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Modifiable health risk behaviors such as physical inactivity, unhealthy eating, and tobacco use are linked to the most common chronic diseases, and chronic diseases contribute to 70% of deaths in the United States. Health risk behaviors can be reduced by helping small workplaces implement evidence-based workplace health promotion programs. The American Cancer Society's HealthLinks is a workplace health promotion program that targets 3 modifiable health risk behaviors: physical inactivity, unhealthy eating, and tobacco use. We evaluated employers' implementation of HealthLinks in small workplaces. Methods We targeted Mason County, Washington, a rural low-income community with elevated obesity and smoking rates. We conducted baseline assessments of workplaces' implementation of program, policy, and communication best practices targeting the health risk behaviors. We offered tailored recommendations of best practices to improve priority health behaviors and helped workplaces implement HealthLinks. At 6 months postintervention, we assessed changes in best practices implementation and employers' attitude about HealthLinks. Results Twenty-three workplaces participated in the program. From baseline to follow-up, we observed significant increases in the implementation of physical activity programs (29% to 51%, P = .02), health behavior policy (40% to 46%, P = .047), and health information communication (40% to 81%, P = .001). Employers favorably rated HealthLinks' appeal, relevance, and future utility. Conclusion When offered resources and support, small and low-wage workplaces increased implementation of evidence-based workplace health promotion best practices designed to reduce modifiable health risk behaviors associated with chronic diseases. Results also suggest that HealthLinks might be a sustainable program for small workplaces with limited resources.

Increasing Evidence-Based Workplace Health Promotion Best Practices in Small and Low-Wage Companies, Mason County, Washington, 2009