Disseminating Evidence-Based Interventions in Small, Low-Wage Worksites: A Randomized Controlled Trial in King County, Washington (2014-2017).

Abstract

<i>Objectives.</i> To determine whether (1) participating in <i>HealthLinks</i>, and (2) adding wellness committees to <i>HealthLinks</i> increases worksites' evidence-based intervention (EBI) implementation.<i>Methods.</i> We developed <i>HealthLinks</i> to disseminate EBIs to small, low-wage worksites. From 2014 to 2017, we conducted a site-randomized trial in King County, Washington, with 68 small worksites (20-200 employees). We assigned worksites to 1 of 3 arms: <i>HealthLinks</i>, <i>HealthLinks</i> plus wellness committee (<i>HealthLinks+</i>), or delayed control. At baseline, 15 months, and 24 months, we assessed worksites' EBI implementation on a 0% to 100% scale and employees' perceived support for their health behaviors.<i>Results.</i> Postintervention EBI scores in both intervention arms (<i>HealthLinks</i> and <i>HealthLinks+</i>) were significantly higher than in the control arm at 15 months (51%, 51%, and 23%, respectively) and at 24 months (33%, 37%, and 24%, respectively; <i>P</i> < .001). Employees in the intervention arms perceived greater support for their health at 15 and 24 months than did employees in control worksites.<i>Conclusions. HealthLinks</i> is an effective strategy for disseminating EBIs to small worksites in low-wage industries.<i>Public Health Implications.</i> Future research should focus on scaling up <i>HealthLinks</i>, improving EBI maintenance, and measuring impact of these on health behavior.