• Change in employer practices in health benefits, policies and programs [ Time Frame: 15 month follow-up survey ] [ Designated as safety issue: No ]
  

• Development and pilot-testing of an employee-level health risk behavior survey [ Time Frame: within 12 months of recruitment completion ] [ Designated as safety issue: No ]
  
• Cost analysis and assessment of feasibility of this intervention [ Time Frame: within 15 months of recommendations ] [ Designated as safety issue: No ]
  

Employers have the incentive and the means to play a key role in chronic disease prevention. The incentive - employers need to control the costly and growing burden of chronic diseases among their employees. The means - employers purchase 94% of private health insurance, and employees spend one third of their lives in the workplace, where they often eat, move, socialize, and smoke. Over the past 5 years, the CDC and the Task Force on Community Preventive Services have recommended a number of chronic disease prevention practices. Among these, we have identified 17 practices that employers should adopt. These practices include health insurance benefits, workplace policies, and workplace programs, and aim at increasing employees' disease screening, healthy eating, influenza immunization, physical activity and tobacco cessation. Unfortunately, employer surveys reveal low adoption of these practices.

Working with the American Cancer Society, our research team from the University of Washington has developed and pilot-tested an innovative consulting intervention to increase adoption of these practices. Our two-stage intervention is comprehensive yet tailored by employer feedback.

The intervention:

• markets the "business case" that employers can help control health-care costs and productivity losses through adoption of these practices
• enables implementation by providing tools for each practice.

In this proposal, our primary aim is to test this intervention in a randomized, controlled trial among 48 medium-sized employers with a high proportion of socioeconomically disadvantaged employees in the Puget Sound area. Our primary outcome is change in employer practices as measured by survey and validated by audit and contract and policy review.

Our secondary aims include:

• development and pilot-testing of an employee-level health risk behavior survey
• cost analysis and assessment of feasibility of our intervention
• assessment of employees' preference for different message sources and message appeals.

Our multidisciplinary research team includes business, communication, and public health faculty and has more than 10 years of experience in both chronic disease prevention and working with business. If successful, our team's approach has broad applicability to other public health problems.