Men in Rural and Remote Locations

Readers are invited to submit letters for publication in this department. Submit letters online at http://joem.edmgr.com. Choose “Submit New Manuscript.” A signed copyright assignment and financial disclosure form must be submitted with the letter. Form available at www.joem.org under Author and Reviewer information. To the Editor: Across the globe, men experience significantly worse health outcomes than women.1 And while workplace health promotion programs have demonstrated benefits for both employees2 and employers,3 men are less likely to participate in these programs.4,5 As a consequence, using the worksite to improve men's health is an unrealized potential. Evidence shows that workplace health promotion programs that are tailored to employee needs and preferences, and designed with employee input, have higher participation rates than generic interventions.6 We assessed health behaviors and preferences for worksite wellness programs in a distinct group of men: workers in rural and remote work camps in northern Canada. METHODS Nine hundred forty three men from seven remote worksites in northern British Columbia (BC) and Northwest Territories (NWT) completed self-administered surveys. They were asked about their current health behaviors and their preferences for health topics to inform a workplace wellness program. RESULTS Fifty nine percent of the respondents were at least 40 years of age, 16% were Aboriginal, and 83% worked in the mining industry (with 9% in the energy sector and 8% in office-based work). Regarding health behaviors, the men consumed an average of more than four servings of fruits and vegetables daily (mean = 4.3), 75% reported being “somewhat” or “very” stressed at work, and 25% were daily smokers. Almost all (92%) consumed alcohol. Binge drinking, categorized as drinking more than five servings of alcohol in one sitting, was common; three out of five men binge drank at least once a month, and one in five binge drank at least once a week. Use of sunscreen was low, with only about one-quarter saying that they were regular users. The men were asked about their interest in eight different areas that could be addressed in worksite wellness programs. As seen in Table 1, there was considerable interest in most of these topics, with well more than half of respondents interested in all issues except tobacco and alcohol control.TABLE 1: Interests in Worksite Wellness Program TopicsDISCUSSION This study examined health behaviors and interests in worksite health promotion programs among men working in rural and remote communities in northern Canada. The men expressed highest interest in worksite programs in four key areas: physical activity, healthy eating, screening and early detection of chronic disease, and stress control. These findings reflect the heterogeneous nature of the men's health interests and the potential for multi-component workplace health interventions. The findings also demonstrated challenges for these programs. The behavioral data indicated that the men smoked more than the BC and Canadian average,7 exceeded safe drinking guidelines by a considerable amount,8 and did not adhere to sun protection. However, the respondents did not indicate as much interest in worksite programs in these areas. While programs to modify these risk behaviors could offer considerable health benefits, initiatives focused on areas that individuals are not interested in changing are unlikely to attract wide participation. A successful approach for multi-component workplace health interventions might be to integrate strategies to modify “nonpreferred” risk behaviors with interventions directed at behaviors that individuals want to change. For example, men in our study were not much interested in reducing their alcohol consumption, but healthy eating programs had considerable appeal. Workplace wellness programs could reframe alcohol as a food with high calories and low nutritional value. Incorporating safe drinking messages in programs for chronic disease early detection and screening or stress reduction could also be successful ways to decrease alcohol consumption through “under the radar” messages. Such approaches could reduce risky behaviors without being seen as promulgating health dogmatism. CONCLUSIONS Few research projects have examined men's preferences for worksite health promotion programs, particularly for men in rural and remote work settings. Our study identified key health interests of men in these worksites. The findings have informed the design of a workplace wellness program that is currently being implemented in these communities.9 Our next steps are to evaluate the program and assess the extent to which it is successful in addressing the preferences the men expressed.

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