Moral issues in workplace health promotion. Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2. CA Rotterdam, The Netherlands 2. Department of Medical Ethics and Philosophy of Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2. CA Rotterdam, The Netherlands Corresponding author. Received 2. 01. 1 Jan 1. Accepted 2. 01. 1 Jun 1. Ethical Issues In Health Promotion Program IdeasThis article has been cited by other articles in PMC. Abstract. Purpose. There is debate to what extent employers are entitled to interfere with the lifestyle and health of their workers. In this context, little information is available on the opinion of employees. Within the framework of a workplace health promotion (WHP) program, moral considerations among workers were investigated. Methods. Employees from five companies were invited to participate in a WHP program. Both participants (n = 5. Ethical Issues In Health Promotion Program DefinitionWHP. Results. Nineteen percent of the non- participants did not participate in the WHP program because they prefer to arrange it themselves, and 1. More participants (8. Employees aged 5. OR = 1. 5. 6, 9. 5% CI 1. Conclusion. This study showed that most employees support the importance of WHP, but in a modest group of employees, moral considerations may play a role in their decision whether or not to participate in WHP. Older workers were more likely to resist employer interference with their health. Therefore, special attention on such moral considerations may be needed in the communication, design, and implementation of workplace health promotion programs. Keywords: Ethics, Participation, Workplace, Health promotion, Lifestyle. How to Think about Health Promotion Ethics. employers may buyin health promotion programs and then cut. Persuasion and coercion for health: ethical issues in. The range of ethical issues in health promotion is as. Health promotion programs. A medical sociologist looks at health promotion. Journal of Health and. Ethical Issues Worksite Health Promotion Programs: Ethical Issues Roberta B. Hollander, Ph.D., M.P.H. Janet Fraser Hale, Ph.D., R.N. Roberta B. Hollander, Ph.D., M. . workplace health promotion may pose ethical. moral issues in workplace health promotion. workplace health promotion program find a. HEALTH PROMOTION: ETHICAL. public health to examine the ethical issues in government health promotion. Ethical and Social Dilemmas of Government Policy. Introduction. Health promotion is a cornerstone of public health policy in most western countries. In order to reach as many individuals as possible, different settings are explored to provide health promotion programs. Ethical dilemmas in health promotion. the ethical analysis of health promotion programs has. The diversity of health issues, practicesin health promotion. . Issues in Health Education and Health. pertinent to ethical issues in health promotion. to health education and health promotion. Because of the possibility to reach large groups, and the presence of a natural social network, the workplace is regarded as a promising context for health promotion. The World Health Organization (WHO 2. World Health Assembly of the WHO (2. Workers’ health: Global Plan of Action”, aimed to protect and promote health at the workplace. Workplace health promotion (WHP) is defined as the combined efforts of employers, employees, and society to improve the health and wellbeing of people at work. The European Agency for Safety and Health at Work (2. WHP should be achieved by promoting the participation of workers in the whole process of WHP. Employers are encouraged to provide health promotion activities to their employees. With the aim to become the worlds’ healthiest country in 2. Australia gives workplaces a key role in preventative health (Australian Government Preventive Health Taskforce 2. Individual health risk assessments and health risk reduction programs aimed at lifestyle are popular applications for WHP (for example Ott et al. Rocha et al. 2. 01. However, the participation in such programs varies considerably between companies and is often low (Robroek et al. Why are participation levels so low in these kinds of WHP? Do moral considerations regarding lifestyle interference play a role in the low participation levels? Rothstein and Harrell (2. Already in 1. 98. Allegrantte and Sloan discussed how workplace health promotion may pose ethical problems. In 1. 98. 7, Gordon presented her doubts on health promotion at the workplace and described that trust is an essential ingredient for successful health promotion. The debate still continues to what extent employers are entitled to interfere with the lifestyle and health of their workers. Where does undue interference begin? In this context, little information is available on the opinion of employees regarding WHP. Within the framework of a WHP program, we have investigated moral considerations among workers in relation to WHP offered by their employer. Methods. Study design and population. The study is embedded in a larger study in which we investigated the effectiveness of a WHP program consisting of a physical health check with subsequent advice, and a website with general information, individualized advice and for the intervention group possibilities to ask questions and to monitor their own behavior. An extensive description of the study protocol is published elsewhere (Robroek et al. Employees working in six companies from different branches were invited to participate in the study. Participants received a questionnaire asking for individual characteristics, lifestyle, and health. A sample of 8. 60 non- participants in the health care organizations (n = 2) and all non- participants in the commercial services organizations (n = 2) and in the executive branch of government (n = 1) received an abbreviated version of the questionnaire. In the other organization in the executive branch of government (n = 1), non- respondents were not invited to fill in the questionnaire because the program was initiated in the holiday period and communicated in a very limited way, and only 2. Therefore, most workers in that organization were unaware of the program. Due to privacy regulations, the questionnaire was send out only once without any reminders. In total, 2. 13 employees out of 8. Moral considerations. Non- participants were asked why they did not participate, with multiple responses possible. In addition, both participants and non- participants were asked to indicate on a 5- point scale ranging from “totally disagree” to “totally agree” to what extent they agree with five statements addressing their opinion on WHP (Table 1). Answers of participants (P) and non- participants (NP) on five statements addressing their opinion on WHPAdditional information. In the questionnaire, participants were asked about age, sex, educational level, ethnicity, lifestyle, and health. Educational level was assessed as the highest level of education completed and was categorized into low (primary school, lower and intermediate secondary schooling, or lower vocational training), intermediate (higher secondary schooling or intermediate vocational schooling), and high (higher vocational schooling or university). We applied the standard definition of ethnicity of Statistics Netherlands and considered a person to be non- Dutch if at least one parent was born abroad (Statistics Netherlands 2. Lifestyle behaviors (physical activity, smoking, and alcohol intake) were dichotomized indicating whether they engaged in sufficient physical activity (at least 3. Craig et al. 2. 00. Body mass index (BMI) was measured by asking for weight and height and classified as normal weight (BMI < 2. BMI < 3. 0 kg/m. BMI ≥ 3. 0 kg/m. 2). Self- perceived health was dichotomized into “poor or moderate” and “good to excellent” (Ware et al. Statistical analyses. The opinion of participants and non- participants regarding WHP was compared with a chi- square test. Logistic regression analyses were used to analyze the relation between individual characteristics and health- related factors with having problems with employer interference concerning employees’ health. All analyses were adjusted for company. Results. In total, 5. Table 2 shows the characteristics of the study population. Characteristics of the study population and associations between demographics, lifestyle, and health factors with agreeing with the statement “employer interference with my health is a violation of my privacy” among participants and non- participants.. Why do employees not participate in workplace health promotion? Most non- participants gave “I am healthy” (4. Nine percent of the non- participants did not participate because they are currently in treatment for health problems. However, a modest group of non- participants did seem to have objections to health promotion in the workplace setting, arguing they would like to keep private life and work separated (1. Two percent thinks it is not the employers’ task to offer health promotion programs, and 6% is concerned that their results may be made known to their employer or colleagues. Almost one- fifth of the non- participants preferred to arrange a lifestyle promotion program themselves (1. Role of moral issues in workplace health promotion. Almost all participants and non- participants found a healthy lifestyle important (9. Table 1). Most participants (7. However, this did not lead to many concerns regarding the WHP. Actually, the majority of both participants and non- participants agreed that it is good that the employer tries to improve employees’ health. However, we observed more participants (8. A small majority of the participants (5. Particularly, employees who find lifestyle a personal matter feel that employer interference with their health is a violation of privacy (2. Non- participants who did not participate because of reasons that might be related to moral considerations (e. OR = 2. 2. 0, 9. 5% CI 1. Who are the employees having problems with employer interference with employees’ health? As shown in Table 2, the reluctance against employer interference was in our study population not statistically significantly associated with an unhealthy lifestyle or a poor health. Older workers were more likely to resist employer interference with their health (OR = 1. CI: 1. 0. 2–2. 3. This was particularly the case among older non- participants. Discussion. The importance of health promotion in the workplace setting is supported by employees. Although the most important reason for non- participation did not include moral issues, a modest group argued they would like to keep private life and work separated or preferred to arrange participation in a program themselves and not via their employer. Both participants and non- participants in the workplace health promotion program find a healthy lifestyle important, and most employees think it is good that the employer tries to improve the employees’ health.
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