksites., Aims: This study aims to guide future recruitment for community-based worksite health promotion interventions by comparing three approaches, including leveraging relationships with community partners., Method: We recruited 78 small, low-wage worksites in King County, Washington, to participate in the trial via three approaches: phone calls to companies on a purchased list ("cold"), phone calls to a list of eligible companies provided by a health insurer ("lukewarm"), and personal referrals from local health insurers and brokers ("warm"). Eligible and interested worksites received an in-person visit from researchers and completed additional steps to enroll., Results: Of the worksites screened and deemed eligible, 32% of the "cold" worksites enrolled in HealthLinks, as did 48% and 60%, respectively, of the "lukewarm" and "warm" worksites. Compared with "warm" worksites, "cold" worksites were twice as likely to be ineligible., Discussion: Two distinct factors help explain why "warmer" worksites were more likely to enroll in HealthLinks. First, eligibility was significantly higher among warmer referrals. Second, most of the warm-referred worksites eligible for the study agreed to meet in person with the project team to hear more about the project., Conclusions: "Warmer" recruitment approaches yielded higher recruitment. Leveraging relationships with community partners can help researchers identify and successfully recruit small, low-wage worksites.

Objective: The aim of this study was to identify alignments between wellness offerings low socioeconomic status (SES) employees need and those large companies can provide., Methods: Focus groups (employees); telephone interviews (large companies). Employees were low-SES, insured through their employers, and employed by large Washington State companies. Focus groups covered perceived barriers to healthy behaviors at work and potential support from companies. Interviews focused on priorities for employee health and challenges reaching low-SES employees., Results: Seventy-seven employees participated in eight focus groups; 12 companies completed interviews. Employees identified facilitators and barriers to healthier work environments; companies expressed care for employees, concerns about employee obesity, and reluctance to discuss SES., Conclusion: Our findings combine low-SES employee and large company perspectives and indicate three ways workplaces could most effectively support low-SES employee health: create healthier workplace food environments; prioritize onsite physical activity facilities; use clearer health communications.

Purpose: To develop a theory-based questionnaire to assess readiness for change in small workplaces adopting wellness programs., Design: In developing our scale, we first tested items via "think-aloud" interviews. We tested the revised items in a cross-sectional quantitative telephone survey., Setting: The study setting comprised small workplaces (20-250 employees) in low-wage industries., Subjects: Decision-makers representing small workplaces in King County, Washington (think-aloud interviews, n = 9), and the United States (telephone survey, n = 201) served as study subjects., Measures: We generated items for each construct in Weiner's theory of organizational readiness for change. We also measured workplace characteristics and current implementation of workplace wellness programs., Analysis: We assessed reliability by coefficient alpha for each of the readiness questionnaire subscales. We tested the association of all subscales with employers' current implementation of wellness policies, programs, and communications, and conducted a path analysis to test the associations in the theory of organizational readiness to change., Results: Each of the readiness subscales exhibited acceptable internal reliability (coefficient alpha range, .75-.88) and was positively associated with wellness program implementation ( p < .05). The path analysis was consistent with the theory of organizational readiness to change, except change efficacy did not predict change-related effort., Conclusion: We developed a new questionnaire to assess small workplaces' readiness to adopt and implement evidence-based wellness programs. Our findings also provide empirical validation of Weiner's theory of readiness for change.

Purpose: To evaluate an evidence-based workplace approach to increasing adult influenza vaccination levels applied in the restaurant setting, Design: We implemented an intervention and conducted a pre/post analysis to determine effect on vaccination., Setting: Eleven Seattle-area restaurants., Subjects: Restaurants with 25+ employees speaking English or Spanish and over 18 years., Intervention: Restaurants received influenza vaccination promotion materials, assistance arranging on-site vaccination events, and free influenza vaccinations for employees., Measures: Pre/post employee surveys of vaccination status with direct observation and employer interviews to evaluate implementation., Analysis: We conducted descriptive analysis of employee survey data and performed qualitative analysis of implementation data. To assess intervention effect, we used a mixed-effects logistic regression model with a restaurant-specific random effect., Results: Vaccination levels increased from 26% to 46% (adjusted odds ratio 2.33, 95% confidence interval 1.69, 3.22), with 428 employees surveyed preintervention, 305 surveyed postintervention, and response rates of 73% and 55%, respectively. The intervention was effective across subgroups, but there were restaurant-level differences., Conclusion: An access-based workplace intervention can increase influenza vaccination levels in restaurant employees, but restaurant-level factors may influence success., (© 2016 by American Journal of Health Promotion, Inc.)

Background: Poor balance between work and family can be a major stressor for women with young children and have a negative impact on emotional well-being. Family-friendly workplace attributes may reduce stress and depressive symptoms among this population. However, few studies have analyzed the role of specific workplace attributes on mental health outcomes among women with young children because available data are limited., Purpose: This study examines the impact of workplace attributes on changes in depressive symptoms among working women with young children between 6 and 24 months of age., Method: This study uses data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) collected between 1991 and 1993 to examine the effects of work intensity, work schedule (night/day/variable), schedule flexibility, working from home, and work stress on changes in depressive symptoms among a national US sample of 570 women who returned to work within 6 months after childbirth. Depressive symptoms were assessed using the CES-D score. Treatment effects were estimated using fixed effects regression models., Results: Working from home and work stress predicted within-individual changes in depressive symptoms between 6 and 24 months postchildbirth. Women who worked from home reported a statistically significant decrease in depression scores over time (β = -1.36, SE = 0.51, p = 0.002). Women who reported a one-unit increase in job concerns experienced, on average, a 2-point increase in depression scores over time (β = 1.73, SE = 0.37, p < 0.01). Work intensity, work schedule, and schedule flexibility were not associated with changes in depressive symptoms., Conclusions: This study is one of the few to use longitudinal data and causal-inference techniques to examine whether specific workplace attributes influence depressive symptoms among women with young children. Reducing stress in the workplace and allowing women to work from home may improve mental health among women who transition back to work soon after childbirth.

Introduction: Restaurant workers are a large population at high risk for tobacco use, physical inactivity, and influenza. They are difficult to reach with health care interventions and may be more accessible through workplaces, yet few studies have explored the feasibility of workplace health promotion in this population. This study sought to identify barriers and facilitators to promotion of tobacco cessation, physical activity, and influenza vaccination in restaurants., Methods: Moderators conducted 7 focus groups, 3 with restaurant owners and managers, 2 with English-speaking workers, and 2 with Spanish-speaking workers. All groups were recorded, and recordings were transcribed and uploaded to qualitative-analysis software. Two researchers coded each transcript independently and analyzed codes and quotations for common themes., Results: Seventy people from the restaurant industry participated. Barriers to workplace health promotion included smoking-break customs, little interest in physical activity outside of work, and misinformation about influenza vaccinations. Facilitators included creating and enforcing equitable break policies and offering free, on-site influenza vaccinations. Spanish-speakers were particularly amenable to vaccination, despite their perceptions of low levels of management support for health promotion overall. Owners required a strong business case to consider investing in long-term prevention for their employees., Conclusion: Tobacco cessation and influenza vaccinations are opportunities for health promotion among restaurant workers, whereas physical activity interventions face greater challenges. Promotion of equitable breaks, limited smoking-break policies, and free, on-site influenza vaccinations could improve health for restaurant workers, who often do not have health insurance. Workplace interventions may be particularly important for Hispanic workers who have additional access barriers.

Purpose: Study goals were to (1) understand the attitudes of employees in low-wage industries toward workplace health promotion, including views on appropriateness of employer involvement in employee health and level of interest in workplace health promotion overall and in specific programs, and (2) determine the potential for extending workplace health promotion to spouses and partners of these employees., Approach: The study used 42 interviews of 60 to 90 minutes., Setting: Interviews were conducted with couples (married or living together) in the Seattle/King County metropolitan area of Washington State., Participants: Study participants were forty-two couples with one or more members working in one of five low-wage industries: accommodation/food services, education, health care/social assistance, manufacturing, and retail trade., Method: The study employed qualitative analysis of interview transcripts using grounded theory to identify themes., Results: Employees consider workplace health promotion both appropriate and desirable and believe it benefits employers through increased productivity and morale. Most have little personal experience with it and doubt their employers would prioritize employee health. Employees are most interested in efforts focused on nutrition and physical activity. Both employees and their partners support extending workplace health promotion to include partners., Conclusion: Employees and their partners are interested in workplace health promotion if it addresses behaviors they care about. Concern over employer involvement in their personal health decisions is minimal; instead, employees view employer interest in their health as a sign that they are valued.

Purpose: To examine the relationship between perceived workplace health support and employee productivity., Design: A quantitative cross-sectional study., Setting: Washington State agencies., Subjects: A total of 3528 employees from six state agencies were included in this analysis., Measures: Perceived workplace health support was assessed by two questions that queried respondents on how often they felt supported by the workplace for healthy living and physical activity. The Work Productivity and Activity Impairment Questionnaire was used to measure health-related absenteeism and presenteeism in the past 7 days., Analysis: Multivariate linear regression was used to estimate the mean differences in productivity by levels of perceived health support., Results: Most participants were between 45 and 64 years of age and were predominantly non-Hispanic white. Presenteeism varied significantly by the level of perceived workplace health support, with those who felt least supported having higher presenteeism than those who felt most supported. The difference in presenteeism by perceived workplace support remained significant in models adjusting for sociodemographic and health characteristics (mean difference: 7.1% for support for healthy living, 95% confidence interval: 3.7%, 10.4%; 4.3% for support for physical activity, 95% confidence interval: 1.7%, 6.8%). Absenteeism was not associated with perceived workplace health support., Conclusion: Higher perceived workplace health support is independently associated with higher work productivity. Employers may see productivity benefit from wellness programs through improved perceptions of workplace health support.

Objective: Small employers are underserved with workplace health promotion services, so we explored the potential for group purchasing of these services., Methods: We conducted semistructured telephone interviews of member organizations serving small employers, as well as workplace health promotion vendors, in Washington State., Results: We interviewed 22 employer organizations (chambers of commerce, trade associations, and an insurance trust) and vendors (of fitness facilities, healthy vending machines, fresh produce delivery, weight management services, and tobacco cessation quitlines). Both cautiously supported the idea of group purchasing but felt that small employers' workplace health promotion demand must increase first. Vendors providing off-site services, for example, quitline, found group purchasing more feasible than vendors providing on-site services, for example, produce delivery., Conclusions: Employer member organizations are well-positioned to group purchase workplace health promotion services; vendors are receptive if there is potential profit.

Most American workplaces are smaller, with fewer than 1,000 employees. Many of these employees are low-wage earners and at increased risk for chronic diseases. Owing to the challenges smaller workplaces face to offering health-promotion programs, their employees often lack access to health-promotion opportunities available at larger workplaces. Many smaller employers do not offer health insurance, which is currently the major funding vehicle for health-promotion services. They also have few health-promotion vendors to serve them and low internal capacity for, and commitment to, delivery of on-site programs. The programs they offer, whether aimed at health promotion alone or integrated with health protection, are rarely comprehensive and are understudied. Research priorities for health promotion in smaller workplaces include developing programs feasible for the smallest workplaces with fewer than 20 employees. Policy priorities include incentives for smaller workplaces to implement comprehensive programs and an ongoing system for monitoring and evaluation.

Introduction: Little research exists on the prevalence of evidence-based tobacco cessation practices in workplaces, employer promotion of state-sponsored quitlines and predictors of these practices., Methods: Cross-sectional analysis of the 2008 Healthy Worksite Survey, a telephone survey administered to Washington employers with 50 or more employees (n=693). The objectives were to describe workplaces' implementation of evidence-based tobacco cessation practices and identify key predictors of implementation in order to highlight opportunities for interventions., Results: Among these employers, 38.6% promoted quitting tobacco, and 33.8% offered insurance coverage for cessation medications and counselling, 27.5% referred no-smoking violators to cessation services, and 5.7% included the state-sponsored quitline in health promotion messages. Larger workplaces and workplaces with a wellness staff, committee or coordinator had greater insurance coverage for tobacco cessation, communications promoting tobacco cessation, and promotion of the state-sponsored quitline (p<0.01). Workplaces with a wellness staff, committee or coordinator referred more violators of no-smoking policies to cessation services (p<0.01)., Conclusions: In Washington State workplaces do little to promote tobacco cessation by their employees. The lack of tobacco cessation promoting practices at small businesses, restaurants and bars, and businesses without wellness personnel indicates an opportunity for finding and reaching current smokers at businesses with limited resources. By adopting inexpensive prevention efforts, such as promoting the state-sponsored tobacco cessation quitline, employers can help employees quit smoking and, thereby, assist in improving employee health and lower medical costs.

The workplace is a powerful setting to reach large numbers of at-risk adults with effective chronic disease prevention programs. Missed preventive care is a particular problem for workers with low income and no health insurance. The costs of chronic diseases among workers--including health care costs, productivity losses, and employee turnover--have prompted employers to seek health promotion interventions that are both effective and cost-effective. The workplace offers 4 avenues for delivering preventive interventions: health insurance, workplace policies, health promotion programs, and communications. For each of the avenues, the evidence base describes a number of preventive interventions that are applicable to the workplace. On the basis of the evidence and of our work in Washington State, we present a public health approach to preventing chronic diseases via the workplace. In addition to relying on the evidence, this approach makes a compelling business case for preventive interventions to employers.

Synopsis: Social determinants of health (SDOH), such as food security and healthcare access, are key to maintaining and improving health. Publicly funded safety-net programs, such as Medicaid and the Supplemental Nutrition Assistance Program, address SDOH. Many low-wage employees are program-eligible, but there are substantial participation gaps. Providing information and assistance boosts program participation, and there are third-party organizations ready to aid employers in doing so. In an ideal world, everyone with a job would have the resources to thrive on their pay and benefits, but many do not. Employers could help bridge these gaps via promoting these programs via the workplace. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has led to profound changes in the workplace as well as increases in stress, missed preventive care, and other health concerns. There is limited research since the onset of the pandemic on employees' primary health concerns and their willingness to engage with workplace health promotion (WHP) programs to address these needs. We conducted this survey about employees' current health priorities as a first step to exploring whether WHP programs need to evolve to be responsive to employees' needs at this stage of the pandemic. Design: National cross-sectional survey. Setting: United States, April 29-May 5, 2022. Subjects: 2053 Americans employed part or full time. Measures: 17-item online survey assessing demographics, health priorities, and impact of the pandemic on health. Analysis: Descriptive statistics, SPSS Version 19. Results: Employees' most common health concerns included work/life balance and stress (each cited by 55%). Nearly half (46%) said their health or well-being was affected by the pandemic; within this group, the most common concerns were stress (66%), anxiety (61%), sleep (49%), and depression (48%). Almost all (94%) indicated they would be open to receiving support from their employers. Conclusion: This research is a first step in learning about employees' current health priorities and how they may have changed. WHP researchers and practitioners can determine how their programs align with current priorities. Our future research will explore employees' preferences, heath behaviors, and their current workplace environments in more depth. [ABSTRACT FROM AUTHOR]

Purpose. To examine the prevalence of health behaviors, including clinical preventive services and lifestyle risk behaviors, among insured workers and to determine whether disparities in health behaviors based on demographic factors exist among this group. Design. Cross-sectional analysis of 2004-2005 Behavioral Risk Factor Surveillance System data. Setting. United States. Subjects. A representative sample of noninstitutionalized employed and insured adults aged 18 to 64 years (139,738 in 2004 and 159,755 in 2005). Measures. Self-reported clinical preventive services utilization and lifestyle-related behaviors, as well as multiple logistic regression analyses assessing the independent effects of demographic and access variables on health behaviors. Results. Among insured workers, rates of not using recommended clinical preventive services ranged from 8.5% (cervical cancer screening) to 73.9% (influenza vaccination). Rates for engaging in lifestyle-related risks ranged from 5.5% (heavy drinking) to 77.1% (inadequate fruit-vegetable consumption). In multivariate analyses, lower income, lower education, cost as a barrier to health care, and no health care provider were associated with significantly decreased clinical preventive services utilization (p < .01). Lower education and no health care provider were associated with lifestyle-related risks (p < .01). Conclusions. Working insured adults are not meeting recommendations for health behaviors. Significant disparities in health behaviors related to socioeconomic status exist among this group. Employers and insurers should consider these poor health behaviors and disparities when designing insurance benefits addressing clinical preventive services utilization and workplace health promotion programs addressing lifestyle-related behaviors. [ABSTRACT FROM AUTHOR]

Purpose. Study goals were to (1) describe stakeholder perceptions of workplace health promotion (WHP) appropriateness, (2) describe barriers and facilitators to implementing WHP, (3) learn the extent to which WHP programs are offered to workers' spouses and partners and assess attitudes toward including partners in WHP programs, and (4) describe willingness to collaborate with nonprofit agencies to offer WHP. Design. Five 1.5-hour focus groups. Setting. The focus groups were conducted with representatives of midsized (100-999 workers) workplaces in the Seattle metropolitan area, Washington state. Subjects. Thirty-four human resources professionals in charge of WHP programs and policies from five low-wage industries: accommodation/food services, manufacturing, health care/social assistance, education, and retail trade. Measures. A semistructured discussion guide. Analysis. Qualitative analysis of focus group transcripts using grounded theory to identify themes. Results. Most participants viewed WHP as appropriate, but many expressed reservations about intruding in workers' personal lives. Barriers to implementing WHP included cost, time, logistical challenges, and unsupportive culture. Participants saw value in extending WHP programs to workers' partners, but were unsure how to do so. Most were willing to work with nonprofit agencies to offer WHP. Conclusion. Midsized, low-wage employers face significant barriers to implementing WHP; to reach these employers and their workers, nonprofit agencies and WHP vendors need to offer WHP programs that are inexpensive, turnkey, and easy to adapt. [ABSTRACT FROM AUTHOR]