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ABSTRACT Introduction: As the impact of HIV/AIDS on the business sector has become more visible, businesses have increasingly seen the advantages of creating HIV/AIDS management programmes for their workplaces – and some even beyond the workplace, to their surrounding communities. The aim of the study was to determine the effect and benefit of a large company’s HIV/AIDS workplace wellness programme. Study objectives were to a) describe the effect of the wellness programme as measured by differences in CD4 counts and percentages, weight, episodes of diarrhoea and sick leave; and b) to explore the perceptions and views of the occupational health nursing practitioners (OHNPs) regarding what they observe the benefit of the wellness programme to be on the general sense of health and well-being of the HIV-positive employees. Materials and methods: The study was performed at 10 of the Gauteng factories of a large multi-national packaging company. Quantitative data was collected by means of a confidential retrospective review of 36 HIV-positive employees’ occupational health records. Mostly descriptive and some inferential data analysis was performed. Qualitative measurement was done through semi-structured interviews with nine OHNPs to gain information about their perceptions and opinions regarding the benefit of the wellness programme. Thematic analysis of qualitative data was carried out. Results: The benefit of the HIV workplace wellness programme was not seen when considering CD4 counts and CD4 percentages. Episodes of diarrhoea over time and absenteeism data also did not show any benefit. However, changes in weight were observed (participants gained an average of 1.5kg over the study period) although this was not statistically significant. The qualitative data showed that employees benefit from the wellness programme, particularly in terms of their physical and mental well-being. Emerging themes related to fear of loosing one’s job and denial of the reality of HIV/AIDS; stigma and discrimination in the workplace and in the community at large; trust versus mistrust of the Company’s HIV management system; acceptance of the condition; the acceptability of nutritional supplements; and the general benefit of the wellness programme. Other related themes that emerged included issues regarding VCT, peer education, the provision of anti-retroviral therapy (ART), the role of trade unions, barriers in the public health care system and OHNPs’ frustrations with the wellness programme. Discussion: The most beneficial aspect of the wellness programme appeared to be the trust relationship that employees on the wellness programme have with the OHNPs. Because of this, employees experience a sense of support and are more likely to accept their HIV-positive condition. This contributes to a sense of mental well-being. Early intervention and better management of the condition also occur and there is better compliance to treatment and disease management protocols. There was also a general sentiment that there were benefits in the use of nutritional supplements. Employees reported feeling healthier (e.g. having more energy when using nutritional supplements) and this contributed to a sense of physical well-being. A big challenge is to overcome mistrust amongst the general employee population who have not joined the wellness programme and to deal with the ever-present issues relating to the fear of loosing their job if found to be HIV-positive as well as denial of the condition. This fear and denial perpetuates the reality of discrimination and stigmatisation, which inevitably negatively affects the social well-being of HIV-positive employees. Limitations of the study included a small sample size; inconsistent data collection methods by the OHNPs in the various clinics; the complicated nature of nutritional supplementation, which makes it difficult to study superficially; and that HIV-positive employees could not be interviewed directly as they were not willing to be interviewed. Recommendations: Further research should be performed in the area of workplace wellness programmes. More efficient data collection systems should be put in place to measure the impact of HIV/AIDS and the effectiveness of workplace interventions. HIV-positive employees who have disclosed their status could be used as positive role models in HIV/AIDS programmes. Confidentiality protocols should continue to be strictly adhered to as this promotes the trust relationship. An HIV/AIDS nutritional expert should be involved in advising about the use of optimal supplements in the wellness programmes as OHNPs have differing opinions. Other health professionals could be involved in HIV wellness programmes, e.g. occupational therapists, social workers, etc. Companies should investigate how they can get involved in HIV/AIDS-related activities and partnerships in the communities where their employees live as many employees struggle with issues of poverty over-and-above being HIV-positive.

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The long-term goal of this research is to reduce the number of deaths by suicide. Suicide is the leading cause of violent death in the United States, and is currently the 10th most common cause of death across all age groups. Suicide prevention efforts have historically been focused on youth/young adults, and the elderly, with less attention on programming for individuals in the working years. Our intention is to generally broaden the understanding of suicide, depression and the workplace, with the hope of improving interventions for this underserved population. The research activities outlined below were conducted under the auspices of a larger quasi-experiment at the University of Iowa. We first sought to assess the experiences of professional, nonclinical staff identifying and responding to apparently mental health problems in the workplace. We looked at the impact of two exposures on engagement with individuals in crisis: self-reported contact (the number of students or coworkers a participant interacted with each week), and participation in any suicide prevention training/programming over the previous five years. High contact with students was generally associated with a greater capacity for recognizing and responding to depression and potential suicidality. In contrast, the association between high contact with employees and recognition and response was insignificant for four of the six recognition and response behaviors. Participation in any form of suicide prevention training or programming in the previous five years was highly associated with recognizing and responding to depressed or suicidal coworkers and students. Next, we considered the impact of a personal prior experience with suicide and prior suicide prevention training/programming on four constructs: preparedness to respond to someone in crisis, familiarity with appropriate resources, gatekeeper self-efficacy, and gatekeeper reluctance. Suicide prevention training/programming was significantly associated with higher perception of three constructs: preparedness, familiarity, and self-efficacy. There was no statistical difference in reluctance between previously training participants and participants who had not previously taken suicide prevention training or programming. Individuals who had a personal prior experience with suicide were less reluctant to engage, although the results were not significant. There was an association between individuals who had a personal prior experience with suicide and suicide prevention training/programming, suggesting that individuals with a personal connection to suicide might be more likely to enroll in suicide prevention programming. Finally, we examined how a suicide prevention training programming impacted the perception of safety culture in the workplace. On the 10 item safety scale, there was a significant difference between the means scores reported by the intervention and control group on 7 of the 10 questions. Individuals who participated in QPR gatekeeper training reported a higher sum safety culture score than individuals who did not participate in the training; the overall model was statistically significant. This project shows that suicide prevention training/programming of any kind in the workplace can have a persistent, positive training impact on employees by informing and empowering them to act. It suggests that individuals with a personal prior experience with suicide may be more likely to take suicide prevention training, and may be less reluctant to engage with someone in crisis. It also demonstrates that suicide prevention training may have a positive impact on other workplace psychosocial factors, and deserves prioritization in workplace wellness programming.

Guidelines and laws prohibit smoking in public places, and evidence supports the safety and effectiveness of workplace wellness programs in promoting healthy environments. A long-term care (LTC) facility selected as the focus for this project does not offer wellness programs and does not restrict on-site smoking by employees. The purpose of this project was to construct an evidence-based smoking cessation education program for delivery to employees at the LTC facility. The practice-focused question addressed whether a workplace wellness smoking cessation education program would increase employees' knowledge of the harmful effects of smoking and promote engagement in smoking cessation strategies. A pretest and posttest to assess knowledge of the harmful effects of smoking was designed to be administered to employees prior to and after the education program. A panel of 6 experts consisting of 4 clinical nurse specialists, a nurse educator, and a nurse researcher was selected to assess the potential effectiveness of the education program. A 10-question survey was used to obtain the panel experts' evaluation of the program. Descriptive statistics were then used to analyze the results. Nearly all of the experts surveyed reported that they would recommend the education program to a friend or colleague, with 66% selecting "very likely" This is indicative of the potential for the program to be effective. Findings might support social change at the selected facility by increasing staff knowledge of the harmful effects of smoking and staff commitment to participating in a smoking cessation program.

Indiana University-Purdue University Indianapolis (IUPUI) / Creating a culture of health within an organization offers benefits such as reducing costs and supporting employees in becoming and staying healthy. A variety of health and wellness programs within an organization are important for establishing a culture of health. These programs are supported communicatively to encourage employee participation and healthful behavior changes. Recognized for their success in creating a culture of health, a group of organizations, distinguished as 5-Star AchieveWELL organizations, offer an opportunity to identify messaging strategies effective at promoting health and wellness within the workplace and therefore, creating a culture of health. The goals of this study included learning successful organization’s communication strategies utilized to create a culture of health, understanding how new employees are socialized into this culture, identifying how employees may resist the culture, and exploring how resistance is addressed. Based on in-depth interviews with 19 5-Star AchieveWELL organizational representatives and grounded theory analysis of collected data, evident themes related to the goals of this study were identified. Key communication strategies to support a culture of health include using multiple communication channels, demonstrating leadership support, and being willing to adapt and change over time. New employees are socialized into the culture of health during the recruitment process as well as new employee orientation. Resistance to health and wellness occurs in the form of non-participation and employee push-back, with this resistance often being met with compassion. These results offer practical implications for organizations desiring to create a culture of health as well as theoretical implications for scholars studying organizational socialization.

Abstract Employees experience workplace stress that can affect their health resulting in chronic diseases such as diabetes, stress, hypertension, and cardiovascular diseases. Stress also contributes to staff presentism, absenteeism, and high turnover rate. The employee wellness program (EWP) yoga class at a metropolitan teaching hospital has not been evaluated for its effectiveness in employee stress reduction and improvement in employee health. The practice focus question for this project explored employees' perception of the impact of a metropolitan teaching hospital's EWP yoga class on their stress reduction and health promotion activities. The theoretical framework for this project is Lazarus' transactional model of stress and coping. This model suggests that individuals assess the stressor and find strategies for coping with the stress as it relates to them and their environment. The evidence that guided this project included a comprehensive literature review and the analysis of data retrieved from semi structured interviews with 20 participants in the yoga class who responded to an open invitation. Audiotaped interviews with the participants were analyzed and coded for common themes and revealed that participating in the EWP yoga program helped to reduce their perceived stress and improve their mental and physical well-being. The findings of this project were used to inform organizational leadership and may provide opportunities to evaluate the current yoga program regarding employee stress reduction, improving healthy activities, expansion of the program to other work sites within the organization, maintaining a healthy workforce, and reducing health care costs.

This study presents a qualitative analysis of the dichotomy between official HIV and AIDS policy and its implementation in a Human Rights based, United Nations (UN) agency, located in South Africa. The study demonstrates that although HIV and AIDS policy is an intrinsic part of the commitment of this large organisation, the implementation of the policy, in the form of a Workplace Wellness Programme supported by budgetary resources, is weak and incomplete. The thesis integrates detailed vignettes in drawing attention to how personnel in the South Africa office perceive and experience the implementation of HIV and AIDS policy. Additionally, the voices of bureaucrats are also integrated in an effort to interrogate management attitudes and mindsets on matters of policy and treatment of staff. The study explores staff members’ sense of being stigmatised and discriminated, when living with the virus and their responses to it. In this, I bring a personal perspective to the study, by relating my own views of living with a potentially life-threatening disease to the views of the participants in the workplace in which the study is conducted. Classical Weberian and contemporary accounts of ‘bureaucracy’ and the organisational ‘rule book‘ are drawn upon. It is argued that whilst the value systems and politics of managers in the United Nations system lead them to be defined as progressive, some of the practices within their own institutions are contradictory, indifferent and manipulative leading to the perpetuation of discrimination and anxiety amongst HIV-positive staff. Thus, human agency and ingenuity supersedes organisational structure and the rigour of organisational policies and rules. The contradictions highlighted necessitate a careful scrutiny of organisational dynamics, within the wider international development scenario, and organisational introspection within individual UN offices vis-à-vis HIV and AIDS policy implementation. It is envisaged that the study will induce the commissioning of a larger study carried out by an independent body and funded by the United Nations, enabling the validation and enhancement of the argument presented in the case study and provide more recommendations for the way forward for the United Nations. / Thesis (DPhil)--University of Pretoria, 2010. / Sociology / unrestricted

Workplace wellness programs (WWP) were developed to support employees’ health behaviors and well-being. Although physical activity is incorporated into the definition of wellness and is a modifiable behavior that can both reduce the risk for chronic disease and lifestyle-related diseases and enhance health and well-being, performance of physical activity is often overlooked within WWP and the workplace in general. Rather than investigating organizational aspects of the WWP, this grounded theory-based study explored employees’ perceptions concerning how their organization facilitated their participation in physical activity within WWP. To provide a theoretical framework, Self-Determination Theory (SDT) from Ryan and Deci (2000) offered the lens to understand the employees’ motivation to participate in physical activity and Social Ecological Model (SEM) by Bronfenbrenner (1977) described the multiple levels of interaction between the employee and their organizational environment. The employees’ perceptions elucidated their decision-making process. The emergent themes were time management, advantageousness, need for movement, supervisor ambivalence, social / “gregarious” connection, messages from leadership, limited awareness, culture of health, and incentives and reimbursements. Three levels (individual, relational, and organizational) and three facets (barriers, bolsters, and facilitators) illustrated the relationships among these themes. These themes, levels, and facets are exemplified in the grounded theory model. Consequently, six implications for practice were illuminated for organizations to employ for encouraging their employees to join and actively participate in physical activity in the WWP and in the workplace in general, providing better health outcomes for employees and improving the organizations’ bottom line. / Kinesiology

Employee absenteeism costs organizations billions of dollars annually in losses in revenue and productivity, temporary labor costs, and low morale. The purpose of this qualitative single case study was to explore the strategies information technology (IT) managers in the manufacturing industry used to reduce employee absenteeism. The theory of planned behavior provided the conceptual framework for the study. Data collection included semistructured interviews with 5 IT managers in Maryland and a review of organizational documents addressing nutritional education information, employee participation rates in health programs, and physical activity. Data were analyzed using compilation, disassembly, reassembly, interpretation, and development of conclusions. Through thematic analysis, 4 themes emerged: workplace wellness and health programs, employee engagement, work-life balance programs, and organizational culture. Findings of this study may be used by IT managers to bring about positive change by reducing employee absences, encouraging employment opportunities, contributing to organizational sustainability, and improving quality of life for community members.