Experiences of Workplace Health Promotion in the Province of Modena Francesco Venturelli, MD, Resident in Hygiene and Preventive Medicine Department of Public Health Modena Rome, September 29 th -30 th 2016
National and Regional Context National Prevention Plan 2014-2018 Regional Prevention Plan 2015-2018 WHP Project - LHU of Modena 2013-14 Regional model for others LHU Life-course approach and per setting strategies: School, Workplace, Community and Health Services Implementation of NPP strategies and definition of preventive interventions in School, Workplace, Community and Health Services Working group: Occupational Health Physicians, Department of Public Health; Shared with social partners WHP project - In 2015, formal participation of 48 companies and 1698 workers in the Province of Modena
Local Context Careful analysis of the adult population s behaviours Based on the characteristics of our territory activities Mainly small and medium-sized companies ISTAT, January 2016 Strong local awareness of the WPH s strategic value in the reduction of additive or synergistic effects on the health risks related to lifestyle and occupational risk in a perspective of the inevitable aging of the employees WHP as tool for active aging strategies
Main Objectives The promotion of workplace interventions carried out by the institutional entities for prevention (Occupational Health Physician) and aimed at an overall improvement of the working place Specific occupational health and safety legislation Innovative health promotion approach The promotion of the physicians active role in directing the workers towards favorable choices and health behaviours, avoiding harmful habits (i.e. smoking, alcohol abuse, inappropriate diet, sedentary lifestyle, nonparticipation in screening or immunization programs)
Levels of Intervention and Experiences 1 st Individual and collective actions (i.e. environmental) aim to inform and to sensitize 2 nd Collective promotion actions aim to change workers inappropriate health behaviours A bulletin health board comprising posters, billboards and other illustrative material Provision of information materials on issues related to lifestyle Anamnesis of non-occupational risk factors by the OHP during the occupational health surveillance (i.e. preventive, periodic), reporting of risk behaviours in worker s record and development of individually tailored health initiatives
Levels of intervention and Experiences 1 st Individual and collective actions (i.e. environmental) aim to inform and to sensitize 2 nd Collective promotion actions aim to change workers inappropriate health behaviours Business strategies to promote a healthy diet (i.e. changes in menu of the company canteen and/or dispensers of healthy food) Specific company rules regarding the respect of a total smoking ban Agreements with gyms and/or swimming pools or organization of specific activities aimed at promoting physical activity Implementation of dedicated programs of education/training for workers, managers and worker s representatives for health and safety (role as promoter) Counseling with experienced professionals regarding the collective health promotion action (i.e. the company catering service)
Occupational Healthcare Physician Central role as Performer and Promoter of Workplace Health Promotion Confiding relation with both employers and workers Often, the only physician the healthy workers refer to Department of Public Health - LHU Modena Continuous Education Program for OHPs 1. Information and sensitization about Workplace Health Promotion 2. Introduction to the project and its instruments (i.e. software PSALL) 3. Specific training on the motivational approach 4. Insights on specific health issues
Occupational Healthcare Physician 1. Information and sensitization about Workplace Health Promotion: Data on prevalence of unhealthy behaviours among workers in the Province of Modena collected by the PASSI (18-65 y.o. people) and PASSI d Argento (over 65 y.o. people) surveillances Highlight the synergistic, complementary and not substitutive role of WHP to the traditional prevention of occupational disease and injuries 2. Introduction to the project and its instruments (software PSALL): Electronic tool developed to facilitate and standardize the assessment of behavioural risk factors during the workers visit and to track the activities carried out by the OHP for each specific topic PSALL is also used to monitor and evaluate the evolution of the project by the Department of Public Health by the collection of anonymous data
Occupational Healthcare Physician 3. Specific training on the motivational approach: from transtheorical model of behaviour changing (Di Clemente and Prochaska, University of Maryland) educational training carried out in collaboration with «Luoghi di Prevenzione», a regional centre of educational multimedia 4. Insights on specific health issues: Up-to-date lectures with experts in different fields Main topics and under request from OHPs: Healthy diet, Smoking habit, Alcohol consumption, Physical activity, Vaccinations and Screening
Results from a test of the Project in 2015 Sample: 8 OHPs 742 workers Gender Visits n % Male 527 71.0% Female 215 29.0% Age (y.o.) Visits n % 18-34 172 23.2% 35-49 362 48.8% 50-69 208 28.0% Alcohol Sedentary Partially Smoking Overweight consumption Lifestyle active Prevalence 25.6 % 68.2% 38.3% 16.0% 46,9% State of willingness to change harmful behaviours in the workers sample Motivational Alcohol Smoking assessment consumption Overweight Sedentary Partially lifestyle active Pre-contemplation 26.5 % 45.2% 18.0% 16.8% 28.7% Contemplation 58.4% 35.5% 60.9% 77.3% 59.2% Determination 7.0% 6.5% 7.4% 4.2% 4.0% Action 0.5% 6.5% 11.6% 1.7% 2.9% Maintenance 1.1% - 1.1% - 0.9% Relapse 6.5% - 1.1% - 0.9% Does not know/respond - 6.5% - - 3.4%
Results from a test of the Project in 2015 Interventions performed by the Occupational Health Physicians in the workers sample Health topic Eligibles Brief Motivational Motivational Referral to Referral No actions No actions advice interview reinforcement a specialist to GP needed taken Smoking 190 66% 0.5% 14% 4.2% 0.0% 3% 0.0% Nutritional status 284 39% 0.0% 15% 0.4% 0.4% 4% 4% Alcohol consumption 506 6% 0.0% 7% 0.0% 0.0% 19% 0.0% Alimentation 375 24% 0.0% 14% 0.3% 1.1% 5% 4% Physical activity level 467 18% 0.0% 13% 0.0% 0.0% 5% 3% Vaccinations 45 51% 0.0% 7% 0.0% 2.2% 22% 11% Flu vaccination 42 52% 0.0% 7% 0.0% 2.4% 19% 12% Cervix screening 206 6% 0.5% 14% 0.5% 0.5% 45% 2% Mammography 99 6% 0.0% 11% 0.0% 0.0% 45% 1% Colorectal screening 210 27% 0.0% 11% 0.0% 1.0% 18% 5% Eligibility criteria Smoking habit Smokers, former smokers Vaccinations Risk group for at least 1 vaccination Nutritional status Overweight or obese workers Flu vaccination Risk group for flu vaccination Alcohol consumption Workers not abstemious Cervix screening Women 25-64 yo Alimentation* Low adherence to Mediterranean diet Mammography Women 45-74 yo Physical activity** Sedentary and partially active workers Colorectal screening Workers 50-69 yo * Alimentation assessed using the modified Meditterranen diet score (Sofi et al. 2013) ** Physical activity level assessed using the PASSI surveillance criteria
Thanks for your kind attention from the working group of the Local Health Unit of Modena Davide Ferrari, Mara Bernardini, Giuliano Carrozzi, Roberto Roveta, Anna Rita Tarantini, Gianni Gilioli, Giuseppe Giubbarelli, Arrigo Mordini, Nerella Sala, Stefania Barbanti. For any questions or suggestions please refer to: m.bernardini@ausl.mo.it g.carrozzi@ausl.mo.it venturellif@hotmail.it