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Objective: To test the validity and reliability of the American Heart Association’s (AHA) updated Workplace Health Achievement Index (WHAI). Methods: We piloted the updated WHAI with respondent pairs at 94 organizations, and examined the... more
Objective: To test the validity and reliability of the American Heart Association’s (AHA) updated Workplace Health Achievement Index (WHAI). Methods: We piloted the updated WHAI with respondent pairs at 94 organizations, and examined the inter-rater reliability (percent agreement) for each item on the survey. To evaluate face and content validity, we conducted preliminary focus groups pre-survey, and follow-up cognitive interviews post-survey administration. Results: Respondents found the updated WHAI to be comprehensive and useful in identifying gaps and opportunities for improving their health and wellbeing programs. The mean percent agreement on all items was 73.1%. Only 9% (or 14 items out of 146) had poor inter-rater reliability (below 61 percent agreement), but through follow-up cognitive interviews we determined that most were due to artifacts of the study design or were resolved through minor revisions to the survey question, instructions, and/or adding examples for clarity. Only 1 question was deleted due to lack of relevance. Conclusion: The updated WHAI is a valid and reliable tool for employers to assess how well they promote the health and wellbeing of their employees.
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Objective: To provide a narrative review of best and promising practices for achieving exemplary mental health in the workplace as the foundation for the inaugural Carolyn C. Mattingly Award for Mental Health in the Workplace. Methods:... more
Objective: To provide a narrative review of best and promising practices for achieving exemplary mental health in the workplace as the foundation for the inaugural Carolyn C. Mattingly Award for Mental Health in the Workplace. Methods: Research was drawn from peer-reviewed articles using the search terms associated with workplace mental health. Results: Eight categories of best practices were identified: (1) culture, (2) robust mental health benefits, (3) mental health resources, (4) workplace policies and practices, (5) healthy work environment, (6) leadership support, (7) outcomes measurement, and (8) innovation. Conclusion: The review provided the scientific backing to support criteria developed for the Carolyn C. Mattingly Award for Mental Health in the Workplace. By recognizing organizations that apply evidence-based practices in their health and well-being programs, the Mattingly Award may inspire employers to adopt best practices.
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Research Interests: Nursing, Obesity, Environmental Health, Medicine, Overweight, and 15 moreHumans, Blood Pressure, Weight Loss, Female, Male, Follow-up studies, Second Year, Body Mass Index, Middle Aged, Occupational, Adult, Public health systems and services research, Chemical Industry, Weight Management, and Case Control Studies
PurposeThe paper seeks to describe the evolution of an integrated approach to health and productivity management that combines the disciplines of worksite health promotion and occupational safety and health, and to offer advice on how to... more
PurposeThe paper seeks to describe the evolution of an integrated approach to health and productivity management that combines the disciplines of worksite health promotion and occupational safety and health, and to offer advice on how to implement such an integrated approach.Design/methodology/approachThe paper takes the form of a review of the literature, focusing on the psychological, organizational, and human capital models that must be integrated for successful health and productivity management.FindingsThe first integrated health, safety, and productivity model was presented by DeJoy and Southern in 1993. However, occupational safety and health and worksite health promotion professionals view the workplace in different ways (from psychological and public health orientations, respectively) that may result in siloed work environments. Better communication and collaboration across these disciplines is essential for success. That can be fostered by adopting a human capital framewor...
Research Interests: Health Promotion, Monitoring And Evaluation, Human Capital, Public Health, Production Management, and 9 moreMedicine, Work Environment, Occupational health and safety, Business and Management, Product Model, Occupational Safety and Health, Design Methodology, Health and Safety, and Integrated Approach
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Research Interests: Health Promotion, Health Education, Environmental Change, Humans, Blood Glucose, and 15 moreHigh Blood Pressure, Female, Male, Cohort Study, Body Mass Index, Adult, Chemical Industry, First Year, Health risk, Chi Square Distribution, Logistic Models, Control Group, Case Control Studies, Diastolic Blood Pressure, and High risk
The COVID-19 pandemic presents a unique opportunity to gain support from the business community for rebuilding a more effective and resilient public health infrastructure in the U.S. This commentary provides the rationale for more engaged... more
The COVID-19 pandemic presents a unique opportunity to gain support from the business community for rebuilding a more effective and resilient public health infrastructure in the U.S. This commentary provides the rationale for more engaged business involvement in efforts to promote public health during the time of COVID-19. Drawing on the current pandemic, the commentary highlights the implications of a fragmented public health system for businesses and the nation at large, the shortcomings of which are apparent as never before.
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This case study describes a multistage approach applied to evaluation of an employee wellness program at Northwell Health. The paper describes a framework that other large employers may adopt in their wellness program evaluations.... more
This case study describes a multistage approach applied to evaluation of an employee wellness program at Northwell Health. The paper describes a framework that other large employers may adopt in their wellness program evaluations. Evaluators worked with Northwell to develop, tailor, and apply a structure-process-outcome framework aligned with the organization's specific goals. Analyses of structural, process, and outcome variables will provide Northwell with valuable information about strengths and weaknesses of its wellness program. The measurement and evaluation framework can serve as a model for businesses aspiring to improve their workplace programs. This framework provides businesses with the opportunity to analyze key elements that need to be addressed collectively to gain a complete picture of program implementation processes and subsequent health and business outcomes.
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Purpose: We investigated the relationship between companies’ efforts to build internal (COH-INT) and external cultures of health (COH-EXT) and their stock performance. Design: We administered 2 surveys, which measure companies’ programs,... more
Purpose: We investigated the relationship between companies’ efforts to build internal (COH-INT) and external cultures of health (COH-EXT) and their stock performance. Design: We administered 2 surveys, which measure companies’ programs, policies, and supports for improving the health of their employees and communities. We then compared the companies’ stock performance to the Standard and Poor’s (S&P) 500 Index from January 2013 through August 2017. Setting: United States. Participants: Representatives from 17 publicly traded companies who completed the COH-INT survey, of whom 14 also completed the COH-EXT. Measures: Culture of health scores were dichotomized into high versus low for both surveys. Stock price data for all companies were gathered from public sources. Analysis: We constructed 5 stock portfolios: all 17 companies, high COH-INT, low COH-INT, high COH-EXT, and low COH-EXT companies. We examined total returns for each portfolio compared to the S&P 500. Results: High COH-I...
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Objective: To examine changes in internal and external cultures of health scores and relate those changes to employees’ health risks, health care utilization, and costs for 21 large employers (N = 641,901). Methods: We measured the... more
Objective: To examine changes in internal and external cultures of health scores and relate those changes to employees’ health risks, health care utilization, and costs for 21 large employers (N = 641,901). Methods: We measured the relationship between changes in internal and external culture of health scores and changes in employee health risks, health care utilization, and costs. Results: Improvements in a company's internal culture of health predicted lower levels of obesity, poor diet, and tobacco use but higher stress for employees reporting high baseline risk. For those not at high baseline risk, health improved for depression, alcohol consumption, and diet. Improvements in internal culture of health also led to lower prescription drug utilization. Conclusion: Investments in internal culture of health predict improvements in some employee health risks and health care utilization.
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Objective: The aim of the study was to develop tools that quantify employers’ investment in building cultures of health (COH)—inside and outside company walls. Methods: Two COH instruments were developed through literature reviews and... more
Objective: The aim of the study was to develop tools that quantify employers’ investment in building cultures of health (COH)—inside and outside company walls. Methods: Two COH instruments were developed through literature reviews and expert consultation. The first focused on internal culture of health (COH-INT), that is, programs, policies, and attributes of the physical and social environments that support employees’ health and well-being. The second focused on external culture of health (COH-EXT), that is, programs, policies, and environmental supports that promote communities’ health. We administered these tools to 32 employers and examined instrument reliability, distribution of scores, and correlation between the two instruments. Results: Both tools demonstrated adequate reliability. COH-EXT scores changed minimally over the 3-year study timeframe. There was little correlation between the COH-INT and COH-EXT scores. Conclusions: More research is needed to further develop and validate COH-EXT instruments.
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The aim of this study was to provide a current picture of the state of workplace health promotion (wellness) programs in the U.S. from both employer and employee perspectives. We analyzed data from two independent surveys of employers... more
The aim of this study was to provide a current picture of the state of workplace health promotion (wellness) programs in the U.S. from both employer and employee perspectives. We analyzed data from two independent surveys of employers (N = 1500) and the general population (N = 4611). Employers reported offering wellness programs at almost twice the rate of employees who reported having these programs available to them. Most (59.4%) employees felt employers should play a role in improving worker health and nearly three-fourths (72.1%) thought that lower insurance premiums should be offered for participation in wellness programs. However, fewer than half felt that their work environment allows them to maintain good health. Although wellness programs are offered at the majority of workplaces in the U.S., employees are unlikely to be aware of these efforts and would like employers to be forthcoming in providing programs promoting good health.
Research Interests: Nursing, Health Promotion, Public Opinion, Occupational Health, Health insurance, and 14 moreAdolescent, Medicine, Workplace, Humans, United States, Female, Male, Young Adult, Middle Aged, Adult, Public health systems and services research, Occupational and environmental medicine, Surveys and Questionnaires, and attitude to health
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OBJECTIVE To evaluate the reliability and validity of the updated 2019 CDC Worksite Health ScoreCard (CDC ScoreCard), which includes four new modules. METHODS We pilot tested the updated instrument at 93 worksites, examining question... more
OBJECTIVE To evaluate the reliability and validity of the updated 2019 CDC Worksite Health ScoreCard (CDC ScoreCard), which includes four new modules. METHODS We pilot tested the updated instrument at 93 worksites, examining question response concurrence between two representatives from each worksite. We conducted cognitive interviews and site visits to evaluate face validity, and refined the instrument for public distribution. RESULTS The mean question concurrence rate was 73.4%. Respondents reported the tool to be useful for assessing current workplace programs and planning future initiatives. On average, 43% of possible interventions included in the CDC ScoreCard were in place at the pilot sites. CONCLUSIONS The updated CDC ScoreCard is a valid and reliable tool for assessing worksite health promotion policies, educational and lifestyle counseling programs, environmental supports, and health benefits.
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Research Interests: Nursing, Health Promotion, Occupational Health, Health, Public sector, and 20 moreRisk assessment, Cooperation, Workplace, Humans, Partnership, New York City, Intervention, Female, Male, Data Collection, Operation, Occupational, Adult, Risk Reduction, Public health systems and services research, Private Sector, Risk Assessment, Cooperative Behavior, Cohort Studies, and Occupational and environmental medicine
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Research Interests: Nursing, Obesity, Health Education, Treatment Outcome, Public Health, and 30 morePrevention, Environmental Change, Humans, Blood Glucose, High Blood Pressure, Tobacco Use, United States, Female, Male, Cohort Study, Body Mass Index, Risk factors, Prevalence, Middle Aged, Body mass index (BMI), Adult, Public health systems and services research, Chemical Industry, First Year, Weight Management, Health risk, Chi Square Distribution, Occupational therapy services in mental health services, Risk Factors, Logistic Models, Control Group, Case Control Studies, Occupational and environmental medicine, Treatment Effect, and Organizational case studies
Research Interests: Health Promotion, Obesity, Focus Groups, Health Education, Ecology, and 24 moreResearch, Multidisciplinary, Organizational Climate, Workplace, Humans, Health Services, Intervention, Female, Feasibility Studies, Male, Focus Group, Research Method, Environmental Assessment, Social Environment, Food Services, Middle Aged, Adult, Chemical Industry, Physical Environment, Occupational therapy services in mental health services, Intervention study, Mixed Method, Environment, and Food Choice
Research Interests: Nursing, Health Promotion, Health, Health Services Research, Production Management, and 10 moreBenchmarking, Workplace, Humans, Needs Assessment, Data Collection, Efficiency, Online Systems, Public health systems and services research, Occupational therapy services in mental health services, and Occupational and environmental medicine
Research Interests: Nursing, Health Promotion, Occupational Health, Health, Public sector, and 20 moreRisk assessment, Cooperation, Workplace, Humans, Partnership, New York City, Intervention, Female, Male, Data Collection, Operation, Occupational, Adult, Risk Reduction, Public health systems and services research, Private Sector, Risk Assessment, Cooperative Behavior, Cohort Studies, and Occupational and environmental medicine
Relatively little is known about the integration of people's fear-related dispositions and their expectations about stressful events. This research used information integration theory to examine how... more
Relatively little is known about the integration of people's fear-related dispositions and their expectations about stressful events. This research used information integration theory to examine how participants’ anxiety sensitivity and event expectancy are integrated to determine their social anxiety. Three studies were conducted—two with university students and one with anxiety clinic patients—in which participants were presented with multiple scenarios of
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This study tested a repeated-measures application of the Leading by Example (LBE) questionnaire, a self-report instrument measuring organizational leadership support for health promotion. The efficacy of the LBE was tested in a... more
This study tested a repeated-measures application of the Leading by Example (LBE) questionnaire, a self-report instrument measuring organizational leadership support for health promotion. The efficacy of the LBE was tested in a quasi-experimental health promotion intervention trial. Twelve worksites were assigned to three intervention conditions (i.e., control, moderate, high intensity). The worksites were selected from a large U.S.-based chemical company. Baseline data were collected from employees in various job roles in 2005 (N = 125). Follow-up data were collected in 2006 (N = 114) and 2007 (N = 106). Response rates ranged from 54% to nearly three-fourths of potential respondents. Worksites assigned to both treatment conditions received changes in the built environment via supports for weight management. Worksites assigned to the intense condition received additional elements designed to impact leadership's support for a positive health promotion climate. Four LBE factors measuring management support for health were assessed over time. The Kruskal-Wallis H-test and analyses of variance/covariance were used to compare LBE scores. Significant changes from baseline to 2006 were identified for the four factors (p = .000) of the LBE. No significant changes were found from 2006 to 2007. The LBE effectively captured perceptions of management support for health. Researchers and practitioners alike should consider using the LBE to track and evaluate perceptions of management support for health promotion.
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The aim of the study was to identify key success elements of employer-sponsored health promotion (wellness) programs. We conducted an updated literature review, held discussions with subject matter experts, and visited nine companies with... more
The aim of the study was to identify key success elements of employer-sponsored health promotion (wellness) programs. We conducted an updated literature review, held discussions with subject matter experts, and visited nine companies with exemplary programs to examine current best and promising practices in workplace health promotion programs. Best practices include establishing a culture of health and using strategic communications. Key elements that contribute to a culture of health are leadership commitment, social and physical environmental support, and employee involvement. Strategic communications are designed to educate, motivate, market offerings, and build trust. They are tailored and targeted, multichanneled, bidirectional, with optimum timing, frequency, and placement. Increased efforts are needed to disseminate lessons learned from employers who have built cultures of health and excellent communications strategies and apply these insights more broadly in workplace settings.
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To explore the link between companies investing in the health and well-being programs of their employees and stock market performance. Stock performance of C. Everett Koop National Health Award winners (n = 26) was measured over time and... more
To explore the link between companies investing in the health and well-being programs of their employees and stock market performance. Stock performance of C. Everett Koop National Health Award winners (n = 26) was measured over time and compared with the average performance of companies comprising the Standard and Poor's (S&P) 500 Index. The Koop Award portfolio outperformed the S&P 500 Index. In the 14-year period tracked (2000-2014), Koop Award winners' stock values appreciated by 325% compared with the market average appreciation of 105%. This study supports prior and ongoing research demonstrating a higher market valuation-an affirmation of business success by Wall Street investors-of socially responsible companies that invest in the health and well-being of their workers when compared with other publicly traded firms.