Lombardian Workplace Health Promotion (WHP) programme: a comprehensive multi-domain intervention in North-Italian enterprises
At a glance
Country of origin
- Italy
Level(s) of intervention
- Environmental prevention,
- Universal prevention
The WHP in the Region of Lombardy has the general objective of promoting organisational changes in the workplace in order to create environments that are conducive to the adoption and spread of healthy lifestyles, aimed at prevention of non-communicable chronic diseases. The Programme is based on the WHO model “Healthy Workplaces: a model for action” that identifies 4 areas to be influenced: physical work environment, psychosocial work environment, personal health resources, and enterprise involvement in the community.
It works by offering a mix of environmental and informational interventions for workers to participate in and to reduce one or more of the targeted risk behaviours. The target populations are: adults, i.e., workers from different kinds of enterprises (public, private, hospitals, small or large business). The programme applies a multi-component approach, promoting the implementation of recommended and evidence-based practices in the areas of healthy diet, physical activity, smoking cessation, drug use prevention, work-life balance, wellbeing and mental health, involving employers and workers in a continual step-by-step process to create safe and healthy workplaces.
Keywords
No dataLinks to this programme in other registries
Implementation Experiences
Read the experiences of people who have implemented this programme.Contact details
ATS Milano Tel: 02 85789633
nvimercati[at]ats-milano.it
Overview of results from the European studies
Studies overview
The evaluation study by Cremaschini (2015) is a controlled, non-randomised, quasi-experimental evaluation of this intervention package. The intervention group are workers of the companies having selected to implement a specific sub-programme (i.e. on tobacco). The control group are workers of the companies involved in the WHP programme, but without having selected that specific programme (i.e. companies having selected a sub-programme for alcohol and other substances, physical activity etc). Exclusion criteria: companies with a low response rate among workers. Analysed were only data from workplaces,
1) where >70% of workers filled in the risk factor questionnaire at T0,
2) and >70% at T1,
3) which participated for 12 months and
4) which are health promoting workplaces.
There were significant results for smoking cessation and for healthier food intake, i.e., 4 fold increase in smoking cessation rates among exposed workers (and no among controls); 10% increase in consuming 5 portions of fruit/vegetable a day among exposed (and 4% among controls).
There are positive, but non-significant effects for alcohol use and physical activity. No effects on personal relationship and road injury risk were detected.
There are some concerns about validity, e.g. the appropriateness of the outcomes that were measured and the overall quality of the study, such as: a) unlinked pre-post questionnaires (it is not a cohort design but two prevalence surveys on the same population), b) no randomisation (selection bias), c) contamination of the control group, given that they are involved by an intervention, even if with different objective (this could underestimate association).
Nevertheless, this intervention is a crucial piece in the puzzle of the health promotion strategies in the workplace, and the impact shown on tobacco cessation and alcohol abuse are very promising.
Countries where evaluated
- Italy
Characteristics
Protective factor(s) addressed
- Individual and peers: prosocial behaviour
- School and work: commitment and attachment to school
- Environmental: Comprehensive and strict local alcohol policy and enforcement
Risk factor(s) addressed
- Environmental: Drug use/sale in on-site alcohol-selling premise
- Environmental physical: Lack of adequate emergency services in on-site alcohol-selling premise
- Environmental physical: Lack of opportunities for participation in positive and prosocial development
Outcomes targeted
- Physical health
- Positive relationships
- Alcohol use
- Other health outcomes
- Smoking (tobacco)
Description of programme
For the pilot study in the province of Bergamo, the programme was addressed to 21000 factory workers from 94 enterprises corresponding to 20% of enterprises (with more than 200 workers) in the Province. Every company selected a sub-programme, out of 6, to be implemented. The sub-programmes are: diet, tobacco, physical activity, road safety, alcohol and other substance use, and well-being.
The participants were factory workers and they participated in a 12-month health promotion programme. The participating enterprises were able to choose which domain they wanted to target: smoking, alcohol, food intake, physical activity or road accident prevention. Intervention components were e.g. smoking policies, environmental approaches (vending machines, serving sizes, saliency of food offers), but also information campaigns. Workers who participated in an action of a list of "best practices" were considered as "exposed to the intervention"
The Programme as such is active in all of Lombardy since 2014, embedded in a broader regional prevention action plan. In the Lombardy region there are currently 1,100 companies involved in it, with a total of around 300,000 workers. The Italian new National Prevention Plan 2021-2025 has made its implementation mandatory in all Italian regions. The Programme has also been adapted for its implementation in Andalusia, Spain.
