Qualitative Vs. Quantative Assignment

Qualitative Vs. Quantative Assignment

Given two quantitative and two qualitative research studies, minus  the abstracts, choose one quantitative study and one qualitative study  to analyze. Then, write a 250-word abstract for each one.

As you read each study, take notes that will help you write the abstracts. Consider:

• The purpose of the research.
• How the sample of participants was selected.
• The rationale given for the choice of a qualitative versus a quantitative approach.
• The main findings of the study.
• Any limitations of the study.
• Any recommendations made for further research.

In addition, keep a record of key words or concepts to add to each abstract. Qualitative Vs. Quantative Assignment

Document Format and Length

Each abstract should be 250 words in length.

MPH5200 Qualitative Study 2
Introduction
Obesity, a major risk factor for diabetes, affects more than one-third of adults in the UnitedStates and is associated with several demographic and socioeconomic factors, including lowincome (1). Several studies have found that obesity rates are generally higher among workingclass occupations than professional occupations, even after controlling for demographic factors(2,3).
From a sociological perspective, the environments in which people live and work are stronginfluences on obesity and diabetes (4,5). The work environment is especially important becausemany adults spend a significant amount of time at work and because obesity affects employersthrough reduced productivity and absenteeism as well as increased health care costs anddisability (6). Numerous studies acknowledge the negative health consequences of workplacefactors such as stress, low autonomy, poor coworker and managerial support, and unhealthyphysical work environments (2,7). These workplace risk factors may be more common in lowwage and working- class jobs and may explain some occupational differences in obesityprevalence (2,8).
Promoting health through worksite wellness programs is a national priority. The Affordable CareAct creates new incentives to promote employer wellness programs and encourageopportunities to support healthier workplaces (9). The National Institutes of Health and theCenters for Disease Control and Prevention have targeted worksites as a priority location forhealth interventions because they offer an efficient means of delivering and evaluating programsand provide opportunities to reach socially disadvantaged populations (10,11). However, datafor the effectiveness of workplace health programs are limited and may not be generalizable toall types of workers (6,11–13). National data show that blue-collar and service workers are lesslikely to work for an employer who offers health promotion activities and are less likely toparticipate in such programs when offered (14). Qualitative Vs. Quantative Assignment
This study focused on a little-studied health disparity — workplace health promotion among lowwage workers. The objective of the study was to examine through interviews and focus groups1) worksite culture, environment, and policies that influence healthy eating and physical activity;and 2) barriers that reduce worker participation in workplace health promotion programs. Anunderstanding of how the workplace affects health behaviors is can inform design of effectiveinterventions to reduce and prevent obesity.
Methods
We partnered with a large health care system and a national labor union representing retail
workers to recruit study participants. Qualitative data collection included interviews with keyinformants (eg, employer representatives, union leaders, benefits administrators) and workerfocus groups with both partner organizations. The workforce in the union was relativelyhomogenous with regard to income and included workers in jobs such as cashier andmerchandise stocker. Within the health care system, we targeted hospital work departmentsand locations that employed a large proportion of low-wage workers, including housekeepers,patient care technicians, and food service workers.
This study was approved by the Washington University institutional review board.
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We interviewed 10 individuals from the union partner: 4 local union leaders, 5 storerepresentatives, and 1 health benefits administrator. Key informants were recruited in person orthrough email, and interviews were conducted in person or over the telephone. We asked aboutcurrent and previous wellness initiatives offered to employees, employee participation in theseinitiatives, and potential barriers to participation. Informants were also asked about workplacefactors that influenced health behaviors (ie, physical activity and healthy eating) and employeeattitudes about health and wellness.
We conducted a total of 9 focus groups involving 61 workers. Twenty hospital employees (4men and 16 women) participated in 4 groups. Forty-one unionized retail workers including 12men and 29 women participated in 5 focus groups. Focus group participants were recruitedthrough their work department, store, or local union hall. The research team attended unionmeetings to recruit members in person and posted flyers in break rooms at selected stores andhospital departments. We used a semistructured script to guide focus group discussions. Thescripts covered 11 broad domains with follow-up questions and prompts for each domain (Table1). All group discussions were audio recorded and transcribed. Transcriptions were entered intoQSR International’s NVivo 10 software (QSR International Pty Ltd), and all were coded by 2independent raters using a predefined code book based on the domains in the focus groupscript. After initial coding and consensus of all transcripts, we applied a phenomenological
approach for data analysis to find the “essence” or common themes across individual
experiences (15). The purpose of the thematic analysis was to answer 2 questions: “what
impacts healthy eating and physical activity” and “what can be modified at the workplace?”Through systematic review and discussion, codes were merged and grouped under mainthemes. Each transcript was re-read and re-coded for consistency. Qualitative Vs. Quantative Assignment
Results
Key informant interviews
The informants indicated that very few wellness programs related to weight management wereoffered to retail workers. The union-sponsored health plan covered some costs for nutritional
counseling, but that benefit was not well advertised. The employer-sponsored initiatives such asan onsite gym or weight loss programs were primarily available to employees in the corporateoffices, not to workers in retail stores. Both the union and employer representatives recognizedthe need for workplace wellness programs but were unsure about how to proceed withdeveloping and implementing a program to reach their diverse and widespread workforce.

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Informants described various programs available to employees but noted several barriers toeffective program implementation, including lack of management commitment at some levels,limited budgets, and communication and advertising limitations. One informant described resultsof a focus group conducted among employees of 1 hospital department regarding awareness ofexisting wellness programs and preferred methods of communication; results indicated that
most workers were unaware of the wellness program and did not regularly use company email,which was the primary method of communicating information about the wellness program.
Workers preferred to get information via personal email, text message, or in person. Workplacewellness efforts within the health care organization varied by worksite; some sites were moresuccessful in promoting and delivering their wellness initiatives than others. Informants thoughtthe size of organization and motivation of appointed representatives for each location influencedprogram success. An informant from a smaller hospital mentioned several successful wellnessinitiatives at her location, including an onsite gym, exercise classes, and 2 weight-losschallenges each year, and an informant from a larger hospital discussed struggles to find2
effective communication methods to reach all worker groups.
Worker focus groups
The final list of themes from the focus group analysis included 10 work-related themes and 10general themes (Table 2). Workers commonly discussed how their job characteristicscontributed to their health. For example, they mentioned that physical demands and stress of
their jobs left them too exhausted or unmotivated to exercise or plan healthy meals (Table 3).Many also described how the physical environment affected their health (eg, small work area,concrete floors). Past or current company programs and priorities was another common themeidentified, although details varied by group. Overall, the retail workers talked about lack of
wellness programs; some mentioned store weight-loss competitions and previous companycampaigns but felt that their employers and union did not prioritize health and wellness.
Responses of the health care worker groups differed; those working in a large hospital settingwere much less aware of wellness initiatives and felt less company or management support forhealth promotion. Many were aware of the onsite gym and the weight-loss program, but cost,
work schedule, and home responsibilities made it difficult to participate. Conversely, a groupworking in a smaller clinic felt tremendous upper-management support and described numerousworkplace supports, including a produce garden at the worksite, access to exercise equipment,afternoon stretch breaks, and healthy potluck lunches.
Workers also discussed schedules and breaks as having a significant impact on their healthyeating and physical activity. For many retail workers, their schedules varied week-to-week,
making it difficult to maintain any routine. Workers from both organizations stated that short andinterrupted breaks made it difficult to eat healthy. They discussed how food options —healthy orunhealthy and purchased or provided for free (eg, incentive lunches, holiday parties) — affectedtheir eating behaviors at work. Workers from both organizations felt that their workplaces had alack of quick, convenient, and low-cost healthy food options. Moreover, in all groups we heardthat free food was almost always unhealthy. Nearly all workers commented that social supportand accountability to coworkers would improve their ability to initiate and maintain healthybehaviors. Qualitative Vs. Quantative Assignment
General themes were those that may be related to the workplace but also extended intoworkers’ personal lives. For example, workers often discussed how intrapersonal factors (eg,
motivation, willpower) and home life (eg, responsibilities, family support) affected their healthbehaviors both in the workplace and at home. Workers often discussed how their jobsinfluenced their health in terms of not having the money, time, or energy to exercise or planhealthy meals. Some workers also discussed the roles that health issues and transportationplayed in initiating and sustaining healthy behaviors.
Discussion
This study highlights factors related to obesity as described by 2 low-wage work groups; ourfindings are consistent with results from a similar study among low-wage workers in variousindustries (8). The workplace was often viewed as a barrier to healthy eating and physical
activity; however, workers supported the concept of workplace health promotion and offeredsuggestions for overcoming many of the identified barriers. As demonstrated in this study, theworkplace may be effective in engaging populations at risk for obesity and related illnesses,
though it may be necessary to go beyond traditional workplace wellness approaches. Usingmore innovative methods may increase program reach, effectiveness, and sustainability.
Policy changes have increasingly been recognized as essential components of worksite healthpromotion (16) and are more sustainable than individual-level behavior interventions (17).
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Policies promoting a culture and environment conducive to reducing obesity can be a strongcatalyst to behavior change. These can include top-level policies, such as offering a health careplan that has wellness options or implementing organizational policies that provide for access tolow-cost healthy foods at the worksite, encourage active transportation to and from work, orallow for flexible work schedules to encourage lunch or break-time physical activity. The workenvironment (both indoor and outdoor) is also an important component of behavior change andcan have a significant impact on behavior choice (18). An environment that encourages lesssedentary work and more physical activity could include well-placed and maintained stairwellsfor stair use versus elevators or distant parking.
Changes solely in the workplace environment may not be enough to encourage healthybehaviors (19). Health behavior decisions are affected by the social context in which they aremade, such that the social support and social norms surrounding a health issue have asubstantial effect on how that health behavior is perceived. Changing social norms and fosteringa supportive work environment for the desired behavior is a necessary complement to the otherlevels of intervention. Social norms have been studied as a way to promote nutrition (20) andphysical activity (21).
Workplace participatory approaches may foster social support and help to overcomeorganizational and employee barriers to program success. Most worksite weight-loss programshave relied on a top-down approach, rather than a participatory approach based on employeeinvolvement in the design of interventions (22). In workplaces where employees generally havelittle influence on their work environment, similar to those sampled in this study, participatoryapproaches can result in better program implementation and subsequent health improvement(22). The recently described Healthy Workplace Participatory Program (HWPP) includes workenvironment changes, as well as healthy eating and physical activity interventions (23). A small
study based on HWPP found promising changes in behaviors and weight loss in a pre–post
evaluation of a participatory worksite intervention (24). To our knowledge, this HWPP-basedstudy is the only controlled study to date using a worker health participatory program to attainweight loss. Future research should implement and evaluate workplace participatoryinterventions for weight loss.
Workplace wellness programs should also use effective communication strategies to engageworkers from diverse work groups and backgrounds. As demonstrated with the health caresystem in this study, many low-wage workers were not aware of the wellness programs that
were available to them. The same programs, however, have good participation from other workgroups in the health care organization, primarily because of the method of communication.
Rapid changes in information technology have enabled new interventions that use mobiletelephones and other mobile devices (mHealth). These techniques show great promise forweight reduction in low-income populations (25), and such interventions are readily scalable tolarger populations (13).
Although we did not directly ask about incentives, several participants discussed monetaryincentives as a possible motivator to eat healthy and exercise. The use of incentives is commonin workplace wellness programs; employers could maximize the benefits of incentives byincorporating lessons from behavioral economics. For example, the increasingly popular

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approach of delivering incentives through health insurance premium adjustments is unlikely tobe as effective as more frequent and immediate rewards for behavior. This is because peopletend to discount the future, meaning that they respond more readily to immediate than delayedcosts and benefits (26). The participants in our study commonly discussed cost as a barrier toeating healthy and exercising. As suggested by others (27), low-income workers may be morelikely to change and sustain healthy behaviors if provided with financial support for healthy foodand participation in other weight-loss activities. Employers should also be aware of the4
limitations of incentives for behavior change. Qualitative Vs. Quantative Assignment
Recent reviews have shown behavioral effects to be relatively short-lived after incentives areremoved (27), and considerable attrition is found in workplace programs for weight loss (28).
More research is needed to determine the optimal timing, magnitude, and structure of
incentives, but results to date suggest that incentives may need to be an ongoing feature of theworkplace to have maximum impact.
Finally, employers may consider integrating traditional occupational safety and health programs(ie, those that focus on health hazards unique to the workplace) with health promotion andwellness programs (ie, those that focus exclusively on lifestyle factors off the job). The Total
Worker Health program was launched by the National Institute of Occupational Safety andHealth (NIOSH) to support the development and adoption of research and best practices tointegrate these approaches and address health and safety risks at multiple levels, including thework environment (physical and organizational) and individual behaviors. This integrativeapproach may lead to greater adoption of interventions by management and workers and henceto improvements in the health of workers (11), but more research is needed to evaluate both thedevelopment process and the effectiveness of integrated programs (29).
The results of this study can help inform future worksite interventions for low-wage workers;
however, our study has several limitations. First, we collected data from key informants whocould be contacted or agreed to be interviewed. Second, although the participants in the focusgroups represented a range of positions and worker groups, they were limited to those availableduring the implementation of the focus group discussions. Although using a conveniencesample may be a limitation, those who elected to participate in the interviews or focus groupswere able to provide helpful insights on the topic. Future intervention planning would need to bepreceded by additional input from a broader participant base. Third, the information we collectedmay not be generalizable to other health conditions or work settings. Despite these limitations,the key informants and focus group participants provided rich and potentially actionableinformation on addressing obesity at the worksites of these worker populations.
Workplaces can provide an effective venue for engaging low-income populations at risk forobesity and related illnesses. Results of this study suggest that future worksite interventions forlow-wage workers can improve reach, effectiveness, and sustainability if they embrace moreinnovative methods than those used in current workplace wellness programs. Futureinterventions should address workplace policies and environment and social norms that affecthealth behavior decisions. Communication strategies and financial incentives should be betteraligned with the needs of low- wage workers. Workplace participatory programs are a promisingapproach to engage workers in health improvement. Qualitative Vs. Quantative Assignment
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