A needs assessment of Indian factory workers to design acceptable and feasible worksite wellness initiatives for reducing the burden of cardiovascular diseases

The Employee State Insurance Scheme (ESIS) is the largest health insurance company in India covering over 40 million beneficiaries, including factory workers who make less than Rupees 15,000 ($330) per month as well as their immediate family members. The disease burden in these ESIS beneficiaries is high from non-communicable and communicable diseases based on the 2008 morbidity data. The purpose of this study was to conduct a needs assessment to help design effective health promotion programs. This study utilized a mixed-methods design using quantitative and qualitative methods. Twenty-five workers (39.6 +/- 6.7 years) from one worksite completed a quantitative survey as well as a semi-structured interview to assess (a) their and their spouse's health and health practices (b) health related practices at the factory and (c) their interest in health promotion programs. The interviews were audio-recorded, transcribed and open-coded to identify recurring themes. Results showed that 90% of participants were very concerned about their health and healthcare costs. Smoking was a key risk factor workers faced (48% were smokers), followed by the consumption of an unhealthy diet (56% eating fried foods at least 3 times/wk). Forty-four percent of participants indicated that other workers smoked at the workplace in spite of policies against it. Workers were more interested in educational health programs (e.g. 80% reporting interested or very interested) rather than health screening tests. This study will help design effective health promotion programs for ESIS beneficiaries to reduce their disease burden. It should emphasize prevention of smoking and healthier diets.