WOMEN WHO WORK IN MANUFACTURING SETTINGS - FACTORS INFLUENCING THEIR PARTICIPATION IN WORKSITE HEALTH PROMOTION PROGRAMS

The workplace is an effective channel for disseminating health promoti on interventions,(1) and it is becoming an increasingly important vehi cle for reaching women. In the United States, 54% of women over 18 wor k outside the home. Bureau of Labor projections indicate that by the y ear 2005, women will be entering the workforce at a faster rate than m en. Manufacturing worksites, in particular, offer an effective means o f reaching women who are underserved, undereducated, and from lower in come strata. The worksite may play a particularly important role in re aching these underserved women because they may have less access to tr aditional channels for health care and prevention. However, poor parti cipation in worksite programs is often cited as a major contributor to less than optimal outcomes in worksite-based programs. Little is know n about the determinants of participation in worksite health promotion programs. In addition, there is no common definition of ''participati on,'' which adds to the confusion in this literature.(2) While it is d ifficult to make comparisons across data that use different definition s of participation, several recurrent themes exist. Demographic charac teristics tend to predict participation in worksite health promotion p rograms. Younger employees, those with higher education levels, and wo men are more likely to participate,(2,6) although men are more likely to participate in fitness programs.(7,8) Organizational or worksite-le vel factors that promote individual participation in health promotion programs are less clear. Top management support, willingness to allow attendance on company time, and line supervisor permission to attend p rograms all seem to play a role in facilitating participation. Althoug h the importance of organizational factors has been acknowledged,(2,6, 9-11) the systematic study of how these factors differentially predict participation by gender-occupational characteristics, age, and health status has only recently begun.(12,13) The Working Well Trial, a rand omized trial of worksite health promotion,12 13 offers a unique opport unity to investigate factors influencing participation in health promo tion programs. In one of the four participating study centers (Brown U niversity), it was observed that 57% of women employed in participatin g companies did not attend any of the intervention activities. These d ata indicated that the program was not effectively reaching a large pe rcentage of the women employed in these companies. As a result, the pr esent study was designed to investigate the facilitators and barriers to women's participation in worksite health promotion.