Employers have the incentive and the means to play a key role in chronic disease prevention. Theincentive?employers need to control the costly and growing burden of chronic diseases among theiremployees. The means?employers purchase 94% of private health insurance, and employees spend onethird of their lives in the workplace, where they often eat, move, socialize, and smoke. Over the past 5years, the CDC and the Task Force on Community Preventive Services have recommended a number ofchronic-disease-prevention practices. Among these, we have identified 15 practices that employers shouldadopt. These practices include health insurance benefits, workplace policies, and workplace programs, andaim 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 hasdeveloped and pilot-tested an innovative consulting intervention to increasing adoption of these practices.Our two-stage intervention is comprehensive yet tailored by employer feedback. The intervention a) marketsthe 'business case' that employers can help control health-care costs and productivity losses throughadoption of these practices, and b) 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 48medim-sized employers with a high proportion of socioeconomically disadvantaged employees in the PugetSound area. Our primary outcome is change in employer practices as measured by survey and validated byaudit and contract and policy review. Our secondary aims include a) development and pilot-testing of anemployee-level behavior survey, b) cost analysis and assessment of feasibility of our intervention, and c)assessment of employees' preference for different message sources and message appeals.Our multidisciplinary research team includes Business, Communication, and Public Health faculty andhas more than 10 years of experience in both chronic disease prevention and working with business. Ifuccessful, our team's approach of working with a national community partner to market organizationaloractice changes to employers has broad applicability to other public health problems.
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