Healthy@work? : Lifestyle factors and workplace health promotion

Adverse lifestyle factors, such as cigarette smoking, poor diet, risky alcohol consumption, overweight and obesity, physical inactivity and sedentary behaviours, are associated with non-communicable diseases and premature mortality. Evidence from controlled interventions shows that workplaces are settings where employee lifestyle factors can be improved via workplace health promotion (WHP). Less clear is what happens outside of controlled trials, when organisations attempt to implement WHP underpinned by best-evidence principles. In 2009 the Tasmanian State Service invested in a four-year WHP program that targeted its entire workforce. The aims of this thesis were to investigate employee participation in, and the benefits of, the Healthy@Work project. Of particular focus were employee lifestyle factors, including sedentary behaviours, and recommended WHP implementation strategies in practice. The study used a repeated cross-sectional survey design with stratified random samples. Survey data was collected in 2010 (n=3408) and 2013 (n=3228) from Tasmanian State Service employees, and respondent characteristics were similar in both surveys. With regard to implementation, the findings indicated employee needs assessments and health risks are likely to align with employee preferences for programs. Inequitable access to WHP activities, and lower levels of participation in some at risk groups, was evident. Barriers to participation included time, health problems and location of activities. However, recommended implementation practices, and social support, were related to participation in more activities. For lifestyle factors, prolonged sitting at work was found to be associated with psychological distress. Finally, participation in activities related to health behaviours was associated with a range of employee-perceived benefits, such as being motivated or assisted to be physically active, yet population-level differences in lifestyle factors were not observed between 2010 and 2013. Despite observed intermediary benefits, Healthy@Work was either ineffective in regard to achieving measurable behaviour change, or insufficient time had elapsed to detect a population-level shift. Organisations administering WHP should establish clearly defined outcomes and appropriately match expectations, resources and time frames to realising those outcomes.