Dr. Mari-Amanda Dyal, Lyric Hayden-LanierDepartment of Health Promotion and Physical EducationORGANIZATION

The organization is a municipal workplace in metro Atlanta, GA with an authorized strength of 1,500 individuals in a variety of job descriptions. The organization houses an award-winning wellness program that is comprehensive in nature but incorporates specificity with design, delivery, and evaluation.

The wellness program goes to great lengths to provide evidence-based best practices that focus on providing employees with knowledge, skills, and application opportunities that improve health. The latest push for programming improvements is related to health literacy, which has been identified as a priority area in the healthcare setting but has only been recently and minimally explored in the workplace setting.

PROGRAM PLAN

EVALUATION PLAN

PROGRAM IMPACT

Utilization of workplace health promotion (WHP) programming to improve health literacy

“Occupational health literacy is the degree to which workers have the capacity to obtain, communicate, process, and understand occupational health and safety information and services to make appropriate health de-cisions in the workplace (Rauscher & Myers, 2008) .”

OHL Skill HRA Sample Item Number of Items

Reliability Statistic (α)

Prose Literacy

For the following passage, please identify the risk factors for high blood pressure.

5 .79

Document Literacy

Using the provided BMI table, please identify where you currently are. 5 .91

NumeracyUsing the provided food label, please calculate the total fat grams for 2 servings

5 .88

Health Literacy

SkillDescription

Prose Literacy

Reading comprehension skills that involve critical searching and scanning of continuous text materials, such as disease management instructions, recommended guidelines, and general educational materials (fact sheets, follow-up communication, etc.).

Document Literacy

Reading comprehension skills that involve critical searching and scanning of disjointed text materials, such as medical history forms, HRA results, and general data reports (tables, graphs, etc.).

NumeracyReckoning skills required to identify and perform computations, either alone or sequentially using numbers embedded in printed material (food labels, cost comparison, etc.).

Figure 1: Description of Health Literacy Skills

WHP within the organization provides a wellness package of knowledge and skills that seek to improve outcomes on several levels: promotion, prevention, treatment, management, and diagnostic. While knowledge and skills are important, an employee’s ability to obtain, process, and understand the knowledge and skills is equally important, which sets the stage for occupational health literacy (OHL), a concept defined by Rauscher and Myers (2008) that influences the degree to which employees make appropriate health decisions in the workplace.

The healthcare setting has identified specific skills for health literacy that improve knowledge and skill acquisition, application, and adherence. While these skills have been designed for measurement within the healthcare setting, the current research demonstrates a translation appropriate for the workplace setting that provides guidance for assessment and improvement of OHL in WHP programming.

Specific health literacy skills that have been identified are prose literacy, document literacy, and numeracy. Other skills are related to language, communication, and critical inquiry. The Consumer Assessment Surveys (CAS, 2012) provides a comprehensive set of items that assess health literacy in the healthcare setting. A subset of these items was modified for the workplace in order to provide a relevant method for measurement of OHL.

Incorporating OHL into WHP programming underwent several forms of evaluation on both a qualitative and quantitative level. An annual health risk assessment (HRA) with the modified items from the CAS provided data that was used to determine increases/decreases in OHL.

Various qualitative assessments assessed impact and meaningfulness of OHL in WHP programming. Exit interviews followed specific program offerings to assess immediate absorption of OHL:

“Following the grocery store tour, were you able to use the food labels to make healthy choices?”

Focus groups evaluated the place of OHL in WHP programming:

“Has the translation of health literacy into the workplace been observable and measurable?”

HRA data continues to show increases in OHL among program members, more specifically 29% experienced an overall improvement in FY2013-14 (n=383) with specific skill increases outlined in Table 1.

Program planning has incorporated several improvements based upon exit interviews and focus groups:• Emphasis on critical review of health promotion

print materials (continuous/disjointed)• Skill-based offerings that promote practice with

tabulating percent values of intake and output• Behavior change offerings that focus on

communication between practitioners and partaker

Research and practice implications for this OHL translation set the stage for further steps to incorporate all health literacy skills into WHP programming so that employees can properly acquire and apply knowledge and skills in and out of the workplace.

REFERENCES

Figure 2: Sample Items of OHL Skills

HRA Data (FY 2013-2014)0%

10%

20%

30%

40%

50%

60%

70%

80%

35%

69%

45%

Prose LiteracyDocument LiteracyNumeracy

Table 1: Quantitative Assessment (n = 383)

Consumer Assessment Surveys (2012). Agency for Healthcare Research and Quality, Rockville, MD.

Rauscher, K. J., & Myers, D. J. (2008). Socioeconomic disparities in the prevalence of work-related injuries among adolescents in the United States. Journal of Adolescent Health, 42, 50-57.