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Use of Surveillance Data to Design and Evaluate Worksite Programs to Address Cardiovascular

Disease in New York State

Lori IarossiBonnie Eisenberg, MPH

Ian Brissette, PhD

Bureau of Chronic Disease Epidemiology & SurveillanceDivision of Chronic Disease and Injury Prevention

New York State Department of Health

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Timeline for Worksite Surveillance and Program Evaluation

1980s

Cohort 11995-1997

Cohort 21997-1999

Cohort 31999-2003

Cohort 42005-2009

Why create a Worksite Assessment Tool?

Why create a Statewide Surveillance System?

Why create a Program Evaluation System?

Need to document pre and post measures for heart healthy worksite supports

Developed out of the need for putting into context the work and results of the HHP Contractors interventions in worksites documented through HeartCheck

Developed out of the need for validating Healthy Heart Program funded contractor worksite, school and community interventions

Statewide Worksite

Surveillance

Worksite Assessment

Tool

Program Evaluation System

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HeartCheck: A Worksite Assessment Tool

Analysis and Reporting: HeartCheck Scores calculated using SPSS from 1999-2002 and SAS from 2002 to current. Final charts and

reports produced in Microsoft Access and distributed to DOH program staff and contractors.

Methods: The survey was administered in person with data collection via:

1998-2007- Scannable forms 2007-Current- web-based data collection

Design: Healthy Heart Program worksite funded contractors complete Pre and Post HeartCheck

Instrument: Developed from the National Worksite Health Promotion Survey, the data source for the Healthy People

Objectives

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HeartCheck

Healthy Eating

Do you provide labels to identify "healthy" foods in the cafeteria?

Yes No

1 0

Physical Activity

Does the worksite provide a shower and changing facility for employees who want to bike/run/walk to work or exercise during off hours (lunch)?

Yes No

1 0

Healthy Eating Physical Activity

Preventive Health Screening

Administrative SupportsTobacco Use

Stress ManagementOrganizational Foundations

HeartCheck

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Heart Check: Results

0% 5% 10% 15% 20% 25% 30% 35% 40%

Total

Admin Supports

Stress

Physical Activity

Healthy Eating

Tobacco Use

29%

26%

38%

24%

27%

31%

20%

14%

32%

14%

15%

25%

New York State Department of Health 1995 - 2009 Heart Check: 1,062 Worksites / 323,616 Employees

Baseline

Follow-up

Mean Score

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Analysis and Reporting: Weighted prevalence estimates were calculated using software for complex survey analysis. Multivariate‐models examining worksite and workforce characteristics associated with the availability of policy supports for wellness were published.

Methods: The survey was administered by mail using a compressed mailing schedule with three contacts. A postage‐paid envelope was

included for returns and phone follow‐up was used to verify worksites were in operation.

Design: A Dun and Bradstreet database of worksites with 75+ employees served as the sampling frame from which a stratified

random sample of private and public sector worksites was drawn

Instrument: Developed in 2002 from HeartCheck and the National Worksite Health Promotion Survey, the data source for the Healthy

People Objectives

Statewide Surveillance System

Preventing Chronic Disease Journal http://www.cdc.gov/pcd/issues/2008/apr/07_0196.htm

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Statewide Surveillance System: Results

2. Importance of Worksite Wellness Coordinator

0

2

4

6

8

10

None Coordinator or

Committee

Coordinator &

Committee

Number of Health Promotion Supports by Administrative Supports

1. Workforce Size Matters

0

2

4

6

8

10

75-99 100-199 200-299 300+

Worksite Size

Number of Health Promotion Supportsby Worksite Size

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0%5%

10%15%20%25%30%35%40%

Baseline/1999 Follow up/2003

27%

36%

Mean Smoking Score

Average Heart Check ScoresWorksite Wellness Contractors

1999-2003785 worksites /242,700 Employees HHP funded

activity DID NOT cause this increase

Need for Data Validation

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Performance Management Data Entry System (PMDES)

Analysis and Reporting: Monthly downloads are imported in a Microsoft Access database. Data is cleaned and analyzed in SAS and monthly reports are generated in Access and distributed to

DOH program staff and Contractors.

Methods: Following training, regional contract managers oversee technical support of data entry

Design: Contracted with Binghamton University to develop system based on Reporting needs of NYS Healthy Heart Program

Objectives Major Activities Evaluation Resources

System: Web-based reporting system developed in 2002-2004

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PMDES

Healthy EatingPhysical Activity

Preventive Health Screening

Administrative Supports

PMDES

Healthy Eating

Do you provide labels to identify "healthy" foods in the cafeteria?

Yes No

1 0

Physical Activity

Does the worksite provide a shower and changing facility for employees who want to bike/run/walk to work or exercise during off hours (lunch)?

Yes No

1 0

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Performance Management Data Entry System (PMDES)

Web-based data collection database established in 2005 for contractor reporting

Worksites track intervention and evaluation measures through monthly reporting

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Linkage of Data Systems

Healthy Eating Physical Activity

Preventive Health ScreeningAdministrative Supports

Tobacco UseStress Management

Organizational Foundations

Healthy EatingPhysical Activity

Preventive Health ScreeningAdministrative Supports

Merge and Validate Data

PMDES

Heart Chec

k

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Contractor Work

No Contractor Work

0 5 10 15 20 25 30 35

34

20

14

10

BaselineFollow Up

Worksite Healthy Eating Supports

Mean Healthy Eating Score

t(275)=3.85, p<.0001

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0 5 10 15 20 25 30

Contractor Work

No Contractor Work

30

15

13

9

Baseline

Follow Up

Mean Physical Activity Score

Worksite Physical Activity Supports

t(275)=4.00, p<.0001

15

0 5 10 15 20 25 30

Contractor Work

No Contractor Work

25

16

11

11

Baseline

Follow Up

Mean Administrative Supports Score

Worksite Administrative Supports

t(275)=2.45, p=.024

(Satterthwaite)

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Conclusions• PMDES validates that HeartCheck score improvements are a result of Healthy Heart Program (HHP) funded Interventions

Data Validation

• PMDES documents HHP Program results, including environmental supports and impact on target populations

Documentation

• Future Contractor funded work is determined based on “Best Practices”

Action

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Next Steps

• Relationship between Baseline HeartCheck Scores to:

• 1) Interventions selected by HHP Contractors

• 2)Success in achieving Policy and Environmental Changes

Data Analysi

s

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Questions

Lori IarossiNew York State Department of Health

lsm06@health.state.ny.us

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Thank You!