Workplace Environmental and Policy Practices that Support Healthy Behavior Among Employees with Prediabetes: Implications for Employers Public Deposited

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  • March 20, 2019
Creator
  • Osgood, Julie
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
Abstract
  • In the United States, 86 million people have prediabetes putting them at significant risk for type 2 diabetes in the absence of lifestyle modification. The health and economic consequences of type 2 diabetes are significant for individuals and society. In response, the U.S. Centers for Disease Control and Prevention has implemented an evidence-based National Diabetes Prevention Program (NDPP) that reduces the incidence of prediabetes and type 2 diabetes. In this program, lifestyle coaches teach participants to eat healthy foods, be physically active, deal with stress, and overcome barriers to success. Many employers offer this program to employees as a way of improving the health status and avoiding future healthcare costs associated with diabetes care and its complications. Adults spend the majority of their waking days at their place of employment. Researchers have shown that workplace physical and social environments and policies affect health behavior, particularly when used in combination. This dissertation aims to understand how employers can optimize enrollment and support participation in worksite NDPP using physical/social environmental and policy practices. The study was based in Maine and utilized an exploratory sequential mixed methods design. The plan for change is based on the Diffusion of Innovations theory. In this study, I found that worksites in Maine are using a variety of physical/social environment and policy practices to promote healthy lifestyle behaviors, though there are opportunities for more. Employers struggle with barriers, including: (1) how to identify and communicate directly with employees who have prediabetes; (2) how to appropriately support and incentivize NDPP participation; (3) how to engage senior leaders and middle managers in supporting healthy behavior; and (4) how to effectively engage a diverse workgroup in lifestyle behavior change. A survey of employees with prediabetes indicates that employees have noticed workplace environment and policy changes related to health behaviors. I discuss barriers preventing them from enrolling in NDPP and factors that could motivate them to do so. This work provides employers with recommendations and a process for using environmental and policy practices to support employee lifestyle behavior change and ultimately to reduce the incidence and prevalence of prediabetes.
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  • In Copyright
Advisor
  • Deprez, Ronald
  • Greene, Sandra
  • Albright, Ann
  • Silberman, Pam
  • Skinner, Asheley
Degree
  • Doctor of Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2017
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