Suchergebnisse

Purpose. To explore similar patterns of fruit and vegetable consumption between health center employees and their spouses. Design. Cross-sectional mailed survey assessing frequency of fruit and vegetable consumption, as well as demographics and knowledge, attitudes, access, and social support related to fruit and vegetable consumption. Setting. Six Massachusetts health centers. Subjects. Two hundred eleven health center employee/spouse pairs (422 individuals). Measures. The kappa statistic measured agreement in fruit and vegetable consumption between employees and spouses. The Spearman rho coefficient measured correlations for individual responses. Multiple Linear Regression Models examined variables that explained fruit and vegetable consumption level differences. Results. Response rate was 59%. Mean fruit and vegetable daily intake was 4.68 and 4.30 servings for employees and spouses, respectively. Over 75% of employee and spouse estimates measuring fruit and vegetable consumption-related information, on average, were within one survey response category of each other. Knowledge, attitudes, and access indices were significantly correlated with fruit and vegetable consumption for both employees and spouses. The social support index was significantly correlated with fruit and vegetable consumption only for the spouses. Differences in knowledge, attitudes, and access indices between employees and spouses helped to explain different fruit and vegetable consumption levels. Nonresponse, selection, recall, and seasonal reporting biases may limit the findings' generalizability. Conclusions. The effectiveness of worksite nutrition interventions may be improved by involving family/household members.

Purpose. To summarize and provide a critical review of worksite health promotion program evaluations published between 1980 and 1995 that address nutrition and hypercholesterolemia. The article discusses and critiques both intervention methods and research methodologies to identify the most effective strategies. Methods. Core articles are 26 original, data-based studies that report on measures of health status, behavior, attitudes, and knowledge as outcomes of worksite nutrition and cholesterol interventions. Only work published since 1980 that clearly describes nutrition or cholesterol interventions and that includes identifiable nutrition-related outcomes is reviewed. The main search method was the same one used for this special issue; supplementary sources included those found in earlier reviews or identified through backward searches or expert contact. Summary of Important Findings. Ten worksite nutrition education programs were reviewed and were categorized as group education, group education plus individual counseling/instruction, cafeteria-based programs, and group education plus cafeteria-based programs. Four of these were randomized studies, and one used the worksite as the unit of randomization and analysis. Sixteen worksite cholesterol programs were reviewed, in five categories: monitoring; individual counseling; group sessions or classes; mediated methods using print, audiovisual, telephone, and self-help kits; and combination approaches. Of these, eight were randomized controlled trials; most tested interventions for persons with elevated cholesterol levels, although four studies reported cholesterol education programs for the general employee population. Six large controlled trials of worksite nutrition and cholesterol interventions in progress are also described. Major Conclusions. The conclusions that can be drawn from this review are limited by the study designs used, which often lacked control groups, used nonrandomized designs, or relied on self-selected high-risk or volunteer participants. Our rating for the quality of the evidence in the literature as a whole lies between suggestive and indicative. It is clear that worksite nutrition and cholesterol programs are feasible and that participants benefit in the short-term. Conclusive evidence about a causal relationship between worksite nutrition and cholesterol programs and improved behavior or health is not yet available, although studies currently underway hold promise for providing more solid evidence about the potential efficacy of these interventions.

Purpose. Little is known about compliance with worksite nonsmoking policies. This study provides an examination of the relationship of policy compliance to characteristics of the organization and the manner in which the policy was implemented Design. Data came from two separate surveys of 1) representatives of worksites that reported having a nonsmoking policy and 2) employed residents from the same communities whose worksites had nonsmoking policies. Setting. This study was conducted as part of the Community Intervention Trial for Smoking Cessation (COMMIT), being conducted in 11 diverse intervention communities. Subjects. Data are presented from surveys of 710 worksites (response rate =90%) and 3,143 employed residents (response rate = 80%) of the same communities. Measures. Compliance with nonsmoking policies was measured by self-report in both surveys and is compared with worksite and respondent characteristics, type of policy, and methods of policy implementation. Results. Compliance with nonsmoking policies was high; 55% of worksites with a policy restricting smoking reported that employees always adhered to the policy. Compliance was highest in worksites with more restrictive policies and where labor-management relations were reported to be good. Compliance also was high where the policy was effectively communicated to workers, as through worksite distribution channels, the absence of cigarette vending machines, and the availability cessation assistance. Conclusions. These findings indicate that compliance with worksite nonsmoking policies is generally high, especially in the presence of more stringent policies.

Purpose. To examine worker characteristics explicated in our social-contextual intervention model that might be associated with participation in a cancer prevention intervention. These characteristics included sociodemographic variables, mediating mechanisms, and modifying conditions. Methods. Randomized, controlled study in 24 small multiethnic manufacturing worksites. Analyses were conducted on an embedded cohort of 456 employees in the intervention condition, incorporating the clustering of respondents in worksites using generalized linear mixed modeling methods. The intervention was based on an inclusive, comprehensive social-contextual model targeting fruit, vegetable, and red meat consumption, multivitamin use, and physical activity. Results. Gender (p = .02) and self-efficacy (p < .01) were associated with participation. There were no differences in participation by race/ethnicity or occupational status. We observed no associations between participation of individual workers in intervention activities and health behavior change. Conclusions. The intervention attracted workers across racial/ethnic and occupational groups. The combination of a comprehensive intervention with wide diffusion of program messages may have been more powerful in influencing participation and behavior change than characteristics of individual employees.

Purpose. To examine occupational differences in social influences supporting quitting smoking and their relationships to intentions and self-efficacy to quit smoking and to quitting. Design. Data were collected as part of a large worksite cancer prevention intervention trial. Setting. Forty-four worksites. Subjects. Subjects included 2626 smokers from a total baseline survey sample of 11,456 employees (response rate = 63%). Measures. Differences by job category in social support for quitting, pressure to quit smoking, rewards for quitting, and nonacceptability of smoking were measured using mixed model analysis of variance and the Cochran–Mantel–Haenszel test. Their association to self-efficacy, intention to quit, and quitting smoking was assessed using mixed model analysis of variance and linear logistic regression modeling. Results. Compared with other workers, blue-collar workers reported less pressure to quit ( p = .0001), social support for quitting ( p = .0001), and nonacceptability of smoking among their coworkers ( p < .001). Intention to quit was associated with higher levels of social pressure to quit smoking ( p = .0001) and social support for quitting ( p = .002). Self-efficacy was associated with social pressure to quit ( p = .0001), social support for quitting ( p = .004), and perceiving greater rewards for quitting ( p = .0001). Conclusions. Although these results are limited somewhat by response and attrition rates, these results suggest that differing social environments may contribute to the differences by occupational category in smoking prevalence and smoking cessation.

Purpose. To examine the relationships between worksite interpersonal influences and smoking and quitting behavior among adolescent workers. Design. The cross-sectional survey assessed factors influencing tobacco use behavior. Setting. During the fall of 1998, data were collected from 10 grocery stores in Massachusetts that were owned and managed by the same company. Subjects. Eligible participants included 474 working adolescents ages 15 to 18. Eighty-three percent of workers (n = 379) completed the survey. Measures. The self-report questionnaire assessed social influences, social norms, social support, friendship networks, stage of smoking and quitting behavior, employment patterns, and demographic factors. Results. Thirty-five percent of respondents were never smokers, 21% experimental, 5% occasional, 18% regular, and 23% former smokers. Using analysis of variance (ANOVA), results indicate that regular smokers were 30% more likely than experimental or occasional smokers to report coworker encouragement to quit (p = .0002). Compared with regular smokers, never smokers were 15% more likely to report greater nonacceptability of smoking (p = .01). χ2 tests of association revealed no differences in friendship networks by stage of smoking. Conclusions. These data provide evidence for the need to further explore social factors inside and outside the work environment that influence smoking and quitting behavior among working teens. Interpretations of the data are limited because of cross-sectional and self-report data collection methods used in one segment of the retail sector.

The National Institute for Occupational Safety and Health (NIOSH) WorkLife Initiative (WLI) [http://www.cdc.gov/niosh/worklife] seeks to promote workplace programs, policies, and practices that result in healthier, more productive employees through a focus simultaneously on disease prevention, health promotion, and accommodations to age, family, and life stage. The Initiative incorporates the Institute's foundational commitment to workplaces free of recognized hazards into broader consideration of the factors that affect worker health and wellbeing. Workplace hazards, such as physical demands, chemical exposures, and work organization, often interact with non-work factors such as family demands and health behaviors to increase health and safety risks. New workplace interventions being tested by the first three NIOSH WLI Centers of WorkLife Excellence are exploring innovative models for employee health programs to reduce the human, social, and economic costs of compromised health and quality of life. Many parties in industry, labor, and government share the goals of improving employee health while controlling health care costs. NIOSH convened a workshop in 2008 with representatives of the three Centers of Excellence to develop a comprehensive, long-range strategy for advancing the WorkLife Initiative. The recommendations below fall into three areas: practice, research, and policy. Responding to these recommendations would permit the WorkLife Center system to establish a new infrastructure for workplace prevention programs by compiling and disseminating the innovative practices being developed and tested at the Centers, and elsewhere. The WLI would also extend the customary scope of NIOSH by engaging with multiple NIH Institutes that are already generating research-to-practice programs involving the working-age population, in areas such as chronic disease prevention and management. Research to Practice (r2p) is a concept focused on the translation of research findings, technologies, and information into ...

Purpose. Spillover is the effect of one role on another as working adults attempt to integrate demands from work and family. We conducted a survey to understand how worker, job, and family characteristics were related to negative work-to-family spillover and how spillover was related to fruit and vegetable consumption to inform intervention design. Design. A combined mail and telephone survey. Setting. A national random sample in the United States. Subjects. 1108 (44% response) unionized construction laborers. Measures. Personal characteristics, job factors, family factors, work-to-family spillover, and fruit and vegetable consumption. Analysis. Multivariable logistic and least-squares regression. Results. A range of 20% to 50% of respondents reported negative work-to-family spillover, agreeing that work demands, time, fatigue, and stress interfered with family meals or food choices. Higher spillover was associated with job factors, being of white race/ethnicity, and having children at home. Lower fruit and vegetable consumption was associated with higher work-to-family spillover (p = .002), being of white race or ethnicity (p < .0001), and working the graveyard or day shift (p = .02). Conclusion. Negative experience of work-to-family spillover may link employment to fruit and vegetable consumption and thus to worker health. Understanding the contribution of spillover to fruit and vegetable consumption aids understanding of how work experience affects health.

Purpose. To report findings from Treatwell 5-a-Day process tracking. Design. Worksites were randomly assigned to a minimal intervention control, worksite-only condition, or worksite-plus-family condition. Setting. Twenty-two small community health centers in Massachusetts. Subjects. Employees of the community health centers. Intervention. Both intervention conditions included the formation of employee advisory boards; activities such as nutrition discussions and taste tests targeting individual behavior change; and point-of-purchase labeling as an environmental strategy. Worksite-plus-family sites incorporated activities such as family contests, campaigns, and picnics. Measures. Documentation of the number and type of activities for extent of implementation; number of participants in activities for reach; program awareness and participation from the follow-up employee survey (n = 1306, representing 76% [range, 56%–100%] of the sample); change in fruit and vegetable consumption from a comparison between the follow-up and baseline surveys (n = 1359, representing 87% [range, 75%–100%] of the sample). Results. A higher number of activities per employee was significantly correlated with greater program awareness (. 68; p = . 006) and greater change in fruit and vegetable consumption (.55; p = .04). Greater participation in activities was significantly correlated with greater awareness (.67; p = .007), higher participation (.61; p = .02), and increase in fruit and vegetable consumption. (.55; p = .04). Conclusions. These results provide quantitative indicators of a dose-response relationship between the number of intervention activities per employee and higher percentage of employee participation and observed increases in fruit and vegetable consumption.

Purpose. The purpose of this article is to describe the "employee advisory board model" applied in the Treatwell program, a worksite nutrition intervention program. Design. The employee advisory boards of five of the seven intervention worksites participating in the Treatwell program were surveyed. Results were compared with results of employee surveys conducted in these five worksites. Setting. The five worksites included in this study are among 16 participating worksites from Massachusetts and Rhode Island. Subjects. Of the 95 board members represented in the five worksites, 88% responded to the survey. This article also presents results from the 698 respondents of the five intervention worksites where the board surveys were conducted. Intervention. The boards in each worksite participated in planning, promoting, and implementing this program in each worksite. Measures. Respondents to the board survey were asked about their participation on and satisfaction with the board and factors they thought contributed to its effectiveness. A survey of all employees included information on demographics and program participation. Results. Board members reported that they were highly satisfied with the board's functioning. Board member hours spent on Treatwell activities were directly related to the proportion of employees aware of the program. (r = .82). The boards' effectiveness was limited by conflicting priorities between the job and board responsibilities. Conclusion. The employee advisory board model povides promise for increasing worker awareness of worksite health promotion programs through enhanced worker ownership.