Person-specific health promotion in the health-care setting: an exploratory study

BACKGROUND: Healthy living reduces mortality and morbidity in health-care workers and health-care cost, and improves health service efficiency. There is little information about health-care workers' physical wellbeing. We aimed to assess self-reported indicators of healthy living in members of staff and to identify areas for potential health promotion. METHODS: A questionnaire was devised, incorporating questions about height, weight, smoking, alcohol intake, and interest in receiving health promotion. It was distributed to 221 doctors, nurses, and administrative staff from inpatient and outpatient settings at the Royal Free Hospital, London, UK. Data were anonymised and analysed by Kruskal-Wallis, Mann Whitney U (Bonferroni adjustment, p=0·008 post hoc), χ², or Fisher's exact test, with independent variables being assessed for correlation. Open-space questions were analysed by thematic coding and content analysis. All questions were coded and analysed by qualitative analysis software (NVivo 10). FINDINGS: We recruited 72 administrative staff (33%), 67 doctors (30%), and 82 nurses (37%). Mean age was 37·3 years (SD 10·4). Most participants were women (68%). Mean body-mass index (BMI) values between groups were as follows: doctors (24·4, 95% CI 23·0–25·7), nurses (27·5, 26·1–28·8), and administrative staff (25·6, 24·3–26·8). Doctors had a significantly lower BMI than nurses (p<0·0001). 47 (57%) of 82 nurses were overweight (BMI of ≥25), in comparison with 18 (27%) of 67 doctors and 28 (39%) of 72 administrative staff (p=0·001). Administrative staff (20 of 72, 28%) were more likely to smoke than doctors (five of 67, 7%; p=0·002), and nurses (nine of 82, 11%; p=0·008). Doctors' weekly alcohol intake (mean 9·2, 95% CI 7·0–11·5) was higher than for nurses (2·80, 1·7–3·9; p<0·0001) and administrative staff (3·8, 2·5–50·2; p<0·0001). Additionally, ten (15%) of 67 doctors, two (2%) of 82 nurses, and five (7%) of 72 administrative staff exceeded the Department of Health recommended weekly limit, with doctors doing so significantly more than nurses (p=0·006). Exercise frequency, duration, and type of exercise were also recorded. 63 (94%) of 67 doctors exercised, in comparison with 65 (79%) of 82 nurses and 58 (81%) of 72 administrative staff (p=0·029). Doctors were the most likely to engage in strengthening exercise (p=0·033), which was also associated with lower BMI (p=0·033). Doctors (37 of 67, 55%), nurses (61 of 82, 74%), and administrative staff (54 of 72, 75%) were interested in receiving further health promotion information. 115 (52%) of 221 requested information for exercise, 86 (39%) healthy weight maintenance, 18 (8%) smoking cessation, and seven (3%) alcohol consumption. Those who exercised less frequently were more likely to seek advice on exercise (p=0·005), those smoking the greatest number of cigarettes to seek advice on smoking (p<0·0001), and those with overweight BMI to seek advice on weight maintenance (p<0·0001). However, health-care staff with alcohol problems did not request the corresponding advice (p=1·00). Qualitative analysis of health-care professionals' views about health promotion was divided in two main areas. First, availability of healthy activities: cost and accessibility of exercise, state of facilities, absence of healthy food in canteen, and time constraints. Second, promotion of healthy activities: inadequacy of health promotion solely by posters and poor follow-up after induction. INTERPRETATION: The variations between groups suggest that different populations would benefit from tailored health promotion. Additionally, our findings for health-care workers with alcohol problems suggest that health promotion in this area should be strengthened in the entire population. This is a small-scale study with findings that warrant further investigation and represent an opportunity to improve existing health promotion strategies. FUNDING: None.