2005
Primary Health Care Policy Fellowship
A Proposal to Develop an Evidence-Based Guide to Workplace Preventive Services
Authors and Sponsoring Organizations:
Wendy E. Braund,
MD, MSEd
American Medical Women’s Association
Timothy E. Corden,
MD
American Academy of Pediatrics
Mary E. Foley RDH,
MPH
American Association of Public Health Dentistry
Kelley M. Korona
MSN, NP-C
American Academy of Nurse Practitioners
Christopher P.
Landrigan, MD, MPH
Ambulatory Pediatric Association
Charles T. Lucey,
MD, JD, MPH
Food and Drug Administration
Miriam A. Mobley
Smith, PharmD
American Association of Colleges of Pharmacy
Donna Tomlinson,
MD, MSc
National Business Group on Health
Purpose
To establish an evidence-based Guide to Worksite Preventive Services that will promote widespread adoption of effective worksite health promotion programs.
Statement of the Problem
Millions of Americans suffer from preventable diseases and injuries that cost the healthcare system and employers over 263 billion dollars annually. Several major U.S. corporations have begun to establish health promotion initiatives that incorporate strategies to discourage risky behaviors and encourage healthy lifestyles. Although limited data suggest that such programs may improve health and yield substantial returns on investment in a handful of large companies, general information and evidence to support broader implementation of worksite health promotion activities is lacking.
The Agency for Healthcare Research and Quality’s US Preventive Services Task Force has been influential in conducting high quality, evidence-based reviews of preventive services. The Centers for Disease Control and Prevention is similarly advancing the state of the art in community-based interventions to improve health through its sponsorship of the Community Preventive Services Task Force. No public or private agency, however, has evaluated the evidence and issued guidelines regarding health promotion programs in the workplace.
Recommendation
Existing and emerging workplace health promotion initiatives need to be identified, with rigorous, evidence-based assessment of clinical efficacy and cost-effectiveness. Promising practices must be evaluated and the strength of the scientific evidence rated. A database of best practices should be established and a system developed for translating relevant findings into workplace initiatives.
We suggest that DHHS develop a Guide to Worksite Preventive Services that will promote adoption of effective worksite health promotion programs. The guide will provide evidence-based assessments of health promotion programs, making best practices in workplace health promotion readily accessible to employers, health professionals, and the public. These will be published on a web-based clearing house that will be updated regularly.
To accomplish this goal, we recommend DHHS establish an independent, multidisciplinary Worksite Preventive Services Taskforce, with representation from the public and private sectors. The charge of this public-private partnership will be to:
Expected Outcomes
We anticipate that these recommendations will result in the publication of a web-based Guide to Worksite Preventive Services, which will:
Finances and Support
As is the case with the U. S. Preventive Services Taskforce, the Worksite Preventive Services Taskforce members will be volunteers. Initial costs would include Taskforce travel expenses and hiring of a project coordinator, web designer, and research staff to gather the evidence regarding health promotion programs. Altogether, we anticipate that this will cost no more than $500,000 per year. Of note, preliminary studies of several effective worksite health promotion programs have indicated that a return on investment (ROI) of 6:1 or greater is possible. We therefore anticipate that although there will be modest start-up costs to implement this program, it will ultimately focus health promotion expenditures on the most clinically efficacious and cost-effective programs.
References and Resources
Community Guide, http://www.thecommunityguide.org.
Centers for Disease Control and Prevention, CDC DATA 2010 http://wonder.cdc.gov/scripts/broker.exe
National Center for Health Statistics, Employer-Sponsored Health Insurance: State and National Estimates. Hyattsville, MD: U.S. Department of Health & Human Services, 1997.
Association for Worksite Health Promotion, 1999 National Worksite Health Promotion Survey. Northbrook, IL: The Association, 1999.
American College of Occupational and Environmental Medicine, How Companies Consider Value in Health Policy and Design, Results of the Survey of Employer Decision-making for Health and Productivity, June 2004, http://www.acoem.org/health_productivity/AventisReport.pdf.
The Business Case for Managing Health and Productivity, Integrated Benefits Institute, June 2004, http://www.acoem.org/health_productivity/IBIFull-CostResearch.pdf.
Worksite Health, http://www.hap.org/healthy_living/worksitehealth/worksite_health.php#1.
U.S. Department of Health & Human Services, http://www.dhhs.gov/.
Health Promotion, DHHS Centers for Disease Control and Prevention, http://www.cdc.gov/node.do/id/0900f3ec80059b1a).
The National Institute for Occupational Safety and Health, http://www.cdc.gov/niosh/homepage.html.
Agency for Healthcare Research and Quality, http://www.ahrq.gov/.
U.S. Preventive Services Task Force (USPSTF), http://www.ahrq.gov/clinic/uspstfix.htm
U.S. Department of Labor Occupational Safety & Health Administration, http://www.osha.gov/.
US Army Center for Health Promotion and Preventive Medicine, http://chppm-www.apgea.army.mil/.
American College of Preventive Medicine, http://www.acpm.org/.
American College of Occupational and Environmental Medicine, http://www.acoem.org/.
World Health Organization, Occupational Health, http://www.who.int/topics/occupational_health/en/.