Barriers and facilitators to participation in workplace health promotion (WHP) activities: results from a cross-sectional survey of public-sector employees in Tasmania, Australia
Michelle Kilpatrick A , Leigh Blizzard A , Kristy Sanderson A , Brook Teale B , Kim Jose A and Alison Venn A C
+ Author Affiliations
- Author Affiliations
A Menzies Institute for Medical Research, University of Tasmania, Medical Science 1 Building, Private Bag 23, Hobart, Tas. 7000, Australia.
B Department of Premier and Cabinet, Tasmanian State Government, Hobart, Australia, GPO Box 123, Hobart, Tas. 7001, Australia.
C Corresponding author. Email: alison.venn@utas.edu.au
Health Promotion Journal of Australia 28(3) 225-232 https://doi.org/10.1071/HE16052
Submitted: 10 May 2016 Accepted: 11 November 2016 Published: 19 January 2017
Abstract
Issue addressed: Workplaces are promising settings for health promotion, yet employee participation in workplace health promotion (WHP) activities is often low or variable. This study explored facilitating factors and barriers associated with participation in WHP activities that formed part of a comprehensive WHP initiative run within the Tasmanian State Service (TSS) between 2009 and 2013.
Methods: TSS employee (n = 3228) completed surveys in 2013. Data included sociodemographic characteristics, employee-perceived availability of WHP activities, employee-reported participation in WHP activities, and facilitators and barriers to participation. Ordinal log-link regression was used in cross-sectional analyses.
Results: Significant associations were found for all facilitating factors and participation. Respondents who felt their organisation placed a high priority on WHP, who believed that management supported participation or that the activities could improve their health were more likely to participate. Time- and health-related barriers were associated with participation in fewer activities. All associations were independent of age, sex, work schedule and employee-perceived availability of programs. Part-time and shift-work patterns, and location of activities were additionally identified barriers.
Conclusion: Facilitating factors relating to implementation, peer and environmental support, were associated with participation in more types of activities, time- and health-related barriers were associated with less participation.
So what?: Large and diverse organisations should ensure WHP efforts have manager support and adopt flexible approaches to maximise employee engagement.
Key words: behaviour change, engagement, health behaviour, healthy environments.
References
[1] World Health Organization. Preventing chronic diseases: a vital investment. Geneva, Switzerland: World Health Organization; 2005.[2] Martin-Diener E, Meyer J, Braun J, Tarnutzer S, Faeh D, Rohrmann S, et al (2014) The combined effect on survival of four main behavioural risk factors for non-communicable diseases. Prev Med 65, 148–52.
| The combined effect on survival of four main behavioural risk factors for non-communicable diseases.Crossref | GoogleScholarGoogle Scholar |
[3] Mozaffarian D, Afshin A, Benowitz NL, Bittner V, Daniels SR, Franch HA, et al (2012) Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association. Circulation 126, 1514–63.
| Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association.Crossref | GoogleScholarGoogle Scholar |
[4] Pelletier KR (2011) A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the Worksite Update VIII 2008 to 2010. J Occup Environ Med 53, 1310–31.
| A review and analysis of the clinical and cost-effectiveness studies of comprehensive health promotion and disease management programs at the Worksite Update VIII 2008 to 2010.Crossref | GoogleScholarGoogle Scholar |
[5] Robroek SJ, van Lenthe F, van Empelen P, Burdorf A (2009) Determinants of participation in worksite health promotion programmes: a systematic review. Int J Behav Nutr Phys Act 6, 26
| Determinants of participation in worksite health promotion programmes: a systematic review.Crossref | GoogleScholarGoogle Scholar |
[6] Weiner BJ, Lewis MA, Linnan LA (2008) Using organization theory to understand the determinants of effective implementation of worksite health promotion programs. Health Educ Res 24, 292–305.
| Using organization theory to understand the determinants of effective implementation of worksite health promotion programs.Crossref | GoogleScholarGoogle Scholar |
[7] Persson R, Cleal B, Bihal T, Hansen SM, Jakobsen MØ, Villadsen E, et al (2013) Why do people with suboptimal health avoid health promotion at work? Am J Health Behav 37, 43–55.
| Why do people with suboptimal health avoid health promotion at work?Crossref | GoogleScholarGoogle Scholar |
[8] Rongen A, Robroek S, van Ginkel W, Lindeboom D, Altink B, Burdorf A (2014) Barriers and facilitators for participation in health promotion programs among employees: a six-month follow-up study. BMC Public Health 14, 573
| Barriers and facilitators for participation in health promotion programs among employees: a six-month follow-up study.Crossref | GoogleScholarGoogle Scholar |
[9] Crespo NC, Sallis JF, Conway TL, Saelens BE, Frank LD (2011) Worksite physical activity policies and environments in relation to employee physical activity. Am J Health Promot 25, 264–71.
| Worksite physical activity policies and environments in relation to employee physical activity.Crossref | GoogleScholarGoogle Scholar |
[10] Ferraro L, Faghri PD, Henning R, Cherniack M, Center for the Promotion of Health in the New England Workplace Team. (2013) Workplace-based participatory approach to weight loss for correctional employees. J Occup Environ Med 55, 147–55.
| Workplace-based participatory approach to weight loss for correctional employees.Crossref | GoogleScholarGoogle Scholar |
[11] Nielsen K (2013) Review article: how can we make organizational interventions work? Employees and line managers as actively crafting interventions. Hum Relat 66, 1029–50.
| Review article: how can we make organizational interventions work? Employees and line managers as actively crafting interventions.Crossref | GoogleScholarGoogle Scholar |
[12] Shain M, Kramer DM (2004) Health promotion in the workplace: framing the concept; reviewing the evidence. Occup Environ Med 61, 643–8.
| Health promotion in the workplace: framing the concept; reviewing the evidence.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2czgs1eksQ%3D%3D&md5=2f6d2ce6155e1699675edd60e364f2b9CAS |
[13] Nöhammer E, Schusterschitz C, Stummer H (2010) Determinants of employee participation in workplace health promotion. Int J Workplace Health Manag 3, 97–110.
| Determinants of employee participation in workplace health promotion.Crossref | GoogleScholarGoogle Scholar |
[14] Benach J, Muntaner C (2007) Precarious employment and health: developing a research agenda. J Epidemiol Community Health 61, 276–7.
| Precarious employment and health: developing a research agenda.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2s7ntl2isQ%3D%3D&md5=d9b3bb66244759c1b3923a453fe120baCAS |
[15] Global Corporate Challenge. Global challenge. 2016. Available from: https://globalchallenge.virginpulse.com/ [Verified 22 December 2016].
[16] Ware JE, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34, 220–33.
| A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity.Crossref | GoogleScholarGoogle Scholar |
[17] Bull F, Adams E, Hooper P. Well@Work: promoting active and healthy workplaces final evaluation report. 2008. Available from: http://www.bhfactive.org.uk/userfiles/Documents/WWEVALUATIONREPORT1.pdf [Verified 17 November 2016].
[18] Ezzati M, Riboli E (2013) Behavioral and dietary risk factors for noncommunicable diseases. N Engl J Med 369, 954–64.
| Behavioral and dietary risk factors for noncommunicable diseases.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhsVegsb3F&md5=46ef1013910a5fb77b1ce23ea48ec9ccCAS |
[19] Blizzard CL (2013) Log-link regression models for ordinal responses. Open J Stat 03, 16–25.
| Log-link regression models for ordinal responses.Crossref | GoogleScholarGoogle Scholar |
[20] Greenland S (1989) Modeling and variable selection in epidemiologic analysis. Am J Public Health 79, 340–9.
| Modeling and variable selection in epidemiologic analysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1M7jt12jsw%3D%3D&md5=b549172d5e2c9a775ab1e47737c6f192CAS |
[21] Kilpatrick M, Sanderson K, Blizzard L, Teale B, Venn A (2013) Cross-sectional associations between sitting at work and psychological distress: reducing sitting time may benefit mental health. Ment Health Phys Act 6, 103–9.
| Cross-sectional associations between sitting at work and psychological distress: reducing sitting time may benefit mental health.Crossref | GoogleScholarGoogle Scholar |
[22] Höfler M, Pfister H, Lieb R, Wittchen HU (2005) The use of weights to account for non-response and drop-out. Soc Psychiatry Psychiatr Epidemiol 40, 291–9.
| The use of weights to account for non-response and drop-out.Crossref | GoogleScholarGoogle Scholar |
[23] Creswell J, Plano C, Clark V. Designing and conducting mixed-methods research. 2nd edn. Los Angeles: Sage; 2011.
[24] Office of the State Service Commissioner. Annual report: 2012–2013. Hobart; 2013.
[25] Middlestadt SE, Sheats JL, Geshnizjani A, Sullivan MR, Arvin CS (2011) Factors associated with participation in work-site wellness programs: implications for increasing willingness among rural service employees. Health Educ Behav 38, 502–9.
| Factors associated with participation in work-site wellness programs: implications for increasing willingness among rural service employees.Crossref | GoogleScholarGoogle Scholar |
[26] Kent K, Goetzel RZ, Roemer EC, Prasad A, Freundlich N (2016) Promoting healthy workplaces by building cultures of health and applying strategic communications. J Occup Environ Med 58, 114–22.
| Promoting healthy workplaces by building cultures of health and applying strategic communications.Crossref | GoogleScholarGoogle Scholar |
[27] Bale JM, Gazmararian JA, Elon L (2015) Effect of the work environment on using time at work to exercise. Am J Health Promot 29, 345–52.
| Effect of the work environment on using time at work to exercise.Crossref | GoogleScholarGoogle Scholar |
[28] Rongen A, Robroek SJW, van Ginkel W, Lindeboom D, Pet M, Burdorf A (2014) How needs and preferences of employees influence participation in health promotion programs: a six-month follow-up study. BMC Public Health 14, 1277
| How needs and preferences of employees influence participation in health promotion programs: a six-month follow-up study.Crossref | GoogleScholarGoogle Scholar |
[29] Hasson H, Villaume K, Schwarz UV, Palm K (2014) Managing implementation roles of line managers, senior managers, and human resource professionals in an occupational health intervention. J Occup Environ Med 56, 58–65.
| Managing implementation roles of line managers, senior managers, and human resource professionals in an occupational health intervention.Crossref | GoogleScholarGoogle Scholar |
[30] Coyle-Shapiro J (1999) Employee participation and assessment of an organizational change intervention: a three-wave study of total quality management. J Appl Behav Sci 35, 439–56.
| Employee participation and assessment of an organizational change intervention: a three-wave study of total quality management.Crossref | GoogleScholarGoogle Scholar |
[31] Fletcher GM, Behrens TK, Domina L (2008) Barriers and enabling factors for work-site physical activity programs: a qualitative examination. J Phys Act Health 5, 418–29.
| Barriers and enabling factors for work-site physical activity programs: a qualitative examination.Crossref | GoogleScholarGoogle Scholar |
[32] Marqueze EC, Ulhoa MA, Moreno CRC (2014) Leisure-time physical activity does not fully explain the higher body mass index in irregular-shift workers. Int Arch Occup Environ Health 87, 229–39.
| Leisure-time physical activity does not fully explain the higher body mass index in irregular-shift workers.Crossref | GoogleScholarGoogle Scholar |
[33] Thomas C, Power C (2010) Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort. Eur J Epidemiol 25, 305–14.
| Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort.Crossref | GoogleScholarGoogle Scholar |
[34] Macniven R, Engelen L, Kacen MJ, Bauman A (2015) Does a corporate worksite physical activity program reach those who are inactive? Findings from an evaluation of the Global Corporate Challenge. Health Promot J Austr 26, 142–5.
| Does a corporate worksite physical activity program reach those who are inactive? Findings from an evaluation of the Global Corporate Challenge.Crossref | GoogleScholarGoogle Scholar |
[35] Aneni EC, Roberson LL, Maziak W, Agatston AS, Feldman T, Rouseff M, et al (2014) A systematic review of internet-based worksite wellness approaches for cardiovascular disease risk management: outcomes, challenges & opportunities. PLoS One 9, e83594
| A systematic review of internet-based worksite wellness approaches for cardiovascular disease risk management: outcomes, challenges & opportunities.Crossref | GoogleScholarGoogle Scholar |
[36] O’Hara BJ, Phongsavan P, Eakin EG, Develin E, Smith J, Greenaway M, et al (2013) Effectiveness of Australia’s Get Healthy Information and Coaching Service (R): maintenance of self-reported anthropometric and behavioural changes after program completion. BMC Public Health 13, 175.1–175.14.
| Effectiveness of Australia’s Get Healthy Information and Coaching Service (R): maintenance of self-reported anthropometric and behavioural changes after program completion.Crossref | GoogleScholarGoogle Scholar |
[37] Morgan PJ, Collins CE, Plotnikoff RC, Cook AT, Berthon B, Mitchell S, et al (2011) Efficacy of a workplace-based weight loss program for overweight male shift workers: The Workplace POWER (Preventing Obesity Without Eating like a Rabbit) randomized controlled trial. Prev Med 52, 317–25.
| Efficacy of a workplace-based weight loss program for overweight male shift workers: The Workplace POWER (Preventing Obesity Without Eating like a Rabbit) randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |
[38] Anseel F, Lievens F, Schollaert E, Choragwicka B (2010) Response rates in organizational science, 1995–2008: a meta-analytic review and guidelines for survey researchers. J Bus Psychol 25, 335–49.
| Response rates in organizational science, 1995–2008: a meta-analytic review and guidelines for survey researchers.Crossref | GoogleScholarGoogle Scholar |
[39] Wang PS, Beck AL, McKenas DK, Meneades LM, Pronk NP, Saylor JS, et al (2002) Effects of efforts to increase response rates on a workplace chronic condition screening survey. Med Care 40, 752–60.
| Effects of efforts to increase response rates on a workplace chronic condition screening survey.Crossref | GoogleScholarGoogle Scholar |
[40] Delgado-Rodríguez M, Llorca J (2004) Bias. J Epidemiol Community Health 58, 635–41.
| Bias.Crossref | GoogleScholarGoogle Scholar |