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Targeting the Working Populations
I have learned from interviewing diabetes experts, hospital administrators, and diabetes educators that the hardest group to engage and motivate on diabetes awareness and management is the working-age population. Workers generally are “too busy” with day-to-day activities, family, friends, work pressures, and such, to prioritize personal health—until they end up in the hospital with complications from undiagnosed diabetes.
To see if a workplace initiative would be a useful tactic in my diabetes awareness, prevention, and education strategy, I met with folks from an NGO working on a two-year project on improving awareness of Hepatitis B among Chinese factory workers. I was taken to a major brand sneaker factory in Guangdong province, about an hour and a half outside of Guangzhou, for a health “carnival,” timed to fit into the workers’ designated 1.5-hour mid-day rest period. The NGO recruited volunteers to set up games at six stations where the workers could play – some with messages about the transmission of Hepatitis B and others just games for the workers’ relaxation. In about half of the games (one was a charades game and another involved moving messages written on ping pong balls to the right basket using chopsticks) workers needed to match messages about Hepatitis B transmission with the right answers to get prizes. The volunteers were giving out hundreds of little cartoon books with Hepatitis information embedded within stories and larger stuffed animals as multiple games winners came up to collect their prizes. Other games – like blowing a ping-pong ball across a line of six water-filled paper cups – were interspersed for the fun of it. Around noon, a flood of workers left the factory building streaming to the canteen, the dorms, and other places to get food. I followed the workers into the canteen where they were getting their food served from canteen workers manning the steam tables and ladling out rice and a hot lunch. The hall held several hundred people who were soon sitting at tables eating their meals. After fifteen minutes in the canteen, a couple of hundred workers made their way back to the carnival and started playing the games. I met the factory Director of Corporate Social Responsibility (“CSR”) who was pleased with the turnout of the workers at the carnival. His take on the carnival: the Hepatitis B educational message was useful, and he wanted his CSR staff trained to do similar health carnivals. When I asked him about a carnival on diabetes, he thought that such a carnival would be useful to the 80,000 workers at his employer’s five factories. The carnival closed around 2PM as the last of the prizes and the literature were given out. However, this initiative did not end with the last game. The cartoon books and promotional posters carried a toll-free number for workers to call if they had questions about Hepatitis B or complaints about prejudicial treatment (e.g., being fired after a diagnosis of Hepatitis B). All of the information from the call was captured into a searchable database by using a smart phone that provided a script for the call, one-way recording for quality control, and a link to the database. Since the implementation of the initiative two years ago, worker knowledge rose from a score of 20% to 70% correct answers, and the percent of factory brand workers carrying the disease dropped relative to the Guangdong area – 7.8% versus 33%. I was impressed with this workplace initiative that targets difficult-to-reach populations, gets information directly into workers’ hands in an engaging/entertaining way, provides follow-up support via a toll-free call center, and has a proven success rate. I am encouraged to consider this a key component in my strategy.