Applying Salutogenesis in the Workplace

This chapter presents models, measures, and intervention approaches that relate to the double nature of work and its salutogenic quality. Hereby, the view of Aaron Antonovsky is enhanced insofar that health-promoting, salutogenic job characteristics are not solely understood as mitigating the pathogenic effects of stressors at work but have a distinct effect on positive health outcomes. In the chapter, Antonovsky’s original model is first specified and simplified for the context of work. Next, Antonovsky’s line of thinking is related to frameworks researching job resources and demands. After a review of the prevalence of salutogenic measures in worksite health promotion, the point of making salutogenesis more visible in work-related research and practice is elaborated. This is illustrated with a practical example of a survey-feedback process promoting salutogenic work.

Adoption and Implementation Barriers for Worksite Health Programs in the United States

Worksite health promotion programs have been identified as having the potential to mitigate chronic health risks. In the most recent 2017 U.S. CDC survey of workplace health promotion, respondents identified several perceived barriers related to program adoption and implementation. The analysis indicates that challenges negatively associated with having worksite program were lack of senior management support (OR = 0.50, 95% CI: 0.32–0.78), lack of qualified vendors (OR = 0.56, 95% CI: 0.4–0.79), lack of qualified personnel (OR = 0.56, 95% CI: 0.35–0.73), and cost (OR = 0.58, 95% CI: 0.39–0.88). Challenges associated with having a program were lack of employee interest (OR = 2.09, 95% CI = 1.44–3.03), lack of space (OR = 1.76, 95% CI: 1.26–2.48), and demonstrating program results (OR = 2.09, 95% CI = 1.44–3.03). These findings can provide insights to policy makers, insurers, and employers seeking to implement workplace-based health promotion initiatives.

“A Bowl of Vegetables With Someone You Love”: Faith, Health and Workplace Well-Being

Worksite health and well-being initiatives will ideally be integrated with employers’ efforts to address diversity, equity and inclusion issues. Social Determinants of Health (SDOH) include race, class, community health, income and other variables that companies can play a role in ameliorating. As much as spirituality is commonly espoused as a component of a holistic approach to health promotion, making space to discuss faith and health remains an uncommon strategy in the workplace wellness movement. Recognizing the value on investment (VOI) in wellness has eclipsed a return on investment as a driver of an employer’s well-being strategy. This editorial argues that making space for learning about faith and health will intersect in vital ways with anti-racism work, diversity programs and similar efforts to eliminate health inequities, address SDOH and bolster the VOI of worksite well-being initiatives. A fictional dialogue between executives is used to review these issues and related literature.

Blood Pressure Changes After a Health Promotion Program Among Mexican Workers

Background: Cardiovascular disease is becoming increasingly prevalent in low and middle-income countries (LMIC), and high blood pressure (BP) is one of the main risk factors. The efficacy and sustainability of worksite health promotion (WHP) programs for BP reduction in LMIC have yet to be determined.Methods: This non-randomized company-based trial evaluated 6- and 12-months effects of a WHP intervention on BP among 2,002 participating workers from seven Mexican companies. Intervention and control groups were assigned at the company level. The intervention included nutrition counseling, physical exercise, and stress management components. Mixed models assessed differences in BP change between intervention and control companies in intent-to-treat (ITT), per-protocol (PerP), and as-treated (AsTr) analyses, and also within-group changes stratified by company, intervention component, and baseline cardiovascular risk factor levels. All analyses were adjusted for potential confounders. We accounted for missing data and loss to follow-up using inverse probability of censoring weighting.Results: ITT analyses revealed mean BP change differences of −1.1 mmHg at 12 months (95% CI: −2.9; 0.6) in intervention companies relative to control companies. PerP and AsTr analyses confirmed this finding. Within-group analyses showed consistent BP reductions at both 6 and 12 months. Substantial differences in BP changes ranging from diastolic −6.1 mmHg, (95% CI: −11.2; −1.2) to systolic −13.0 mmHg (95% CI: −16.0; −10.1) were found among individuals with diabetes at baseline in intervention companies relative to control companies.Conclusion: After 1 year, WHP was associated with modest but uncertain BP reductions. Substantial reductions were mainly observed among diabetic workers.

Using the CDC Worksite Health ScoreCard to Promote Organizational Change

Purpose: To measure the impact of tying adoption of evidence-based worksite health promotion (WHP) interventions to annual organizational strategic objectives, as measured by the Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard (ScoreCard). Design: A prospective cohort study following Johns Hopkins Medicine (JHM) affiliates against industry-specific and large employer benchmarks from 2016-2020. Settings: JHM, the largest private employer in Maryland with facilities in Florida and the District of Columbia. Subjects: Twelve JHM affiliates representing over 40,000 employees. Intervention: A strategic objective was established annually based on the ScoreCard and organizational priorities. Measures: JHM affiliates measured their WHP efforts annually using the ScoreCard. CDC industry-specific and large employer benchmarks were collected for comparison. Analysis: ScoreCard data was assessed annually to measure deviations from CDC benchmarks, determine whether strategic objectives were met, and inform additional annual objectives. Results: JHM demonstrated improvement from 8.9 percentage points above industry-specific and 3.4 percentage points below large employer benchmarks in 2016, to 26.4 percentage points above industry-specific and 21.8 percentage points above large employer benchmarks in 2020. Conclusion: Large employers face unique challenges in implementing WHP programs. Our study suggests embedding health promotion in annual strategic objectives may alleviate these challenges by prioritizing the goal and ensuring adequate resources to be successful. There are however, some limitations on using benchmarking data for comparison.

Intrapersonal Mindfulness is Associated with Reduced Risk of Burnout among Central Appalachian Educators

IntroductionNational statistics suggest that up to 40% of new teachers will leave their school or the teaching profession within their first five years of teaching. Much of this attrition is associated with work-related burnout, some of which may be preventable with targeted worksite health interventions. Previous research suggests that mindfulness skills may be protective from burnout, ultimately reducing the likelihood of attrition from the profession.MethodsThis study compared the self-reported levels of burnout and secondary traumatic stress with participants’ levels of interpersonal and intrapersonal mindfulness. Participants completed the Professional Quality of Life Inventory and the Mindfulness in Teaching Inventory. Odds Ratios and Relative Risks were calculated using Epi Info. Pearson correlations, linear regression, and ANOVA analyses were completed using SPSS. Chronbach’s alpha values were also calculated to evaluate score reliability of the five constructs.ResultsRelative Risks and Odds Ratios of having secondary traumatic stress scores of “average/high” were significantly lower for those with high intrapersonal mindfulness scores. Those who reported high intrapersonal mindfulness scores were up to 11 times more likely to report “low” burnout than those who reported low intrapersonal mindfulness scores. Burnout negatively correlated with both intrapersonal mindfulness suggesting that as intrapersonal mindfulness level decreases, burnout increases. ANOVA testing identified significant differences in burnout based on intrapersonal mindfulness level.ConclusionThose who reported high levels of intrapersonal mindfulness had significantly reduced risk of burnout. These results will inform further research in the region regarding mindfulness practice and the experience of burnout among teachers in the region. Thus, mindfulness may be protective from occupation-related burnout for this population. Interventions informed by additional research could reduce the burden of occupation-related burnout and may ultimately contribute toward reduced attrition in the teaching profession.

Intrapersonal Mindfulness is Associated with Reduced Risk of Burnout among Central Appalachian Educators

IntroductionNational statistics suggest that up to 40% of new teachers will leave their school or the teaching profession within their first five years of teaching. Much of this attrition is associated with work-related burnout, some of which may be preventable with targeted worksite health interventions. Previous research suggests that mindfulness skills may be protective from burnout, ultimately reducing the likelihood of attrition from the profession.MethodsThis study compared the self-reported levels of burnout and secondary traumatic stress with participants’ levels of interpersonal and intrapersonal mindfulness. Participants completed the Professional Quality of Life Inventory and the Mindfulness in Teaching Inventory. Odds Ratios and Relative Risks were calculated using Epi Info. Pearson correlations, linear regression, and ANOVA analyses were completed using SPSS. Chronbach’s alpha values were also calculated to evaluate score reliability of the five constructs.ResultsRelative Risks and Odds Ratios of having secondary traumatic stress scores of “average/high” were significantly lower for those with high intrapersonal mindfulness scores. Those who reported high intrapersonal mindfulness scores were up to 11 times more likely to report “low” burnout than those who reported low intrapersonal mindfulness scores. Burnout negatively correlated with both intrapersonal mindfulness suggesting that as intrapersonal mindfulness level decreases, burnout increases. ANOVA testing identified significant differences in burnout based on intrapersonal mindfulness level.ConclusionThose who reported high levels of intrapersonal mindfulness had significantly reduced risk of burnout. These results will inform further research in the region regarding mindfulness practice and the experience of burnout among teachers in the region. Thus, mindfulness may be protective from occupation-related burnout for this population. Interventions informed by additional research could reduce the burden of occupation-related burnout and may ultimately contribute toward reduced attrition in the teaching profession.

Qualidade de vida no trabalho: abrangência das intervenções de promoção da saúde em ambiente hospitalar

O objetivo do estudo foi de avaliar a abrangência das intervenções de promoção de saúde adotadas em instituição hospitalar. Trata-se de uma pesquisa transversal realizada com 13 gestores de um ambiente hospitalar. Foi utilizado o questionário CDC - Worksite Health Score Card (HSC). Os dados foram analisados por meio da estatística descritiva. Comparando as pontuações das 12 seções do HSC de forma individual, observou-se que oito apresentaram pontuações e quatro não pontuaram. Partindo para verificação das questões que obtiveram a resposta “sim” e sua pontuação, onde 1 é bom, 2 é muito bom e 3 é ótimo, percebe-se que a instituição estudada possui atividades de promoção da saúde voltadas ao trabalhador. Das 26 questões que possuem um nível de impacto 1, a instituição respondeu sim em oito, o equivalente a 31% de estratégias com impacto bom na saúde. Das 30 questões com o valor de impacto 2 a instituição respondeu sim em quatro, o equivalente a 13% de ações com impacto muito bom na saúde. Por fim, das 43 questões de nível de impacto 3 a instituição respondeu sim em oito, o equivalente a 19% de atividades com nível de impacto ótimo. A instituição estudada, embora de forma não organizada em programas, desenvolve práticas em promoção da saúde no ambiente de trabalho hospitalar com níveis de impacto bom, muito bom e ótimo.