Creating healthy hearts, one hard hat at a time
When Bart Dickson recognized that construction craft workers were among the U.S. workers most at risk for heart disease, he was concerned.
When the construction industry veteran began losing his own employees and colleagues to heart disease, he took action.
Dickson has been a driving force in establishing a local version of Hard Hats With Heart. Created and implemented by the American Heart Association, the program aims to educate workers in the construction industry about ways to protect themselves from heart disease.
Many construction companies have implemented programs to help office workers eat better, stop using tobacco and incorporate exercise into their daily routines at work and at home. However, those programs have rarely made it to jobs sites and the craft workers who are surrounded by a culture where food carts and energy drinks have contributed to health issues.
One in four construction workers in the country is obese, one in four regularly uses tobacco products, and one out of 25 has diabetes, according to the American Heart Association (AHA).
In addition, while about 50% of Americans have hypertension, or high blood pressure, screenings conducted on construction jobs sites in Portland during the past year indicated that only 10% of those screened had normal readings.
"The numbers are pretty staggering," Lanette Trickey, executive director of the Oregon and Southwest Washington division of the AHA, said.
The blood pressure data isn't official validated information, but the results were enough to lead Dickson, now a developer and owner of Cobalt Development, to join with Trickey and her team to take the existing Hard Hats With Heart program and localize it with a few unique twists.
Instead of expecting workers to come to the program, for example, the local program is designed to go to the job sites where the workers were located.
The national program also focused mainly on a single event, a day-long health fair with booths offering educational information such as blood pressure screenings. The local campaign kept the screenings. But instead of a one-day event, it offers a series of sessions that can be provided over an entire year.
Introduced locally as the Industrial Athletes campaign, the pilot program already has started to make to make a small — but important — difference that's expected to grow in the future.
"It was a fantastic pilot year that we're wrapping up, and we're excited to see this move forward," Jana Boyle, senior business development director with the local Heart Association division, said.
One of the most eye-opening statistics for Dickson was the fact that while 20% of heart disease is tied to genetics, 80% can be controlled by making lifestyle changes.
Those changes make up the four pillars — or focus areas — of the Hard Hats With Heart program. The focus areas include knowing one's blood pressure numbers, increasing the amount of daily exercise, incorporating more fruits and vegetables into a daily diet, and reducing or eliminating energy drinks and sugar-heavy beverages.
The quartet of pillars also makes up the curriculum of the four main sessions that Dickson and Trickey's team have developed for the local year-long pilot program.
One of the sessions called "Rethink Your Drink," for example, asks workers willing to participate to pledge to refrain from drinking sugary beverages and energy drinks for a specific time period of their choice: a day, a week, or even a month. During a recent visit to a job site where 6% of craftworkers signed up to participate, Trickey's team brought a sack of sugar and dumped it out in a pile.
'We did a sugar dump ... 25 pounds of sugar," Trickey said. "That represented the amount of sugar that this team had given up just over the course of 30 days."
More recently, during Construction Safety Week at the beginning of May, Boyle engaged 350 workers on a jobsite in a "portion distortion" activity. Workers were given bags of chips, crackers and other popular snack foods and asked to pour out the portion they would normally consume. Then Boyle brought out prepared portions that represented actual serving sizes as indicated in the nutritional information panel on each package. In almost every instance, the actual portion represented a smaller serving than what the workers portioned out.
"The people who participated were really interested," Boyle said. "A lot of them were kind of shocked to see an actual serving size."
Different by design
A unique aspect of the Portland-area Hard Hats With Heart program is that companies and project owners can customize it to fit their needs, Boyle said. Participation can focus on a single topic area, or it can span a year's worth of sessions.
One of the most popular sessions so far has been an initial awareness campaign that focuses on blood pressure. Nurses show up on sites armed with blood pressure cuffs and conduct screenings. Workers with above-normal blood pressure readings receive opportunities to meet confidentially with nurses, where they are given information about next steps. The advice includes suggestions for setting up medical appointments and information about steps the workers can do on their own to lower their readings, from quitting smoking to eating healthier to exercising more. They're also given access to "Check. Change. Control," an online resource that provides a way to track blood pressure on a regular basis.
"We got some great results already coming out of that work," Trickey said. "On many (job sites), they've already had blood pressure cuffs available, and where they haven't, we've broug
ht them in. Our goal is not to be Big Brother ... It's really to empower people to take charge of their own health."
When Skanska USA Building learned about the local Hard Hats With Heart campaign, the company decided to become involved. So far, the program has been introduced at two of the company's project sites, reaching about 2,500 craft workers. The company also plans on bringing it to two more project sites — and another 500 or so craft workers — by the end of the year, according to Tim Baugus, a Skanska senior vice president and account manager.
For at least one craft worker participating in the program through Skanska, the information received about dietary adjustments had a positive effect. After an above-average reading during a blood pressure screening, a worker stopped drinking energy drinks for a week. A rescreening indicated eliminating the beverages had reduced the worker's blood pressure reading by 20 points.
Dickson thinks the program will lead to more results like that in the future.
"One of the things we talked about during the campaign this past year was, we always have to read the specifications of what we're going to install on a project ... (but) how infrequently we read the specs of what we're putting in our own bodies," Dickson said. "That was something that resonated for me. We really aren't very informed about what we're taking into our bodies and what it does to us, whether it's our blood pressure or our waistline. It's exciting to see the light bulbs come on and see people realize (they) can do something about this."
A need to lead
While conversations with workers are important, it can be even more important to reach leaders of companies and project owners in order to obtain that buy-in for the local campaign, including helping them adopt healthier approaches to diet and exercise in their own lives.
"I've had a number of executives say to me, we need our own support program because of the way we entertain clients, the way we go to meetings and the stress we carry and the lack of sleep," Dickson said. "We've got our own problems on the executive side — it's not just the people who use tools."
With an eye toward creating a full support system from the board room to the job site, Dickson planned a May meeting with leaders from some of the largest general contracting companies and several key subcontractors to brainstorm and share ideas for how employers can lead the much-needed culture shift.
Kick-starting that shift could be an effort as detailed as an owner making sure there's a food cart with healthy options at a project site. Or it could be as simple as taking time out each day to support employees in efforts to adopt healthier lifestyles.
"If someone really wants to show they care about it, let's see where they put their resources," Dickson said. "You have time every Monday morning at a safety meeting for the whole job site. How do you use
that time and what are you using for messaging? ... We can do small investments that make a significant investment. But also, they're signposts that show (workers) we're serious about helping them make changes."
The pilot program, initially called the Industrial Athletes campaign, will soon transition to a full program that will carry the Hard Hats With Heart name. The permanent program isn't just expected to continue to have an impact in the Portland metro area. Heart Association divisions around the country are looking at adopting the local program for use in their areas.
"We have other markets that are kind of taking our cue, to really bring these job site initiatives to the craft workers," Trickey said. "But really, that it was started in the Portland market is kind of exciting."