Occupational health promotion and cancer screening: Analyzing online-health methods for office workers in Germany and Prostate Specific Antigen screening in Canada for Disease Prevention Improvement
Background Two ways to prevent diseases are through health promotion and screening. With respect to health promotion, this thesis investigated the impact an online-health promotion program had on the well-being of office workers. With respect to screening, this thesis identified characteristics of men who are undergoing prostate-specific antigen (PSA) screening for prostate cancer (PCa) despite mounting literature suggesting PSA screening is not beneficial, and in fact may cause more harm than it prevents. Our study objectives were to: 1) identify health issues faced by office workers and improve our understanding of online-health promotion in the context of office worker well-being, and 2) estimate recent PSA screening rates, compare these rates to past national data, and characterize the men who are screened. Methods Data for study objective 1 included a needs assessment, questionnaire(s), and activity log data of office workers undergoing online-health training. These data were provided by fitbase GmbH. Data for study objective 2 included the Canadian Community Health Surveys (CCHS) from 2009-2014, which had information related to PSA screening and the characteristics of a respondent. Needs assessment data were summarized to identify the perceived health issues of office workers for objective 1. Prevalence estimates with 95% confidence intervals were computed to determine recent PSA screening rates and to compare with past national rates for study objective 2. Logistic regression analysis (using the questionnaire and activity log data) was conducted to determine factors of the online-health promotion intervention associated with improved well-being for study objective 1. Logistic regression analysis using the CCHS data was conducted to determine the characteristics of Canadian men with increased odds of being screened with the PSA test for study objective 2. Results For study objective 1, about half of office workers frequently or constantly have issues with stress or back pain. Office workers who focused on completing practical exercises (guided, follow-along health activities) compared to information modules (reading health information) and who focused on completing back pain practical exercises compared to other health categories had higher odds of having their well-being improved. For study objective 2, we found that PSA screening rates have generally increased in eastern Canadian regions since 2000/2001. Physician-related factors were positively associated with having been screened, even among men who are not recommended to be screened (<50 years of age). Conclusions Health promotion and screening can help prevent health issues. Office workers in an online-health promotion intervention who chose to focus on completing practical exercises and to focus on back pain as a health issue they were experiencing had an increased odds of improved well-being. This information can help inform online-health interventions (that intend to prevent health issues) by maximizing one’s well-being. Despite controversy surrounding the PSA test, screening rates have generally increased since 2000/2001 in Canada. Physician-related factors play a role in screening for men at all ages. This work can help identify those who are currently being screened for PCa with the PSA test and to prevent the stress and complications that could result from a false positive.
occupational health, screening, health promotion, prevention, prostate-specific antigen
Master of Public Health (M.P.H.)
School of Public Health