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Biomedical subjects

G Sorensen

Publications and source records attributed to G Sorensen.

85 records · Page 5Linked to original sources
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A model for worksite cancer prevention: integration of health protection and health promotion in the WellWorks Project.

OBJECTIVES: To describe a theoretic approach and rationale for the integration of health protection and health promotion in worksite cancer prevention programs and to describe an intervention study designed to implement this integration. METHODS: Twenty-four worksites were recruited to participate in this randomized, controlled study. The theoretically based intervention model integrates health promotion and health protection through (1) joint worker-management participation in program planning and implementation, (2) consultation on worksite changes, and (3) educational programs targeting health behavior change. RESULTS: Although the primary purpose of this paper is to describe a theoretic approach to the integration of health promotion and health protection, preliminary results are also noted. In these predominantly manufacturing worksites, many workers faced the double jeopardy of exposures to occupational carcinogens and personal risks such as smoking or poor dietary habits. Production workers' job responsibilities frequently limited their full participation. Barriers to participation were identified early in the project, and strategies were developed to facilitate maximal worker involvement and worksite changes. CONCLUSIONS: Lifestyle changes such as smoking cessation or dietary changes may be more effectively promoted among blue collar audiences when programs also encourage management actions to reduce occupational exposures. Public health professionals trained in health promotion and health protection must work together to effectively address the health concerns of this population.

Health Education↗
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Double jeopardy: workplace hazards and behavioral risks for craftspersons and laborers.

PURPOSE: To address three specific questions in a sample of craftspersons and laborers: (1) Do craftspersons and laborers exposed to workplace hazards have higher behavioral risks, such as smoking and high-fat diets, than those with few job risks? (2) Compared to workers with few job risks, do workers exposed to risks on the job have higher intentions to reduce their behavioral risks? (3) Does concern about the level of exposure to risks on the job increase workers' intentions to reduce behavioral risks? DESIGN: A cross-sectional self-administered survey was conducted in participating worksites. SETTING: Twenty-two predominantly manufacturing worksites in Massachusetts. SUBJECTS: Craftspersons and laborers responding to the survey and employed in these 22 worksites (completion rate = 61%, N = 1841). MEASURES: By using standardized items, this survey measured self-reported exposure to workplace hazards, concern about job exposures, smoking status, fat and fiber intake, readiness to quit smoking, plans to reduce fat intake, plans to eat more fruits and vegetables, and sociodemographic variables. RESULTS: Workers reporting exposure to chemical hazards on the job were significantly more likely to be smokers than were unexposed workers, even when results were controlled for gender. Compared with unexposed workers, smokers exposed to chemical hazards were significantly more likely to be thinking of quitting or taking action to quit, when results were controlled for gender, race, and education. Among workers exposed to occupational chemical hazards, concern about this exposure was significantly associated with intentions to decrease fat intake and increase fruit and vegetable intake, and, among men, intentions to quit smoking. CONCLUSIONS: Efforts aimed at integrating health promotion and health protection are needed to address simultaneously the job risks and personal risks these workers face.

Adult↗
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The health impact of worksite nutrition and cholesterol intervention programs.

PURPOSE: To summarize and provide a critical review of worksite health promotion program evaluations published between 1980 and 1995 that address nutrition and hypercholesterolemia. The article discusses and critiques both intervention methods and research methodologies to identify the most effective strategies. METHODS: Core articles are 26 original, data-based studies that report on measures of health status, behavior, attitudes, and knowledge as outcomes of worksite nutrition and cholesterol interventions. Only work published since 1980 that clearly describes nutrition or cholesterol interventions and that includes identifiable nutrition-related outcomes is reviewed. The main search method was the same one used for this special issue; supplementary sources included those found in earlier reviews or identified through backward searches or expert contact. SUMMARY OF IMPORTANT FINDINGS: Ten worksite nutrition education programs were reviewed and were categorized as group education, group education plus individual counseling/instruction, cafeteria-based programs, and group education plus cafeteria-based programs. Four of these were randomized studies, and one used the worksite as the unit of randomization and analysis. Sixteen worksite cholesterol programs were reviewed, in five categories: monitoring; individual counseling; group sessions or classes; mediated methods using print, audiovisual, telephone, and self-help kits; and combination approaches. Of these, eight were randomized controlled trials; most tested interventions for persons with elevated cholesterol levels, although four studies reported cholesterol education programs for the general employee population. Six large controlled trials of worksite nutrition and cholesterol interventions in progress are also described. MAJOR CONCLUSIONS: The conclusions that can be drawn from this review are limited by the study designs used, which often lacked control groups, used nonrandomized designs, or relied on self-selected high-risk or volunteer participants. Our rating for the quality of the evidence in the literature as a whole lies between suggestive and indicative. It is clear that worksite nutrition and cholesterol programs are feasible and that participants benefit in the short-term. Conclusive evidence about a causal relationship between worksite nutrition and cholesterol programs and improved behavior or health is not yet available, although studies currently underway hold promise for providing more solid evidence about the potential efficacy of these interventions.

Health Knowledge, Attitudes, Practice↗
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Spousal similarities in fruit and vegetable consumption.

PURPOSE: To explore similar patterns of fruit and vegetable consumption between health center employees and their spouses. DESIGN: Cross-sectional mailed survey assessing frequency of fruit and vegetable consumption, as well as demographics and knowledge, attitudes, access, and social support related to fruit and vegetable consumption. SETTING: Six Massachusetts health centers. SUBJECTS: Two hundred eleven health center employee/spouse pairs (422 individuals). MEASURES: The kappa statistic measured agreement in fruit and vegetable consumption between employees and spouses. The Spearman rho coefficient measured correlations for individual responses. Multiple Linear Regression Models examined variables that explained fruit and vegetable consumption level differences. RESULTS: Response rate was 59%. Mean fruit and vegetable daily intake was 4.68 and 4.30 servings for employees and spouses, respectively. Over 75% of employee and spouse estimates measuring fruit and vegetable consumption-related information, on average, were within one survey response category of each other. Knowledge, attitudes, and access indices were significantly correlated with fruit and vegetable consumption for both employees and spouses. The social support index was significantly correlated with fruit and vegetable consumption only for the spouses. Differences in knowledge, attitudes, and access indices between employees and spouses helped to explain different fruit and vegetable consumption levels. Nonresponse, selection, recall, and seasonal reporting biases may limit the findings' generalizability. CONCLUSIONS: The effectiveness of worksite nutrition interventions may be improved by involving family/household members.

Adult↗
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Process tracking results from the Treatwell 5-a-Day Worksite Study.

PURPOSE: To report findings from Treatwell 5-a-Day process tracking. DESIGN: Worksites were randomly assigned to a minimal intervention control, worksite-only condition, or worksite-plus-family condition. SETTING: Twenty-two small community health centers in Massachusetts. SUBJECTS: Employees of the community health centers. INTERVENTION: Both intervention conditions included the formation of employee advisory boards; activities such as nutrition discussions and taste tests targeting individual behavior change; and point-of-purchase labeling as an environmental strategy. Worksite-plus-family sites incorporated activities such as family contests, campaigns, and picnics. MEASURES: Documentation of the number and type of activities for extent of implementation; number of participants in activities for reach; program awareness and participation from the follow-up employee survey (n = 1306, representing 76% [range, 56%-100%] of the sample); change in fruit and vegetable consumption from a comparison between the follow-up and baseline surveys (n = 1359, representing 87% [range, 75%-100%] of the sample). RESULTS: A higher number of activities per employee was significantly correlated with greater program awareness (.68; p = .006) and greater change in fruit and vegetable consumption (.55; p = .04). Greater participation in activities was significantly correlated with greater awareness (.67; p = .007), higher participation (.61; p = .02), and increase in fruit and vegetable consumption. (.55; p = .04). CONCLUSIONS: These results provide quantitative indicators of a dose-response relationship between the number of intervention activities per employee and higher percentage of employee participation and observed increases in fruit and vegetable consumption.

Documentation↗
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Social influences, social norms, social support, and smoking behavior among adolescent workers.

PURPOSE: To examine the relationships between worksite interpersonal influences and smoking and quitting behavior among adolescent workers. DESIGN: The cross-sectional survey assessed factors influencing tobacco use behavior. SETTING: During the fall of 1998, data were collected from 10 grocery stores in Massachusetts that were owned and managed by the same company. SUBJECTS: Eligible participants included 474 working adolescents ages 15 to 18. Eighty-three percent of workers (n = 379) completed the survey. MEASURES: The self-report questionnaire assessed social influences, social norms, social support, friendship networks, stage of smoking and quitting behavior, employment patterns, and demographic factors. RESULTS: Thirty-five percent of respondents were never smokers, 21% experimental, 5% occasional, 18% regular, and 23% former smokers. Using analysis of variance (ANOVA), results indicate that regular smokers were 30% more likely than experimental or occasional smokers to report coworker encouragement to quit (p = .0002). Compared with regular smokers, never smokers were 15% more likely to report greater nonacceptability of smoking (p = .01). chi 2 tests of association revealed no differences in friendship networks by stage of smoking. CONCLUSIONS: These data provide evidence for the need to further explore social factors inside and outside the work environment that influence smoking and quitting behavior among working teens. Interpretations of the data are limited because of cross-sectional and self-report data collection methods used in one segment of the retail sector.

Adolescent↗
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Employee advisory boards as a vehicle for organizing worksite health promotion programs.

PURPOSE: The purpose of this article is to describe the "employee advisory board model" applied in the Treatwell program, a worksite nutrition intervention program. DESIGN: The employee advisory boards of five of the seven intervention worksites participating in the Treatwell program were surveyed. Results were compared with results of employee surveys conducted in these five worksites. SETTING: The five worksites included in this study are among 16 participating worksites from Massachusetts and Rhode Island. SUBJECTS: Of the 95 board members represented in the five worksites, 88% responded to the survey. This article also presents results from the 698 respondents of the five intervention worksites where the board surveys were conducted. INTERVENTION: The boards in each worksite participated in planning, promoting, and implementing this program in each worksite. MEASURES: Respondents to the board survey were asked about their participation on and satisfaction with the board and factors they thought contributed to its effectiveness. A survey of all employees included information on demographics and program participation. RESULTS: Board members reported that they were highly satisfied with the board's functioning. Board member hours spent on Treatwell activities were directly related to the proportion of employees aware of the program. (r = .82). The boards' effectiveness was limited by conflicting priorities between the job and board responsibilities. CONCLUSION: The employee advisory board model provides promise for increasing worker awareness of worksite health promotion programs through enhanced worker ownership.

Adult↗
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Compliance with worksite nonsmoking policies: baseline results from the COMMIT study of worksites.

PURPOSE: Little is known about compliance with worksite nonsmoking policies. This study provides an examination of the relationship of policy compliance to characteristics of the organization and the manner in which the policy was implemented. DESIGN: Data came from two separate surveys of 1) representatives of worksites that reported having a nonsmoking policy and 2) employed residents from the same communities whose worksites had nonsmoking policies. SETTING: This study was conducted as part of the Community Intervention Trial for Smoking Cessation (COMMIT), being conducted in 11 diverse intervention communities. SUBJECTS: Data are presented from surveys of 710 worksites (response rate = 90%) and 3,143 employed residents (response rate = 80%) of the same communities. MEASURES: Compliance with nonsmoking policies was measured by self-report in both surveys and is compared with worksite and respondent characteristics, type of policy, and methods of policy implementation. RESULTS: Compliance with nonsmoking policies was high; 55% of worksites with a policy restricting smoking reported that employees always adhered to the policy. Compliance was highest in worksites with more restrictive policies and where labor-management relations were reported to be good. Compliance also was high where the policy was effectively communicated to workers, as through worksite distribution channels, the absence of cigarette vending machines, and the availability of cessation assistance. CONCLUSIONS: These findings indicate that compliance with worksite nonsmoking policies is generally high, especially in the presence of more stringent policies.

Adult↗
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Heavy smoking among a sample of employed women.

Understanding the phenomenon of heavy smoking among women and factors related to it is of considerable public health importance. Whereas lighter smokers have been more successful in their cessation attempts, the percentage of smokers who smoke more than 25 cigarettes per day has increased in recent years. This article examines the hypothesis that, compared to lighter smokers, female heavy smokers will report more responsiveness to internal cues to smoke, less interest in quitting, more difficulty with previous cessation attempts, more uncertainty about cessation strategies, and more concern about weight gain as a result of quitting. We collected data in 1984 through a self-administered survey completed by 874 women employed as nurses in acute care, chronic care, and home care nursing in Worcester, Massachusetts; we base our analyses on data collected from 158 light and moderate smokers and 67 heavy smokers. Our findings suggest that, compared to lighter smokers, heavy smokers may depend more on nicotine and are likely to respond to a broader array of cues to smoke, factors that appear to contribute to heavy smokers' greater difficulties with quitting. These female heavy smokers are just as likely as lighter smokers to have made previous attempts to quit and want to quit just as much. Major barriers to quitting for female heavy smokers include a lack of confidence in their ability to quit, insufficient tools to succeed with cessation attempts, and fear that weight gain will accompany quitting.

Adult↗
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Integrating occupational health, safety and worksite health promotion: opportunities for research and practice.

BACKGROUND: There is emerging evidence that coordinating and integrating worksite health promotion and occupational health and safety enhances the effectiveness of efforts to promote and protect worker health, and growing attention internationally to the importance of integrating worksite health promotion and occupational health and safety. OBJECTIVES: (1) To present the rationale and scientific evidence for coordinating and integrating worksite health promotion and occupational health and safety as a means of enhancing the effectiveness of efforts to promote and protect worker health; and (2) to discuss recommendations for research priorities and future directions. METHODS: Review of the literature, drawing mainly on studies from the United States and Europe. RESULTS: The strongest evidence available supports the efficacy of this intervention model in promoting smoking cessation, particularly among blue-collar workers; some evidence additionally indicates significant effects for other health behaviors. Little evidence is available to date documenting the impact of these programs on occupational health and safety outcomes. CONCLUSIONS: Priority research directions include: social epidemiological research to identify key work-related factors associated with hazardous occupational exposures and risk-related behaviors, and to identify the underlying causes of social disparities in worker health; methods development research aimed at developing both appropriate measurement tools and new intervention approaches; efficacy and effectiveness studies to examine the effects of integrated interventions on both occupational health and safety outcomes as well as health behavior changes; assessments of the process of intervention implementation, including intervention implementation evaluation, cost assessments, and process-to-outcome assessments; and dissemination and durability studies, to identify strategies to promote the sustainability and dissemination of evidence-based programs.

Diet↗
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Reducing the risk of cancer through worksite intervention.

This chapter examines existing activities reported in the literature in the areas of smoking, nutrition, and screening; explores the prominent theories of behavior change that have guided some of these activities; and presents a model for worksite cancer prevention programs that is currently being tested in a large trial. A major theme of this chapter is the need for simultaneous changes in individual behaviors and the worksite environment. For each factor (smoking, nutrition, and screening) the discussion is divided into interventions for individuals and those for the environment or organization.

Health Promotion↗
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5 A Day for better health--nine community research projects to increase fruit and vegetable consumption.

One of the national objectives in "Healthy People 2000" is for members of the public to increase their consumption of fruits and vegetables to five or more servings daily. The National Cancer Institute (NCI) began a nationwide campaign to achieve this objective in 1991. As part of this campaign, the NCI funded nine research studies in 1993. These projects are implementing and evaluating community-based programs designed to increase fruit and vegetable consumption among different segments of the population in Alabama, Arizona, Georgia, Louisiana, Maryland, Massachusetts, Minnesota, North Carolina, and Washington. The settings for these projects include the Special Supplement Food Program for Women, Infants, and Children (WIC Programs), churches, worksites, and schools. The projects are led by multidisciplinary teams and entail extensive collaboration among academic, governmental, private sector, and voluntary agencies within each State. The projects represent a model public health paradigm for conducting this type of research.

Diet↗