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Dr Fiona Cocker

Understanding the impact of a workplace health promotion program : How do we know who got what, and how much is enough?. Dr Fiona Cocker. Evaluating Interventions. Randomised Controlled Trial (RCT) Aims to evaluate program/trial efficacy Considered the “gold standard”

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Dr Fiona Cocker

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  1. Understanding the impact of a workplace health promotion program:How do we know who got what, and how much is enough? Dr Fiona Cocker

  2. Evaluating Interventions • Randomised Controlled Trial (RCT) • Aims to evaluate program/trial efficacy • Considered the “gold standard” • Pros: double blind, placebo controlled, strong internal validity • Cons: Limited external/“real world” validity, limited “generalisability”

  3. Evaluating Interventions • Pragmatic RCTs • Aims to evaluate program/trial effectiveness, whilst reflecting the heterogeneity of individuals encountered in the “real world” • Minimise exclusion criteria • Functional outcomes emphasised, and measured over a sufficient time period • Pros: rigour of randomisation, applicable to group of interest

  4. Evaluating Interventions “Real World” Evaluation Evaluation aim: Implementation Pros: more practical in a large, diverse, populations such as a multi-site workforce Cons: no control group, may have no control over intervention Example: Well@Work: Promoting Active and Healthy Workplaces by researchers at Loughborough University, UK

  5. Evaluating H@W • Healthy@Work H&WB activities and initiatives • varied widely between agencies • implemented at different times during H@W • How do we know who got what? • How do we determine how much is enough? • Comprehensiveness • Potential to influence health outcomes? • How do we control for this?

  6. What is a comprehensive WHP programme? • Linnan et al. Results of the 2004 National Worksite Health Promotion Survey. Am J Public Health. 2008;98(8):1503-9. • Surveyed individuals “responsible for health promotion or wellness” to identify which worksites offered “comprehensive” worksite health promotion program • Pilkington et al. Survey of use of occupational health support. Edinburgh: Institute of Occup Med; 2002. • Surveyed 4950 randomly selected companies of varying size, sector and region, to determine who uses occupational health support • Used to inform exposure variable development because: • national in scope • covered multiple worksites of different sizes and industries

  7. Components of a comprehensive work program • Health education (skill development, awareness building) • Supportive social & physical environment (accessible stairs or shower facilities, time to allow participation) • Integration into organisation’s structure (management support, dedicated H&WB position/s)* • Linkage to related programs (EAP, OH&S) • Worksite screening (blood pressure, health checks) Linnan et al. Am J Public Health. 2008;98:1503-09. *Pilkington et al. Institute of Occupational Medicine; 2002.

  8. Measuring “comprehensive” or H&WB exposure: Methodology Dose • How many H&WB activities and initiatives did each agency implement? • Cumulative exposure • Add activities across life of H@W to get a total score

  9. Example of Raw Data - 2010

  10. Total Score per Year Total Score/Year = 56

  11. Total Score per Year Total Score/Year = 56

  12. Agency Example Number of H&WB Activities Year

  13. Sensitivity of Measurement Can we see differences between agencies? Number of H&WB Activities Year

  14. What’s next? • Currently focused on an overall indicator • Total dose • Employee reports of what was available & what they used • measure of individual exposure • When did agencies implement activities? • Duration i.e. from 2008 or not until 2012 • Were activities in every domain? • Quality and comprehensiveness • Does this impact on health outcomes? • Only 2012 important, close to measurement point?

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