Rebekah K. Hersch

Workplace health promotion and utilization of health services

This article reports findings from a workplace substance abuse prevention program designed to investigate best practices. The study sought to assess the effects of the worksite wellness program and employee assistance program (EAP) on healthcare utilization and costs, identify predictors of outpatient costs and visits, and assess the effect of the intervention on health attitudes, behaviors, and behavioral health-related costs and visits. Results indicated that visits to the EAP increased as did overall healthcare visits, that utilization of healthcare services and costs were higher in the population receiving substance abuse prevention intervention, and that employees in the substance abuse prevention intervention reported lower heavy drinking and binge drinking. Data suggest that substance abuse prevention may result in higher healthcare costs and utilization in the short term, but a reduction in health risk behaviors such as heavy drinking may result in lower healthcare costs and utilization in the long term.

Workplace health promotion and utilization of health services: follow-up data findings.

This article reports findings from a workplace substance abuse prevention program designed to investigate best practices. The study sought to assess the effects of the worksite wellness program and employee assistance program (EAP) on healthcare utilization and costs, identify predictors of outpatient costs and visits, and assess the effect of the intervention on health attitudes, behaviors, and behavioral health-related costs and visits. Results indicated that visits to the EAP increased as did overall healthcare visits, that utilization of healthcare services and costs were higher in the population receiving substance abuse prevention intervention, and that employees in the substance abuse prevention intervention reported lower heavy drinking and binge drinking. Data suggest that substance abuse prevention may result in higher healthcare costs and utilization in the short term, but a reduction in health risk behaviors such as heavy drinking may result in lower healthcare costs and utilization in the long term.

The Prevention of Substance Abuse Among Construction Workers: A Field Test of a Social-Cognitive Program

A substance abuse prevention program based on social-cognitive principles and cast in a health promotion framework was tested on 374 construction workers from 5 sites. Subjects were randomly assigned to receive the “Power Tools” program with substance abuse material or without the material. Both self-report and bioassay data were collected before and approximately one year after the program. Data were analyzed mainly by analysis of covariance, analysis of variance, and chi-square analysis. Program effects were not demonstrated on consumption of substances, but were found on stages-of-change measures of smoking and drinking and on the frequency with which parents talk with their children about alcohol and drugs. The results suggest that a program of this type might help construction workers move toward reductions in licit substance use, but not in illicit drug use.

A Web-Based Health Promotion Program for Older Workers: Randomized Controlled Trial

Background Recent evidence supports the efficacy of programs that promote improvements in the health practices of workers 50 years and older who are at higher risk for chronic diseases than younger workers are. Internet-based programs that promote healthy practices have also shown promise and, therefore, should be especially appropriate for workers aged 50 years and older. Objective The purpose of the research was to evaluate the effectiveness of HealthyPast50, a fully automated Web-based health promotion program based on social cognitive theory and aimed specifically at workers 50 years and older. Methods The randomized controlled trial was conducted across multiple US offices of a large global information technology company. The sample included 278 employees aged 50 to 68 who were recruited online and randomly assigned to the Web-based HealthyPast50 program or to a wait-list control condition. Self-report measures of diet, physical activity, stress, and tobacco use were collected online before and 3 months after the program group was given access to the program. Use data included number of log-ins and number of pages accessed. The primary analysis was multiple linear regression, following intent-to-treat principles with multiple imputation using the Markov chain Monte Carlo (MCMC) approach for nonmonotone missing data. Potential moderators from demographic characteristics and program dosage effects were assessed using multiple linear regression models. Additional analyses were conducted on complete (nonimputed) cases, excluding program participants who used the program for less than 30 minutes. Results Retention rates were good for both groups: 80.4% (111/138) for the program group and 94.3% (132/140) for the control group. Program group participants spent a mean of 102.26 minutes in the program (SD 148.32), logged in a mean of 4.33 times (SD 4.28), and viewed a mean of 11.04 pages (SD 20.08). In the analysis of the imputed dataset, the program group performed significantly better than the control group on diet behavioral change self-efficacy (estimated adjusted difference [Δ]=0.16, P=.048), planning healthy eating (Δ=0.17, P=.03), and mild exercise (Δ=1.03, P=.01). Moderator and dosage analyses of the dataset found no significant program effects. Analyses of the nonimputed dataset comparing program users with controls found additional significant program effects on eating practices (Δ=0.09, P=.03), exercise self-efficacy (Δ=0.12, P=.03), exercise planning (Δ=0.18, P=.03), and aging beliefs (Δ=0.17, P=.01). Moderator analysis of this dataset also found significant moderator effects of gender on multiple measures of exercise. Conclusions A Web-based health promotion program showed promise for making a significant contribution to the short-term dietary and exercise practices of older working adults. Gender effects suggest that the program effects on exercise are due mainly to improvements among women.

SUBSTANCE USE IN THE CONSTRUCTION INDUSTRY: A COMPARISON OF ASSESSMENT METHODS

Most users of illicit drugs are employed adults, with substance use rates especially high in the construction industry. In an effort to shed light on the nature and extent of drug use among construction industry workers, and to compare drug use assessment methods, substance use among construction workers, 60% of whom were apprentices, across six sites was assessed by questionnaire, urinalysis, and hair analysis. Nearly 17% of the participants reported current drug use, although drug use differed dramatically by site. Drug use rates also differed by respondent characteristics, participation rates, and assessment method. The strengths and weaknesses of each assessment method are discussed, along with the rationale for combining methods.

A field test of a web-based substance abuse prevention training program for health promotion professionals

Purpose. To evaluate a multimedia substance abuse prevention (SAP) training program for health promotion (HP) practitioners designed to provide opportunities for behavioral modeling and skills building and to motivate and build confidence in ability to integrate SAP into HP offerings. Methods. Using a posttest only design, 192 practitioners were randomly assigned to receive web-based (experimental group) or print-based (control group) training. Feelings about ability to conduct effective SAP programming, reactions to training materials, and knowledge about substance abuse and how to implement SAP were assessed. The experimental group also rated specific aspects of the web training. Results. The experimental group gave high evaluation ratings, scored significantly higher on self-efficacy items, and gave significantly higher ratings on 12 of 15 reaction items. Conclusion. Web-based training was more engaging, understandable, user-friendly, useful, comprehensive, and motivating than print-based training; it is believed to be more effective in helping to integrate substance abuse prevention; and it will serve as a continuous resource.

Heart healthy online: an innovative approach to risk reduction in the workplace.

Objectives: To examine whether a Web-based cardiovascular health promotion program was associated with changes in self-reported behaviors, attitudes, and biometric indicators in a population of working adults. Methods: Employees (n = 210) were recruited and randomized into either an Internet-based or control condition. Participants completed pre- and postintervention self-report assessments on diet, exercise, smoking, and mental health. Pre- and postintervention biometric screenings were also obtained on blood pressure, heart rate, weight, and hip/waist circumference. Results: The intervention was associated with significant improvements in dietary attitudes (P = 0.003; F = 8.83), dietary intentions (P = 0.031; F = 4.72), dietary self-efficacy (P = 0.015; F = 5.97), exercise self-efficacy (P = 0.002; F = 9.51), exercise habits (P = 0.016; F = 5.94), and coping with stress (P = 0.003; F = 8.85) and depression (P = 0.036; F = 4.46). Conclusions: The program showed promise for promoting cardiovascular risk reduction behaviors. These results are consistent with similar Web-based interventions.