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Purpose. To summarize and provide a critical review of worksite health promotion program evaluations published between 1968 and 1994 that addressed the health impact of worksite smoking cessation programs and smoking policies. Methods. A comprehensive literature search conducted under the auspices of the Centers for Disease Control and Prevention identified 53 smoking cessation program evaluation reports, of which 41 covered worksite single-topic cessation programs. Nine additional reports were located through manual search of citations from published reports and reviews. These 50 reports covered 52 original data-based studies of cessation programs. The search produced 19 reports for tobacco policy evaluations, of which 12 addressed health impact. An additional 17 reports were located by the authors. These 29 reports covered 29 studies of policy impact. Summary of Important Findings. Smoking cessation group programs were found to be more effective than minimal treatment programs, although less intensive treatment, when combined with high participation rates, can influence the total population. Tobacco policies were found to reduce cigarette consumption at work and worksite environmental tobacco smoke (ETS) exposure. Conclusions. The literature is rated suggestive for group and incentive interventions; indicative for minimal interventions, competitions, and medical interventions; and acceptable for the testing of incremental effects. Because of the lack of experimental control, the smoking policy literature is rated as weak, although there is strong consistency in results for reduced cigarette consumption and decreased exposure to ETS at work.

Purpose. Present a 10-year update of the ecologic model of health promotion published by Richard et al. in the American Journal of Health Promotion in 1996. Approach. We adapted and simplified the model by leaving out settings, focusing on levels, and incorporating interpersonal and individual levels and agents that are in control of environmental conditions. Setting. Health care facilities, schools, workplaces, living environments, and public environments were represented in program descriptions. Participants. Forty-three program coordinators responsible for 47 programs were interviewed in the United States and The Netherlands. Methods. A systematic interview protocol elicited general program descriptions and relevant aspects of the ecologic approach. Program aspects from written reports were coded by the authors into levels, interventions, targets, and strategies. Results. The programs had 234 strategies and 276 targets, with a mean of 2.15 levels. Twenty-seven distinct intervention strategies were identified, with the most common being modification of an organization to which the at-risk individuals belong, followed by policy and community changes. Conclusion. Our data fit the ecologic model and our adaptations and indicate that over the past decade health promotion practice may have changed to include more multilevel programs. Systematic analysis of program strategies within and across environmental levels allows better understanding of the social ecology of health-related behavior and potential leverage points for change.

This article tests a theoretically driven model of the relationship between work environment, specifically, management practices, and employee mental health, specifically depression. It draws on theoretical perspectives connecting work environment and stress, and on others linking stress and depression. It also examines sense of coherence as a possible mediator of the relationships among work environment, work stress, and depression. Results showed that perceived exposure to employee involvement management practices was related to perceived work stress, sense of coherence, and depression. A model was specified to assess potential causal relationships using LISREL. Results suggested that increased exposure to employee involvement practices was indirectly associated with lower levels of depression through both perceived work stress and sense of coherence. The implications of these findings for management practice are discussed.

Purpose. The purpose of this study was to operationalize adopter characteristics identified by Rogers and assess their relationship to the adoption and implementation of health innovations in schools. Design. A two-year cohort study of teachers was used following introduction of a new health promotion program. Subjects. From a randomly selected statewide sample of 300 second grade Texas teachers, 131 completed an initial questionnaire (54% of 244 eligible participants). Among those 131 who completed the initial questionnaire, 103 (79%) completed a follow-up postcard in year two. These represented 42 % of the original sample eligible to participate. Measures. The self-administered questionnaire explored the structure of underlying cognitions towards adoption of innovations, teachers' communication patterns with health agencies, responses to various tobacco prevention and general educational materials, and the association of their views about adoption with practice. Descriptive statistics, principal components analysis, and nonparametric correlation coefficients were used. Results. Three components of teacher views which measured adopter characteristics described by Rogers (1983) were identified: Innovativeness, Need for Collegial Support, and Conservativeness. Respective levels of reliability were .83, .76, and .60. Associations of the components with user communication patterns with health agencies and use of innovations were found. Conclusions. Scales identified adopter cognitions associated with use of innovations. These may be used to diagnose target audiences, plan training programs, and expand research to enhance adoption and use of new programs.

Personnel directors of Texas state agencies were surveyed one month prior to and one year following the passage of the 1983 Texas State Employee Health Fitness and Education Act. This legislation allowed the agencies to use available funds and facilities for health promotion programs. Most of the personnel directors were aware of the Act and of the potential benefits of health promotion programs. There was general interest in learning more about health promotion, available community resources, and about the time and energy commitments in developing a program. Most believed they would implement programs in the future. In the year following the passage of the Act, 16 percent of the agencies, covering 30,852 employees, had received approval to begin programs. Size was positively related to plan development and approval. The results are discussed using diffusion theory.

Purpose.This study tested a conceptual model based on research supporting the relationship between the predictors of hardiness, supervisor support, and group cohesion and the criterions of job stress and job satisfaction and between the predictor of job stress and the criterion of job satisfaction.Design.The study employed a cross-sectional research design. Survey data were collected as part of the baseline measures assessed prior to an organizational hardiness intervention.Setting.Worksite of Dell Computer Corporation in Austin, Texas.Subjects.The subjects included 160 full-time Dell employees recruited from a convenience sample representing nine work groups (response rate = 90%).Measures.Hardiness was measured using the Dispositional Resilience Scale (DRS), job stress was measured using the Perceived Work Stress Scale (PWSS), and supervisor support, group cohesion, and job satisfaction were measured using a proprietary employee attitude survey.Results.In the proposed model, high hardiness, supervisor support, and group cohesion were related to lower levels of job stress, which in turn was related to higher levels of job satisfaction. The model also proposed direct paths from hardiness, supervisor support, and group cohesion to job satisfaction. Path analysis was used to examine the goodness of fit of the model. The proposed model was a good fit for the data (χ2[1, N = 160] = 1.85, p = .174) with the exception of the direct path between group cohesion and job satisfaction. Substantial portions of the variances in job stress ( R2= .19) and job satisfaction (R2= .44) were accounted for by the predictors.Conclusion.Implications for targeted worksite health promotion efforts to lower job stress and enhance job satisfaction are discussed.