If we want more evidence-based practice, we need more practice-based evidence.*

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Health Program Planning, 4th edition

Chapter 7 (formerly Chap. 9 in previous editions)

Applications in Occupational Settings

Table of Contents (Click on the section to go to the new endnotes for that section)

The Ecological Context of Workplace Health Programs

    Historical Context of Health in the Workplace

    Demographic Context

    Political-Regulatory Context: Occupational Health & Safety Legislation

    Economic Context

    The Worksite Wellness and Health Promotion Context

    The Blending of the Occupational Health Ecologies and Cultures

Caveats

    Ethical Concerns

    Exaggerated Benefits?

Application of the Precede-Proceed Model

    Phase 1: Social Assessment and Participatory Planning

    Phase 2: Epidemiological Diagnosis: Health, Behavioral, and Environmental Assessments

        Descriptive Epidemiology: Extent and Distribution of the Health Problems

        Etiological Epidemiology: The Behavioral and Environmental Determinants

    Phase 3: Educational and Ecological Assessment

    Phase 4: Administrative and Policy Assessment

    Phase 5: Implementation and Evaluation

A Case Study: Air Quality Control in a State Agency

Headlines and Milestones in Recent Occupational Health Developments

Notation: The number before ">" is the endnote number in the 3rd edition; the number after > is the new endnote number that will appear in the 4th edition. The endnotes provide citations to literature and sources referenced in the text of Chapter 8. Below each endnote are the actual bibliographic references for the corresponding citations. References that appeared in the 3rd edition may not be listed here (see 3rd edition endnotes and bibliography). Click on the author link (if highlighted) for the abstract of the article.

The Ecological Context of Workplace Health Programs

2>1. First publications of PRECEDE-PROCEED, Green, 1974; followed by formal tests in clinical and community settings, but the first test of the model on employee health in an occupational setting was R. L. Bertera, 1981; Bertera & Cuthie, 1984; Bertera, Levine, & Green, 1982.

Bertera, R. L., & Cuthie, J. C. (1984). Blood pressure self-monitoring in the workplace. Journal of Occupational Medicine, 26, 183-8.

Bertera, R., Levine, D. M., and Green, L. W. (1982). Behavioral effects of blood pressure self‑monitoring in the workplace using automated measurements.  Preventive Medicine, 11, 158-63.

3>2. Subsequent publications of applications in occupational and other settings. See continuously updated and searchable bibliography and links to abstracts at http://www.lgreen.net/bibliog.htm. This website also updates the endnotes to this and the other chapters in this book and provides links to many of their abstra

4>3. The most extensive application of the Precede-Proceed model in a series of work-site health programs, with needs assessments and evaluation of efficiency and effectiveness at several levels, is that by Robert Bertera and his colleagues for the international employee health improvement programs of the Du Pont Corporation. For his most recent publications reporting and reflecting on the results of this series of programs, see R. L. Bertera, 1991, 1993, 1999. The article in which he describes how the Precede-Proceed model was applied is R. L. Bertera, 1990b.

Bertera, R. L. (1990a). The effects of workplace health promotion on absenteeism and employment costs in a large industrial population. American Journal of Public Health, 80, 1101-5.

Bertera, R. L. (1990b). Planning and implementing health promotion in the workplace: a case study of the Du Pont Company experience. Health Education Quarterly, 17, 307-27.

Bertera, R. L. (1991). The effects of behavioral risks on absenteeism and health-care costs in the workplace.
Journal of Occupational Medicine 33, 1119-24.

Bertera, R. L. (1999). Worksite health promotion. In B. Poland, L. W. Green, & I. Rootman (Eds.), Settings approaches to health promotion. Thousand Oaks, CA: Sage.

5>4. Minimalist program theory. Scriven, 1998. See also Glanz & Rimer, 1995.

Glanz, K, and B. Rimer (1995). Theory at a Glance: A Guide for Health Promotion Practice. Bethesda: National Cancer Institute, NIH Pub. No. 95-3896, Public Health Service, U.S. Dept. of Health and Human Services, July.

Scriven, M. (1998). Minimalist theory: The least theory that practice requires. American Journal of Evaluation, 19, 57-70

    Historical Context of Health in the Workplace 

        See also below Headlines & Milestones in Occupational  Health

    Demographic Context

12>5. Changing Workforce: aging and feminization. Evans, McGrail, et al., 2001; O'Campo, Eaton, & Muntaner, 2003. The aging workforce might have been offset by the early retirement of many, except that the economy at the turn of the century interfered with those plans for most, and those who took early retirement did not fare well financially, so many of them returned to work; e.g., Haveman, Holden, et al., 2003.

Evans RG, McGrail KM, Morgan SG, Barer ML, Hertzman C. Apocalypse no: population aging and the future of health care systems. Can J Aging 2001; 20: (Suppl 1):160-91.

Haveman R, Holden K, Wilson K, Wolfe B. (2003). Social security, age of retirement, and economic well-being: intertemporal and demographic patterns among retired-worker beneficiaries. Demography. 2003 May;40(2):369-94.

O'Campo P, Eaton WW, Muntaner C. (2004). Labor market experience, work organization, gender inequalities and health status: results from a prospective analysis of US employed women. Soc Sci Med. 2004 Feb;58(3):585-94.

13>6. Workplace replacing neighborhood as community of identity and social support for many.  Dean & Hancock, 1992; Green, 1990. Lack of social support outside the workplace causes some, especially women, to forego early retirement possibilities; e.g., Elovainio, Kivimaki, et al., 2003.

Elovainio M, Kivimaki M, Vahtera J, Ojanlatva A, Korkeila K, Suominen S, Helenius H, Koskenvuo M. (2003). Social support, early retirement, and a retirement preference: a study of 10,489 Finnish adults. J Occup Environ Med. 2003 Apr;45(4):433-9.
 

    Political-Regulatory Context: Occupational Health & Safety Legislation

14>7. Occupational Safety and Health Act, 1970, created the Occupational Safety and Health Agency (OSHA) within the U.S. Department o f Labor. http://www.osha.gov, accessed Dec 6, 2003. Since the agency was created in 1971, workplace fatalities in the U.S. have been cut in half and occupational injury and illness rates have declined 40%, at the same time that U.S. employment has doubled from 56 million workers at 3.5 million worksites to 111 million workers at 7 million sites.

8. History of work and workers' health protection. Frank, 2002.

Frank, A. L. (2002). Occupational safety and health. In L. Breslow, B. Goldstein, L. W. Green, C. W. Keck, J. M. Last, & M. McGinnis (Eds.), Encyclopedia of public health (pp. 849-55). New York: Macmillan Reference USA.

22>9. Workplace hazard exposure injuries increased while other injuries and occupational deaths were decreasing in the 1990s and early 2000s. U.S. Department of Labor, Bureau of Labor Statistics, http://data.bls.gov/cgi-bin/surveymost?cf, accessed March 21, 2004.

23>10. Highway injuries account for largest proportion of work-related deaths. http://www.bls.gov/iif/oshwc/cfoi/cfch0001.pdf, accessed March 21, 2004.

11. Health issues arising with increases in working mothers. E.g., Anderson, Butcher, & Levine, 2003; Galambos, Barker, & Almeida, 2003; Lakati, Binns, & Stevenson, 2003.

Anderson PM, Butcher KF, Levine PB. (2003). Maternal employment and overweight children.J Health Econ.  May;22(3):477-504.

Galambos NL, Barker ET, Almeida DM. (2003). Parents do matter: trajectories of change in externalizing and internalizing problems in early adolescence. Child Dev. Mar-Apr;74(2):578-94.

Lakati A, Binns C, Stevenson M. (2003). Breast-feeding and the working mother in Nairobi. Public Health Nutr.  Dec;5(6):715-8.

26>12. Combining interventions of work environment and employees' health behavior.  E.g., DeJoy, & Wilson, 2003; Secker, & Membrey, 2003; Sorensen, Stoddard, et al, 2002.

DeJoy DM, Wilson MG. (2003). Organizational health promotion: broadening the horizon of workplace health promotion. Am J Health Promot. May-Jun;17(5):337-41.

Secker J, Membrey H. (2003). Promoting mental health through employment and developing healthy workplaces: the potential of natural supports at work. Health Educ Res. 18(2):207-15.

Sorensen G, Stoddard AM, LaMontagne AD, Emmons K, Hunt MK, Youngstrom R, McLellan D, Christiani DC. (2002). A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial (United States). Cancer Causes Control. 13(6):493-502.
 

13. Adding interventions with family to comprehensive workplace health programs. E.g., Sorensen, Stoddard, et al., 1999, had a multilevel environmental and educational program on fruit and vegetable consumption at a work site, producing a 7% increase in consumption after statistical controls, whereas an added intervention with family members increased the rate of fruit and vegetable consumption by 19%. Sorensen, Emmons, et al., 2003, have extended this experience to a model for using the various social contexts in which a behavior occurs to structure interventions that address both the environment and the behavior.

Sorensen G, Emmons K, Hunt MK, Barbeau E, Goldman R, Peterson K, Kuntz K, Stoddard A, Berkman L.(2003). Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations. Prev Med. 37(3):188-97.

Sorensen, G., Stoddard, A., Peterson, K., Cohen, N., Hunt, M. K., Stein, E., Palombo, R., & Lederman, R. (1999). Increasing fruit and vegetable consumption through worksites and families in the Treatwell 5-a-Day Study. American Journal of Public Health, 89, 54-60.

27>14. Range of worksite medical surveillance: E.g., Faucett & McCarthy, 2003, on lower back and other chronic pain; Office of the Secretary, Department of Transportation, 2001; Ozminkowski, Mark, et al., 2003, Wong, 2002, on drug and alcohol testing.

Faucett J, McCarthy D. (2003). Chronic pain in the workplace. Nurs Clin North Am., 38(3):509-23.

Office of the Secretary, DOT. (2001). Procedures for transportation workplace drug and alcohol testing programs; technical amendments. Final rule. Fed Regist. 66(154):41944-55.

Ozminkowski RJ, Mark TL, Goetzel RZ, Blank D, Walsh JM, Cangianelli L. (2003). Relationships between urinalysis testing for substance use, medical expenditures, and the occurrence of injuries at a large manufacturing firm. Am J Drug Alcohol Abuse. 29(1):151-67.

Wong R. (2002). The current status of drug testing in the U.S. workforce. Am Clin Laboratories, 21(3):14-7.

28>15. Hypertension screening: elevated blood pressure caused by the job or other lifestyle risks?  R. L. Bertera, & Cuthie, 1984; Getliffe, Crouch, et al., 2000.

Getliffe KA, Crouch R, Gage H, Lake F, Wilson SL. (2000). Hypertension awareness, detection and treatment in a university community: results of a worksite screening. Public Health, 114(5):361-6.

29>16. Privacy, confidentiality, and job discrimination issues arising from HIV and drug testing. Burris, 1997; London, Benjamin, & Bass, 2002; Warner, Walker, & Friedmann, 2003.

London L, Benjamin P, Bass DH. (2002). HIV testing and the Employment Equity Act--putting an end to the confusion. S Afr Med J., 92(3):199-201.

Warner EA, Walker RM, Friedmann PD. (2003). Should informed consent be required for laboratory testing for drugs of abuse in medical settings? Am J Med. 115(1):54-8. Review.

30>17. Health risk appraisal questionnaires. Burton, Chen, et al., 2003; Sloan, Gruman, & Allegrante, 1987. Yen, McDonald, et al., 2003. For application with older adults, see Haber, 1994. Both Burton, et al. and Yen et al. found the health risk appraisal scores to be highly predictive of subsequent medical and pharmaceutical expenditures by the employees.

Burton WN, Chen CY, Conti DJ, Schultz AB, Edington DW (2003). Measuring the relationship between employees' health risk factors and corporate pharmaceutical expenditures.
J Occup Environ Med. 2003 Aug;45(8):793-802.

Haber, D. (1994). Medical screenings and health assessments. In D. Haber (Ed.), Health Promotion and Aging (pp. 41-76). New York, NY: Springer Publishing Company.

Yen L, McDonald T, Hirschland D, Edington DW. (2003). Association between wellness score from a health risk appraisal and prospective medical claims costs. J Occup Environ Med., 45(10):1049-57.

31>18. Genetic testing at the worksite, ethical and legal complications. Krumm, 2002; Makdisi, 2001; McCunney, 2002; Schill, 2000.

Krumm J. (2002). Genetic discrimination. Why Congress must ban genetic testing in the workplace. J Leg Med. 2002 Dec;23(4):491-521. Review. No abstract available.

Makdisi JM. (2001). Genetic privacy: new intrusion a new tort? Creighton Law Rev., 34(4):965-1026.

McCunney RJ. (2002). Genetic testing: ethical implications in the workplace. Occup Med. 17(4):665-72. Review.

Schill AL. (2000). Genetic information in the workplace. Implications for occupational health surveillance. AAOHN J. , 48(2):80-91. Review.

36>19. Early occupational health and safety focused on hazards outside the control of employees. DeJoy, 1990; Eddy, Fitzhugh & Wang, 1997; Winett, King & Altman, 1989.

DeJoy, D. M. (1990) Toward a comprehensive human factors model of workplace accident causation. Professional Safety 35:11-16.

Winett, R. A., D. G. Altman and A. C. King (1990). "Conceptual and Strategic Foundations for Effective Media Campaigns for Preventing the Spread of HIV Infection," Evaluation and Program Planning 13: 91-104.

37>20. Employers gave greater weight to individual behavioral and psychological determinants. E.g., Bellingham, 1994; Brailey, 1986;  For critiques of this approach, see Bibeau, Mullen, et al., 1988; Eakin, 1992; Green, 1995; and Polanyi, Frank, et al., 2000, who characterize this as the "traditional worksite health promotion approach," (p. 141).

Bellingham, R. (1994). Critical issues in worksite health promotion. New York: Macmillan Publishing Co., 1994.

Bibeau, D. L.,  Mullen, K. D.,  McLeroy, K. R., Green, L.W., & Foshee, V. (1988).  Evaluations of workplace smoking cessation programs: A critique. American Journal of Preventive Medicine, 4, 87-95.

Brailey, L. J. (1986). "Effects of Health Teaching in the Workplace on Women's Knowledge, Beliefs, and Practices Regarding Breast Self-Examination," Research in Nursing and Health 9: 223-31.

Green, LW (1996). Health promotion in the worksite: theory and practice.  Japan Health and Culture Promotion Center newsletter.  No. 3: 2-13 (in Japenese).

Polanyi, M. F. D., Frank, J. W., Shannon, H. S., Sullivan, T. J., & Lavis, J. N. (2000). Promoting the determinants of good health in the workplace. In B. D. Poland, L. W. Green, & I. Rootman (Eds.), Settings for health promotion: Linking theory and practice (pp. 138-60). Thousand Oaks, CA: Sage.

38>21. Movement toward work organization and its influence on health. E.g., Bunce, 1997; Kagan, Kagan, & Watson, 1995; Quick, Murphy, & Hurrell, 1992; Polanyi, Frank, et al., 2000; Schnall, Landsbergis, & Baker, 1994. For applications of PRECEDE toward this approach, see Conrad, Campbell, et al., 1996; Daltroy et al., 1993; DeJoy, & Wilson, 2003; Kaukiainen, 2000. In China, an application of PRECEDE concluded "that smoking is affected strongly by enabling factors and reinforcing factors...in the workplace" (Sun & Shun, 1995, p. 266), a step toward addressing work organization as a key point of intervention. In their implementation of smoking control policy in Sweden, Pucci & Haglund, 1994, observed that,“...on-the-job smoking may, in part, be associated with the structure and function of the work organization...tools developed and tested for assessing organizational climate and its link to worksite health promotion are required. Green & Kreuter propose an administrative diagnosis as part of their Precede model...Such a diagnosis might even facilitate adaptation of the current implementation model to Swedish reality" (p. 66).

*Conrad, K. M., Campbell, R. T., Edington, D. W.,  Faust, H. S., &  Vilnius, D.(1996). The worksite environment as a cue to smoking reduction. Research in Nursing and Health, 19, 21-31.

*Daltroy, L. H., Iversen, M. D., Larson, M.G., et al. (1993). Teaching and social support: effects on knowledge, attitudes, and behaviors to prevent low back injuries in industry. Health Education Quarterly, 20, 43-62.

*DeJoy, D. M., & Wilson, M. G. (2003). Organizational health promotion: broadening the horizon of workplace health promotion. American Journal of Health Promotion, 17, 337-41.

*Kaukiainen, A. (2000). Promotion of the Health of Construction Workers. Tampere, Finland: Finnish Institute of Occupational Health, Research Reports 35. Esp. pp. 24-38, 60-62.

*Pucci, Linda G., & Haglund,  B.(1994). "Naturally smoke free": A support program for facilitating worksite smoking control policy implementation in SwedenHealth Promotion International9, 177-87.

*Sun, W. Y., & Shun, J. (1995). Smoking behavior amongst different socioeconomic groups in the workplace in the People's Republic of China. Health Promotion International, 10, 261-66.

39>22. Attention to psychosocial aspects of occupational health opened the door to the workplace mental health movement. Lovato, Green, & Stainbrook, 1993; Vasse, Nijhuis, et al., 1997a; 1997b.

*Lovato, C. Y., Green, L. W., & Stainbrook, G. (1993). The benefits perceived by industry in supporting health promotion programs in the worksite. In J. P. Opatz (Ed.). Economic impact of worksite health promotion (pp. 3-31). Champaign, IL: Human Kinetics Press.

*Vasse, R. M., Nijhuis, F. J. N., Kok, G., & Kroodsma, A. T. (1997a). Effectiveness of a worksite alcohol program (pp. 43-58).  In R. Vasse (Ed.), The development, implementation and evaluation of two worksite health programs aimed at preventing alcohol problems. Maastricht: Maastricht University.

*Vasse, R. M., Nijhuis, F.J. N., Kok, G., & Kroodsma, A. T.  (1997b). Process evaluation of two worksite alcohol programs (pp. 71-88).  In R. Vasse (Ed.), The development, implementation and evaluation of two worksite health programs aimed at preventing alcohol problems. Maastricht: Maastricht University.

40>23. Progress in occupational safety and health noted at the turn of the century. Cullen, 1999, notes that the gains of the last three decades were the most impressive following previous eras of pendulum swings, but he cautions that broad social currents over which occupational health professionals have little control could reverse some of the gains (pp. 10-11).

Cullen, M. R. (1999). Personal reflections on occupational health in the twentieth century: Spiraling to the future. Annual Review of Public Health, 20, 1-13.

24. Recent deregulatory trends could reverse some gains, e.g., Chenet, & McKee, 1998; Rosner, 2000.

Chenet L, McKee M. (1998). Down the road to deregulation. Alcohol Alcohol. 1998 Jul-Aug;33(4):337-40.

Rosner D. (2000). When does a worker's death become murder? Am J Public Health. 90(4):535-40. Review. [full text]

25. Need for attention to the dissemination, translation, and application of legislative, regulatory, and voluntary initiative information, e.g., Schulte, Okun, et al., 2003.

Schulte PA, Okun A, Stephenson CM, Colligan M, Ahlers H, Gjessing C, Loos G, Niemeier RW, Sweeney MH. (2003). Information dissemination and use: critical components in occupational safety and health. Am J Ind Med., 44(5):515-31.

26. Globalization of trade requires more attention to equivalent worker protections in countries. Frank, p. 854.

See endnote 8.

    The Economic Context

44>27. Continuing growth of payout for health care of employees captures the attention of employers on health program innovations. Data from Centers for Medicare and Medicaid Systems, 2002.

Centers for Medicare and Medicaid Systems, 2002. U.S. health care system. Chapter 1 slides at http://cms.hhs.gov/charts/default.asp, accessed Dec 7, 2003. See also chapter 4 slides on private insurance (three of which are reproduced below; Table 4.2 and 4.3 will appear in the 4th edition).

For the originals of these three slides, go to http://cms.hhs.gov/charts/default.asp, accessed Dec 7, 2003.

28. Growing evidence of the workplace effectiveness and cost-containment potential of health education and health promotion strategies. E.g., Pelletier, 2001.

Pelletier KR. (2001). A review and analysis of the clinical- and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1998-2000 update. Am J Health Promotion, 16(2):107-16. Review.

 

The Worksite Wellness and Health Promotion Context


49>
29. Smoke-free workplace legislation gave worksite health promotion its first major regulatory support. Eriksen, 1986; Fielding, 1991; Pucci & Haglund, 1994.

Eriksen, M. P. (1986). "Workplace Smoking Control: Rationale and Approaches," Advances in Health Education and Promotion, vol. 1, part A (Greenwich, CT: JAI Press), pp. 65-103.

Fielding, J. E. (1990). "Worksite Health Promotion Programs in the United States: Progress, Lessons and Challenges," Health Promotion International 5: 75-84.

Pucci, L. G., & Haglund, B. (1994). “Naturally Smoke Free”: A support program for facilitating worksite smoking control policy implementation in Sweden. Health Promotion International, 9, 177-87.

50>30. Early attempts to estimate cost-benefit potential of health education and health promotion programs. Warner, 1987. For early applications of PRECEDE for cost-benefit evaluations, see Bertera, 1990a, 1993; Eastaugh & Hatcher, 1982; Green, 1974; Windsor, Lowe, & Perkins, 1993. A recent review is Riedel, Lynch, et al., 2001.

*Bertera, R. L. (1990a). The effects of workplace health promotion on absenteeism and employment costs in a large industrial population. American Journal of Public Health, 80, 1101-1105.

*Eastaugh, Steven R. and Myron E. Hatcher (1982).  Improving Compliance Among Hypertensives: A Triage Criterion with Cost-Benefit Implications. Medical Care 20(10):1001-17. 

*Green, L. W. (1974).  Toward Cost-Benefit Evaluations of Health Education: Some Concepts, Methods, and Examples. Health Education Monographs 2 (Suppl. 1): 34-64. Reprinted in Supplement to the Report of the President's Committee on Health Education (New York: National Health Council, Sept. 1974), and in U.S. Congress, Disease Control and Health Education and Promotion (Washington, DC: U.S. Congress, 1975), pp.939-965.

This was the first peer reviewed journal publication of the PRECEDE model, though it was not called that until publication of the first edition of the textbook (Green, Kreuter, Deeds & Partridge, 1980).

Riedel JE, Lynch W, Baase C, Hymel P, Peterson KW. (2001). The effect of disease prevention and health promotion on workplace productivity: a literature review. American Journal of Health Promotion, 15, 167-91. Review.

Warner, K. E. (1987). Selling health promotion to corporate America: Uses and abuses of the economic argument. Health Education Quarterly, 14, 39-55.

*Windsor, R., Lowe, J., Perkins, L.,et al  (1993). Health education methods for pregnant smokers: Behavioral impact and cost-benefit. American Journal of Public Health, 83(2): 201-6.

51>31. Concern that cost-benefit arguments for health promotion might be oversold. Warner, 1987; Warner, Wickizer, et al., 1987; see also Warner's more recent reflections and analyses on some aspects of this issue as applied to smoking cessation and to tobacco control in developing countries, Warner, 2003; Warner, Hodgson, & Carroll, 1999.

Warner KE. (1987). Selling health promotion to corporate America: uses and abuses of the economic argument. Health Educ Q. 14(1):39-55.

Warner KE. (2003). The costs of benefits: smoking cessation and health care expenditures. Am J Health Promotion, 18, 123-4, ii.

Warner KE, Hodgson TA, Carroll CE. (1999). Medical costs of smoking in the United States: estimates, their validity, and their implications. Tob Control. 1999 Autumn;8(3):290-300. Review. [full text free online via abstract]

Warner KE, Wickizer TM, Wolfe RA, Schildroth JE, Samuelson MH. (1987). Economic implications of workplace health promotion programs: review of the literature. J Occup Med. 30(2):106-12. Review.

52>32. Cost-benefit impact on bottom line should not be sole basis for program implementation. Warner, Smith, Smith, & Fries, 1996. Warner, 1998, also showed how the same problems of deferred benefits (10-25 years in the case of most economic benefits of smoking cessation), turnover (those who benefit might switch their employment or membership to a competitor, who then reaps the economic benefit) apply to managed care organizations' reluctance to invest more in prevention and health promotion counseling.

Warner KE. (1998). Smoking out the incentives for tobacco control in managed care settings. Tob Control.  7 (Suppl) S50-4. [full text]

Warner KE, Smith RJ, Smith DG, Fries BE. (1996). Health and economic implications of a work-site smoking-cessation program: a simulation analysis. J Occup Environ Med. 38(10):981-92.

33. Evaluations of cost-effectiveness of comprehensive, as distinct from categorical programs. Pelletier, 2003.

Pelletier KR. (2001). A review and analysis of the clinical- and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1998-2000 update. Am J Health Promotion, 16(2):107-16. Review.

53>34. Systematic reviews support effectiveness of workplace smoking cessation interventions. Moher, Hey, & Lancaster, 2003.

Moher M, Hey K, Lancaster T. (2003). Workplace interventions for smoking cessation. Cochrane Database Syst Rev. (2):CD003440. Review.

54>35. Factors enhancing or suppressing effectiveness of smoking cessation in workplace programs. Brownson, Hopkins, & Wakefield, 2002; Burns, Shanks, et al., 2000; Hopkins, Briss, et al., 2001.

Brownson, R. C., Hopkins, D. P., & Wakefield, M. A. (2002). Effects of smoking restrictions in the workplace. Annual Review of Public Health, 23, 333-48.

Burns, D. M., Shanks, T. G., Major, J. M., Gower, K. B., & Shopland, D. R. (2000). Restrictions on smoking in the workplace. In National Cancer Institute. Population based smoking cessation: Proceedings of a conference on what works to influence cessation in the general population. Smoking and Tobacco Control Monograph No. 12. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, NIH Pub. No. 00-4892.

Hopkins DP, Briss PA, Ricard CJ, Husten CG, Carande-Kulis VG, Fielding JE, Alao MO, McKenna JW, Sharp DJ, Harris JR, Woollery TA, Harris KW; Task Force on Community Preventive Services. (2001). Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med. 2001 Feb;20(2 Suppl):16-66.

55>36. Simulation of the stream of benefits accruing from workplace smoking-cessation program. Warner, Smith, et al., 1996, p. 981.

Warner KE, Smith RJ, Smith DG, Fries BE. (1996). Health and economic implications of a work-site smoking-cessation program: a simulation analysis. J Occup Environ Med. 38(10):981-92.

56>37. Comprehensive behavioral-environmental stress management programs more effective than behavioral-only. McLeroy, Green, et al., 1984; McVicar, 2003; Pelletier & Lutz, 1998. A recent book devoted to review and synthesis of the research on stress management and its measurement derives an approach from the cognitive ergonomics and brain research literature, Belik, 2003.

Belik, K. (2003). The occupational stress index: An approach derived from cognitive ergonomics and brain research for clinical practice. Cambridge: Cambridge International Science Publishing.

McLeroy, K., L. W. Green, K. Mullen, and V. Foshee (1984). "Assessing the Effects of Health Promotion in Worksites: A Review of the Stress Program Evaluations," Health Education Quarterly 11: 379-401.

McVicar A. (2003). Workplace stress in nursing: a literature review. J Adv Nurs., 44(6):633-42.

Pelletier, K. R. and R. Lutz (1988). "Healthy People--Healthy Business: A Critical Review of Stress Management Programs in the Workplace," American Journal of Health Promotion 2(3): 5-12.

57>38. Low participation rates in workplace health promotion programs limit generalizability of evaluation results. Linnan, Emmons, et al., 2002, found that passive methods of recruitment produced a much greater reach and number enrolled, though lower rate of enrollment and a higher rate of attrition. The trade-off seems to favor the greater reach and enrollment, and the greater diversity and therefore representativeness of the passive method. See also, Linnan, Sorensen, et al., 2001; Lovato & Green, 1990. For evidence-based Guidelines to comprehensive programs to promote health eating and physical activity, see Gregory, 2002.

Gregory, S. (2002). Guidelines for comprehensive programs to promote healthy eating and physcial activity. Champaign, IL: Human Kenetics.

Linnan LA, Emmons KM, Klar N, Fava JL, LaForge RG, Abrams DB. (2002). Challenges to improving the impact of worksite cancer prevention programs: comparing reach, enrollment, and attrition using active versus passive recruitment strategies. Ann Behav Med., 24(2):157-66.

Linnan LA, Sorensen G, Colditz G, Klar DN, Emmons KM. (2001). Using theory to understand the multiple determinants of low participation in worksite health promotion programs. Health Educ Behav. 28, 591-607. Review.
 

59>39. Competitions help in recruiting participants. Croghan, O'Hara, et al., 2001; Koffman, Lee, et al., 1998.

Croghan IT, O'Hara MR, Schroeder DR, Patten CA, Croghan GA, Hays JT, Dale LC, Bowen D, Kottke T, Hurt RD. (2001). A community-wide smoking cessation program: Quit and Win 1998 in Olmsted county. Prev Med., 33(4):229-38.

Koffman DM, Lee JW, Hopp JW, Emont SL. (1998). The impact of including incentives and competition in a workplace smoking cessation program on quit rates. Am J Health Promot. 13(2):105-11.

60>40. Hypertension screening, benefits and absenteeism. Sheridan, Pignone, & Donahue, 2003.

Sheridan S, Pignone M, Donahue K. (2003). Screening for high blood pressure: A review of the evidence for the U.S. Preventive Services Task Force. Am J Prev Med., 25(2):151-8. Review.

61>41. Cost-benefit studies in hypertension control. A. J. Brennan, 1985; see also Aldana, 2003.  For cost-benefit applications of PRECEDE in hypertension, see Cote, Gregoire, et al., 2003; Eastaugh, & Hatcher, 1982; Hatcher, Green, et al., 1986.

Aldana SG. (2003). Financial impact of health promotion programs: A comprehensive review of the literature. Am J Health Promotion, 15, 296-320. Review.

*Cote I, Gregoire JP, Moisan J, Chabot I, Lacroix G. (2003). A pharmacy-based health promotion programme in hypertension: cost-benefit analysis. Pharmacoeconomics, 21(6):415-28.

*Eastaugh, S. R. and Hatcher, M. E. (1982).  Improving compliance among hypertensives: A triage criterion with cost-benefit implications. Medical Care, 20, 1001-17. 

*Hatcher, M. E.,  Green, L. W., Levine, D. M., &  Flagle, C. E.(1986).  Validation of a decision model for triaging hypertensive patients to alternate health education interventions. Social Science and Medicine, 22, 813-19.

62>42. Cost-effectiveness of comprehensive workplace health promotion programs. Pelletier, 2001.

Pelletier KR. (2001). A review and analysis of the clinical- and cost-effectiveness studies of comprehensive health promotion and disease management programs at the worksite: 1998-2000 update. Am J Health Promotion, 16(2):107-16. Review.

63>43. Johnson & Johnson comprehensive "Live For Life" program.  Bly, Jones, & Richardson, 1986; Jones, Bly, & Richardson, 1990. .

Bly JL, Jones RC, Richardson JE. (1986). Impact of worksite health promotion on health care costs and utilization. Evaluation of Johnson & Johnson's Live for Life program. JAMA, 256, 3235-40.

Jones RC, Bly JL, Richardson JE. (1990). A study of a work site health promotion program and absenteeism. J Occup Med., 32, 95-9.

64>44. Comprehensive worksite health promotion programs are not necessarily ecological.  Best, Stokols, et al., 2003; Richard, Potvin, et al., 1996. "Comprehensive" has two meanings in the health program literature: one is the multi-risk-factor notion, as suggested here, to mean encompassing multiple behavioral or health issues; the other refers to "comprehensive programs" as multiple levels and types of interventions in one program addressed often to just one or two risk factors, e.g., Centers for Disease Control & Prevention, 1999a; Gregory, 2002; Pelletier, 2001.

Centers for Disease Control and Prevention (1999a). Best practices for comprehensive tobacco control programs - August 1999. Atlanta, GA:  U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

Gregory, S. (2002). Guidelines for comprehensive programs to promote healthy eating and physcial activity. Champaign, IL: Human Kenetics.

65>45. Barriers to randomized controlled designs for program evaluation in the worksite; and limitations of their generalizability.  Green, 2001b.

Green LW. (2001b). From research to "best practices" in other settings and populations. Am J Health Behavior, 25, 165-78.

66>46. Social support as a buffer for work stress. The classic work on this subject is House, 1981. For PRECEDE applications: Daltroy et al., 1993; Hubball, 1996. Bailey, Richards, et al., 1987, noted in their PRECEDE-based study of education and social support for adults with asthma, “the need to conduct research in diverse environments, rather than usually conducting research in the unusually favorable environment of a university medical center” (p. 355). This supports the point made in the previous section and endnote about the limitations of the highly research-controlled, socially artificial environment in which most randomized controlled trials are done. See also their later trial in which "usual care" control groups were now getting the interventions tested in their earlier trials (Bailey, Kohler, et al., 1999).

*Bailey WC, Kohler CL, Richards JM Jr, Windsor RA, Brooks CM, Gerald LB, Martin B, Higgins DM, Liu T. (1999). Asthma self-management: do patient education programs always have an impact? Arch Intern Med. 159, 2422-8.

*Bailey WC, Richards JM Jr, Manzella BA, Windsor RA, Brooks CM, Soong SJ. (1987). Promoting self-management in adults with asthma: an overview of the UAB program. Health Education Quarterly, 14, 345-55.

*Daltroy, L. H., Iversen, M. D., Larson, M.G., et al. (1993). Teaching and social support: effects on knowledge, attitudes, and behaviors to prevent low back injuries in industry. Health Education Quarterly, 20, 43-62.

House, J. S. (1981). Work stress and social support. Reading MA: Addison-Wesley.

*Hubball, H. (1996). Development and Evaluation of a Worksite Health Promotion Program: Application of Critical Self-Directed Learning for Exercise Behaviour Change. Unpublished doctoral dissertation. Vancouver, B. C.: University of British Columbia, Faculty of Graduate Studies, Institute of Health Promotion Research.

67>47. Family of employees as major part of health care insurance expenditures. Chenoweth, 1994.

Chenoweth, D. (1994). Positioning health promotion to make an economic impact. Chap. 2 in J. P. Opatz (Ed.), Economic impact of worksite health promotion (pp. 33-49). Champaign, IL: Human Kinetics.

68>48. Family as secondary target of workplace health programs. E.g., Hunt, Lederman, et al., 2000; Schuster, Eastman, et al., 2001; Watts, Vernon, et al., 2003.

Hunt MK, Lederman R, Stoddard A, Potter S, Phillips J, Sorensen G. (2000). Process tracking results from the Treatwell 5-a-Day Worksite Study. Am J Health Promotion, 14, 179-87.

Schuster MA, Eastman KL, Fielding JE, Rotheram-Borus MJ, Breslow L, Franzoi LL, Kanouse DE. (2001). Promoting adolescent health: worksite-based interventions with parents of adolescents. J Public Health Manag Practice, 7, 41-52.

Watts BG, Vernon SW, Myers RE, Tilley BC. (2003). Intention to be screened over time for colorectal cancer in male automotive workers. Cancer Epidemiol Biomarkers  & Prevention, 12, 339-49.

69>49. Specific company programs. For descriptions of these and 59 other U.S. company programs, some of which were international, see Office of Disease Prevention and Health Promotion, 1993. For Canada, a similar inventory provides descriptions of 62 company health promotion programs: Health and Welfare Canada, 1992. For the more recent status of workplace program statistics as used for 1998-2001 baselines for the U.S. Healthy People 2010 objectives for the nation in disease prevention and health promotion, go to http://www.healthypeople.gov/hpscripts/SearchObjectives_FT.asp, accessed Dec 8, 2003. For other publications of Health Canada on worksite health: http://www.hc-sc.gc.ca/pphb-dgspsp/pubssub_e.html#work.

Health and Welfare Canada. (1992). Health promotion in the workplace: A sampling of company programs and initiatives. Ottawa: Minister of Supply and Services.

Office of Disease Prevention and Health Promotion. (1993). Health promotion goes to work: Programs with an impact. Washington, DC: U.S. Department of Health and Human Services.

70>50. Cost of one unhealthy baby to an employer. Howse, 1991.

Howse, J. D. (1991). Lessons learned from the Babies and You Program. White Plains, NY: March of Dimes Birth Defects Foundation.

71>51. Prenatal and breastfeeding programs for working mothers. Ibid. For PRECEDE analyses of breastfeeding and prenatal programs, Burglehaus, Smith, et al., 1997; Olson, 1994; Sword, 1999; Williams, Innis, et al., 1999.

*Burglehaus, M. J., Smith, L. A., Sheps, S. B., & Green, L. W. (1997). Physicians and breastfeeding: Beliefs, knowledge, self-efficacy and counselling practices. Canadian Journal of Public Health, 88, 383-87, 1997.

*Olson, C. M. (1994). Promoting positive nutritional practices during pregnancy and lactation. American Journal of Clinical Nutrition, 59(suppl.), 525S-31S.

*Sword, W. (1999). A socio-ecological approach to understanding barriers to prenatal care for women of low income.  Journal of Advanced Nursing, 29, 1170-7.

*Williams, P. L., Innis, S. M., Vogel, A. M. P., & Stephen, L. J. (1999).  Factors influencing infant feeding practices of mothers in Vancouver.  Canadian Journal of Public Health 90(2): 114-119.

72>52. Programs directed at children of employees. Vass & Walsh-Allis, 1990.

Vass, M., & Walsh-Allis, G. A. (1990). Employee dependents: The future focus of worksite health promotion programs and the potential role of the allied health professional. Journal of Allied Health, 19, 39-48.

73>53. Employee Assistance Program guidelines. Employee Assistance Professionals Association, 1999.

Employee Assistance Professionals Association. (1999). EAPA standards and professional guidelines-1999. Arlington, VA: Employee Assistance Professionals Association. http://www.eapassn.org/store/, accessed Dec 8, 2003.

74>54. Alcohol problems of employees. Des Jarlais & Hubbard, 1997; Marchand, Demers, et al. 2003.

Marchand A, Demers A, Durand P, Simard M. (2003). The moderating effect of alcohol intake on the relationship between work strains and psychological distress. Journal of Studies on Alcohol, 64, 419-27.

75>55. Alcohol and psychosocial disturbance, e.g., domestic violence. Stuart, Moore, et al., 2003.

Stuart GL, Moore TM, Ramsey SE, Kahler CW. (2003). Relationship aggression and substance use among women court-referred to domestic violence intervention programs. Addictive Behavior, 28, 1603-10.

76>56. Alcohol costs to employers.  R. L. Bertera, 1991. See also Lipscomb, Dement, & Li, 2003. .

Bertera, R. L. (1991).The effects of behavioral risks on absenteeism and health-care costs in the workplace. Journal of Occupational Medicine 33, 1119-24.

Lipscomb HJ, Dement JM, Li L (2003). Health care utilization of carpenters with substance abuse-related diagnoses. Am J Ind Med. 43(2):120-31.
 

77>57. Early medical model of alcohol treatment and referral. Walsh & Kelleher, 1987. See also Glenn, 1994. Cf. Treno & Lee, 2002.

Glenn, M. K. (1994). Preparing rehabilitation specialists to address the prevention of substance abuse problems. Rehabilitation Couseling, 38, 164-79.

Treno, A. J., & Lee, J. P. (2002). Approaching alcohol problems through local environmental interventions. Alcohol Research and Health, 26, 35-40.

78>58. Social-behavioral and ecological approaches to alcohol prevention, treatment and referral. Girdano, 1986; Polcin, 2003. For PRECEDE applications: Dedobbeleer, & Desjardins, 2001; Newman, Martin, & Weppner, 1982; Rice & Green, 1992.

*Dedobbeleer, N., & Desjardins, S. (2001). Outcomes of an ecological and participatory approach to prevent alcohol and other drug abuse among multiethnic adolescents.  Substance Use and Misuse 36(13): 1959-91.  

*Newman, I. M., G. L. Martin, and R. Weppner (1982). "A Conceptual Model for Developing Prevention Programs," The International Journal of the Addictions 17: 493-504.

Polcin DL. (2003). Rethinking confrontation in alcohol and drug treatment: consideration of the clinical context. Substance Use and Misuse, 38, 165-84. Review.

Rice, M. and Green, L.W. (1992). Prevention and education.  Chapter 7 in Kronstadt, D. (Ed.), Pregnancy and exposure to alcohol and other drug use. Washington, D.C.: The CDM Group, for the Office of Substance Abuse Prevention, U.S. Department of Health and Human Services.

79>59. Constructive confrontation. Trice & Beyer, 1984.

Trice HM, Beyer JM. (1984). Work-related outcomes of the constructive-confrontation strategy in a job-based alcoholism program. Journal of  Studies on Alcohol, 45, 393-404.

80>60. NIAAA evidence of EAP effectiveness led to their expansion since 1970s. Kurtz, Googins, & Howard, 1984.

83>61. From treatment to secondary prevention and self-referral. J. B. Franz, 1987; Garrett, Landau-Stanton, 1997; Gossop, Stephens, et al., 2001. For a European example: Vasse, Nijhuis, Kok, & Kroodsma, 1997a,b.

Garrett J, Landau-Stanton J, Stanton MD, Stellato-Kabat J, Stellato-Kabat D. (1997). ARISE: a method for engaging reluctant alcohol- and drug-dependent individuals in treatment. Albany-Rochester Interventional Sequence for Engagement. J Subst Abuse Treatment, 14, 235-48.

Gossop M, Stephens S, Stewart D, Marshall J, Bearn J, Strang J. (2001). Health care professionals referred for treatment of alcohol and drug problems. Alcohol and Alcoholism, 36, 160-4.

*Vasse, R. M., Nijhuis, F. J. N., Kok, G., & Kroodsma, A. T. (1997a). Effectiveness of a worksite alcohol program (pp. 43-58). In R. Vasse (Ed.), The development, implementation and evaluation of two worksite health programs aimed at preventing alcohol problems. Maastricht: Maastricht University.

Vasse, R. M., Nijhuis, F.J. N., Kok, G., & Kroodsma, A. T. (1997b). Process evaluation of two worksite alcohol programs (pp. 71-88). In R. Vasse (Ed.), The development, implementation and evaluation of two worksite health programs aimed at preventing alcohol problems. Maastricht: Maastricht University.
 

 The Blending of the Occupational Health Ecologies and Cultures

90>62. Karasek's work on stress in work pace and worker control. Karasek & Theorell, 1990. For a recent commentary on the significance of this work, see de Lange, Taris, et al., 2003.

Karasek, R. and T. Theorell (1990). Healthy Work: Stress, Productivity, and the Reconstruction of Working Life (New York: Basic Books).

de Lange AH, Taris TW, Kompier MA, Houtman IL, Bongers PM. (2003). "The very best of the millennium": longitudinal research and the demand-control-(support) model. Journal of Occupational Health Psychology, 8, 282-305.

91>63. Psychosocial and physiological pathways for effects of the organization of work on health. Ostry, Marion, et al., 2000; Schechter, Green, et al., 1997; Stronks et al., 1998.

Ostry A, Marion S, Green LW, Demers P, Teschke K, Hershler R, Kelly S, Hertzman C. (2000). Downsizing and industrial restructuring in related to changes in psychosocial conditions of work in British Columbia sawmills.
Scandanavian Journal of Work & Environmental Health, 26, 273-8.

Schechter J, Green LW, Olsen L, Kruse K, Cargo M. (1997).  Application of Karasek's demand/control model a Canadian occupational setting including shift workers during a period of reorganization and downsizing.
American Journal of Health Promotion, 11, 394-9.

92>64. Whitehall study of British civil servants. One of the earliest and most frequently cited of the 57 or more publications from this study is Marmot, Rose, et al., 1978; see more recently, Ferrie, Shipley, et al., 2002;  Steptoe, Feldman, et al., 2002. 

Ferrie JE, Shipley MJ, Stansfeld SA, Marmot MG (2002). Effects of chronic job insecurity and change in job security on self reported health, minor psychiatric morbidity, physiological measures, and health related behaviours in British civil servants: the Whitehall II study. J Epidemiol Community Health, 56, 450-4.

Marmot MG, Rose G, Shipley M, Hamilton PJ. (1978). Employment grade and coronary heart disease in British civil servants.J Epidemiol Community Health, 32, 244-9.

Steptoe A, Feldman PJ, Kunz S, Owen N, Willemsen G, Marmot M. (2002). Stress responsivity and socioeconomic status: a mechanism for increased cardiovascular disease risk? European Heart Journal, 23, 1757-63.

93>65. San Francisco bus drivers study.  Syme, 1986; 1987. See more recent secondary analyses: VanderVoort, Ragland, & Syme, 2001.

Syme, L. W. (1986). "Strategies for Health Promotion," Preventive Medicine, 15, 492-507

Syme SL. (1987). Coronary artery disease: a sociocultural perspective. Circulation. 1987 Jul;76(1 Pt 2), I112-6. Review.

VanderVoort DJ, Ragland DR, Syme SL. (2001). Anger expression and hypertension in transit workers. Ethnicity and Disease, 11, 80-9.

94>66. Disability claims for office work.  Schechter, Green, et al., 1997.

Schechter J, Green LW, Olsen L, Kruse K, Cargo M. (1997).  Application of Karasek's demand/control model a Canadian occupational setting including shift workers during a period of reorganization and downsizing.
American Journal of Health Promotion, 11, 394-9.

96>67. Systems approach to workplace organizational culture change.  J. Allen & Allen, 1986, 1990.

Allen, J. and R. F. Allen (1990). "A Sense of Community, a Shared Vision and a Positive Culture: Core Enabling Factors in Successful Culture-based Change," in Community Organization: Traditional Principles and Modern Applications, R. D. Patton and W. B. Cissel, eds. (Johnson City, TN: Latchpins Press), pp. 5-18.

97>68. Same programs implemented in different sites have different outcomes.  Green & Cargo, 1994; Hubball, 1996.

Green, L. W., & Cargo, M. (1994). The changing context of health promotion in the workplace. In M. P. O’Donnell & J. s. Harris (Eds.), Health Promotion in the Workplace (2nd ed., pp. 497-524). Albany, NY: Delmar Publishers.

Hubball, H. (1996). Development and Evaluation of a Worksite Health Promotion Program: Application of Critical Self-Directed Learning for Exercise Behaviour Change. Unpublished doctoral dissertation. Vancouver, B. C.: University of British Columbia, Faculty of Graduate Studies, Institute of Health Promotion Research.

98>69 Characteristics of worksites that made a standardized smoking cessation program more effective. Sorenson, Glasgow, et al., 1992.

Sorensen, G., Glasgow, R. E., Corbett, K., & Topor, M. (1992). Compliance with worksite nonsmoking policies: Baseline results from the COMMIT study of worksites. American Journal of Health Promotion, 7, 103-9.

99>70. Adapting the organization to the intervention or the work. Ottoson & Green, 1987. See also Hubbard & Ottoson, 1997. Polanyi, Frank, 2000, esp. pp. 147-55.

Hubbard, L., & Ottoson, J. M. (1997). When a bottom-up innovation meets itself as a top-down policy: The AVID untracking program. Science Communication, 19, 41-55.

Ottoson J. M., & Green, L. W. (1987). Reconciling concept and context: Theory of implementation. In W. B. Ward and M. H. Becker (Eds.). Advances in Health Education and Promotion, vol. 2, pp. 353-382. Greenwich, CT: JAI Press, pp. 353-82.

Polanyi, M. F. D., Frank, J. W., Shannon, H. S., Sullivan, T. J., & Lavis, J. N. (2000). Promoting the determinants of good health in the workplace. In B. D. Poland, L. W. Green, & I. Rootman (Eds.), Settings for health promotion: Linking theory and practice (pp. 138-60). Thousand Oaks, CA: Sage.

Caveats

    Ethical Concerns

104>71. The ethical and political traps. Allegrante, 1986; Allegrante & Sloan, 1986; Eakin, 2000; Hollander & Hale, 1987;  O'Rourke & Macrina, 1989; Ratcliff & Wallack, 1986; Warner, Walker, & Friedmann, 2003.

Allegrante, J. P. and R. P. Sloan (1986). Ethical Dilemmas in Workplace Health Promotion. Preventive Medicine, 15, 313-20.

Eakin, J. M. (2000). Commentary. In B. D. Poland, L. W.Green, & I. Rootman (Eds.), Settings for health promotion: Linking theory and practice (pp. 166-74). Thousand Oaks: Sage Publications.

Hollander, R. B. and J. G. Hale (1987). "Worksite Health Promotion Programs: Ethical Issues," American Journal of Health Promotion, 2(2), 37-43.

Warner EA, Walker RM, Friedmann PD. (2003). Should informed consent be required for laboratory testing for drugs of abuse in medical settings? American Journal of Medicine, 115, 54-8. Review.

106>72. Problem of stress management programs putting the entire emphasis on personal coping.  Karasek & Theorell, 1990; McLeroy, Green, Mullen, & Foshee, 1984.

Karasek, R. and T. Theorell (1990). Healthy Work: Stress, Productivity, and the Reconstruction of Working Life (New York: Basic Books).

McLeroy, K., L. W. Green, K. Mullen, and V. Foshee (1984). "Assessing the Effects of Health Promotion in Worksites: A Review of the Stress Program Evaluations," Health Education Quarterly 11: 379-401.

108>73. Health worker's divided allegiance and ethical dilemmas. Botes, & Otto, 2003; Harvey, Fleming, & patterson, 2002; Lutzen, Cronqvist, et al., 2003.

Botes A, Otto M. (2003). Ethical dilemmas related to the HIV-positive person in the workplace. Nursing Ethics, 10, 281-94.

Harvey HD, Fleming P, Patterson M. (2002). Ethical dilemmas and human rights considerations arising from the evaluation of a smoking policy in a health promoting setting. Int J Environ Health Research, 12, 269-75.

Lutzen K, Cronqvist A, Magnusson A, Andersson L. (2003). Moral stress: synthesis of a concept. Nursing Ethics, 10, 312-22. Review.

112>74. Solution to the moral delimmas usually lies in balance between individual-behavioral and environmental strategies, with input from both management and workers. Vojtecky, 1986. PRECEDE example: Wong, Chan, Kok, & Wong, 1996; and see the case study at the end of this chapter.

Vojtecky, M. A. (1986). "Commentary: A Unified Approach to Health Promotion and Health Protection," Journal of Community Health, 11, 219-21.

Wong ML, Chan R, Koh D, Wong CM. (1994-1995). Theory and action for effective condom promotion: illustrations from a behavior intervention project for sex workers in Singapore. International Quarterly of Community Health Education, 15, 405-421.

113>75. Blue collar response to workplace health programs. E.g., Elbel, Aldana, et al., 2003; Hart, Glover, et al., 2003.

Elbel R, Aldana S, Bloswick D, Lyon JL. (2003). A pilot study evaluating a peer led and professional led physical activity intervention with blue-collar employees. Work, 21, 199-210.

Hart AR, Glover N, Howick-Baker J, Mayberry JF. (2003). An industry based approach to colorectal cancer screening in an asymptomatic population. Postgraduate Medical Journal, 79, 646-9.

 

  Exaggerated Benefits?

114>76. Caveats on the economic argument for worksite health programs. Warner, 1987, 2003; Warner, Hodgson, & Carroll, 1999.

Warner KE. (1987). Selling health promotion to corporate America: uses and abuses of the economic argument. Health Educ Q. 14(1):39-55.

Warner KE. (2003). The costs of benefits: smoking cessation and health care expenditures. Am J Health Promotion, 18, 123-4, ii.

Warner KE, Hodgson TA, Carroll CE. (1999). Medical costs of smoking in the United States: estimates, their validity, and their implications. Tob Control. 1999 Autumn;8(3):290-300. Review. [full text free online via abstract]

 

Application of the Precede-Proceed Model

    Phase 1: Social Assessment and Participatory Planning

    Phase 2: Epidemiological Diagnosis: Health, Behavioral, and Environmental Assessments

        Descriptive Epidemiology: Extent and Distribution of the Health Problem

116>77. Sources of data for the epidemiological diagnosis in occupational settings.  Lovato & Green, 1986; Lovato, Green, & Conley, 1986. For discussions of data sources for epidemiological surveillance of occupational illness and injury in the United States, see Baker, Melius, & Millar, 1988; Dement, Pompeii, et al., 2003, on using a state cancer registry with workers' names; Kim, Ridzon, et al., 2003, on designing a "no-name" surveillance system; Sauter, & the NORA Organization of Work Team Members, 2002, on surveillance of organization of work issues related to health and safety in an occupational setting. .

Dement J, Pompeii L, Lipkus IM, Samsa GP. (2003). Cancer incidence among union carpenters in New Jersey. J Occupational & Environmental Medicine, 45, 1059-67.

Kim DY, Ridzon R, Giles B, Mireles T, Garrity K, Hathcock AL, Crowder D, Jackson R, Taylor Z. (2003). A no-name tuberculosis tracking system. Am J Public Health, 93, 1637-9.

Sauter, S. L., & NORA Organization of Work Team Members. (2002). The changing organization of work and the safety and health of working people: Knowledge gaps and research directions. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.

Etiological Epidemiology: The Behavioral and Environmental Determinants

117>78. Adaptation of Precede-Proceed Model combining the several "ecologies" of worksite health programs. DeJoy, 1986a, b, 1990 (quotation from p. 11); DeJoy, Murphy, & Gershon, 1995; DeJoy & Southern, 1993; DeJoy & Wilson, 2003.

DeJoy, D. M. (1986a). Behavioral-diagnostic model for self-protective behavior in the workplace. Professional Safety, 31, 26-30.

DeJoy, D. . (1986b). Behavioral-diagnostic analysis of compliance with hearing protectors. Proceedings of the 30th Meeting of the Human Factors Society, Vol. II (pp. 1433-1437). Santa Monica, CA: Human Factors Society.

DeJoy, D. M. (1990) Toward a comprehensive human factors model of workplace accident causation. Professional Safety, 35, 11-16.

*DeJoy DM, Southern DJ. (1993). An integrative perspective on work-site health promotion. Journal of Occupational Medicine, 35, 1221-30.

*DeJoy DM, Wilson MG. (2003). Organizational health promotion: broadening the horizon of workplace health promotion. Am J Health Promotion, 17, 337-41.

>79.  Job conditions that may lead to stress defined and illustrated. Sauter, Murphy, and NIOSH Working Group, 1999. For examples and analytic approaches to these work conditions, see DeJoy & Wilson, 2003; Polanyi, Frank, et al., 2000.

*DeJoy DM, Wilson MG. (2003). Organizational health promotion: broadening the horizon of workplace health promotion. Am J Health Promotion, 17, 337-41.

Polanyi, M. F. D., Frank, J. W., Shannon, H. S., Sullivan, T. J., & Lavis, J. N. (2000). Promoting the determinants of good health in the workplace. In B. D. Poland, L. W. Green, & I. Rootman (Eds.), Settings for health promotion: Linking theory and practice (pp. 138-60). Thousand Oaks, CA: Sage.

119>80. Use of national statistics to select criteria and indicators, and estimate targets for objectives. E.g., American Cancer Society,  Statistics for 2003. Online at http://www.cancer.org/docroot/STT/stt_0.asp, accessed Dec 9, 2003.

120>81. Setting achievable objectives, with criteria, indicators, and targets.  Chomik & Frankish, 1999; Nutbeam, Wise, et al., 1995; Ratner, Green, et al., 1997.

Chomik TA, Frankish CJ. (1999). Factors that facilitated and challenged the development of health goals and targets: the British Columbia experience. Canadian Journal of Public Health, 90 Suppl 1, S39-42.

Frankish CJ, Green LW, Ratner PA, Chomik T, Larsen C. (2001). Health impact assessment as a tool for health promotion and population health. WHO Regional Publications European Series, 92, 405-37. Review.

Nutbeam, D., M. Wise, M., A. Bauman, A., E. Harris, E. and& S. Leeder, S (1993). Goals and Targets for Australia's Health in the Year 2000 and Beyond. (Portland, OR: International Specialized Books Services; also published by Canberra: Australian Government Publishing Service).

Ratner, P., L. W. Green, C. J. Frankish, T. Chomik, and C. Larson (1997). “Setting the Stage for Health Impact Assessment,” Journal of Public Health Policy 18: 67-79.

 

Phase 3: Educational and Ecological Assessment

121>82. The trade-offs of expediency and durability of change.  Green, Wilson, & Lovato, 1986; Wong & Seet, 1998.

Green, L. W., Wilson, A. L., & Lovato, C. Y. (1986). What changes can health promotion achieve and how long do these changes last? The tradeoffs between expediency and durability. Preventive Medicine, 15, 508-21.

*Wong, T. Y. and B. Seet (1998). “A Behavioral Analysis of Eye Protection Use by Soldiers,” Military Medicine 162: 744-8.

124>83. Predisposing factors predicting employee behavior in response to worksite health programs.  P. Conrad, 1987; Fielding, 1984. Linnan, Emmons, et al., 2002; Linnan, Sorensen, et al., 2001. In nutrition, Kristal, Patterson, et al., 1995, specifically constructed a 5-item scale of predisposing factors, and a similar scale consisting of a combination of enabling and reinforcing factors. The predisposing factors were more predictive of adopting recommended dietary practices. In sun protection, outdoor workers maintain high levels of sun exposure without protective measures, even after having skin lesions removed, apparently because they get little support (enabling or reinforcing) from their employers to change their exposure behavior (Wooley, Buettner, & Lowe, 2002).

Kristal AR, Patterson RE, Glanz K, Heimendinger J, Hebert JR, Feng Z, Probart C. (1995). Psychosocial correlates of healthful diets: baseline results from the Working Well Study. Preventive Medicine, 24, 221-8.

Linnan LA, Emmons KM, Klar N, Fava JL, LaForge RG, Abrams DB. (2002). Challenges to improving the impact of worksite cancer prevention programs: Comparing reach, enrollment, and attrition using active versus passive recruitment strategies. Annals of Behavioral Medicine, 24, 157-66.

Linnan LA, Sorensen G, Colditz G, Klar DN, Emmons KM. (2001). Using theory to understand the multiple determinants of low participation in worksite health promotion programs. Health Educ Behav. 28, 591-607.

Shoveller JA, Lovato CY, Peters L, Rivers JK. (2000). Canadian National Survey on Sun Exposure & Protective Behaviours: outdoor workers. Canadian Journal of Public Health, 91, 34-5.

Woolley T, Buettner PG, Lowe J. (2002). Sun-related behaviors of outdoor working men with a history of non-melanoma skin cancer. Journal of Occupational and Environmental Medicine, 44, 847-54.

125>84. Self-efficacy as predictor of employee continued participation in worksite programs. Hubball, 1996; King, Marcus, et al., 1996; Maurer, Weiss, & Barbeite, 2003. Lechner & De Vries, 1995, in the Netherlands, found the  "The low-adherence group and the dropouts were least convinced of their ability to participate in a fitness program" (p. 429).

King TK, Marcus BH, Pinto BM, Emmons KM, Abrams DB. (1996). Cognitive-behavioral mediators of changing multiple behaviors: smoking and a sedentary lifestyle. Preventive Medicine, 25, 684-91.

Lechner L, De Vries H. (1995). Participation in an employee fitness program: determinants of high adherence, low adherence, and dropout. Journal of Occupational and Environmental Medicine, 37, 429-36.

Maurer TJ, Weiss EM, Barbeite FG. (2003). A model of involvement in work-related learning and development activity: the effects of individual, situational, motivational, and age variables. Journal of Applied Psychology, 88, 707-24.


126>85. Perceived job stress as a predictor of participation. K. E. Davis, Jackson, et al., 1987; Keith, Cann, et al., 2001; Leo, 1996; Lovato & Green, 1990; McLeroy, Green, et al., 1984.

Keith MM, Cann B, Brophy JT, Hellyer D, Day M, Egan S, Mayville K, Watterson A. (2001). Identifying and prioritizing gaming workers' health and safety concerns using mapping for data collection. American Journal of Industrial Medicine, 39, 42-51.

Leo, R., (1996). Research note. Managing workplace stress: A Canadian study among resource managers. Work and Stress, 10, 183-191.

Lovato, C. Y. and L. W. Green (1990). Maintaining employee participation in workplace health promotion programs. Health Education Quarterly, 17, 73-88.

McLeroy, K., L. W. Green, K. Mullen, and V. Foshee (1984). "Assessing the Effects of Health Promotion in Worksites: A Review of the Stress Program Evaluations," Health Education Quarterly 11: 379-401.

127>86. Job stress as a motivator may work both for and against behavior conducive to health.  N. H. Gottlieb & Nelson, 1990.

Gottlieb, N. H. and A. Nelson (1990). A systematic effort to reduce smoking at the worksite. Health Education Quarterly, 17, 99-118.

128>87. Loss of interest as reason most cited for dropping out of worksite programs. Bellingham, 1994.

Bellingham, R. (1994). Critical issues in worksite health promotion. New York: Macmillan Publishing Co., 1994.

129>88. Participation in planning predicts satisfaction with program. Alderman, Green, & Flynn, 1982; Everly & Feldman, 1985; O'Donnell & Ainsworth, 1995.

Alderman, M.,  Green, L. W., & Flynn, B. S.(1980). Hypertension control programs in occupational settings. Public Health Reports, 90. Also in Managing Health Promotion in the Workplace: Guidelines for Implementation and Evaluation, R. S. Parkinson and Associates, eds. (Palo Alto: Mayfield Pub. Co.), pp. 162-72.

Everly, G. S. and R. H. Feldman, eds. (1985). Occupational Health Promotion: Health Behavior in the Workplace. New York: Wiley.

O'Donnell, M. P., & Harris, J. S. (Eds). (1995). Health Promotion in the Workplace (2nd ed). New York: Wiley.

130>89. Employee satisfaction predicted by warmth and concern shown by health personnel. P. H. Bailey, Rukholm, Vanderlee, & Hyland, 1994; Feldman, 1983; 1984.

*Bailey, P. H., Rukholm, E. E., Vanderlee, R., & Hyland, J. (1994). A heart health survey at the worksite: The first step to effective programming. AAOHN Journal, 42, 9-14.

Feldman, R. H. (1984). "Increasing Compliance in Worksite Health Promotion: Organizational, Educational, and Psychological Strategies," Corporate Commentary, 1(2): 45-50.

131>90. Contacts and contact time predict higher employee satisfaction and blood pressure control. Alderman, Green, & Flynn, 1980.

Alderman, M., L. W. Green, B. S. Flynn (1980). Hypertension Control Programs in Occupational Settings. Public Health Reports, 90. Also in Managing Health Promotion in the Workplace: Guidelines for Implementation and Evaluation, R. S. Parkinson and Associates, eds. (Palo Alto: Mayfield Pub. Co.), pp. 162-72.

132>91. Organizational climate as a reinforcing factor.  Conrad, Campbell, et al., 1996. DeJoy, Searcy, et al., 2000, found in a study of nurses' compliance with universal safety standards that "All 3 categories of diagnostic factors (predisposing, enabling, and reinforcing) influenced general compliance, but ...the greatest improvement in model fit occurred when the indirect effects of reinforcing factors were added" (p. 127). Another example was in Morisky, Pena, et al., 2002, on the impact of the work environment on condom use among female sex workers in bars in the Philippines. With management encouragement and regular meetings with employees, backed by a policy of 100% condom use, "female bar workers were 2.6 times more likely to consistently use condoms during sexual intercourse…”(p. 461).

*Conrad, K. M., Campbell, R. T., Edington, D. W., Faust, H. S., & Vilnius, D.(1996). The worksite environment as a cue to smoking reduction. Research in Nursing and Health, 19, 21-31.

DeJoy DM, Searcy CA, Murphy LR, Gershon RR. (2000). Behavioral-diagnostic analysis of compliance with universal precautions among nurses. Journal of Occupational Health Psychology5, 127-41.

Morisky DE, Pena M, Tiglao TV, Liu KY. (2002). The impact of the work environment on condom use among female bar workers in the Philippines. Health Education & Behavior, 29, 461-72.

133>92. The paradox of senior management leadership and advocacy. N. H. Gottlieb et al., 1990, p. 22.

Gottlieb, N. H., Eriksen, M. P., Lovato, C. Y., et al. (1990). Impact of a restrictive work site smoking policy on smoking behavior, attitudes, and norms. Journal of Occupational Medicine, 32, 20-3.

134>93. Confidentiality as a reinforcing factor.  Wong, Chan, Kok, & Wong, 1994–95, Wong, Chan, & Wee, 2000.

*Wong ML, Chan R, Koh D, Wong CM. (1994-1995). Theory and action for effective condom promotion: illustrations from a behavior intervention project for sex workers in Singapore. International Quarterly of Community Health Education, 15, 405-421.

*4-59,90 Wong, M. L., Chan, R., Wee, S. (2000). Sex workers’ perspectives on condom use for oral sex with clients: a qualitative study. Health Education and Behavior 27, 502-16.

Wong, M. L., Chan, R., Wee, S. (2000). Factors associated with condom use for oral sex among female brothel-based sex workers in Singapore. Sexually Transmitted Diseases, 27, 39-45.

135>94. The value of games, contests, social activity to reinforce participation.  Blake, Caspersen, et al., 1996; Cummings, Hellmann, & Emont, 1988; Glasgow, Klesges, et al., 1985; Jason et al., 1990; Matson, Lee, & Hopp, 1993.

Blake SM, Caspersen CJ, Finnegan J, Crow RA, Mittlemark MB, & Ringhofer KR. (1996). The shape up challenge: a community-based worksite exercise competition. American Journal of Health Promotion, 11, 23-34.

Cummings KM, Hellmann R, & Emont SL. (1988). Correlates of participation in a worksite stop-smoking contest. Journal of Behavioral Medicine, 11, 267-77.

Glasgow, R., R. Klesges, J. Mizes, and T. Pechacek (1985). "Quitting Smoking: Strategies Used and Variables Associated With Success in a Stop-smoking Contest," Journal of Consulting and Clinical Psychology, 53, 905-12.

137>95. Caveat: Token rewards may yield only token behavior.  Green, Wilson, Lovato, 1986.

Green, L. W., Wilson, A. L., & Lovato, C. Y. (1986). What changes can health promotion achieve and how long do these changes last? The tradeoffs between expediency and durability. Preventive Medicine, 15, 508-21.

Phase 4: Administrative and Policy Assessment

141>96. Worksite smoking policies in various countries. Borland, Chapman, et al., 1990; Brownson, Hopkins, & Wakefield, 2002; Flynn, Gurdon, & Secker-Walker, 1995; Frankish & Green, 1994, 1998; Frankish, Johnson, Ratner, & Lovato, 1997; Levy & Friend, 2003.

Brownson RC, Hopkins DP, & Wakefield MA. (2002). Effects of smoking restrictions in the workplace. Annual Review of Public Health, 23, 333-48.

Levy DT, & Friend KB. (2003). The effects of clean indoor air laws: what do we know and what do we need to know? Health Education Research, 18, 592-609. Review.

143>97. For an application of PRECEDE to the activation of workers to bring pressure on management for a policy change regarding work-site hazards, see Appendix C-1 in the first edition: Green, Kreuter, et al., 1980, pp. 212–224.

Green, L. W., M. W. Kreuter, S. G. Deeds, and K. B. Partridge (1980). Health Education Planning: A Diagnostic Approach (Palo Alto, CA : Mayfield).

For suggestions on components of a program: http://www.acoem.org/pdfs/2004LaborDayChecklist.pdf.

 Phase 5: Implementation and Process Evaluation

145>98. Time-honored public health tradition of screening populations to identify and focus on high-risk subpopulations. Haber, 1994; Kingery, 1995; Robinson, 2002; Sloan & Gruman, 1988.

Haber, D. (1994). Medical screenings and health assessments. In D. Habder (Ed.), Health promotion and aging (pp. 41-76). New York, NY: Springer Publishing Company.

Robinson, T. N. (2002). Screening. In L. Breslow, B. Goldstein, L. W. Green, C. W. Keck, J. M. Last, & M. McGinnis (Eds.), Encyclopedia of public health, vol 3 (pp. 1081-3). New York: Macmillan Reference USA.

146>99. Diary as a pre-participation screening on motivation.  P. D. Mullen & Culjat, 1980.

Mullen, P., K. Kukowski, and S. Mazelis (1979). "Health Education in Health Maintenance Organizations," in Handbook of Health Education, P. M. Lazes, ed. (Germantown, MD: Aspen Systems), pp. 53-76.

147>100. Self-help materials most effective with the highly motivated.  Frankish & Green, 1998; T. J. Glynn, Boyd, & Gruman, 1990; Sallis et al., 1986; Glasgow, Schafer, & O'Neill, 1981; Scholes, McBride, et al., 2003; Windsor, Cutter, et al., 1985.

Glasgow, R. E., L. Schafer, and H. K. O'Neill, (1981). "Self-help Books and Amount of Therapist Contact in Smoking Cessation Programs," Journal of Consulting and Clinical Psychology 49: 659-67.

Scholes, D., McBride, C. M., Grothaus, L., Civic, D., Ichikawa, L. E., Fish, L. J., & Yarnall, K. S. (2003). A tailored minimal self-help intervention to promote condom use in young women: Results from a randomized trial. AIDS, 17, 1547-56.

Windsor, R. A., Cutter, G.. Morris, J. Reese, Y Adams, B. & Bartlett, E. (1985). Effectiveness of self-help smoking cessation interventions for pregnant women in public health maternity clinics: A randomized trial. American Journal of Public Health, 75, 1389-92.

148>101. Algorithm for applying PRECEDE at the individual level to screen employees for focused intervention. Lovato & Green, 1990.

*Lovato, C. Y. and L. W. Green (1990). Maintaining employee participation in workplace health promotion programs. Health Education Quarterly, 17, 73-88.

A Case Study: Air Quality Control in a State Agency

149>102. Source of the air quality case study. This case description is based on work initiated at the University of Texas Center for Health Promotion Research and Development (now the Center for Health Promotion and Prevention Research), with support from the Texas Affiliate of the American Heart Association and grant K07-CA01286 from the National Cancer Institute. See N. H. Gottlieb, Eriksen, et al., 1990; N. H. Gottlieb & Nelson, 1990. Some variations on the actual history of the case have been introduced for illustrative purposes.

Gottlieb, N. H., Eriksen, M. P., Lovato, C. Y., et al. (1990). Impact of a restrictive work site smoking policy on smoking behavior, attitudes, and norms. Journal of Occupational Medicine, 32, 20-3.

Gottlieb, N. H., & Nelson, A. (1990). A systematic effort to reduce smoking at the worksite. Health Education Quarterly, 17, 99-118.

150>103. Policy development and implementation ideally is context specific. Ottoson & Green, 1987. Also, Hubbard & Ottoson, 1997; C. H. Weiss, 1988, p. 57. If not specific to a context, then policy must be highly flexible and adaptable.

Hubbard, L., & Ottoson, J. M. (1997). When a bottom-up innovation meets itself as a top-down policy: The AVID untracking program. Science Communication, 19, 41-55.

Ottoson J. M., &and L. W. Green, L. W. (1987). Reconciling concept and context: Theory of implementation. In W. B. Ward and M. H. Becker (Eds.). Advances in Health Education and Promotion, vol. 2, pp. 353-382. Greenwich, CT: JAI Press.

Headlines and Milestones in Recent Occupational Health Developments

New exposure at germ lab reignites a public health debate. New York Times, Jan 24, 2005 . Scott Shane

 

Helmet bill surfaces as motorcycle death figures surge in Maine Associated Press, Jan 23, 2005,   Glenn Adams

 

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