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Workplace Health (WPH) Ini4a4ves: Evidence of effec4veness with emphasis on
diet & health
Dr Alexandra Johnstone
`Promo4ng behaviour change in food and drink consump4on and produc4on: Iden4fying future
priori4es: What does the evidence tell us?’
[email protected] h4p://www.abdn.ac.uk/rowe4/research/alex-‐johnstone.php
www.abdn.ac.uk/rowe/
Workplace health ini4a4ves (WPHI) ‘workplace health ini4a4ve’ (WPHI) means specific ac4vi4es & programmes undertaken in the workplace to improve the health of workers through reducing disease-‐specific risk factors and encouraging behaviour change in the UK
M. Bending, S. Beale & J. Hu2on, An Economic Analysis of Workplace IntervenDons that Promote Physical AcDvity, York Health Economics Consor>um (2008) www.citeulike.org/user/vigez/ar>cle/5010080 H. Vaughan-‐Jones & L. Barham, Healthy Work: Evidence into AcDon, BUPA (2010) h2p://workfounda>on.com/Assets/Docs/healthy-‐work-‐evidence-‐into-‐ac>on-‐report.pdf
• Employee • Majority of day at workplace • Eat up to two meals a day
• Employer • Increased produc4vity • Reduced absenteeism • Overall health cost savings
• Prevent premature deaths (NCDs) address -‐ • 1 poor diet (including use of alcohol) • 2 tobacco use • 3 lack of physical ac4vity
hXp://www.healthyworkinglives.com
‘A healthier workforce really does make for a healthier business. Our website is full of pracDcal advice, guides and tools to help with every aspect of health, safety and wellbeing in the workplace’.
www.abdn.ac.uk/rowe/
How does this fit in with the Good Food Na4on plans? ‘Workplace Wellness’ makes financial sense to reduce modifiable risk factors for NCDs by the crea4on of ‘health-‐promoDng environments’ – WPHI can help with this
Workplace Health Ini>a>ves: Evidence of EffecDveness www.c3health.org
• Slow uptake of Workplace Health Ini4a4ves (WPHI) from UK employers -‐ Barriers to change -‐ Not considered it their role to improve the health and well-‐being of their workforce -‐ MoDvaDon for employers -‐ Demonstrate financial return or effects on tangible business benefits • Why implement health promoDng environments ?
• An increase in workforce age and change in composi4on leading to employee expecta4ons of wellness programmes and work-‐life balance ini4a4ves
• Rising costs of chronic disease and ill-‐health to NHS • External governmental and business pressures such as corporate social responsibility and compe44on • Shi_ workers food provision and break 4me in public service
www.abdn.ac.uk/rowe/
Example 1 Impact of Workplace Health Ini4a4ves on Diet Employee health educaDon & changing the physical workplace environment (through provision of healthier op4ons in cafeterias and vending machines) could lead to small to moderate improvements in employee diet
Ni Mhurchu C et al., ‘Effects of worksite health promoDon intervenDons on employee diets: a systemaDc review’, BMC Public Health 2010 10: 62: h2p://www.biomedcentral.com/ 1471-‐2458/10/62Horgen KB, 2. Brownell KD (2002) Comparison of price change and health message intervenDons in promoDng healthy food choices. Health Psychology, 21(5), 505-‐12. French SA (2003) Pricing effects on food choices. Journal of Nutri?on, 133(3), 841S-‐843S.
• ‘AcDons speak louder than words’, such that price reduc4on is more effec4ve than health messages alone
• Price reduc4ons are an effec4ve strategy to increase the purchase of healthier foods
• Proposals to stem the obesity epidemic by taxing junk food and fizzy drinks are being considered worldwide – evidence of effec4veness ?
• The role of the internet in workplace interven4ons – individual support -‐ novel
Waterhouse J, Buckley P, Edwards B, Reilly T. Chronobiol Int. 2003 Nov;20(6):1075-‐92.
Ea4ng is a form of learned behaviour influenced by social experience, internal and external cues – need to address barriers to change and mo4va4on to change (reward)
www.abdn.ac.uk/rowe/
Example 2 Impact of Workplace Health Ini4a4ves on Obesity • The workforce of Britain is becoming obese
• 65% of our firefighters are now overweight, • 30% of office workers • 47% of offshore shi_ workers
• Par4cipa4on has benefits at a personal level & organisa4onal level • Effec4ve at preven4ng weight gain • Few randomized controlled studies on the efficacy of physical ac4vity or dietary
interven4ons during shi_ work
Healthy Weight, Healthy Lives: A Cross-‐Government Strategy for England, London, 2009 Royal College of Physicians. AcDon on obesity: comprehensive care for all. Report of a working party, London 2013. Foresight. Tackling obesiDes: future choices—project report. London: The Sta>onery Office, 2007 Parkes KR. Demographic and lifestyle predictors of body mass index among offshore oil industry workers: Cross-‐secDonal and longitudinal findings. Occup Med (Lond). 2003 May;53(3):213-‐21. Verweij 2011, ‘Meta-‐ analyses of workplace physical acDvity and dietary behavior intervenDons on weight outcomes’, Obes Rev. 2011 Jun;12(6):406-‐29.
• Ironically, the workplace championing the government’s an4-‐obesity message, our NHS, is itself failing to control the problem with 58% of NHS employees reported to be overweight or obese in 2009
21st Oct 2014
Effective obesity WPHI
Financial support or peer support -‐ rewards • Employees taking responsibility to create weight-‐loss support groups and compe44ons • Management including healthy employee weight as a goal • Employee health screening
Health educa4on • Ensuring that employees have access to the appropriate nutri4on informa4on • Weight-‐loss groups or individual diet counselling for high-‐risk employees
Work environment (health promo4ng) • Physical and social environments through providing healthy food op4ons in company
vending machines and cafeteria and at catered company events
Top down approval – lead by example • Just as employee ownership and management buy-‐in are important for workplace
physical ac4vity ini4a4ves, they are also crucial for weight-‐control programmes • Employer mission statement or buy in to wellness programme
www.abdn.ac.uk/rowe/
Example 3 Impact of Workplace Health Ini4a4ves on Physical Ac4vity • Incorpora4ng physical ac4vity in the workplace is a key component of any programme
aiming to reduce the number of obese and overweight employees
• Workplace physical-‐ac4vity interven4ons could lead to increased overall fitness, improved physical-‐ac4vity behaviour, improved body measurements, improved work aXendance and reduc4on in job stress
• Workplace counselling, pedometers and ini4a4ves to encourage ac4ve travel to work were found to have strong effects on individual physical-‐ac4vity choices
Dugdill L et al.,‘Workplace physical acDvity intervenDons: A systemaDc review’, Interna>onal Journal of Workplace Health Management 2008, 1(1): 20– 40 Conn VS et al., ‘Meta-‐analysis of workplace physical acDvity intervenDons’. American Journal of Preven>ve Medicine 2009, 37(4): 330–9
• Employee ownership of any physical ac4vity interven4ons in the workplace
• Management buy-‐in and involvement – prac4ce what they preach – par4cularly regarding taking 4me out (at lunch4me, for example) to take physical ac4vity
Effective physical activity WPHI
• Providing health-‐educaDon materials to raise awareness of the importance of regular physical acDvity
Tools include pamphlets and posters in busy areas, employee health-‐educa4on workshops, and individual fitness coaching
• Physical acDvity in work Dme Simple indoor/outdoor walking route Providing a workout facility with cardiovascular and resistance equipment Promo4ng employee athle4c teams and having physical ac4vity-‐related compe44ons Whatever the size of the workplace, ac4ve travel can be encouraged – walking and cycling, rather than driving
• PracDcal faciliDes Once employees are equipped with informa4on, designated areas where employees feel comfortable exercising & changing & washing essen4al
• Employer commitment The crea4on of a HR post (or expansion of an exis4ng post) to focus on the promo4on of physical ac4vity at the workplace (or a ‘healthy leader’)
www.abdn.ac.uk/rowe/
EffecDve workplace iniDaDves (no one size fits all approach)
• Target mul4ple risk factors, specifically those that represent the highest disease burden in the region where the workplace is located
• Combine health educa4on with changes in the physical and social workplace environment
• Underpinned by management buy-‐in and employee ownership
• Targeted to each unique workplace and cultural seong
• Involve baseline tes4ng and follow-‐up to evaluate and monitor the programmes, and allow for employee feedback to facilitate programme improvement
• Will result in reduced employee absenteeism, increased employee produc4vity, reduced employer health costs, and increased employee job sa4sfac4on
Key messages – moving forward
Stakeholders from non-‐governmental organisa4ons (NGOs), government and the private sector need to work together to ensure that policies, guidelines and tools are readily available to inform and assist businesses
