The purpose of this study was to evaluate one phase of an extensive worksite health promotion program, developed multidisciplinary health care professionals. A single was conducted using the Cardiac Health Questionnaire. results to card: climate and implemented by group pre-post design T-test and chi-square indicated significant changes in attitude and knowledge related ovascular disease prevention. Perceptions of organizational and employee work place, also have The need for worksite concerns regarding issues of confidentiality in the implications for the development of such programs. health programs and the skills health professionals provide to their successful implementation, provide educational direction to the development of health occupations programs

Barzilai, Benico, M.D.

Connell, Cathleen M., Ph.D.

Haire-Joshu, Debra, M.S.N., M.S.Ed.

English

University of Central Florida (UCF): STARS (Showcase of Text, Archives, Research & Scholarship)

Journal of Health Occupations Education Volume 2 Number 2 Article 4 1987 Implications and Impacts of Awareness Sessions in a Work Site Health Promotion Program Debra Haire-Joshu M.S.N., M.S.Ed. Washington University School of Medicine Cathleen M. Connell Ph.D. Washington University School of Medicine Benico Barzilai M.D. Washington University School of Medicine Find similar works at: https://stars.library.ucf.edu/jhoe University of Central Florida Libraries http://library.ucf.edu This Article is brought to you for free and open access by STARS. It has been accepted for inclusion in Journal of Health Occupations Education by an authorized editor of STARS. For more information, please contact STARS@ucf.edu. Recommended Citation Haire-Joshu, Debra M.S.N., M.S.Ed.; Connell, Cathleen M. Ph.D.; and Barzilai, Benico M.D. (1987) "Implications and Impacts of Awareness Sessions in a Work Site Health Promotion Program," Journal of Health Occupations Education: Vol. 2 : No. 2 , Article 4. Available at: https://stars.library.ucf.edu/jhoe/vol2/iss2/4 .IMPLICATIONS AND IMPACTSIN A WORRSITE HEALTHOF AWARENESS SESSIONSPROMOTION PROGRAMDebra Haire-JoshulCathleen  M. ConnellBenico BarzilaiAbstract: The purpose of this study was to evaluate one phase of anextensive worksite health promotion program, developedmultidisciplinary health care professionals. A singlewas conducted using the Cardiac Health Questionnaire.resultsto card:climateand implemented bygroup pre-post designT-test and chi-squareindicated significant changes in attitude and knowledge relatedovascular  disease prevention. Perceptions of organizationaland employeework place, also haveThe need for worksiteconcerns regarding issues of confidentiality in theimplications for the development of such programs.health programs and the skills health professionalsprovide to their successful implementation, provide educational directionto the development of health occupations programs..‘Debra Haire-Joshu, M.S.N., M.S.Ed. , is Research Instructor in Medicineat the Washington University School of Medicine; Cathleen  M. Connell, Ph.D. ,is a Postdoctoral Fellow in Internal Medicine at the Washington UniversitySchool of Medicine; and Benico Barzilai,  M.D., is Assistant Professor ofMedicine at the Washington University School of Medicine, St. Louis, MO.11Haire-Joshu et al.: Implications of Awareness in Work Site Health Promotion ProgramPublished by STARS, 1987Worksite Health.Current trends in health care, including increased incidence of chronicdisease and increased fiscal support for prevention, have stimulatedinterest in expanding the direction of health education programs. One suchdirection is the consideration of new settings for health education programsdeveloped and implemented by multidisciplinary health occupationsprofessionals. The worksite provides an excellent environment for healthcare programs, especially in terms of preventative health promotion.Alderman, Madhaven, and Davis (1983) postulate that the worksite environmentis potentially a major factor in illness and, with appropriate intervention,could be used to promote wellness. The logistical convenience of worksitehealth programs, and the complex social networks that develop among coworkersprovide an alternative environment within which knowledge, attitudes, andbehavior can be changed (Chadwick, 1982; Colletti and Brownell,  1982;Fielding, 1984). Sallis, Hill, Fortmann and Flora (1986) found thatcardiovascular status improved in persons supported by a health consciousnetwork. Given the large percentage of the population which could bereached by health promotion programs at the worksite, successfulintervention efforts could have a significant impact on the public healthproblem of cardiovascular diseases (Blair, et al., 1984). These programsalso can influence the direction of health occupations programs by preparingprofessionals to assume expanded roles within the worksite. Such rolesinclude not only clinical skills, but competencies related to teaching,program development and evaluation. The purpose of this paper is toevaluate one component of a worksite health promotion program entitledWorking Hearts, which demonstrates the expansion of this role.22Journal of Health Occupations Education, Vol. 2 [1987], No. 2, Art. 4https://stars.library.ucf.edu/jhoe/vol2/iss2/4The Working Hearts Program isimplemented at a large corporationWorksite Healtha worksite health promotion programin the midwest. The program is designedto increase the knowledge of cardiovascular disease and encourage- reductionof risk for such disease. The Working Hearts Program is comprised of 4phases, totaling 24 months in length: (a) Baseline Physical Screening,consisting of physiologic measures indicative of health status (i.e. ,height, weight, cholesterol levels, stress level assessment); (b) AwarenessSessions, designed to present a didactic overview of current cardiovascularhealth information; (c) Health Promotion Workshops, consisting of 21discrete presentations of material that allow for active learningexperiences on the part of the participants (topics include nutritionaleating, weight loss, stress reduction, smoking cessation, exercise); (d)Follow-up Screening, which occurs at the conclusion of the program andinvolves a repeat of the physiological measures initially conducted in Phase1.The Working6 company sites,A total of 1,004currently in thewill present theHearts Program is being delivered to 15 divisions withinlocated at various geographic locations across Missouri.subjects are participating in the program, which isthird phase of implementation. The remainder of this paperevaluation of the second component of the Working HeartsProgram: the Awareness Sessions.Working Hearts Awareness SessionThe Working Hearts Awareness Sessions encompassed 4 instructionalmodules, developed by a team of multidisciplinary health professionals.(i.e., nurses, dietitians, social workers). The goals of the AwarenessProgram were to: (a) improve the knowledge level of the worksite population33Haire-Joshu et al.: Implications of Awareness in Work Site Health Promotion ProgramPublished by STARS, 1987Worksite Healthregarding cardiovascular disease; (b) encourage attitudes supportive ofpositive health behaviors; and (c) provide resources for changing behaviorsregarding cardiovascular health. The sessions were delivered by variousmembers of this team using media in the form of slides and educationalmaterials specifically developed for each module. Brochures summarizedthe content related to the objectives of the sessions, presented answersto the most frequently asked questions, and offered referrals toorganizations available for supplemental information. A 10 to 15 minutequestion and answer session followed each 45 minute didactic presentationdeveloped according to the specified curriculum. An overview of thecurriculum for the four sessions follows:1. Your Cardiovascular Health. The objective of this session wasto improve participant knowledge of the physical workings and mechanicalcomposition of the heart. An overview of risk factors associated withcardiovascular disease was presented including information on smokingcessation, hypertension, obesity, exercise, stress, and elevated bloodcholesterol level. Strategies for modifying these risk behaviors werediscussed.2. Hearty Eating. The objective of this session was to promote theconcept of ideal body weight with regard to maintaining optimal health.An overview of nutritional needs, appropriate dieting strategies, andspecific steps for assuring long-term weight loss were presented.3. Stress and Exercise. The objective of this session was to increaseparticipant knowledge of the impact of stress on the body and to introducemethods of identifying and dealing with stress. Specific lifestyle changesand healthful ways of modifying an individuals’ reaction to stress were44Journal of Health Occupations Education, Vol. 2 [1987], No. 2, Art. 4https://stars.library.ucf.edu/jhoe/vol2/iss2/4Worksite Healthintroduced. A second objective was to provide an overview of thephysiologic and psychologic  impacts of exercise on the body.4. Warning Signals of Heart Attack. The objective of this sessionwas to summarize the effects of long-term risk factors on cardiac functioningwith implications for care in terms of myocardial infarction (MI).Information was presented on risk factors and warning signs of heart attack.The importance of decreasing delay time and problems associated withreturning to work after a myocardial  infarction were addressed. Supportivebehaviors by coworkers that promote recovery, as cited by post MI patients,were discussed.Methods and Procedures&?Z@&A single group pre-post design was employed. The sample was derivedfrom a population randomly selected from the corporation to receive theAwareness Program. Approximately 67% of the population were married while24% were college educated. Almost 81% had been with the organization forat least 5 years. The sample, with a mean age of 37 years, was 59% femaleand 32% white collar workers.QuestionnaireThe Cardiovascular Health Questionnaire was used as a measure ofknowledge and attitude change of employees following the delivery of theWorking Hearts Awareness Program. The 80 item, Likert Scale questionnaireconsisted of 4 sections: knowledge of factors predisposing to MyocardialInfarction (MI), the subjects’ perception of how they would respond to anMI, subjects attitudes toward rehabilitation from a cardiac event, andperception of organizational factors that may influence participation in55Haire-Joshu et al.: Implications of Awareness in Work Site Health Promotion ProgramPublished by STARS, 1987Worksite Healtha health promotion program. The 3 subscales  of the Cardiac HealthQuestionnaire (Risk Factors, Symptomatology, Rehabilitation) wereadministered with alpha reliability coefficients of .75, .71, and .75respectively.The sample completed the Cardiac Health Questionnaire 2 weeks priorto the initiation of the first awareness presentation and within 2 weeksof the conclusion of the Awareness Sessions (n=143 at pre-test, 97 at post-test).Data Analyses and ResultsDescriptive analyses of subscale results and organizational climateitems were initially conducted. Pre-post score changes in the 3 subscaleswere assessed by t-test comparisons. Additionally, chi-square analyseswere used to determine if scores were significantly related toorganizational climate items and demographic variables.Change in the Risk Factors subscale, measuring knowledge of cardiacrisk, indicated a significant improvement in knowledge (t=2.49,  p<.01).Significant differences also were discovered when comparing employees’ preand post-test Symptomatology  Subscale scores (t=ll.07,  p<.0001)indicating a post-intervention improvement in cognitive knowledge of MIsymptoms and actions associated with decreasing delay time. Finally,employees’ scores on the Rehabilitation Subscale, which measured cognitiveknowledge and attitudinal change associated with return to work post MI,were significantly higher at the post-measure level (t=5.66,  p<.0001).With regard to the organizational climate questions, 76% of the samplereported they would disclose their disease state to their supervisor. Ofthis number, 48% believed their chances for promotion would be negatively6Journal of Health Occupations Education, Vol. 2 [1987], No. 2, Art. 4https://stars.library.ucf.edu/jhoe/vol2/iss2/4affected by this admission. Approximatelyreported that they would be more likely todiagnosis of chronic disease although onlyWorksiteone-third of all employeesretire early following theHealthone fourth believed that sucha diagnosis would negatively affect their job performance. Significantdifferences in perceptions about disease-status disclosure were discovered(> 35 years) and younger (18-35comparisons. Female employeesreport a diagnosis of a chronic65%), (X2=15.1, p<.004), as.between males and females and between olderI years) employees as indicated by chi-squareperceived that they would be more likely toillness to a supervisor than males (72% vs.would those subjects older than 35 years (74% versus 69%), (XZ=22.4, p<.03).No significant differences in perceptions were found when blue and whitecollar employees were compared (X2=4.6, p<.32).Discussion and ConclusionThese results suggest that following participation in the worksitehealth promotion intervention, employees increased their knowledge of:(a) risk factors of cardiovascular disease, (b) issues related torehabilitation following MI, and (c) the role of coworkers in supportingthe recovery process associated with acute cardiovascular disease.Furthermore, employees improved their intent to intervene appropriatelyupon recognizing such symptoms. These data also suggest that employeesperceive that disclosure of a chronic disease will have a negative impacton job advancement, and influence their decision to retire early (beforeage 65) despite their physical capability to work. These attitudes appearto be most firmly established for females and for those above 35 years ofage. Such perceptions may influence the success of worksite health programsand their impact on promoting employee health since a baseline health survey,7 7Haire-Joshu et al.: Implications of Awareness in Work Site Health Promotion ProgramPublished by STARS, 1987Worksite Healthas was conducted in Phase I of the Working Hearts Program, usually requiresdisclosure of both acute and chronic conditions. Fear of job repercussionsassociated with diagnosis of a chronic disease or its disclosure couldnegatively influence attendance at such programs. These results alsosuggest the worksite is an appropriate environment for employee healthpromotion programs. A worksite health promotion program is a first stepto such a focus as it educates subjects on preventative and rehabilitativeaspects of care.Implications for further study include evaluation.of  long-term impactof such programs on chronic disease development. Physiologic indicatorsof potential disease (i.e., blood pressure, cholesterol levels, etc.),provide valuable parameters whereby programmatic impact on cognitive andbehavioral change can be determined. Such an assessment is currently beingconducted in the Working Hearts Program.In conclusion, our results suggest health occupations professionals,working in collaboration with employers, have an important and expandingrole to play in the development of such programs. Probably the greatestneed is for development of individually tailored, inexpensive programs forworksites with relatively few employees. Health occupations professionalscan contribute health assessment and education skills to programimplementation in a manner more cost efficient in terms of diseaseprevention and rehabilitation. The benefits of worksite locations may haveparticular value in rural communities where access to acute care settingsfor clinical education is limited. These current trends therefore haveimplications for the revision of health occupations curricula which havetraditionally focused on training professionals primarily to meet acute8Journal of Health Occupations Education, Vol. 2 [1987], No. 2, Art. 4https://stars.library.ucf.edu/jhoe/vol2/iss2/4Worksite Healthcare needs. Health professionals educated to function in such innovativeprogram settings are of significant and growing value to employers andemployees dependenthealth education.upon worksite programs for the majority of preventativeReferencesAlderman, M.H., Madhaven, S., & Davis, T. (1983). Reduction ofcardiovascular disease events by worksite hypertension treatment.Hypertension 5_, (Supplement V), V138-145.Blair, S.N., Collingwood,  T.R., Reynolds, R., Smith, M., Hogan, D., &Sterling, C.L. (1984). Health promotion for educators: Impact onhealth behaviors, satisfaction and general well-being. American Journalof Public”Health, ~, 147-149.Chadwick, J.H. (1982). Health behavior change at the worksite; A problem-oriented analysis. In R.S. Parkinson and Associates, Managing health-promotion in the workplace: Guidelines for implementation and evaluation(pp. 144-161). Palo Alto: Mayfield.Colletti, G. & Brownell, K.D. (1982). They physical and emotional benefitsof social support: Application to obesity, smoking, and alcoholism.In M. Herson, R.M. Eisler, and P.M. Mill (Eds.). Progress in behaviormodification, ~, New York: Academic Press.Fielding, J.E. (1984). Health promotion and disease prevention at theworksite. Annual Review of Public Health, ~, 237-265.Sallis, J.F., Hill, R.D., Fortmann, S.P., & Flora, J.A. (1986). Healthbehavior change at the worksite: cardiovascular risk reduction.Progress in behavior modification, 20, Academic Press, Inc..9 9Haire-Joshu et al.: Implications of Awareness in Work Site Health Promotion ProgramPublished by STARS, 198710Journal of Health Occupations Education, Vol. 2 [1987], No. 2, Art. 4https://stars.library.ucf.edu/jhoe/vol2/iss2/4

Implications and Impacts of Awareness Sessions in a Work Site Health Promotion Program

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Implications and Impacts of Awareness Sessions in a Work Site Health Promotion Program

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