Edet Adejoke, Kudrna Laura, Quinn Laura
Medicine and Occupational Health, EPCo Ltd, Fawley, United Kingdom.
Department of Applied Health Sciences, University of Birmingham, Birmingham, United Kingdom.
PLOS Glob Public Health. 2025 Mar 17;5(3):e0003984. doi: 10.1371/journal.pgph.0003984. eCollection 2025.
There are economic and social benefits associated with promoting the health and wellbeing (HWB) of workers. The workplace is an important setting for HWB promotion, however, small and medium size enterprises (SMEs) are less likely to offer these programmes. Uptake is also uneven across demographic groups, contributing to inequalities outcomes. This study investigates if uptake of HWB promotion programmes in SMEs differs by employee demographics and if these factors interact with the effectiveness of organisational-level monetary incentives to improve uptake. In a secondary analysis of quantitative data from a cluster-randomised controlled trial, multilevel logistic regression models were fitted to examine the relationship between the outcome (uptake of HWB initiatives) and employee demographics (age, gender, ethnicity, education level). Models included interactions between the trial arm (monetary incentive or control) and employee demographics. Results showed that employees in the incentive arm had similar uptake of HWB initiatives compared to the control (adjusted OR 1.11, CI 0.72, 1.70, p = 0.64). In tests of the demographic factors, employees 55+ years had 56% lower odds of uptake (CI 0.25, 0.76, p = 0.003) compared to employees aged 17 to 24 years and these results were robust to treating age as a continuous variable. There were no statistically significant interactions between the incentive and the other employee demographic groups for the uptake of HWB initiatives. Organisational-level monetary incentives do not appear to differ in their effectiveness according to employee demographics, although some sub-groups appeared under-represented in the trial including ethnic minorities and those with education below degree-level. Older workers in SMEs may be less likely to engage in workplace HWB initiatives and could be targeted in terms of workplace HWB implementation, policy, and research.
促进员工的健康和幸福（HWB）会带来经济和社会效益。工作场所是促进HWB的重要环境，然而，中小企业（SMEs）提供这些项目的可能性较小。不同人口群体的参与程度也不均衡，导致了不平等的结果。本研究调查中小企业中HWB促进项目的参与情况是否因员工人口统计学特征而异，以及这些因素是否与组织层面的货币激励措施的有效性相互作用以提高参与率。在一项对集群随机对照试验的定量数据进行的二次分析中，采用多水平逻辑回归模型来检验结果（HWB倡议的参与情况）与员工人口统计学特征（年龄、性别、种族、教育水平）之间的关系。模型包括试验组（货币激励或对照组）与员工人口统计学特征之间的相互作用。结果显示，与对照组相比，激励组员工对HWB倡议的参与率相似（调整后的OR为1.11，CI为0.72, 1.70，p = 0.64）。在对人口统计学因素的测试中，55岁及以上的员工参与的可能性比17至24岁的员工低56%（CI为0.25, 0.76，p = 0.003），并且将年龄视为连续变量时这些结果仍然稳健。对于HWB倡议的参与情况，激励措施与其他员工人口群体之间没有统计学上的显著相互作用。组织层面的货币激励措施在有效性方面似乎不因员工人口统计学特征而异，尽管在试验中一些子群体的代表性不足，包括少数族裔和教育程度低于学位水平的人。中小企业中的老年员工可能较少参与工作场所的HWB倡议，在工作场所HWB的实施、政策和研究方面可以将他们作为目标群体。
