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Understanding inpatient nurses' engagement in worksite health promotion: a case study.

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Call No.	RC969.H43 F46 2009
Author	Feng, Yvonne You-Shan.
Title	Understanding inpatient nurses' engagement in worksite health promotion: a case study.
Date	2009
Abstract	Background. Worksite health promotion programs (HPP) support employees' health behaviors to prevent downstream diseases. Maximizing participation can optimize program impact. Objectives. To assess staff nurses' participation in three HPP - flu vaccination, a health risk assessment (HRA), and a set of health improvement programs (HIP) - the author (1) tested the relationship between organizational factors (e.g. staff satisfaction and absenteeism) and participation; (2) examined the dissemination of HPP information; and (3) examined how well a behavioral model founded on context and agency (ability to influence context) explained participation. Methods. Using an embedded case design, this project sampled 19 inpatient nursing units in one hospital. Of 794 staff nurses, 214 participated in a survey and 25 were interviewed. Of 42 inpatient nursing directors, nurse managers, and volunteers who disseminated HPP information, 25 participated in a survey and 11 were interviewed. The author conducted unit environmental audits, observations, and data abstraction. Quantitative analysis included tabulations and logistic, linear, and conditional fixed-effects regression methods. Qualitative analysis included content and thematic analysis. Results. Three positive relationships were found: job satisfaction with flu vaccination participation, workplace stress with HRA participation, and adequate physical activity with HIP participation. Most nurses reported receiving program information through mass communication and high awareness of the flu program. They described overabundance of information as a barrier. Qualitative analysis revealed five themes relevant to work context and agency: workplace stress, being valued, work affecting health, control over work environment, and work-life balance. Nurses from the unit with the highest HRA participation rate reported better teamwork and leadership than those from the unit with the lowest rate. Conclusion. This research uncovered barriers that limit nurses' participation in worksite HPP and developed a conceptual framework to guide future research. Improving job satisfaction and information dissemination can enhance participation. The contradicting relationships observed between workplace stress and HPP participation underline the need for further investigation. However, the data point to varying participation in different types of HPP, implying that no single approach may be effective for all programs. Further research should address why certain factors impact particular programs' participation and tailor interventions accordingly.
Description	xx, 304 leaves : ill. (some col.) 28 cm.
Format	application/pdf
Advisor	McLellan, Robert K., MacKenzie, Todd A., Beyea, Suzanne C., Punnett, Laura, Ceppetelli, Ellen B.
Subject	Nurses -- Health and hygiene. Employee health promotion.
College	Dartmouth Institute for Health Policy and Clinical Practice.
Issuing Body	Dartmouth Dissertations are made available through the Dartmouth Digital Library.
Degree	Thesis (Ph.D.)--Dartmouth College.
Copyright	All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means without permission in writing from the author.
DOI	http://dx.doi.org/10.1349/ddlp.252

Title	Page 1
Format	application/pdf
Issuing Body	Dartmouth Dissertations are made available through the Dartmouth Digital Library.
Degree	Thesis (Ph.D.)--Dartmouth College.
Full Text	Understanding Inpatient Nurses’ Engagement in Worksite Health Promotion: A Case Study A Thesis Submitted to the Faculty in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Health Policy and Clinical Practice by Yvonne You-Shan Feng DARTMOUTH COLLEGE Hanover, New Hampshire May 31, 2009 Examining Committee: (chair) Dr. Robert K. McLellan, MD, MPH, FACOEM, FAAFP Dr. Todd A. MacKenzie, Ph.D. Dr. Suzanne C. Beyea, RN, Ph.D., FAAN Laura Punnett, Sc.D. Brian W. Pogue, Ph.D. Dean of Graduate Studies

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