There is no conflict of interest.
Citation
Wilson, M.G., DeJoy, D.M., Vandenberg, R.J., Padilla, H.M., Haynes, N.J., Zuercher, H., Corso, P., Lorig, K., & Smith, M.L. (2021). Translating CDSMP to the workplace: Results of the Live Healthy Work Healthy Program. American Journal of Health Promotion, 35(4), 491-502. https://doi.org/10.1177/0890117120968031 [LHWH versus Control]
Highlights
- The study's objective was to examine the impact of the Live Healthy, Work Healthy (LHWH) program on health outcomes. The authors investigated similar research questions for another contrast, the profile of which can be found here.
- Chronic Disease Self-Management Program (CDSMP): Translating CDSMP to the workplace: Results of the Live Healthy Work Healthy Program (Wilson et al., 2021) | CLEAR
- The study was a randomized controlled trial that assigned worksites to the treatment group (received the LHWH program) or control group. Using questionnaires and statistical models, the authors compared the outcomes of the treatment and control group members.
- The study found a significant relationship between LHWH program participation and improvements in reported stress and mentally unhealthy days.
- This study receives a low evidence rating. This means we are not confident that the estimated effects are attributable to the Live Healthy, Work Healthy (LHWH) program; other factors are likely to have contributed.
Intervention Examined
Live Healthy, Work Healthy (LHWH) Program
Features of the Intervention
The Live Healthy, Work Healthy (LHWH) program was designed to help workers with chronic diseases manage their health in both their jobs and daily lives. It was based on the Chronic Disease Self-Management Program (CDSMP) but adapted specifically for workplace environments. The program consisted of 50-minute workshops held twice a week for eight weeks, focusing on symptom management, healthy eating, regular exercise, and effective communication with healthcare providers. Key activities of the workshops included interactive discussions, action planning, behavior modeling, problem-solving techniques, decision making, and symptom management activities, such as exercise, communication, and medication management. The program emphasized work-related issues, such as work-life balance, stress management, and communication with coworkers. Participants were required to be at least 40 years old and have at least one chronic condition, which was a lower age limit than the original CDSMP to better serve the working population. The LHWH program was implemented at various worksites in rural counties in Georgia and Tennessee, with YMCA staff trained to facilitate the program at the worksites.
Features of the Study
The study was a randomized controlled trial. Of the 10 eligible worksites, five were randomly assigned to the treatment group and five were randomly assigned to the control group. The individuals in the treatment group participated in the LHWH program while the individuals in the control group did not participate in the program. The study sample included 130 employees in the treatment group and 170 in the control group. In the treatment group, 84% of the participants were women and the average age was 47.2 years. The racial breakdown included 64% White, 31% Black/African American, 10% Hispanic, and 5% other race. Among them, 25% had a high school diploma or less, 40% earned $40,000 or less annually, and the average number of chronic conditions was 3.3. In the control group, 79% of the participants were women and the average age was 46.9 years. The racial breakdown included 62% White, 37% Black/African American, 2% Hispanic, and 1% other race. Also, 6% had a high school diploma or less, 37% earned $40,000 or less annually, and the average number of chronic conditions was 3.
The authors used self-administered questionnaires to collect participants' demographic characteristics, employment information, measures of disease self-management, and information on health behaviors. For the treatment group, data were collected at pretest, posttest (6 months post-intervention), and follow-up (12 months post-intervention). For the control group, data were collected at baseline (6 months before the intervention), pretest, posttest (6 months post-intervention), and follow-up (12 months post-intervention). The authors used statistical models to estimate the differences in disease self-management and health behaviors between the groups during the intervention period (from pretest to 6 months post-intervention).
Findings
Health and safety
- The study found a significant relationship between LHWH program participation and improved stress and mentally unhealthy days.
- However, the study did not find significant relationships between LHWH program participation and sleep quality, chronic disease self-efficacy, pain perception, physically unhealthy days, fatigue, or health interference.
Considerations for Interpreting the Findings
Although the study design was a randomized controlled trial, the study had high attrition for all health outcomes. The authors collected pre-assignment baseline data for the control group only and used the pretest data as the baseline across the groups. They also indicated that the group assignments were known prior to data collection. It is possible that the reported self-management and health behaviors were affected by anticipation of being eligible for the LHWH program.
Causal Evidence Rating
The quality of causal evidence presented in this report is low because it was a randomized controlled trial with high attrition, and there was an issue with anticipating the intervention. This means we are not confident that the estimated effects are attributable to the Live Healthy, Work Healthy (LHWH) program; other factors are likely to have contributed.