HealthLinks: Increasing EBI Implementation in Low-Wage Worksites

1. HealthLinks: Increasing EBI Implementation in Low-Wage Worksites UW CPCRN Peggy Hannon February 15, 2012

2. We Want Employees To Be Able To… Get Screened Get or Stay Fit Quit

3. We Want Employers To Give Employees… Easy Access A Supportive Culture Skills & Tools

4. HPRC Dissemination Framework Fixed Elements Organizational Practices & Individual Behaviors Evidence-Based Practices User Organization Dissemination Resources Diffusion Readiness Researchers Linkages & Learnings Using Principles of Social Marketing Adoption Disseminating Organizations Implementation Maintenance Dissemination Approach Modifiable Outer Context Networks, policies, funding Unmodifiable Outer Context Economic conditions, etc. Harris JR et al. Prev Chronic Dis 2012;9:110081

5. HPRC Dissemination Framework: Worksites Fixed Elements Organizational Practices & Individual Behaviors (Change from Baseline to Follow-up) User Organization (Worksites) Evidence-Based Practices Dissemination Resources Diffusion Readiness Researchers (HPRC) Linkages & Learnings Using Principles of Social Marketing Adoption Disseminating Organizations (American Cancer Society) Implementation Maintenance Dissemination Approach (HealthLinks) Modifiable Outer Context Networks, policies, funding Unmodifiable Outer Context Economic conditions, etc.

6. ACS HealthLinks Small worksites, 20-250 employees Focus= healthy eating, physical activity, and tobacco cessation ACS delivers intervention to employer and employeees at worksite Worksites participate for 6 months Photo: Stafford Healthcare receiving their HealthLinks certificate

7. HealthLinks Best Practices Healthy eating Provide healthy foods on-site Physical activity Provide access to physical activity facilities Provide worksite-based physical activity program Tobacco Ban tobacco at work Communication Promote all of the above to employees, promote free state resources (Quit Line and cancer screening programs)

8. Current HealthLinks Project Communities putting prevention to work

9. Project Goals Recruit 50 small worksites Deliver HealthLinks (6 months at each worksite) Build wellness committees to increase internal capacity and champions Evaluate HealthLinks impact Measure best practices at baseline and 6 months later Measure workers’ health behaviors & awareness of WHP at baseline and 6 months later (~15 worksites)

10. Participating Worksites Variety of industries Education Healthcare/Social Assistance Leisure/Hospitality Manufacturing Wholesale/Retail Trade Other Size range 22-250 employees (mean = 107) Few had wellness committees (n=7) Baseline best practice implementation is low (<30%)

11. Employees’ Characteristics Majority (72%) work full-time Majority make ~ $30,000 per year 61% are women Race/ethnicity African American 13% American Indian/Alaska Native 1% Asian/Pacific Islander 12% Multi-racial or Other 13% White 60% Latino 10% Employers reported their employees’ characteristics. Race/Ethnicity does not sum to 100% b/c not all employers provided estimates for all categories.

12. Lessons Learned Recruitment New challenges Strategies we tried Strategies that worked Implementation Measuring small changes Running with creativity

13. What’s Next? Community Transformation Grant, WA State Deliver HealthLinks to worksites in rural WA counties Develop & pilot-test new HealthLinks model, engaging ACS volunteers to provide implementation support Measure best practice implementation every 6 months

14. Partners American Cancer Society John Craft, Eustacia Mahoney, Patti Santiago, Erin Sheahan, Sara Teague Group Health Cooperative/GHRI David Grossman, Kevin Klein Public Health – Seattle & King County Elaine Cummins, Ryan Kellogg, Sarah Ross-Viles WA Department of Health Sue Grinnell, Pama Joyner, Sheila Pudists, Chris Zipperer

15. Acknowledgements Public Health-Seattle & King County (subcontracts via Communities Putting Prevention to Work, Centers for Disease Control and Prevention) University of Washington Health Promotion Research Center, a CDC Prevention Research Center, cooperative agreement U48DP001911 Centers for Disease Control and Prevention (CDC) and the National Cancer Institute through the Cancer Prevention and Control Research Network, a network within the CDC's Prevention Research Centers Program, cooperative agreement U48DP001911

16. Questions and Discussion Contact: Peggy Hannon peggyh@uw.edu 206-616-7859