Kent State University / Price Chopper Employee Wellness Study
Kent State University / Price Chopper Employee Wellness Study
This is a comprehensive randomized cluster hand-hygiene improvement intervention to reduce:
 self-reported acute respiratory tract infections (ARI) / influenza-like-illness (ILI) and
 gastrointestinal (GI) illness, absenteeism, presenteeism; and related behavioral and
 attitudinal change over a 90 day trial. The Intervention group will receive hand hygiene
 supplies, and a variety of educational materials, including environmental posters in common
 areas. The control group will perform their usual hygiene activities and will not receive an
 intervention.

 Identical weekly surveys will be administered to the intervention and control groups to
 measure self-reported illness, absenteeism, presenteeism, along with behavior and attitudes
 measured at specified intervals during the study. The intervention and control groups were
 randomized by work floors before the onset of the enrollment period. It is hypothesized that
 employees in the intervention group will experience reduced self-reported illness,
 absenteeism and presenteeism along with improved protective hygiene behaviors and related
 attitudes, relative to those in the control group over the 90-day trial.
The annual costs of seasonal influenza in the United States have been estimated at $87.1
 billion, while costs from the common cold have been estimated at $40 billion. Office
 employees are at increased risk for contracting communicable disease at work, since they
 spend nearly half of their waking hours in this setting, work in close proximity with each
 other, and share equipment. Furthermore, employers in the U.S. have a compelling interest to
 reduce the spread of infectious disease, because they pay for the direct and indirect costs
 of absenteeism in employee wages, replacement of staff, reduced quality of services, rising
 health care premiums, and if self-insured, direct health care expenditures.

 Hand hygiene is the single most important action to reduce the transmission of pathogens that
 result in healthcare acquired infections. Moreover, hand hygiene and respiratory etiquette
 have been recommended as primary non-pharmaceutical strategies in the early stages of an
 epidemic before a suitable vaccine is available. While influenza vaccine uptake is the most
 important recommendation to prevent influenza, the vaccine only protects against 3 or 4 of
 the most prevalent circulating strains in a given flu season and does not provide protection
 against non-influenza viral and bacterial pathogens. Meta-analysis has shown that numerous
 community intervention studies in schools, daycare, and private homes have reduced illness
 from infectious disease by 21-31%.

 Despite the enormous burdens from communicable disease and the importance of the workplace as
 a setting for the potential spread of infections, to date, only four randomized control
 trials have been performed world-wide among office-based employees to assess the efficacy of
 hand hygiene interventions to reduce the spread of communicable disease, including acute
 respiratory infections (ARI), influenza-like illness (ILI) and gastrointestinal infections.
 Collectively, these interventions have shown promising results. Hubner and colleagues (2010)
 found a 65% reduction in the odds of contracting the common cold among workers with improved
 hand hygiene in a public administrative setting in Germany while Savolainen-Kopra and
 colleagues (2012) found a reduction in infectious illness among office employees in Finland
 who participated in a study arm that utilized soap and water and educational training. In the
 U.S., Stedman-Smith and colleagues (2015) found a 31% significant reduction in self-reported
 ARI / ILI and gastrointestinal illness combined in a multi-modal hand hygiene pilot
 randomized cluster trial among office employees at a Midwestern government center. While,
 Arbogast and colleagues (2016) found a significant reduction in health care claims for
 communicable infections spread by hand-to-mouth modes of transmissions over a 13-month,
 multi-component hand hygiene trial which utilized education, hand sanitizer and disinfectant
 wipes.

 This is a comprehensive non-pharmaceutical randomized cluster hygiene improvement
 intervention to reduce self-reported acute respiratory tract infections (ARIs) /
 influenza-like-illness (ILI) and gastrointestinal (GI) illness, absenteeism, and presenteeism
 over a 90-day trial. The Intervention group will receive hygiene supplies (hand sanitizer,
 surface disinfectant wipes, tissues) and educational materials in varied mediums, including
 brief educational videos, and motivational posters hung in common work areas, in addition to
 hand sanitizer, along with hand sanitizer and surface disinfectant wipes installed in shared
 work areas. The control group will perform their usual hygiene activities and will not
 receive an intervention. Predominate pathways for the spread of ARI/ILI and non-foodborne GI
 infections include: (1) droplets that land on the nose, mouth, or are inhaled from infected
 persons' who cough, sneeze or talk; or (2) pathogens on hands contaminated from fomites or
 from touching infected persons, which come in contact with portals of entry including the
 mouth and nose. This multi-modal intervention is developed to promote improvements in the
 performance of protective behaviors that will reduce the spread of pathogens for ARI/ILI and
 GI infections by minimizing exposure from these two common pathways.

 Identical weekly surveys will be administered to the intervention and control groups to
 measure self-reported illness, absenteeism and presenteeism; related behavior and attitudinal
 beliefs will be included in the surveys at specified longer intervals during the study. A
 sub-analysis will be performed to determine if those at high-risk for complications resulting
 in severe morbidity and mortality from infections show a reduction in self-reported
 infections, absenteeism and presenteeism. The intervention and control groups were randomized
 by work floors before the onset of the enrollment period.

 It is hypothesized that employees in the intervention group will experience reduced
 self-reported illness, absenteeism and presenteeism along with improved protective hygiene
 behaviors, and attitudinal beliefs relative to those in the control group over the 90-day
 trial. Statistical analysis will be performed to determine if a relative reduction in
 self-reported communicable infections, absenteeism, and presenteeism, along with the
 improvement of related behaviors and attitudinal beliefs occurred among members in the
 intervention group relative to the control group over the 90-day trial. Statistical analysis
 will include the use of multiple imputation to impute missing variables, and the calculation
 of incidence rate ratios with 95% confidence intervals. Incident rate ratios will be
 calculated using generalized linear mixed models with a Poisson distribution and a log link
 function that will be adjusted for potential confounders and intercluster correlation.
Inclusion Criteria:

 -  At least 18 years or older

 -  No known allergies to alcohol or surface disinfecting wipes;

 -  Works at least 30% of office hours at the study host site;

 -  Consent to receiving emails from Kent State University.

 Exclusion Criteria:

 -  Under 18 years of age;

 -  Known allergies to alcohol or surface disinfecting wipes;

 -  Works less than 30% of office hours at the study host site;

 -  Does not consent to receiving emails from Kent State University.