Factors Influencing Participation in Worksite Wellness Programs Among Minority and Underserved Populations.

Not much is known about the determinants of workplace wellness program participation.  What is known about participants are their demographic characteristics.

It is known that women are more likely to participate in wellness activities at the work site than men.  However, men are more likely to participate in fitness activities at a greater rate than women. 

White-collar employees participate in activities at a greater rate than blue-collar employees.  White-collar employees may participate more in workplace activities because of their job flexibility or even the greater value placed on health by those who occupy white-collar positions. 

These differences may be due to the fact that workplace wellness programs are usually not provided to those who are engaged in manual labor.  As well, those who work in part-time, non unionized, and/or low-wage employees may have limited access to health promotion programs.  Those who are employed on a full-time basis with benefits are usually the employees who participate in workplace wellness programs.  

Those who are enrolled in workplace wellness programs usually are healthier than the rest of the work force.  On the other hand, employees who were at greatest risk for various health problems participated less frequently in employee health promotion programs. 

Those who are most likely to benefit most from a workplace wellness program are least likely to participate. 

A good way to get employees to participate is to use incentives.  However, these incentives must fit the company and employee culture.  During a needs assessment it is best to ask them what incentives intrigue them.   

Program flexibility can also increase participation.  There should be a variety of activities at differing intensities, commitment levels, and perceived costs to the participants. 

One of the strongest predictors of health status is socioeconomic status.  Minorities, the poor, and other underserved populations are in desperate need of health promotion programs. 

The work site can be a place to reach minority, low-income, and poorly educated groups by implementing workplace wellness programs that are culturally appropriate and structurally accessible.  Structurally accessible refers to programs, services, and activities that are readily accessible to employees in terms of location and the time of the day the programs are offered. 

There are barriers a wellness coordinator should take into account when implementing programs.  These barriers are: concern about differential treatment and discrimination; concern about little input, control, and ownership of different programs; distrust of persons in authority; a general lack of interest; the perceived cost of participation (both monetary and nonmonetary such as time spent)’; and employer/program planner cultural unawareness or insensitivity or both. 

Attitudes that may influence both participation and adherence include perceived seriousness of, and susceptibility to, the health condition being addressed.  They may not feel they can do anything to improve their health status or they may not think participating in workplace wellness programs will improve their health. 

Cost is one of the major barriers to workplace health promotion.  A solution to this barrier is to utilize the services provided by local or regional not-for-profit and voluntary agencies. 

An innovative approach to address the barriers that can arise when targeting minority and underserved populations at the work site is an adaptation of Bracht’s 5-stage community organizational model for health promotion.  

The five stages of Bracht's model are:

-Community analysis:  conduct a needs assessment among the employee population to decide on problems and level of interest in potential programs.  Potential barriers should be identified at this stage. 

-Design initiation:  During this stage a planning group is created. This group should include people who are enthusiastic and interested members from the priority population who have the potential to influence or recruit other employees. The voices of employees should be represented during this stage of program planning and development.  

-Implementation:  The employee population must be included in the implementation stage of any health promotion programming.  Involvement in all stages of planning will enhance employee “ownership of the program.”   It is important to develop a system to elicit employee feedback in order to continually monitor and adjust activities. 

-Maintenance consolidation:  During this stage, an ongoing recruitment plan must be established not only for employee program participation, but for employee planning and assessment efforts.  It is important to recognize active employees.  Such recognition may reinforce and/or promote further participation. 

-Dissemination reassessment:  During this phase, feedback gathered during earlier stages can be synthesized and prioritized.  Programs can be refined and/or new programs or issues can be addressed.  Disseminating positive impact information to the employee population can stimulate interest and further participation, as well as reinforce positive behavioural changes of existing participants.  

Bracht’s 5-stage model allows for the assistance of members of the community and it also gives ownership of the workplace wellness programs to the employees.  Using this model also identifies influential members of the target employee population.  Members of the population can be trained to act as facilitators for the program. Employee committees that empower the group to work toward their own goals can also be created using this model. 

Another important way to engage the priority population of a workplace wellness program is to make sure that the target group’s priorities, beliefs, values, perceptions, and practices are considered.  To encourage participation and sustain participation the message, format, and delivery of the workplace wellness programs should be culturally meaningful. 

This can be done by identifying knowledge, attitudes, and expectations of the target group, and incorporating these values into the program.  Another important dimension to look at is how the health promotion programs are going to be provided.  It is important to look at providing health promotion programs in the minority populations’ languages. 

For the above reasons, a thorough needs assessment can be very valuable.  The needs assessment can tell you which health promotion activities are of interest to the employees, but it will also motivate the employees to participate. 

One of the greatest indictors of differences in health status is socioeconomic status.  People who are in most need of health promotion programs are also the people who could benefit the most from health promotion programs.  It is important that workplace wellness programs be offered in a culturally sensitive ways that use Bracht’s 5-stage model or other similar models. 

Workplace wellness programs that are culturally sensitive must be developed to encourage and engage participation from low-income minority and other underserved populations. 

Reference:

Thompson, S.E., Smith, B.A., Bybee, R.F. (2005). Factors Influencing Participation in Worksite Wellness Programs Among Minority and Underserved Populations. Family and Community Health, 28(3):267-273.  

Posted by: suhujitha on 2009-03-26 14:15:33

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