lunes, 8 de junio de 2015

Enhancing Workplace Wellness Efforts to Reduce Obesity: A Qualitative Study of Low-Wage Workers in St Louis, Missouri, 2013-2014

FULL-TEXT ►

Enhancing Workplace Wellness Efforts to Reduce Obesity: A Qualitative Study of Low-Wage Workers in St Louis, Missouri, 2013-2014



CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.



PCD logo







Enhancing Workplace Wellness Efforts to Reduce Obesity: A Qualitative Study of Low-Wage Workers in St Louis, Missouri, 2013-2014

Jaime R. Strickland, MA; Amy A. Eyler, PhD; Jason Q. Purnell, PhD; Anna M. Kinghorn, MS; Cynthia Herrick, MD; Bradley A. Evanoff, MD, MPH

Suggested citation for this article: Strickland JR, Eyler AA, Purnell JQ, Kinghorn AM, Herrick C, Evanoff BA. Enhancing Workplace Wellness Efforts to Reduce Obesity: A Qualitative Study of Low-Wage Workers in St Louis, Missouri, 2013–2014. Prev Chronic Dis 2015;12:140405. DOI: http://dx.doi.org/10.5888/pcd12.140405.
PEER REVIEWED

Abstract

Introduction
The objective of this study was to examine workplace determinants of obesity and participation in employer-sponsored wellness programs among low-wage workers.
Methods
We conducted key informant interviews and focus groups with 2 partner organizations: a health care employer and a union representing retail workers. Interviews and focus groups discussed worksite factors that support or constrain healthy eating and physical activity and barriers that reduce participation in workplace wellness programs. Focus group discussions were transcribed and coded to identify main themes related to healthy eating, physical activity, and workplace factors that affect health.
Results
Although the union informants recognized the need for workplace wellness programs, very few programs were offered because informants did not know how to reach their widespread and diverse membership. Informants from the health care organization described various programs available to employees but noted several barriers to effective implementation. Workers discussed how their job characteristics contributed to their weight; irregular schedules, shift work, short breaks, physical job demands, and food options at work were among the most commonly discussed contributors to poor eating and exercise behaviors. Workers also described several general factors such as motivation, time, money, and conflicting responsibilities.
Conclusion
The workplace offers unique opportunities for obesity interventions that go beyond traditional approaches. Our results suggest that modifying the physical and social work environment by using participatory or integrated health and safety approaches may improve eating and physical activity behaviors. However, more research is needed about the methods best suited to the needs of low-wage workers.

Acknowledgments

This study was supported by NIH/NIDDK P30DK092950, Washington University Center for Diabetes Translation Research (WU-CDTR), and by the Washington University Institute of Clinical and Translational Sciences Award, UL1 TR000448, from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the WU-CDTR, National Institute of Diabetes and Digestive and Kidney Diseases, NCATS, or NIH. We acknowledge the support of the Washington University Institute for Public Health for cosponsoring, with theWU-CDTR , the Next Steps in Public Health event that led to the development of this article.
 Top

Author Information

Corresponding Author: Jaime R. Strickland, MA, Division of General Medical Sciences, Washington University School of Medicine, 660 S Euclid Ave, Box 8005, St. Louis, MO 63110. Telephone: 314-454-7337. Email: jstrickl@dom.wustl.edu.
Author affiliations: Amy A. Eyler, Jason Q. Purnell, George Warren Brown School of Social Work, Washington University, St. Louis, Missouri; Anna M. Kinghorn, Cynthia Herrick, Brad A. Evanoff, Washington University School of Medicine, St. Louis, Missouri.
 Top

References

  1. Ogden CL, Lamb MM, Carroll MD, Flegal KM. Obesity and socioeconomic status in adults: United States, 2005–2008. NCHS Data Brief 2010;(51):1–8. PubMed
  2. Luckhaupt SE, Cohen MA, Li J, Calvert GM. Prevalence of obesity among US workers and associations with occupational factors. Am J Prev Med 2014;46(3):237–48. CrossRef PubMed
  3. Bonauto DK, Lu D, Fan ZJ. Obesity prevalence by occupation in Washington State, Behavioral Risk Factor Surveillance System. Prev Chronic Dis 2014;11:E04. CrossRef PubMed
  4. Eyler AA, Brownson RC, Schmid TL. Making strides toward active living: the policy research perspective. J Public Health Manag Pract 2013;19(3 Suppl 1):S5–7. CrossRef PubMed
  5. Lovasi GS, Hutson MA, Guerra M, Neckerman KM. Built environments and obesity in disadvantaged populations. Epidemiol Rev 2009;31(1):7–20. CrossRef PubMed
  6. Heinen L, Darling H. Addressing obesity in the workplace: the role of employers. Milbank Q 2009;87(1):101–22. CrossRef PubMed
  7. Solovieva S, Lallukka T, Virtanen M, Viikari-Juntura E. Psychosocial factors at work, long work hours, and obesity: a systematic review. Scand J Work Environ Health 2013;39(3):241–58.CrossRef PubMed
  8. Champagne N, Abreu M, Nobrega S, Goldstein-Gelb M, Montano M, Lopez I, et al. Study report: obesity/overweight and the role of working conditions: a qualitative, participatory investigation. Lowell (MA): Center for the Promotion of Health in the New England Workplace; 2012. p. 25.
  9. US Department of Labor. Fact sheet: the Affordable Care Act and Wellness Programs; 2014 http://www.dol.gov/ebsa/newsroom/fswellnessprogram.html. Accessed December 18, 2014.
  10. Special Committee on Health Productivity and Disability Management, American College of Occupational and Environmental Medicine. Healthy workforce/healthy economy: the role of health, productivity, and disability management in addressing the nation’s health care crisis: why an emphasis on the health of the workforce is vital to the health of the economy. J Occup Environ Med 2009;51(1):114–9. CrossRef PubMed
  11. NIOSH. Research Compendium: The NIOSH Total Worker Health Program: seminal research papers 2012. Washington (DC): US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. DHHS (NIOSH) Publication No. 2012-146.
  12. Goetzel RZ, Henke RM, Tabrizi M, Pelletier KR, Loeppke R, Ballard DW, et al. Do workplace health promotion (wellness) programs work? J Occup Environ Med 2014;56(9):927–34. CrossRefPubMed
  13. Rongen A, Robroek SJ, van Lenthe FJ, Burdorf A. Workplace health promotion: a meta-analysis of effectiveness. Am J Prev Med 2013;44(4):406–15. CrossRef PubMed
  14. Grosch JW, Alterman T, Petersen MR, Murphy LR. Worksite health promotion programs in the US: factors associated with availability and participation. Am J Health Promot 1998;13(1):36–45. CrossRef PubMed
  15. Padgett D. Qualitative methods in social work research. 2nd ed. Thousand Oaks (CA): Sage; 2008.
  16. Kahn-Marshall JL, Gallant MP. Making healthy behaviors the easy choice for employees: a review of the literature on environmental and policy changes in worksite health promotion. Health Educ Behav 2012;39(6):752–76. CrossRef PubMed
  17. Brownson RC, Haire-Joshu D, Luke DA. Shaping the context of health: a review of environmental and policy approaches in the prevention of chronic diseases. Annu Rev Public Health 2006;27(1):341–70. CrossRef PubMed
  18. Saarloos D, Kim J-E, Timmermans H. The built environment and health: introducing individual space–time behavior. Int J Environ Res Public Health 2009;6(6):1724–43. CrossRef PubMed
  19. Gorman E, Ashe MC, Dunstan DW, Hanson HM, Madden K, Winkler EAH, et al. Does an “activity-permissive” workplace change office workers’ sitting and activity time? PLoS ONE 2013;8(10) e76723. CrossRef PubMed
  20. Ball K, Jeffery RW, Abbott G, McNaughton SA, Crawford D. Is healthy behavior contagious: associations of social norms with physical activity and healthy eating. Int J Behav Nutr Phys Act 2010;7:86. PubMed
  21. McEachan RRC, Lawton RJ, Jackson C, Conner M, Meads DM, West RM. Testing a workplace physical activity intervention: a cluster randomized controlled trial. Int J Behav Nutr Phys Act 2011;8:29. PubMed
  22. Punnett L, Warren N, Henning R, Nobrega S, Cherniack M; CPH-NEW Research Team. Participatory ergonomics as a model for integrated programs to prevent chronic disease. J Occup Environ Med 2013;55(12, Suppl):S19–24. CrossRef PubMed
  23. Henning R, Warren N, Roberston M, Faghri P, Cherniack M. CPH-NEW Research Team. Workplace health protection and promotion through participatory ergonomics: an integrated approach. Public Health Rep 2009;124(Suppl 1):26–35. PubMed
  24. Ferraro L, Faghri PD, Henning R, Cherniack M; Center for the Promotion of Health in the New England Workplace Team. Workplace-based participatory approach to weight loss for correctional employees. J Occup Environ Med 2013;55(2):147–55. CrossRef PubMed
  25. Appel LJ, Clark JM, Yeh HC, Wang NY, Coughlin JW, Daumit G, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med 2011;365(21):1959–68.CrossRef PubMed
  26. Volpp KG, Asch DA, Galvin R, Loewenstein G. Redesigning employee health incentives — lessons from behavioral economics. N Engl J Med 2011;365(5):388–90. CrossRef PubMed
  27. Purnell JQ, Gernes R, Stein R, Sherraden MS, Knoblock-Hahn A. A systematic review of financial incentives for dietary behavior change. J Acad Nutr Diet 2014;114(7):1023–35.
  28. Cawley J, Price J. Outcomes in a program that offers financial rewards for weight loss. NBER working paper series; 2009. p. 169–233.
  29. Pronk NP. Integrated worker health protection and promotion programs: overview and perspectives on health and economic outcomes. J Occup Environ Med 2013;55(12, Suppl):S30–7.CrossRef PubMed

No hay comentarios: