We investigated the impact of elements of a workplace culture of health (COH) on employees’ perceptions of employer support for health and lifestyle risk.
Design:
We used 2013 and 2015 survey data from the National Healthy Worksite Program, a Centers for Disease Control and Prevention (CDC)-led initiative to help workplaces implement health-promoting interventions.
Setting:
Forty-one employers completed the CDC Worksite Health Scorecard to document organizational changes.
Participants:
Eight hundred twenty-five employees provided data to evaluate changes in their health and attitudes.
Measures:
We defined elements of a COH as environmental, policy, and programmatic supports; leadership and coworker support; employee engagement (motivational interventions); and strategic communication. Outcomes included scores of employees’ perceptions of employer support for health and lifestyle risk derived from self-reported physical activity, nutrition, and tobacco use.
Analysis:
We estimated effects using multilevel regression models.
Results:
At the employee level and across time, regression coefficients show positive associations between leadership support, coworker support, employee engagement, and perceived support for health (P < .05). Coefficients suggest a marginally significant negative association between lifestyle risk and the presence of environmental and policy supports (P < .10) and significant associations with leadership support in 2015 only (P < .05).
Conclusion:
Relational elements of COH (leadership and coworker support) tend to be associated with perceived support for health, while workplace elements (environmental and policy supports) are more associated with lifestyle risk. Employers need to confront relational and workplace elements together to build a COH.
SolerRELeeksKDRaziS. A systematic review of selected interventions for worksite health promotion. The assessment of health risks with feedback. Am J Prev Med. 2010;38(2 Suppl):S237–S262. doi:10.1016/j.amepre.2009.10.030.
3.
GoetzelRZHenkeRMTabriziM. Do workplace health promotion (wellness) programs work?J Occup Environ Med. 2014;56(9):927–934. doi:10.1097/JOM.0000000000000276.
4.
TerryPESeaversonELDGrossmeierJAndersonDR. Association between nine quality components and superior worksite health management program results. J Occup Environ Med. 2008;50(6):633–641. doi:10.1097/JOM.0b013e31817e7c1c.
5.
ChapmanLS. Meta-evaluation of worksite health promotion economic return studies. Am J Health Promot. 2003;17(3):1–10.
6.
BaickerKCutlerDSongZ. Workplace wellness programs can generate savings. Health Aff (Millwood). 2010;29(2):304–311. doi:10.1377/hlthaff.2009.0626.
7.
KaspinLCGormanKMMillerRM. Systematic review of employer-sponsored wellness strategies and their economic and health-related outcomes. Popul Health Manag. 2013;16(1):14–21. 8p. doi:10.1089/pop.2012.0006.
8.
GoetzelRZHenkeRMBeneventR. The predictive validity of the HERO scorecard in determining future health care cost and risk trends. J Occup Environ Med. 2014;52(2):136–144.
9.
KentKGoetzelRZRoemerECPrasadAFreundlichN. Promoting healthy workplaces by building cultures of health and applying strategic communications. J Occup Environ Med. 2016;58(2):114–122. doi:10.1097/JOM.0000000000000629.
10.
GoetzelRZShechterDOzminkowskiRJMarmetPFTabriziMJRoemerEC. Promising practices in employer health and productivity management efforts: findings from a benchmarking study. J Occup Environ Med. 2007;49(2):111–130.
11.
ScheinEH. Organizational Culture and Leadership. San Francisco: Jossey-Bass; 2010.
12.
PronkN. Best practice design principles of worksite health and wellness programs. ACSMs Health Fit J. 2014;18(1):42–46.
13.
GoetzelRZGuindonAMTurshenIJOzminkowskiRJ. Health and productivity management: establishing key performance measures, benchmarks, and best practices. J Occup Environ Med. 2001;43(1):10–17.
14.
Centers for Disease Control (CDC). Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing. Atlanta, GA: Work Life A National Institute for Occupational Safety and Health Initiative; 2008. http://www.cdc.gov/niosh/docs/2010-140/pdfs/2010-140.pdf. Published October 2008. Accessed February 5, 2018.
15.
RhoadesLEisenbergerR. Perceived organizational support: a review of the literature. J Appl Psychol. 2002;87(4):698–714. doi:10.1037/0021-9010.87.4.698.
16.
MichieSWilliamsS. Reducing work related psychological Ill health and sickness absence: a systematic literature review. Occup Environ Med. 2003;60(1):3–9. doi:10.1136/oem.60.1.3.
17.
LemonSCZapkaJLiWEstabrookBMagnerRRosalMC. Perceptions of worksite support and employee obesity, activity, and diet. Am J Health Behav. 2009;33(3):299–308.
18.
TabakRGHippJAMarxCMBrownsonRC. Workplace social and organizational environments and healthy-weight behaviors. PLoS One. 2015;10(4):e0125424. doi:10.1371/journal.pone.0125424.
19.
KelseyKSCampbellMKTessaroI. Social support and health behaviors among blue-collar women workers. Am J Health Behav. 2000;24(6):434–443. doi:10.5993/AJHB.24.6.4.
20.
GoetzelRZOzminkowskiRJ. The health and cost benefits of work site health-promotion programs. Annu Rev Public Health. 2008;29(1):303–323. doi:10.1146/annurev.publhealth.29.020907.090930.
21.
TerryPEEisenbergerRShanockS. The art of health promotion. An interview on perceived organizational support and employee well-being with Drs. Robert Eisenberger and Linda Shanock. Am J Health Promot. 2014;29(1):TAHP2–TAHP7.
22.
ZollerHM. Manufacturing health: employee perspectives on problematic outcomes in a workplace health promotion initiative. West J Commun. 2004;68(3):278–301. doi:10.1080/10570310409374802.
23.
BerryLMirabitoAMBaunWB. What’s the hard return on employee wellness programs?Harv Bus Rev. December 2010. https://ssrn.com/abstract=2064874. Accessed February 5, 2018.
24.
PetersonKRogersBMEBrosseauLM. Differences in hospital managers’, unit managers’, and health care workers’ perceptions of the safety climate for respiratory protection. Workplace Health Saf. 2016;64(7):326–336. doi:10.1177/2165079916640550.
25.
LangJCluffLPayneJMatson-KoffmanDHampton. The Centers for Disease Control and Prevention: Findings from the National Healthy Worksite Program. J Occup Environ Med. 2017;59(7):631–641.
26.
Centers for Disease Control (CDC), Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion. Workplace Health Model. https://www.cdc.gov/workplacehealthpromotion/model/index.html. Updated 2016. Accessed February 5, 2018.
27.
U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th ed. Washington, DC: Government Printing Office; 2010.
TerryPEGrossmeierJMangenDJGingerichSB. Analyzing best practices in employee health management: how age, sex, and program components relate to employee engagement and health outcomes. J Occup Environ Med. 2013;55(4):378–392. doi:10.1097/JOM.0b013e31828dca09.
30.
HannonPAGarsonGHarrisJRHammerbackKSopherCJClegg-ThorpC. Workplace health promotion implementation, readiness, and capacity among mid-sized employers in low-wage industries: a national survey. J Occup Environ Med. 2012;54(11):1337–1343. doi:10.1097/JOM.0b013e3182717cf2.
31.
HannonPAHarrisJRSopherCJ. Improving low-wage, midsized employers’ health promotion practices: a randomized controlled trial. Am J Prev Med. 2012;43(2):125–133. doi:10.1016/j.amepre.2012.04.014.
32.
LinnanLBowlingMChildressJ. Results of the 2004 national worksite health promotion survey. Am J Public Health. 2008;98(8):1503–1509. doi:10.2105/AJPH.2006.100313.
33.
DenisonDR. What is the difference between organizational culture and organizational climate? A native’s point of view on a decade of paradigm wars. Acad Manage Rev. 1996;21(3):619–654. doi:10.2307/258997.
34.
DeJoyDMWilsonMGGoetzelRZ. Development of the environmental assessment tool (EAT) to measure organizational physical and social support for worksite obesity prevention programs. J Occup Environ Med. 2008;50(2):126–137. doi:10.1097/JOM.0b013e318161b42a.
35.
WilsonMGDejoyDMVandenbergRJRichardsonHAMcGrathAL. Work characteristics and employee health and well-being: test of a model of healthy work organization. J Occup Organ Psychol. 2004;77(4):565–588.
36.
PersonALColbySEBulovaJAEubanksJW. Barriers to participation in a worksite wellness program. Nutr Res Pract. 2010;4(2):149–154. doi:10.4162/nrp.2010.4.2.149.
