Enhanced Tobacco Control Initiative at Johns Hopkins Health System: Employee Fairness Perception.

Organizations often fail to establish a clear awareness of what employees consider fair when implementing changes to employee benefits in the workplace. In 2016, the Johns Hopkins Health System (JHHS) enhanced their tobacco control efforts. In addition to enhanced smoking cessation benefits, employees were offered an increased reduction in their insurance premiums if they were nonsmokers. To qualify for the reduction, employees participated in testing rather than relying on self-reporting as had been done in the past. The shift to testing prompted a concern by some senior management at JHHS who did not want employees to feel they were not trusted. As the program unfolded at JHHS, the four-component model of procedural justice was applied to provide a framework for reviewing the implementation of the new voluntary tobacco testing at JHHS from a fairness lens. The purpose of this article is to illustrate the application of the four-component procedural model of justice to the tobacco testing process at JHHS. As approximately 75% of employees participated in the program, the experience at JHHS can be instructive to other employers who are looking to implement changes in their workplaces and how to minimize unintended consequences with their employees.

The Psychosocial, Organizational, and Environmental Stressors Experienced by Food Service Workers in a Hospital Setting During the COVID-19 Pandemic.

OBJECTIVE: To identify stressors faced by hospital food service workers amid the COVID-19 pandemic and effective interventions mitigating these stressors. Methods: In this cross-sectional study, we conducted surveys ( n = 305) and interviews ( n = 9) in the summer and fall of 2022 with employees in hospital settings to determine the psychosocial, organizational, and environmental stressors they faced during the COVID-19 pandemic and interventions that improved health and well-being. Findings: The main stressors reported were fear of infection, increased work demands and schedule unpredictability, and financial insecurity. Employee well-being was bolstered by regular, clear, bidirectional communication; a sense of community and purpose; benefits like paid sick leave and health insurance coverage; and organizational policies that included masking and vaccine requirements demonstrating commitment to protecting worker health. Conclusion: Organizations can play a critical role in guarding the health, well-being, and resilience of frontline workers.

Using the CDC Worksite Health ScoreCard to Promote Organizational Change.

PURPOSE: To measure the impact of tying adoption of evidence-based worksite health promotion (WHP) interventions to annual organizational strategic objectives, as measured by the Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard (ScoreCard). DESIGN: A prospective cohort study following Johns Hopkins Medicine (JHM) affiliates against industry-specific and large employer benchmarks from 2016-2020. SETTINGS: JHM, the largest private employer in Maryland with facilities in Florida and the District of Columbia. SUBJECTS: Twelve JHM affiliates representing over 40,000 employees. INTERVENTION: A strategic objective was established annually based on the ScoreCard and organizational priorities. MEASURES: JHM affiliates measured their WHP efforts annually using the ScoreCard. CDC industry-specific and large employer benchmarks were collected for comparison. ANALYSIS: ScoreCard data was assessed annually to measure deviations from CDC benchmarks, determine whether strategic objectives were met, and inform additional annual objectives. RESULTS: JHM demonstrated improvement from 8.9 percentage points above industry-specific and 3.4 percentage points below large employer benchmarks in 2016, to 26.4 percentage points above industry-specific and 21.8 percentage points above large employer benchmarks in 2020. CONCLUSION: Large employers face unique challenges in implementing WHP programs. Our study suggests embedding health promotion in annual strategic objectives may alleviate these challenges by prioritizing the goal and ensuring adequate resources to be successful. There are however, some limitations on using benchmarking data for comparison.

Opportunities to improve cardiovascular health in the new American workplace.

Adult working-class Americans spend on average 50% of their workday awake time at their jobs. The vast majority of these jobs involve mostly physically inactive tasks and frequent exposure to unhealthy food options. Traditionally, the workplace has been a challenging environment for cardiovascular prevention, where cardiovascular guidelines have had limited implementation. Despite the impact that unhealthy lifestyles at the workplace may have on the cardiovascular health of U.S. workers, there is currently no policy in place aimed at improving this. In this review, we discuss recent evidence on the prevalence of physical inactivity among Americans, with a special focus on the time spent at the workplace; and the invaluable opportunity that workplace-based lifestyle interventions may represent for improving the prevention of cardiovascular disease. We describe the current regulatory context, the key stakeholders involved, and present specific, guideline-inspired initiatives to be considered by both Congress and employers to improve the "cardiovascular safety" of US jobs. Additionally, we discuss how the COVID-19 pandemic has forever altered the workplace, and what lessons can be taken from this experience and applied to cardiovascular disease prevention in the new American workplace. For many Americans, long sitting hours at their job represent a risk to their cardiovascular health. We discuss how a paradigm shift in how we approach cardiovascular health, from focusing on leisure time to also focusing on work time, may help curtail the epidemic of cardiovascular disease in this country.

Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

OBJECTIVES: The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. METHODS: Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. RESULTS: Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. CONCLUSION: Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

Mental Health in the Workplace: A Call to Action Proceedings From the Mental Health in the Workplace-Public Health Summit.

OBJECTIVE: The aim of the study was to declare a call to action to improve mental health in the workplace. METHODS: We convened a public health summit and assembled an Advisory Council consisting of experts in the field of occupational health and safety, workplace wellness, and public policy to offer recommendations for action steps to improve health and well-being of workers. RESULTS: The Advisory Council narrowed the list of ideas to four priority projects. CONCLUSIONS: The recommendations for action include developing a mental health in the workplace (1) "how to" guide, (2) scorecard, (3) recognition program, and (4) executive training.

Pharmacy measures to improve medication use through health-literacy principles.

More than 90 million Americans have trouble understanding basic health information. Patients with inadequate health literacy encounter problems when trying to understand information related to medication. Consequently, this population has a greater chance of not using pharmaceuticals properly, resulting in poor clinical outcomes. Health care professionals, particularly pharmacists, should improve communication efforts with low-health literacy patients to achieve optimal results. This review examines the relationship between health literacy and medication use with the goals of helping the reader understand how to improve medication adherence and decrease adverse events from improper medication use.

The impact of health literacy on cardiovascular disease.

One's ability to read, listen, and comprehend health information is a vital element of maintaining and improving health. However, 90 million people in the United States exhibit less than adequate health literacy skills. Given that more than 70 million Americans suffer from cardiovascular diseases, it is certain that every physician's practice is affected by health literacy issues. Those with language and cultural issues tend to be the most affected. Yet numerous studies find physicians do a poor job of assessing their patients' health literacy skills. Patients are also unaware of the steps they should take, and how to take them, to improve their health and prevent complications. Numerous studies find, however, that outcomes can be improved with targeted patient education and improved physician communication skills that take into account patients' health literacy levels. Unfortunately, the health care system is only beginning to recognize this problem and take action to overcome its negative impact. By improving the communication process with patients, physicians may be able to improve cardiovascular outcomes.

Familial hypercholesterolemia: clues to catching it early.

Here's how to spot the red flags that could signal your patient is at risk and steps you can take to potentially extend his or her life.

Creating a physically active society: the next great challenge.

The U.S. National Physical Activity Plan was launched in May 2010 with the goal of weaving physical activity into our culture.Physical inactivity has been shown to be a better predictor of death than traditional medical risk factors, costs employers morein lost productivity than tobacco use, causes more deaths than obesity, and affects more people than high cholesterol, acondition that produces more drug sales than any other condition. Despite its impact on society, it is largely neglected in policyarenas. The authors describe strategies to create a national culture of physical activity.

Dispelling the myths about omega-3 fatty acids.

Although there is an enormous amount of information available on omega-3 fatty acids, it is sometimes misleading, contradictory, and unsupported by scientific fact. Consumers and medical professionals may be confused regarding the potential value of omega-3 fatty acid supplements, despite having either read or heard about fi sh oil consumption and/or omega-3 fatty acid benefits and risks. The availability of a prescription formulation of omega-3-acid ethyl esters (P-OM3) has provided important new information that helps to dispel the myths and alleviate concerns surrounding the use of omega-3 fatty acids in clinical practice. The safety and efficacy of P-OM3, but not dietary-supplement omega-3 fatty acids, are documented in placebo-controlled trials. In general, studies using Food and Drug Administration-approved dosages of P-OM3 have not substantiated various myths surrounding the negative effects of omega-3 fatty acids. Thus, there are now evidence-based clinical guidelines for the use of omega-3 fatty acids in clinical practice.

Patient use of dietary supplements: a clinician's perspective.

BACKGROUND: The estimated prevalence of dietary-supplement use among US adults was 73% in 2002. Appropriate use of dietary supplements within the paradigm of evidence-based medicine may be a challenge for medical doctors and non-physician clinicians. Randomized, controlled, clinical trial data, which are considered the gold standard for evidence-based decision making, are lacking. Standardized guidelines for the use of dietary supplements are lacking, and dietary supplements can bear unsupported claims. OBJECTIVES: This article is intended to review clinically-relevant issues related to the widespread use of dietary supplements, with emphasis on regulatory oversight and safety. METHODS: Review articles and clinical trial articles published up until December 2007 were selected based on a search of the MEDLINE electronic database using PubMed. The Food and Drug Administration (FDA) Website was also used as a resource. We used the search terms dietary supplement(s), vitamin supplements, mineral supplements, and Dietary Supplement and Health Education Act. Articles discussing dietary supplements and their regulation, prevalence of use, prescription and nonprescription formulations, and/or adverse events were selected for review. Articles discussing one or more of these topics in adults were selected for inclusion. RESULTS: New FDA regulations require dietary-supplement manufacturers to evaluate the identity, purity, strength, and composition of their products. However, these regulations are not designed to demonstrate product efficacy and safety, and dietary-supplement manufacturers are not required to submit efficacy and safety data to the FDA prior to marketing. Product contamination and/or mislabeling may undermine the integrity of dietary-supplement formulations. CONCLUSIONS: The use of dietary supplements may be associated with adverse events. Although there are new regulatory requirements for dietary supplements, these products will not require FDA approval or submission of efficacy and safety data prior to marketing under the new regulation. A limitation to the literature used for this review is the lack of prospective, randomized clinical trials on the safety and efficacy of dietary supplements. Clinicians should be aware of all the dietary supplements that their patients consume, and help their patients make informed decisions appropriate to their medical care.