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Grant Details

Grant Number: 5R01CA160217-08 Interpret this number
Primary Investigator: Hannon, Margaret
Organization: University Of Washington
Project Title: Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites
Fiscal Year: 2020


Project Summary/Abstract Cancer and other chronic diseases are the leading causes of death in the United States for working-age adults. There are several behavioral risk factors that increase disease risk, including missed cancer screenings, physical inactivity, poor eating habits, and tobacco use. Evidence-based interventions (EBIs) exist that improve each of these risk behaviors, and many of these EBIs can be implemented in worksites where the majority of U.S. adults spend most of their waking hours. There are significant disparities in access to worksite EBIs; large worksites (more than 1000 employees) are much more likely to offer EBIs to their employees than small worksites with less than 250 employees. The American Cancer Society (ACS) and the University of Washington Health Promotion Research Center (HPRC) developed HealthLinks, a package of EBIs appropriate and feasible for small worksites. We are currently completing a randomized controlled trial of HealthLinks with more than 70 small worksites; results show that worksites in the HealthLinks arms implemented significantly more EBIs at follow-up than worksites in the delayed control arm. Now that we know HealthLinks is effective, we need a way to scale it up beyond the location of the trial. Local health departments (LHDs) cover almost every community in the United States and most LHDs' missions include preventing chronic disease. In a separate project, we pilot-tested training staff in six LHDs in Washington State to deliver HealthLinks to worksites in their communities. We found that LHD staff completed the training and recruited worksites to participate in HealthLinks; these worksites implemented EBIs. The primary goals of this competing renewal are (a) to scale up HealthLinks by training staff in LHDs across the United States to deliver HealthLinks to small employers in their communities, and (b) to further implementation science by conducting a hybrid type III trial comparing the effectiveness and costs of two different implementation strategies. We will achieve these goals through three specific aims, guided by the HPRC Dissemination and Implementation Framework. We will conduct qualitative audience research with state and local health department directors and local health department staff to refine our training and support approaches (Aim 1); we will conduct a hybrid type III trial comparing standard and enhanced technical assistance combined with online training for HealthLinks (Aim 2); and we will measure the costs of each strategy, both to the local health departments and to the research team (Aim 3). The proposed activities will increase the reach of HealthLinks across the United States to small employers with limited capacity for and access to EBIs. These activities will also advance implementation science by measuring the impact and costs of implementation strategies offering different levels of ongoing support. The findings from this project may inform implementation strategies for other workplace health promotion programs focused on EBIs and small worksites, as well as a variety of implementation efforts that include partnerships with LHDs.


Worksite tobacco control - a qualitative study on perspectives from employers and employees at small worksites.
Authors: Kava C.M. , Ruiz R.A. , Harris J.R. , Hannon P.A. .
Source: BMC public health, 2022-05-06; 22(1), p. 904.
EPub date: 2022-05-06.
PMID: 35524298
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Pathways to Employee Outcomes in a Workplace Health Promotion Program.
Authors: Harris J.R. , Kava C.M. , Chan K.C.G. , Kohn M.J. , Hammerback K. , Parrish A.T. , Helfrich C.D. , Hannon P.A. .
Source: American journal of health promotion : AJHP, 2022 May; 36(4), p. 662-672.
EPub date: 2022-01-04.
PMID: 34983199
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By the Seat of Our Pants: the Experience of Small Businesses in the COVID-19 Pandemic, Washington State, March-October 2020.
Authors: Hannon P.A. , Hammerback K. , Kava C.M. , Bravo-Acevedo P. , Strait M. , Harris J.R. .
Source: Preventing chronic disease, 2022-03-24; 19, p. E14.
EPub date: 2022-03-24.
PMID: 35324423
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Partnerships to expand worksite wellness programs - A qualitative analysis of state and local health department perspectives.
Authors: Kava C.M. , Strait M. , Brown M.C. , Hammerback K. , Harris J.R. , Alongi J. , Hannon P.A. .
Source: Inquiry : a journal of medical care organization, provision and financing, 2022 Jan-Dec; 59, p. 469580221092822.
PMID: 35593231
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Local Health Departments' Capacity for Workplace Health Promotion Programs to Prevent Chronic Disease: Comparison of Rural, Micropolitan, and Urban Contexts.
Authors: Brown M.C. , Kava C. , Bekemeier B. , Ornelas I.J. , Harris J.R. , Chan K.C.G. , Robertson M. , Hannon P.A. .
Source: Journal of public health management and practice : JPHMP, 2021 Sep-Oct 01; 27(5), p. E183-E188.
PMID: 32487926
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The Workplace Support for Health Scale: Reliability and Validity of a Brief Scale to Measure Employee Perceptions of Wellness.
Authors: Kava C.M. , Passey D. , Harris J.R. , Chan K.C.G. , Hannon P.A. .
Source: American journal of health promotion : AJHP, 2021 Feb; 35(2), p. 179-185.
EPub date: 2020-08-18.
PMID: 32808553
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Development of a Wellness Committee Implementation Index for Workplace Health Promotion Programs in Small Businesses.
Authors: Brown M.C. , Harris J.R. , Hammerback K. , Kohn M.J. , Parrish A.T. , Chan G.K. , Ornelas I.J. , Helfrich C.D. , Hannon P.A. .
Source: American journal of health promotion : AJHP, 2020 Jul; 34(6), p. 614-621.
EPub date: 2020-02-20.
PMID: 32077300
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Disseminating Evidence-Based Interventions in Small, Low-Wage Worksites: A Randomized Controlled Trial in King County, Washington (2014-2017).
Authors: Hannon P.A. , Hammerback K. , Kohn M.J. , Kava C.M. , Gary Chan K.C. , Parrish A.T. , Allen C. , Helfrich C.D. , Mayotte C. , Beresford S.A. , et al. .
Source: American journal of public health, 2019 Dec; 109(12), p. 1739-1746.
EPub date: 2019-10-17.
PMID: 31622155
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Tobacco Evidence-Based Practice Implementation and Employee Tobacco-Related Outcomes at Small Low-Wage Worksites.
Authors: Kava C.M. , Harris J.R. , Gary Chan K.C. , Kohn M.J. , Parrish A.T. , Hannon P.A. .
Source: Journal of occupational and environmental medicine, 2019 Jul; 61(7), p. e312-e316.
PMID: 31022102
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Comparing Strategies for Recruiting Small, Low-Wage Worksites for Community-Based Health Promotion Research.
Authors: Hammerback K. , Hannon P.A. , Parrish A.T. , Allen C. , Kohn M.J. , Harris J.R. .
Source: Health education & behavior : the official publication of the Society for Public Health Education, 2018 Oct; 45(5), p. 690-696.
EPub date: 2018-04-16.
PMID: 29658314
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Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.
Authors: Helfrich C.D. , Kohn M.J. , Stapleton A. , Allen C.L. , Hammerback K.E. , Chan K.C.G. , Parrish A.T. , Ryan D.E. , Weiner B.J. , Harris J.R. , et al. .
Source: Frontiers in public health, 2018; 6, p. 110.
EPub date: 2018-04-23.
PMID: 29740572
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Development and Pilot Test of the Workplace Readiness Questionnaire, a Theory-Based Instrument to Measure Small Workplaces' Readiness to Implement Wellness Programs.
Authors: Hannon P.A. , Helfrich C.D. , Chan K.G. , Allen C.L. , Hammerback K. , Kohn M.J. , Parrish A.T. , Weiner B.J. , Harris J.R. .
Source: American journal of health promotion : AJHP, 2017 Jan; 31(1), p. 67-75.
EPub date: 2016-11-17.
PMID: 26389975
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HealthLinks randomized controlled trial: Design and baseline results.
Authors: Hannon P.A. , Hammerback K. , Allen C.L. , Parrish A.T. , Chan K.G. , Kohn M.J. , Teague S. , Beresford S.A. , Helfrich C.D. , Harris J.R. .
Source: Contemporary clinical trials, 2016 May; 48, p. 1-11.
EPub date: 2016-03-02.
PMID: 26946121
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