Abigail S. Katz

Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project, 2011

Background Prolonged sitting time is a health risk. We describe a practice-based study designed to reduce prolonged sitting time and improve selected health factors among workers with sedentary jobs. Community Context We conducted our study during March–May 2011 in Minneapolis, Minnesota, among employees with sedentary jobs. Methods Project implementation occurred over 7 weeks with a baseline period of 1 week (period 1), an intervention period of 4 weeks (period 2), and a postintervention period of 2 weeks (period 3). The intervention group (n = 24) received a sit-stand device during period 2 designed to fit their workstation, and the comparison group (n = 10) did not. We used experience-sampling methods to monitor sitting behavior at work during the 7 weeks of the project. We estimated change scores in sitting time, health risk factors, mood states, and several office behaviors on the basis of survey responses. Outcome The Take-a-Stand Project reduced time spent sitting by 224% (66 minutes per day), reduced upper back and neck pain by 54%, and improved mood states. Furthermore, the removal of the device largely negated all observed improvements within 2 weeks. Interpretation Our findings suggest that using a sit-stand device at work can reduce sitting time and generate other health benefits for workers.

Adherence to optimal lifestyle behaviors is related to emotional health indicators among employees.

Simultaneous adherence to abstinence from smoking, adequate physical activity, eating 5 servings of fruits and vegetables each day, and consuming limited or no amount of alcohol has been associated with a variety of health outcomes, but not emotional health. The purpose of this investigation was to study the association between optimal lifestyle behaviors and self-reported emotional health indicators among employed adults. Emotional health indicators studied were feeling depressed, stress risk, and the impact of emotional health on daily life among employees (N = 34,603). Binary logistic regression models were used to predict likelihood of feeling depressed and risk of stress based on degree of adherence to optimal lifestyle. Multinomial logistic regression models were used to assess the association between adherence to optimal lifestyle and likelihood of emotional quality of life among employees. Analyses were adjusted for age, sex, socioeconomic status (using the area deprivation index), sleep, self-perceived health status, self-efficacy, and chronic conditions including depression. All data were self-reported except for the area deprivation index. Adherence to any 3 or 4 components of the optimal lifestyle was associated with all 3 emotional health issues studied: Lower odds of feeling depressed, reporting stress risk, and emotional health affecting daily life. Adherence to any 2 components of the optimal lifestyle metric was associated with lower odds of feeling depressed and emotional health affecting daily life. All 4 individual lifestyle behaviors had significant associations with at least 2 of the 3 emotional health outcomes studied. Adherence to optimal lifestyle is associated with significantly more positive emotional health states as measured by feeling depressed, risk for high stress, and impact of emotional health on daily life. While causality cannot be inferred, the strength of the associations warrants trials to determine the extent to which adopting positive lifestyles can result in improved mental health.

The association between optimal lifestyle-related health behaviors and employee productivity.

Objective: To investigate the association between lifestyle-related health behaviors including sleep and the cluster of physical activity, no tobacco use, fruits and vegetables intake, and alcohol consumption termed the “Optimal Lifestyle Metric” (OLM), and employee productivity. Methods: Data were obtained from employee health assessments (N = 18,079). Regression techniques were used to study the association between OLM and employee productivity, sleep and employee productivity, and the interaction of both OLM and sleep on employee productivity. Results: Employees who slept less or more than 7 or 8 hours per night experienced significantly more productivity loss. Employees who adhered to all four OLM behaviors simultaneously experienced less productivity loss compared with those who did not. Conclusions: Adequate sleep and adherence to the OLM cluster of behaviors are associated with significantly less productivity loss.

The Relationship Between Physical Activity and Care-Seeking Behavior Among Employed Adults

BACKGROUND Physical activity is regarded an important health behavior. Routine doctor visits, dentist visits, and willingness to seek phone advice from a nurse are considered important care-seeking behaviors (ie, behaviors that reflect the way in which people seek and access health care delivery resources available to them). Employers promote physical activity as well as care-seeking behavior to protect and promote health, optimize productivity, and manage health care costs. The purpose of this study was to investigate the association between physical activity and 3 care-seeking behaviors among a sample of 5500 employed adults. METHODS Data were obtained from employee health assessments. Logistic regression was used to test the relationship between physical activity and care-seeking behavior. RESULTS Physical activity was positively associated with all 3 measures of care-seeking behavior: doctor visits (P < .001), dentist visits (P < .001), and willingness to seek phone advice from a nurse (P < .05). For individuals reporting chronic conditions, physical activity was negatively associated with doctor visits for the condition (P < .05) and positively associated with self-perceived health (P < .001). CONCLUSIONS Physical activity is associated with important care-seeking behaviors for employees with and without chronic conditions.

The effect of price reduction on salad bar purchases at a corporate cafeteria.

The objective of this study was to determine the effect of a price reduction on salad bar purchases in a corporate cafeteria. We reduced the price of salad bar purchases by 50% during March 2012 and analyzed sales data by month for February through June 2012. We also conducted an anonymous survey. Salad bar sales by weight more than tripled during the price reduction and returned to baseline afterward. Survey respondents reported that the high price of salad relative to other choices is a barrier to purchases. Policies that make the price of salads equal to other choices in cafeterias may significantly increase healthful food consumption.

Piquing their “Pinterest”: A qualitative study to format and deliver complex fish consumption guidelines to women who are or could become pregnant

Abstract The topic of safe fish consumption among women is complex both in its audience (women who are or could become pregnant) and its message (it is important to eat fish for its many nutritional benefits but because mercury levels vary by species, it is important to make informed choices about which species to eat). These complexities have led to confusion and fish avoidance in this population. Ideal messages about fish consumption have been suggested in the literature, but a more nuanced approach to message delivery that addresses subtleties, such as style and format of information, is needed for women to optimally use the materials. To explore how to package and deliver messages that describe and promote safe fish consumption, we conducted focus groups among women in our target population. Findings were used to design a visually appealing brochure and interactive, mobile-responsive website with recipes and a format that echoes and links to Pinterest. By delivering complex messages using a mode (easily accessible), style (photo-centric) and format (interactive, with recipes similar to Pinterest) desired by women, we have created an opportunity for repeated exposure to appealing fish images and recipes. Ideally, such exposure also piques curiosity and encourages women to seek out more complex fish information and consume safe fish during pregnancy.

Concordance Between Life Satisfaction and Six Elements of Well-Being Among Respondents to a Health Assessment Survey, HealthPartners Employees, Minnesota, 2011

Introduction We assessed and tracked perceptions of well-being among employees of member companies of HealthPartners, a nonprofit health care provider and health insurance company in Bloomington, Minnesota. The objective of our study was to determine the concordance between self-reported life satisfaction and a construct of subjective well-being that comprised 6 elements of well-being: emotional and mental health, social and interpersonal status, financial status, career status, physical health, and community support. Methods We analyzed responses of 23,268 employees (of 37,982 invitees) from 6 HealthPartners companies who completed a health assessment in 2011. We compared respondents’ answers to the question, “How satisfied are you with your life?” with their indicators of well-being where “high life satisfaction” was defined as a rating of 9 or 10 on a scale of 0 (lowest) to 10 (highest) and “high level of well-being” was defined as a rating of 9 or 10 for 5 or 6 of the 6 indicators of well-being. Result We found a correlation between self-reported life satisfaction and the number of well-being elements scored as high (9 or 10) (r = 0.62, P < .001); 73.6% of the respondents were concordant (high on both or high on neither). Although 82.9% of respondents with high overall well-being indicated high life satisfaction, only 34.7% of those indicating high life satisfaction reported high overall well-being. Conclusion The correlation between self-reported life satisfaction and our well-being measure was strong, and members who met our criterion of high overall well-being were likely to report high life satisfaction. However, many respondents who reported high life satisfaction did not meet our criterion for high overall well-being, which suggests that either they adapted to negative life circumstances or that our well-being measure did not identify their sources of life satisfaction.

Congruence of Organizational Self-Score and Audit-Based Organizational Assessments of Workplace Health Capabilities: An Analysis of the HealthLead Workplace Accreditation.

Objective: The aim of this study was to provide descriptive characteristics of companies accredited as part of the HealthLead Workplace Accreditation and to assess congruence between data reported via online organizational self-assessment and third-party onsite audit. Methods: Synthesized organizational level data collected through the HealthLead accreditation process (N = 22). Online self-assessment and onsite third-party audit data were compared using paired t-tests. Results: Statistical tests revealed significantly higher onsite audit scores than organizational self-assessment scores. Descriptive analyses demonstrated that Outcomes Reporting was the lowest scoring area among all companies. Companies also varied widely in levels of Leadership Support for wellness. Conclusions: Gaps observed between organizational self-assessment and onsite audit scores were relatively stable across the sample, indicating that observed differences may be process related. Organizations awarded accreditation show a wide variation in Leadership Support, and Outcomes Reporting appears to be low across the sample.