American Journal of Health Promotion

Intervention at the organizational rather than the individual level is gaining greater attention in worksite health promotion efforts. However, little research has been done on instruments to measure this domain. Therefore, the purpose of this study was to further test the utility of an existing organizational heart health support instrument by examining relationships among worksite structural characteristics and comparing these results to other survey findings.

One-time cross-sectional.

New York State.

One hundred fifteen volunteer worksites in the New York State Healthy Heart Program, representing manufacturing, government, education, health care, and other industries.

A survey was conducted using HeartCheck, an organizational assessment of employee support for heart health. HeartCheck contains 175 items measuring organizational support for tobacco control, nutrition, physical activity, stress, screening, and administrative support structure.

On average, only 22% of all worksite resources assessed were present in the sample. Having a workforce greater than 250 provided a 12% increase in predicted overall worksite resources. A predominantly female workforce (>75%) provided 10% higher levels of worksite stress resources. Worksites with unions had higher levels of resources for physical activity (10%), screening (13%), and general supportive structures (10%). The presence of manual labor diminished support for tobacco control resources (−13%). Finally, manufacturing worksites demonstrated a clear advantage for all types of worksite resources, except for stress.

A number of trends found in this study are consistent with earlier work. Industry type and size both predict worksite supports similar to previous studies. Other findings that appear to contradict previous work, including the relatively low level of support observed in this sample, can be explained by the comprehensive nature of the instrument. Overall, these findings demonstrate the utility of HeartCheck.

Investigators planning studies employing group-randomized designs need good estimates of the extra variation introduced as a result of correlated observations within units of assignment. We report intraclass correlation coefficients (ICCs) for a wide range of outcomes commonly employed in worksite studies and demonstrate analysis methods that can limit their deleterious impact.

A sample of 11, 711 employees of 24 firms recruited from the Minneapolis/St. Paul metropolitan area completed a mailed survey in the SUCCESS study, reporting on a broad array of outcomes. Applying mixed-model regression, we provide both crude and adjusted estimates of ICCs for 27 outcomes.

The crude ICCs were generally small, with a mean of .0163 and values ranging from 0 to .0650. Adjustment for demographics reduced the ICCs for 25 of the 27 outcomes, and adjustment for additional individual-level covariates further reduced the ICCs for 23 of the 27 outcomes.

Our results suggest that worksite-level ICCs for a variety of outcomes are generally small and can generally be reduced by adjustment for individual-level characteristics. Incorporating this information in planning worksite studies can improve sample size calculations to avoid underpowered studies.

This study documents the prevalence of workplace health promotion activities at small worksites with 15 to 99 employees.

A random sample of U.S. worksites stratified by size and industry (n = 3628) was drawn using American Business Lists.

Each worksite was surveyed using a computer-assisted telephone interview system to document activities related to health promotion and related programs, worksite policies regarding health and safety, health insurance, and philanthropic activities.

Participation varied by industry and size, with an overall response rate for eligible worksites of 78% for a total sample of 2680 worksites.

Data were analyzed using SUDAAN statistical software.

Approximately 25 % of worksites with 15 to 99 employees offered health promotion programs to their employees, compared with 44% of worksites with 100+ employees. As with the larger worksites, the most common programs for worksites with 15 to 99 employees were those related to occupational safety and health, back injury prevention, and CPR. The majority of worksites in both size categories had alcohol, illegal drug, smoking, and occupant protection policies. The majority of both small and large worksites also offered group health insurance to their employees (92% and 98%, respectively), with many of the worksites also extending benefits to family members and dependents (approximately 80% for both business sizes).

The results indicated that small worksites are providing programs to their employees, with a primary focus on job-related hazards. Small worksites also have formal policies regarding alcohol, drug use, smoking, and seatbelt use and offer health insurance to their employees at a rate only slightly lower than that of large worksites.