Make the Healthy Choice the Easy Choice

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Make the Healthy Choice the Easy Choice!
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Plans for the Future

• Targeting Low-Income Females at the Workplace

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Purpose of the 5 a Day Worksite Program

• Conduct a statewide worksite campaign that helps
  to reduce the risk of chronic diseases, such as
  cancer, heart disease, and diabetes, by
  empowering low- and middle-income working adults
  in California to consume 5 or more servings of
  fruits and vegetables and engage in at least 30
  minutes of physical activity every day

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Formative Research

• Literature review of worksite nutrition and
  physical activity interventions, etc.
• Key informant interviews with worksite
  gatekeepers
• Focus groups with low- and middle-income working
  women, worksite gatekeepers from small/medium-
  and large-sized businesses, and Latino
  agricultural workers

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• Key Informant Interviews

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Purpose

• To understand employer perceptions of employee
  health
• To determine the level of support and lack of
  support for employee health promotion programs
• To identify strategies to increase fruit and
  vegetable consumption and physical activity in
  the workplace

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Methods

• Random sample of small/medium- and large-sized
  businesses was created from the Dunn and
  Bradstreet database
• Conducted 40 key informant interviews with
  worksite gatekeepers
• 12 large-sized businesses (gt500 employees)
• 28 small/medium-sized businesses (lt500
  employees)
• Worksite gatekeepers any worksite manager or
  executive who has decision-making power/authority
  regarding health promotion programs

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Data Analysis

• Verbatim transcriptions of each interview were
  completed
• Quantitative data were summarized using means,
  standard deviations, highs and lows, and
  percentages
• Inductive content analysis was used to analyze
  the qualitative data

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Demographics

• Employee demographics similar to CA population
• Approximately 40 of employees considered blue
  collar
• Business segments
• 33 service
• 18 manufacturing
• 15 wholesale/retail
• 13 agriculture/construction
• 10 transportation/communications/utility
• 3 insurance/real estate
• 8 other

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Results

• Employer perceptions of unhealthful behaviors
  among employees
• Majority stated one or more of the following
• Smoking
• Poor diet
• Sedentary living
• Overweight
• Being overworked
• Alcohol abuse
• 12.5 stated there were no unhealthful behaviors
  among employees

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Results

• Support for employee health promotion programs
• 50 stated that their worksites have health
  promotion programs
• Most common offerings
• Health screenings
• Health fairs
• Flu vaccinations
• Reasons why programs are offered
• Help maintain healthy, happy employees
• Show employees that management really cares about
  them

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Results

• Support for employee health promotion programs
• Benefits of health promotion programs
• Increase knowledge and awareness of health issues
• Improve employee morale
• Reduce absenteeism
• Problems with health promotion programs
• 50 stated cost
• Lack of employee interest and time
• Productivity losses because of health
  promotion-related distractions

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Results

• Lack of support for employee health promotion
  programs
• 50 stated that their worksites did not have
  health promotion programs
• Reasons why their worksites did not have health
  promotion programs
• Perceived to be cost prohibitive
• Employees were not interested
• 88 believed there were benefits to having a
  program
• Improved employee productivity
• Reduced illnesses and absenteeism
• Lower employee health care costs

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Results

• Lack of support for employee health promotion
  programs
• Barriers to offering a program
• Lack of money
• No time to participate
• Belief that such programs would never be approved
  by management

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Results

• Strategies to increase fruit and vegetable
  consumption and physical activity in the
  workplace
• Most common ideas
• Make healthy foods available in eating areas or
  vending machines
• Provide a fitness or weight control program
• Make fitness facilities and equipment available
• Have flexible work schedules for physical
  activity, but do not give paid time off for
  physical activity
• Distribute written materials/newsletters

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Results

• Several informants stated that a companys
  efforts to help employees eat well and become
  more active could be seen as intrusive or an
  invasion of privacy
• 83 opposed the idea of passing health insurance
  premium costs on to individuals who have high
  lifestyle-related health risks

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• Focus Groups

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Purpose

• To examine factors that would facilitate fruit
  and vegetable consumption and physical activity
  at the workplace.
• To identify ways that the California Department
  of Health Services (CDHS) could help employers
  make a 5 A Day and physical activity program
  possible at the workplace.

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Inclusion Criteria

• Low-income (lt20,000 annual household income),
  English-language dominant, mixed ethnicity,
  female parents, aged 18-54 years who are employed
  in a representative sample of employers and
  industries
• 2 focus groups in Los Angeles and 2 in Oakland
• Middle-income (gt20,000 and lt50,000 annual
  household income), English-language dominant,
  mixed ethnicity, female parents, aged 18-54 years
  who are employed in a representative sample of
  employers and industries
• 2 focus groups in Los Angeles and 2 in Oakland

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Inclusion Criteria

• Worksite gatekeepers, aged 18-65 years who are
  employed in small- to medium-sized businesses
  (20-500 employees)
• 2 focus groups in Los Angeles and 2 in San
  Jose
• Worksite gatekeepers, aged 18-65 years who are
  employed in large-sized businesses (gt500
  employees)
• 2 focus groups in Los Angeles and 2 in San
  Jose

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Recruitment Strategies

• Face-to-face appeals in various locations
• Supermarkets
• Clinics
• Community recreation centers
• Worksite interviews
• Telephone interviews of potential participants
  listed in existing databases

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Data Analysis

• Listened to all tapes and created transcripts
• Sorted data through matrices for each aspect
  pertinent to the research objectives
• Looked for patterns and themes in the matrices
  examined data by site and group
• Looked for frequency and range of ideas expressed
  about each topic

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Results Workers

• Ways employers can motivate employees to eat more
  fruits and vegetables
• Have employers create a work environment that
  supports healthful eating
• Offer fruit and vegetable snacks instead of junk
  foods at meetings, in common work areas, and in
  break rooms
• Offer tasty, affordable, and healthful foods in
  vending machines and in cafeterias
• Organize healthy food potlucks
• Receive coupons, subsidies, and discounts for
  purchasing healthy meals either at the worksite
  cafeteria or at restaurants and stores close to
  the workplace

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Results Workers

• Ways employers can motivate employees to eat more
  fruits and vegetables
• Distribute educational materials at the workplace
  that would provide the hows and whys of
  eating more fruits and vegetables
• Have a knowledge person, like a nutritionist,
  available at work to provide information and
  motivate employees to eat healthier
• Offer incentives for eating 5 a Day
• Gift certificates
• Extra time off
• Small yearly bonus

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Results Worksite Gatekeepers

• Ways employers can motivate employees to eat more
  fruits and vegetables
• Offer more fruits and vegetables in vending
  machines in place of junk food
• Offer coupons or discounts for healthful food
  items either in the worksite cafeteria or at
  local eateries
• Provide information about personal nutrition

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Results Worksite Gatekeepers

• Most felt that no matter what was done, those who
  were already health conscious would continue to
  eat well and those who were not would continue to
  eat unhealthfully
• The best motivation would be for employees to
  witness positive changes in the lives of their
  peers

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Results Workers

• Ways employers can motivate employees to be more
  physically active at work
• Have extra time allotted for physical activity
  either before, during, or after work
• Offer discounts or subsidies for fitness club
  memberships
• Have on-site exercise classes
• Provide showers and changing facilities
• Engage in workplace physical activities with peers

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Results Worksite Gatekeepers

• Ways employers can motivate employees to be more
  physically active at work
• Offer activities before, during, or after work
• Assuming space/facilities and time were given to
  employees to engage in physical activity at work,
  most felt it would be a costly liability if
  someone was injured
• It is best to have a physical activity program
  either run by an outside group or led by
  employees for employees

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Results Worksite Gatekeepers

• How could CDHS help employers make a 5 a Day and
  physical activity program possible at the
  workplace?
• 5 A Day
• Offer tax breaks and financial incentives to
  businesses that offer healthful meals and
  healthful eating environments for employees
• Physical activity
• Most felt it would be best to partner with an
  external entity, such as a health club, to
  provide the physical activity component and
  mitigate the potential liability

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Future Direction

• Worksite-based education and marketing
• Develop a turnkey program to empower employees to
  eat more fruits and vegetables and be physically
  active at work
• Persuade worksite gatekeepers to adopt the 5 a
  Day Worksite Program
• Encourage policy makers to establish healthful
  worksite policies

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Future Direction

• Access to fruits and vegetables and physical
  activity opportunities
• Increase fruit and vegetable options in worksite
  cafeterias, in vending machines, at catering
  trucks, and in meetings, potlucks and other
  workplace gatherings
• Establish standard workplace practices that
  facilitate physical activity during breaks,
  meetings, and before and after work

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Future Direction

• Advocate for, and establish, 5 A Day and physical
  activity friendly policies at worksites statewide
• Establish nutrition standards for food access
  points at worksites
• Reduce employer liability for physical activity
  promotion