Kelly Flannery

Preventing Chronic Disease in the Workplace: A Workshop Report and Recommendations

Chronic disease is the leading cause of death in the United States. Risk factors and work conditions can be addressed through health promotion aimed at improving individual health behaviors; health protection, including occupational safety and health interventions; and efforts to support the work-family interface. Responding to the need to address chronic disease at worksites, the National Institutes of Health and the Centers for Disease Control and Prevention convened a workshop to identify research priorities to advance knowledge and implementation of effective strategies to reduce chronic disease risk. Workshop participants outlined a conceptual framework and corresponding research agenda to address chronic disease prevention by integrating health promotion and health protection in the workplace.

The Worksite Heart Health Improvement Project (WHHIP): feasibility and efficacy.

OBJECTIVE Test the feasibility and efficacy of the Worksite Heart Health Improvement Project (WHHIP). DESIGN The WHHIP was a quasi-experimental 6-month pilot performed in 2 long-term care facilities. SAMPLE Thirty-nine female minority nursing assistants participated in this study with a mean age of 42.39 (SD = 12.79) years. MEASUREMENTS Measures were collected at baseline, 3, and 6 months and included blood pressure, lipid panel, body mass index, physical activity levels, diet behaviors, depressive symptoms, and self-efficacy outcomes. INTERVENTION The 3-month WHHIP intervention included 3 components: environmental and policy assessment; education; and on-going motivation. The control site received education only. RESULTS Subject participation averaged 47% and 58% in exercise and diet related activities, respectively. Generalized estimating equations showed the treatment group showed significant improvements in depressive symptoms (p = .012), systolic blood pressure (p = .028), total cholesterol (p = .002) and triglycerides (p = .011) over time. The treatment group also showed trends for improvement in diet behaviors (p = .069) and diastolic blood pressure (p = .073). CONCLUSIONS This study provided feasibility evidence for the WHHIP and preliminary evidence that the WHHIP can improve heart healthy behaviors and subsequent outcomes among nursing assistants in long-term care settings.

Exercise habits of licensed nurses and nursing assistants: are they meeting national guidelines?

Research shows licensed practical nurses and nursing assistants (NAs) have high rates of obesity and hypertension, potentially from limited engagement in physical activity (PA). Therefore, the purpose of this paper was to describe the self-reported exercise engagement, of licensed nurses (i.e., registered and licensed practical nurses) and NAs. We performed a secondary data analysis of two studies that used the Behavioral Risk Factor Surveillance System - PA questionnaire to assess PA levels. The sample consisted of 31 NAs and 40 licensed nurses. Our findings show 50 (56.9%) NAs and licensed nurses report they engage in enough exercise to meet national guidelines. Our sample reported engaging in more exercise than the general population. We suspect measurement biases as over half of our sample reported engaging in at least 300 min of exercise each week. The potential over-reporting could be due to the perception of their work since they do not have sedentary jobs.

The impact of the Worksite Heart Health Improvement Project on work ability: a pilot study.

Objective: To test the efficacy of the Worksite Heart Health Improvement Project (WHHIP). Methods: The WHHIP was a quasi-experimental, 6-month pilot performed in two long-term care facilities. Thirty-nine minority female nursing assistants participated in this study. The 3-month WHHIP intervention focused on reducing cardiovascular disease risk by increasing physical activity and reducing the amount of salt and fat consumed. The intervention included three components: environmental and policy assessment; education; and ongoing motivation. The control site received education only. Measures were collected at baseline, 3 months, and 6 months and included work ability, job stress, and job satisfaction. Results: Generalized estimating equations showed that the treatment group demonstrated significant improvements in work ability (P = 0.049). Conclusions: There was preliminary evidence that the WHHIP improved work ability, and future research should assess the impact of improved work ability on patients.

Nursing Assistants’ Response to Participation in the Pilot Worksite Heart Health Improvement Project (WHHIP): A Qualitative Study

Despite nursing assistants’ high risk for cardiovascular disease, few studies have aimed to reduce their cardiovascular disease risk. The purpose of this article is to explore factors that facilitated and hindered nursing assistants’ participation in a pilot physical-activity- and diet-focused worksite health promotion program that aimed to reduce cardiovascular disease risk. Three focus groups were conducted with 12 (67%) participants of the program. Four themes emerged: motivation to participate in a worksite health promotion program, program participation facilitators, barriers to program participation, and suggestions for future programs. This data can aid future program development.

Physical activity and diet-focused worksite health promotion for direct care workers.

Direct care workers (DCWs), defined as nursing assistants, home health aides, and/or personal home care assistants, are at risk for cardiovascular disease (CVD). Worksite health promotion (WHP) programs can significantly reduce DCWs’ CVD risk factors. Nurse executives should advocate for WHP as an innovative way to improve the health of workers, generate savings, andpossibly reduceDCW turnover. Evidenceand theory-based recommendations and examples are provided to improve upon prior limitations. Affecting more than 81 million Americans, CVD causes approximately one-third of their deaths. African Americans and Hispanics have a disproportionally higher incidence of many CVD risk factors and African Americans often have multiple CVD risk factors. Physical inactivity and poor nutrition are major public health problems that increase the risk of CVD. For example, when looking at African American women, only 36.1% exercise regularly, only 8.7% meet the guidelines for sodium intake, and only 40.1% meet the guidelines for saturated fat intake. A major barrier to adhering to CVD risk factor recommendations is the lack of information and resources.