Implementing Workplace NCD Screening as a Health Systems Initiative: Participation, Satisfaction and Early Health Risk Signals in Tamil Nadu

Implementing Workplace NCD Screening as a Health Systems Initiative: Participation, Satisfaction and Early Health Risk Signals in Tamil Nadu | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Implementing Workplace NCD Screening as a Health Systems Initiative: Participation, Satisfaction and Early Health Risk Signals in Tamil Nadu Dhivya Karmegham, Geetha Veliah, Balaji Murugesan, Keerthana Chakkaraiappan, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8342107/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Non-communicable diseases account for 74% of annual deaths worldwide. Early detection of these conditions is necessary for timely intervention, and prevention. The workplace serves as a suitable environment for screening by reaching large groups of population under risk. However, the effectiveness of its use for the implementation of screening programs depends on employee participant, satisfaction, and health outcomes. Therefore, this study aims to assess the employee satisfaction, participation rates, and factors influencing participation in workplace NCD screening programs along with the short-term outcomes, such as early detection rates. Methods A descriptive cross-sectional study was conducted across 29 industries from April 2024 to March 2025 in which the workplace NCD screening programs were implemented by the government health department. Information on participants' demographic profile, Morbidity status, overall perception of the screening program, and its impact was collected among its employees. Ethics approval was obtained from SRM IEC. Results A total of 296 employees participated in the study. 92.2% of the respondents had participated in a hypertension or diabetic screening program in the current workplace. Notably 43.8% of those with diabetes and 45.5% with hypertension were initially identified through workplace screening program, and 22.7% of them reported that they have made some lifestyle changes after NCD screening. Overall, two-third of the participants were satisfied with the screening programs. Years of experience and organisations support were the influencing factors for workplace screening programs. Conclusion High participation rate, substantial initial case detection and strong employee satisfaction demonstrates that work place NCD screening program in Tamil Nadu’s organised sector are both feasible and effective even for a Long run. Non-communicable disease workplace screening early detection organised sector Figures Figure 1 Figure 2 Background Chronic non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, cancer, respiratory disorders, and mental disorders, are a considerable global health burden, causing more than 74% of annual deaths worldwide[ 1 ]. India is witnessing a notable epidemiological transition with a striking increase in the non-communicable disease prevalence[ 2 ]. In Tamil Nadu, NCDs are the cause of 75% of all deaths in 2019, with hypertension alone contributing to 22% of mortality. Tamil Nadu STEPS survey provided an alarming prevalence where one-third of adults have hypertension, nearly one in six with diabetes and more than half of them are obese or over weight and at last more than one- fourth of adults have three or more NCD risk factors[ 3 ]. Early detection and prompt intervention are the essential components of NCD prevention. Early disease detection and risk factor identification are made possible by screening programs for diseases like diabetes, breast cancer, and cervical cancer[ 4 ] Recent systematic review evidence shows that multicomponent workplace interventions are consistently effective in reducing NCD risk factors. Over the past few decades, the workplace has been recognized as a critical location for health promotion due to its ability to effectively reach large groups[ 5 ] Workplaces can be used to increase screening engagement and promote positive changes in individual behaviors, as well as in overall public health[ 6 , 7 ]. By offering positive social norms, providing a convenient screening environment, reducing structural barriers, and promoting health education, workplaces can influence screening behavior and facilitate easier and regular access to health care for people across different socio-demographic and economic backgrounds. [ 8 – 10 ]. Tamil Nadu, one of India’s most industrialized states, hosts a diverse range of industries in the manufacturing, Information Technology, and service sectors. The workforce is vital to the state's economy. Still, it faces increasing NCD risks from lifestyle-related health challenges such as sedentary work environments, irregular work hours, poor nutritional habits, and insufficient physical activity. In response to these challenges, initiatives such as “Thozhilalar Thedi Maruthuvam” [ 11 ], a workplace-focused health screening program in Tamil Nadu, aim to overcome structural barriers, provide convenient on site health checks and promote positive health behaviors among workers. Programs that are implemented at work enhance workers' well-being and boost their output. Apart from the advantages, the effectiveness of these health programs at the workplace still depends heavily on participation rates[ 12 ] There is evidence that a variety of factors, including organizational, interpersonal, and intrapersonal determinants, have an impact on participation[ 13 ]. Another crucial element of a successful health program is employee satisfaction. Both immediate participation and long-term behavioral changes are influenced by it, which reflects the programs' perceived worth, practicality, and relevance[ 13 ]. Prior studies in India and some other places have identified some barriers, such as inconvenient scheduling, lack of incentives and health beliefs, and the facilitators, such as employer support and health education, that affect participation in workplace wellness programs. But, quantitative evidence on participation patterns, satisfaction levels, and short-term health outcomes in Tamil Nadu’s industrial workplace remains limited. This study used a Quantitative outcome evaluation approach to assess three key performance indicators of workplace NCD screening programs in Tamil Nadu’s organized sector. The main objective of this study is to assess the employee satisfaction, participation rates, and factors influencing participation in workplace NCD screening programs. The secondary objective is to assess the short-term outcomes, such as early detection rates, and the proportion of those who made some behavior changes. By doing this, the study aims to generate actionable evidence for optimizing workplace NCD screening Initiatives. The findings will inform the policymakers and employers on effective strategies to enhance program uptake that improve worker well-being while boosting organizational efficiency and the field of public health more broadly. Methods Study Design A descriptive cross-sectional study was used to assess the short-term outcomes, employee satisfaction, and participation in workplace NCD screening programs. Study settings and Participant selection The study was conducted across 29 different industries in which the workplace NCD screening programs were implemented. A stratified random sampling methodology was adopted at the district level. 10 districts representing the state's geographical zones (Fig. 1 ) were initially selected, and three industries per district were randomly chosen from the sampling frame provided by the NCD cell of the Directorate of Public Health (DPH). Within each consenting industry, 10 employees were selected completely at random using the employee list as the sampling frame, resulting in a total sample of 296 participants. This two-stage sampling strategy, random selection of industries followed by random selection of employees, ensures internal validity and enhances representativeness across districts and industry types despite the constraints. Eligibility criteria To be included in this study, the participants had to be above 18 years of age, working in any of the selected industries, and willing to participate. Respondents who joined the current industry in the last six months with no previous experience in any other industry were excluded from the study, as they would not be on the beneficiary list of the NCD screening program. Study Tool A semi-structured questionnaire was developed to assess the participation rates, satisfaction, and short-term outcomes of workplace NCD screening programs among employees. This self-reporting, tool consisted 54 items, including demographic characteristics, occupational details, health insurance coverage, family history of NCDs, previous diagnosis of diabetes or hypertension, participation in workplace screening activities, perceptions regarding screening, organizational support, and availability of health-promoting facilities in the industry. A pilot validation process was conducted prior to full-scale data collection. The draft questionnaire was reviewed for face and content validity by a panel of experts from health and social sciences. Interviews with ten employees across one pilot industry were conducted to evaluate item clarity and response interpretation that led to simplification of ambiguous questions and refinement of response options. The revised tool was then tested with 20 more employees from other industries using the KoBo Toolbox app to assess the sequence, logic functionality, and app usability. Minor adjustments to the question were made based on the pilot, and a final expert review confirmed the tools for the main study data collection Data collection Data was collected by scheduled interview face to face, using the semi-structured questionnaire in the Kobo toolbox mobile application. Prior to data collection, investigators underwent training on interview techniques, ethical considerations, informed consent procedures, and use of the KoBo digital platform. The training also included instruction on handling sensitive questions, maintaining privacy during interviews, and ensuring standardization of data collection across sites. Data Analysis The operational definitions used for the key outcome variables were as follows. The outcomes, participation in workplace NCD screening, was defined as self-reported attendance at any hypertension or diabetes screening conducted in the current workplace along with a team from DPH. A participant was classified as having participated if they responded “yes” to screening for either diabetes or hypertension. Employee satisfaction with the screening program was measured using questions related to convenience of scheduling, location, waiting time, perceived usefulness, and overall experience. These items were scored using a Likert-type scale, and the total satisfaction score was categorized into high (> 80%), moderate (60%-80%), or low levels (< 60%). Data was cleaned and analyzed using Statistical Package for Social Sciences (SPSS) Version 28. Descriptive statistics, such as means and standard deviations, were used to summarize continuous variables, while frequencies and percentages were used for categorical variables. To account for the clustered sampling of employees within industries, we initially fitted a mixed-effects logistic regression with a random intercept for industry. The intraclass correlation coefficient (ICC) was estimated to quantify the degree of within-industry correlation. Binary logistic regression was used in determining the factors influencing employees’ participation in the workplace NCD screening programs. Results Characteristics of the participants Thirty-eight industries were approached for participation, and consent was received from 29 industries. From each approved industry, twelve employees were randomly invited for interviews. Close to 360 employees were invited using a random sampling process. A total of 296 employees participated in the study, with a 17.7% non-response rate. Of the 296 participants, 51.7% were female. The mean age group of the participants was 36.17 (SD=10.06) years. Most participants (94.9%) were residents of Tamil Nadu. In terms of educational attainment, 41.2% had completed primary or secondary education, 33.4% had completed higher secondary or diploma, while 5.7% were illiterate. The majority of participants (80.4%) were employed full-time, with 87.5% working in non-administrative positions. More than half (55.4%) of the participants worked general shifts, and 22.3% reported working overtime. Around 26% had 1 to 3 years of experience, and 21% had more than 11 years of work experience. Most participants were married (75.3%). Additionally, 18.2% participants reported engaging in vigorous physical activity such as carrying or lifting heavy loads, digging, or construction work that causes large increases in breathing or heart rate. (Table 1) Organization characteristics Out of the 29 industries, 60% were multinational corporations (MNCs), 10% were government-run, and the remaining were private enterprises. Among them, 7 were in the automobile sector, and 4 belonged to the food industry. 5 reported that they offer diabetes-friendly food in their canteen. Similarly, 6 provide diabetes-friendly snacks. Regarding hypertension-friendly options, four industries provide hypertension-friendly food and snacks. Only 2 industries reported having a gym. Walking tracks are available in 6 industries. Wellness programs, including yoga / Zumba classes, were conducted in four industries. Mandatory health screenings are implemented in 23 industries. The frequency of screenings varied, annually in 9 industries, every six months in 11 industries, and every 3 months in 7 industries. Close to two-thirds of the industries (65.5%) provide education on health screenings to their employees. Participant health status and practices Among the 296 participants, 75% had health insurance. Of those insured, the majority (91%) were covered by company-based health insurance. 42.2% of participants reported a family history of diabetes and 32.1% reported a family history of hypertension. 10.8% (n=32) of participants had been diagnosed with diabetes. Among those diagnosed with diabetes, about 82% (n=26) were under medication and 94% monitored their condition periodically. 22 participants (7.4%) had been diagnosed with hypertension previously, of them 12 were under medication and 13 reported periodic monitoring. Among the participants 18.8% of those with diabetes and 22.7% of those with hypertension reported workplace as their regular place of receiving treatment. Short-term outcomes of workplace NCD Screening 92.2% of the respondents had participated in a hypertension or diabetic screening program in the current workplace. Of those who participated 22.7% reported that they had made some lifestyle changes after NCD screening. Notably 43.8% of those with diabetes and 45.5% of those with hypertension were initially identified through this workplace screening program. (Table 2) Table: 2 Short term outcomes of workplace NCD screening Outcomes n (%) Participated in screening (n=296) 273 (92.2) Made Lifestyle changes after NCD screening (n=273) 62 (22.7) Made life style changes after diabetes diagnosed in workplace (n=14) 13 (92.9) Made Life style changes after hypertension diagnosed in workplace (n=10) 7 (70) Place of initial identification of Diabetes (n=32) Workplace screening Hospital Community screening camps 14 (43.8) 16 (50.0) 2 (6.3) Place of identification of Hypertension (n=22) Workplace screening Hospital Community screening camps 10 (45.5) 11 (50.0) 1 (4.5) Satisfaction in workplace screening The satisfaction of employees with workplace NCD screening is provided in (Table 3). Regarding scheduling 47.6% of the respondents found it more convenient, equally (47.3%) found it to be neutral (Not Difficult nor convenient) while remaining 5.2% find it more difficult. Waiting time was considered convenient by 46.5% of the participants. A majority (82.4%) of the participants expressed interest in participating in future NCD screening programs. 67.4% believe that the NCD screening has positively impacted their overall health. Also, 76.4% indicated that they would recommend the screening program to colleagues. About around 76% felt that workplace NCD screening encouraged them to focus more on their health. Notably 83.8%, reported that the program increased health awareness among friends and family members. When asked about the support of organization in the overall health of employees 49% responded ‘Very much’, 47% said it was ‘Average’ and 4.1% said ‘Not at all’. The satisfaction level was assessed among the 273 respondents who had previously participated in workplace screening. Overall, 46.2% of the participants (n =126) were highly satisfied with the screening programs, that is, by having a satisfaction score greater than 80%. On the other hand, one third of participants (n = 91) were dissatisfied and had a satisfaction score below 60%. (Figure 2) These results indicate that the majority of the participants had a positive experience regarding the screening programs, though a considerable proportion showed dissatisfaction, hence indicating areas where improvement may be needed. Factors influencing participation in workplace screening A mixed-effects logistic regression with a random intercept for industry was initially fitted to account for the clustered sampling of employees within industries. The estimated variance of the industry-level random intercept was effectively zero (σ² ≈ 2.08 × 10⁻¹⁸), yielding an intraclass correlation coefficient (ICC) ≈ 0. This indicates that participation did not cluster by industry, and employees within the same industry were no more similar than those across different industries. Therefore, a standard logistic regression model without cluster adjustment is appropriate. Table 4 presents the factors influencing participation in workplace screening programs, as identified through Binary logistic regression. Variables included were age, gender, education qualification, current designation, years of experience, shift timings, participation in vigorous intensity activities, health insurance, marital status, family history of diabetes and hypertension, education on screening provided by the company, and whether the screening was mandatory. Among these, only years of experience and perceived organizational support to the employees emerged as significant predictors for participation. Specifically year of experience is associated the odds of participating in workplace screening change by 1.127 (p value=0.044). Employees who perceived the companies as very supportive of their health and wellness the odds of taking part in workplace screening programs were 16.9 times (p value = 0.048) higher than those who work for companies that are not as supportive. Discussion This study explored organizational characteristics and employee factors influencing participation in NCD screening program across 29 industries and approximately 300 employees. Findings reveal that perceived organizational support and years of experience of an employee significantly predict screening participation, indicating the crucial role of the workplace in health behavior promotion. Organizational support and Participation Our study findings shows that the Odds of participate in screening programs at workplace were approximately 17 times higher compared to employees perceiving poor organizational support. This is strongly supported by a study by lier et al which found that organizational support especially by leadership associated with the enrollment rates in workplace health promotion programs[ 13 ]. Similarly, a study by Grossmeier J et al identified organizational leadership support as the strongest predictor of both participation in any wellness activities and perceived organizational support[ 13 – 17 ]. Moreover a study Jennifer Altman et al demonstrated a positive correlation between perceived support and wellness program participation, motivation and ability to participate using the workplace support for Health (WSH)[ 18 ] Employee Engagement This study identifies that employees were very much interested in preventive health checks which got reflected by high participation as shown by high satisfaction score. And also each additional year of participants experience increase the odds of participation in the screening program by 1.127 times. Very few studies found experience as a factor but literatures suggest that prolonged experience often correlates with greater awareness of workplace resources and trust in leadership, facilitation program engagement[ 19 , 20 ]. Screening uptake and Impact Participation was high with 92% of the employees taking part, which shows accessibility and acceptability of the screening program. This study has brought out the notable impact of workplace NCD screening by highlighting 43.8% of diabetes cases and 45.5% of Hypertension cases were first identified at workplace screening, highlighting their potential in early detection. This finding is aligned with the study done by Seaverson ELD et al. using a longitudinal study’s showed that higher levels of program participation are associated with significant reductions in health risk factors[ 21 ]. In line with this another study find association between participation in wellness programs to health risk reductions such as blood pressure and stress[ 22 ]. Life style and behaviour change Apart from the identification of new NCD cases, these screening programs also promoted health awareness. This becomes evident as many participants report feeling encouraged to focus on their health, and many have observed increased health awareness among friends and family after the program. Behavioral change is an important component of NCD management and consistent with the findings from a systematic review showing three out of four screening trials small improvements in health behavior were observed[ 23 ]. Similarly in our study 22.7% of participants reported lifestyle modifications following workplace screening, which shows the potential of such programs to drive behavioral changes. Among those identified with diabetes or hypertension during workplace screenings, 84.4% and 72.7%, respectively, adopted healthier lifestyles. And most of the participants believe that the screening has positively impacted their health. Program satisfaction and Organisational commitments Employee satisfaction was the most important strength of the workplace NCD screening programs, with 72.5% of participants reporting overall satisfaction. They also expressed positive attitudes i.e. 67.4% perceived a positive health impact, and 76.4% mentioned they would recommend the program for others and 83.8% reported increased awareness among their family and friends. This result is consistent with the study that shows effective communication, leadership endorsement, and accessibility are crucial facilitators of program engagements[ 24 , 25 ]. A study by also emphasise the communication, convenience and leadership engagement as key for a successful workplace wellness program implementation[ 13 ]. Policy Implications and Future Directions The results of this study highlight the importance of integrating workplace NCD screening programs into broader public health policies. This can be achieved through some actionable strategies Enhanced organisational support in terms of policy and actions that can boost participation and perceived value of such health programs. The industry can shift their focus more on new and contractual employees potentially through regular interaction and workplace culture familiarization By facilitating early identification of NCDs through convenient, accessible screening programs. Also enhancing program satisfaction and effectiveness by strategic communication, leadership advocacy and reducing logistic barriers. This study presents some limitations such as cross-sectional design limits causal relationship with outcomes. The sample was restricted to industries that provided permission, which may affect the generalizability of the study. Data on behaviour, satisfaction were all self-reported and subjected to recall and social desirability bias. Follow-up study is needed to find the sustainable health benefits and cost effectiveness. Conclusion High participation rate, substantial initial case detection and strong employee satisfaction demonstrates that work place NCD screening program in Tamil Nadu’s organised sector are both feasible and effective in the short term. Nearly one fourth of the respondents reported life style modifications, and those identified were also diagnosed and adopted healthier behaviours. Perceived organisational support and more experience significantly associated with the participation ratio, highlights the importance of employer engagement. The findings of this study are consistent with existing literary evidence, as structured workplace interventions can play a key role in managing the burden of NCDs. And also it supports the integration of workplace NCD screening into state and organisational health policies with targeted strategies to enhance education, convenience and leadership support. Further research should assess the long term health outcomes, impact, cost effectiveness and scalability to inform sustainability that can improve employee wellbeing and organisational productivity. Abbreviations DPH – Directorate of Public Health MNC – Multinational Corporation NCD – Non-Communicable Diseases SPSS – Statistical Package for Social Sciences Declarations Ethics approval and consent to participate Ethical approval for the study was obtained from the SRM-IST (IEC) Institutional Ethics Committee (Reference Number: 0059/IEC/2024) and Tamil Nadu DPH Scientific Advisory Committee. Written informed consent was obtained from all participants before data collection. Confidentiality and anonymity of participant data were strictly maintained throughout the study, adhering to ethical research principles. Consent for publication Not Applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. But restrictions apply to the availability of these data, which were used under licence for the current study and so are not publicly available. The data are, however, available upon request and with the permission of Directorate Public Health (DPH), Tamil Nadu, India. Competing interests The authors declare that they have no competing interests Funding Operational Research Program—Tamil Nadu Health System Reform Program (TNHSRP) Coordinated by Indian Institute of Technology Madras (IITM), Chennai. The authors gratefully acknowledge the financial support by School of Public Health, Faculty of Medicine and Health Sciences, SRMIST, Kattankulathur for bearing the defrayed costs of publishing this article Authors' contributions D.K. G.V., and P.M., conceptualised and designed the study. 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Tables Table 1: Demographic characteristics of the participants (n=296) Variables n (%) Age in Years (Mean ± SD) Age groups 19-28 29-38 39-48 49 & above (36.17 ± 10.06) 76 (25.7) 118 (39.9) 62 (20.9) 40 (13.5) Gender Male Female 143 (48.3) 153 (51.7) State Tamil Nadu Others 282 (95.3) 14 (4.7) Education qualification Illiterate Primary /Secondary Higher Secondary / Diploma Undergraduate and above 17 (5.7) 122 (41.2) 99 (33.4) 58 (19.6) Employment status Full-time Part-time 238 (80.4) 58 (19.6) Designation Admin Non-admin 37 (12.5) 259 (87.5) Total years of Experience 1-3 years 4-7 years 8-15 years Above 15 years 75 (25.3) 85 (28.7) 74 (25.0) 62 (20.9) Shift timings General shift Rotational shift 164 (55.4) 132 (44.6) Working overtime 66 (22.3) Marital status Married Unmarried 223 (75.3) 73 (24.7) Involved in Vigorous physical activity 54 (18.2) TABLE: 3 Satisfaction in workplace screening n (%) Convenience of scheduling More convenient Normal (Not difficult nor convenient) More difficult 130 (47.6) 129 (47.3) 14 (5.2) Convenience of location More convenient Normal (Not difficult nor convenient) More difficult 129 (47.3) 131 (48.0) 13 (4.8) Convenience of waiting time More convenient Normal (Not difficult nor convenient) More difficult 127 (46.5) 136 (49.8) 10 (3.7) Respondents who were interested in future NCD screening (n=296) 244 (82.4) Respondents who had concerns in currently conducted NCD screening (n=296) 55 (18.6) Respondents who believed NCD screening positively impacted overall health (n=273) 184 (67.4) Respondents who would recommend worksite NCD screening to colleagues (n=296) 226 (76.4) Respondents who believe Workplace screening encouraged action towards health (n=273) 207 (75.8) Respondents who believe NCD screening raised awareness among friends and family (n=296) 248 (83.8) Organization support on employees’ overall health (n=296) Very much Average Not at all 145 (49.0) 138 (47.0) 12 (4.1) Table 4: Factors influencing participation in workplace screening Variable Category AOR 95% CI p-value Age <30 Reference – – ≥30 0.46 0.06–3.41 0.455 Gender Female Reference – – Male 3.21 0.86–11.98 0.082 Educational qualification Illiterate Reference – – Primary/Secondary 0.38 0.02–5.80 0.493 Higher Secondary/Diploma 0.61 0.04–8.73 0.718 Undergraduate and above 1.92 0.08–42.60 0.678 Current designation Non-administrative Reference – – Administrative 1.28 0.21–7.81 0.789 Total years of experience (Continuous) 1.12 1.00–1.26 0.044* Shift timings Rotational Reference – – General 0.96 0.28–3.31 0.959 Vigorous-intense activity Yes Reference – – No 0.3 0.04–2.11 0.229 Health insurance No Reference – – Yes 0.68 0.13–3.39 0.641 Marital status Unmarried Reference – – Married 3.55 0.52–24.23 0.195 Family history of diabetes No Reference – – Yes 2.76 0.60–12.65 0.19 Family history of hypertension No Reference – – Yes 0.53 0.12–2.26 0.391 Awareness provided by company No Reference – – Yes 1.57 0.30–8.18 0.589 Mandatory screening No Reference – – Yes 3.72 0.80–17.20 0.093 Organizational support Not at all Reference – – Average 8.95 0.53–151.39 0.129 Very much 16.9 1.02–279.69 0.048* (* Note: All odds ratios are adjusted for age, gender, educational qualification, work designation, work experience, shift timing, physical activity, health insurance, marital status, family history of diabetes and hypertension, awareness provided by company, mandatory screening, and organizational support) Additional Declarations No competing interests reported. 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1","display":"","copyAsset":false,"role":"figure","size":69943,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistricts selected for the study\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8342107/v1/020454d40d2a2be723998e68.png"},{"id":98436128,"identity":"3f276a64-ca84-41ce-ae2b-0ce5566c1238","added_by":"auto","created_at":"2025-12-17 16:54:58","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":23898,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSatisfaction levels of participants\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8342107/v1/e6aed6e2a1c61df052b4588c.png"},{"id":98797629,"identity":"0d2f87db-6afe-49b9-af47-07d4153f35ca","added_by":"auto","created_at":"2025-12-22 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India is witnessing a notable epidemiological transition with a striking increase in the non-communicable disease prevalence[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In Tamil Nadu, NCDs are the cause of 75% of all deaths in 2019, with hypertension alone contributing to 22% of mortality. Tamil Nadu STEPS survey provided an alarming prevalence where one-third of adults have hypertension, nearly one in six with diabetes and more than half of them are obese or over weight and at last more than one- fourth of adults have three or more NCD risk factors[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Early detection and prompt intervention are the essential components of NCD prevention. Early disease detection and risk factor identification are made possible by screening programs for diseases like diabetes, breast cancer, and cervical cancer[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eRecent systematic review evidence shows that multicomponent workplace interventions are consistently effective in reducing NCD risk factors. Over the past few decades, the workplace has been recognized as a critical location for health promotion due to its ability to effectively reach large groups[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] Workplaces can be used to increase screening engagement and promote positive changes in individual behaviors, as well as in overall public health[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. By offering positive social norms, providing a convenient screening environment, reducing structural barriers, and promoting health education, workplaces can influence screening behavior and facilitate easier and regular access to health care for people across different socio-demographic and economic backgrounds. [\u003cspan additionalcitationids=\"CR9\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTamil Nadu, one of India\u0026rsquo;s most industrialized states, hosts a diverse range of industries in the manufacturing, Information Technology, and service sectors. The workforce is vital to the state's economy. Still, it faces increasing NCD risks from lifestyle-related health challenges such as sedentary work environments, irregular work hours, poor nutritional habits, and insufficient physical activity. In response to these challenges, initiatives such as \u003cem\u003e\u0026ldquo;Thozhilalar Thedi Maruthuvam\u0026rdquo;\u003c/em\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], a workplace-focused health screening program in Tamil Nadu, aim to overcome structural barriers, provide convenient on site health checks and promote positive health behaviors among workers. Programs that are implemented at work enhance workers' well-being and boost their output.\u003c/p\u003e \u003cp\u003eApart from the advantages, the effectiveness of these health programs at the workplace still depends heavily on participation rates[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] There is evidence that a variety of factors, including organizational, interpersonal, and intrapersonal determinants, have an impact on participation[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Another crucial element of a successful health program is employee satisfaction. Both immediate participation and long-term behavioral changes are influenced by it, which reflects the programs' perceived worth, practicality, and relevance[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Prior studies in India and some other places have identified some barriers, such as inconvenient scheduling, lack of incentives and health beliefs, and the facilitators, such as employer support and health education, that affect participation in workplace wellness programs. But, quantitative evidence on participation patterns, satisfaction levels, and short-term health outcomes in Tamil Nadu\u0026rsquo;s industrial workplace remains limited. This study used a Quantitative outcome evaluation approach to assess three key performance indicators of workplace NCD screening programs in Tamil Nadu\u0026rsquo;s organized sector. The main objective of this study is to assess the employee satisfaction, participation rates, and factors influencing participation in workplace NCD screening programs. The secondary objective is to assess the short-term outcomes, such as early detection rates, and the proportion of those who made some behavior changes. By doing this, the study aims to generate actionable evidence for optimizing workplace NCD screening Initiatives. The findings will inform the policymakers and employers on effective strategies to enhance program uptake that improve worker well-being while boosting organizational efficiency and the field of public health more broadly.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was used to assess the short-term outcomes, employee satisfaction, and participation in workplace NCD screening programs.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy settings and Participant selection\u003c/h3\u003e\n\u003cp\u003eThe study was conducted across 29 different industries in which the workplace NCD screening programs were implemented. A stratified random sampling methodology was adopted at the district level. 10 districts representing the state's geographical zones (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) were initially selected, and three industries per district were randomly chosen from the sampling frame provided by the NCD cell of the Directorate of Public Health (DPH). Within each consenting industry, 10 employees were selected completely at random using the employee list as the sampling frame, resulting in a total sample of 296 participants. This two-stage sampling strategy, random selection of industries followed by random selection of employees, ensures internal validity and enhances representativeness across districts and industry types despite the constraints.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eEligibility criteria\u003c/h3\u003e\n\u003cp\u003eTo be included in this study, the participants had to be above 18 years of age, working in any of the selected industries, and willing to participate. Respondents who joined the current industry in the last six months with no previous experience in any other industry were excluded from the study, as they would not be on the beneficiary list of the NCD screening program.\u003c/p\u003e\n\u003ch3\u003eStudy Tool\u003c/h3\u003e\n\u003cp\u003eA semi-structured questionnaire was developed to assess the participation rates, satisfaction, and short-term outcomes of workplace NCD screening programs among employees. This self-reporting, tool consisted 54 items, including demographic characteristics, occupational details, health insurance coverage, family history of NCDs, previous diagnosis of diabetes or hypertension, participation in workplace screening activities, perceptions regarding screening, organizational support, and availability of health-promoting facilities in the industry. A pilot validation process was conducted prior to full-scale data collection. The draft questionnaire was reviewed for face and content validity by a panel of experts from health and social sciences. Interviews with ten employees across one pilot industry were conducted to evaluate item clarity and response interpretation that led to simplification of ambiguous questions and refinement of response options. The revised tool was then tested with 20 more employees from other industries using the KoBo Toolbox app to assess the sequence, logic functionality, and app usability. Minor adjustments to the question were made based on the pilot, and a final expert review confirmed the tools for the main study data collection\u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eData was collected by scheduled interview face to face, using the semi-structured questionnaire in the Kobo toolbox mobile application. Prior to data collection, investigators underwent training on interview techniques, ethical considerations, informed consent procedures, and use of the KoBo digital platform. The training also included instruction on handling sensitive questions, maintaining privacy during interviews, and ensuring standardization of data collection across sites.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe operational definitions used for the key outcome variables were as follows. The outcomes, participation in workplace NCD screening, was defined as self-reported attendance at any hypertension or diabetes screening conducted in the current workplace along with a team from DPH. A participant was classified as having participated if they responded \u0026ldquo;yes\u0026rdquo; to screening for either diabetes or hypertension. Employee satisfaction with the screening program was measured using questions related to convenience of scheduling, location, waiting time, perceived usefulness, and overall experience. These items were scored using a Likert-type scale, and the total satisfaction score was categorized into high (\u0026gt;\u0026thinsp;80%), moderate (60%-80%), or low levels (\u0026lt;\u0026thinsp;60%).\u003c/p\u003e \u003cp\u003eData was cleaned and analyzed using Statistical Package for Social Sciences (SPSS) Version 28. Descriptive statistics, such as means and standard deviations, were used to summarize continuous variables, while frequencies and percentages were used for categorical variables. To account for the clustered sampling of employees within industries, we initially fitted a mixed-effects logistic regression with a random intercept for industry. The intraclass correlation coefficient (ICC) was estimated to quantify the degree of within-industry correlation. Binary logistic regression was used in determining the factors influencing employees\u0026rsquo; participation in the workplace NCD screening programs.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eCharacteristics of the participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThirty-eight industries were approached for participation, and consent was received from 29 industries. From each approved industry, twelve employees were randomly invited for interviews. Close to 360 employees were invited using a random sampling process. A total of 296 employees participated in the study, with a 17.7% non-response rate. Of the 296 participants, 51.7% were female. The mean age group of the participants was 36.17 (SD=10.06) years.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMost participants (94.9%) were residents of Tamil Nadu. In terms of educational attainment, 41.2% had completed primary or secondary education, 33.4% had completed higher secondary or diploma, while 5.7% were illiterate. The majority of participants (80.4%) were employed full-time, with 87.5% working in non-administrative positions. More than half (55.4%) of the participants worked general shifts, and 22.3% reported working overtime. Around 26% had 1 to 3 years of experience, and 21% had more than 11 years of work experience. Most participants were married (75.3%). Additionally, 18.2% participants reported engaging in vigorous physical activity such as carrying or lifting heavy loads, digging, or construction work that causes large increases in breathing or heart rate. (Table 1)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOrganization characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOut of the 29 industries, 60% were multinational corporations (MNCs), 10% were government-run, and the remaining were private enterprises. Among them, 7 were in the automobile sector, and 4 belonged to the food industry. 5 reported that they offer diabetes-friendly food in their canteen. Similarly, 6 provide diabetes-friendly snacks. Regarding hypertension-friendly options, four industries provide hypertension-friendly food and snacks. Only 2 industries reported having a gym. Walking tracks are available in 6 industries. Wellness programs, including yoga / Zumba classes, were conducted in four industries. Mandatory health screenings are implemented in 23 industries. The frequency of screenings varied, annually in 9 industries, every six months in 11 industries, and every 3 months in 7 industries. Close to two-thirds of the industries (65.5%) provide education on health screenings to their employees.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipant health status and practices\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 296 participants, 75% had health insurance. Of those insured, the majority (91%) were covered by company-based health insurance. 42.2% of participants reported a family history of diabetes and 32.1% reported a family history of hypertension. 10.8% (n=32) of participants had been diagnosed with diabetes. Among those diagnosed with diabetes, about 82% (n=26) were under medication and 94% monitored their condition periodically. 22 participants (7.4%) had been diagnosed with hypertension previously, of them 12 were under medication and 13 reported periodic monitoring. Among the participants 18.8% of those with diabetes and 22.7% of those with hypertension reported workplace as their regular place of receiving treatment.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eShort-term outcomes of workplace NCD Screening\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e92.2% of the respondents had participated in a hypertension or diabetic screening program in the current workplace. Of those who participated 22.7% reported that they had made some lifestyle changes after NCD screening. Notably 43.8% of those with diabetes and 45.5% of those with hypertension were initially identified through this workplace screening program. (Table 2)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable: 2 Short term outcomes of workplace NCD screening\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"586\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOutcomes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003eParticipated in screening (n=296)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e273 (92.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003eMade Lifestyle changes after NCD screening (n=273)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e62 (22.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003eMade life style changes after diabetes diagnosed in workplace (n=14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e13 (92.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003eMade Life style changes after hypertension diagnosed in workplace (n=10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e7 (70)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of initial identification of Diabetes (n=32)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eWorkplace screening\u003c/p\u003e\n \u003cp\u003eHospital\u003c/p\u003e\n \u003cp\u003eCommunity screening camps\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14 (43.8)\u003c/p\u003e\n \u003cp\u003e16 (50.0)\u003c/p\u003e\n \u003cp\u003e2 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 482px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of identification of Hypertension (n=22)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eWorkplace screening\u003c/p\u003e\n \u003cp\u003eHospital\u003c/p\u003e\n \u003cp\u003eCommunity screening camps\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10 (45.5)\u003c/p\u003e\n \u003cp\u003e11 (50.0)\u003c/p\u003e\n \u003cp\u003e1 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction in workplace screening\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe satisfaction of employees with workplace NCD screening is provided in (Table 3). Regarding scheduling 47.6% of the respondents found it more convenient, equally (47.3%) found it to be neutral (Not Difficult nor convenient) while remaining 5.2% find it more difficult. Waiting time was considered convenient by 46.5% of the participants. A majority (82.4%) of the participants expressed interest in participating in future NCD screening\u0026nbsp;programs. 67.4% believe that the NCD screening has positively impacted their overall health. Also, 76.4% indicated that they would recommend the screening program to colleagues. About around 76% felt that workplace NCD screening encouraged them to focus more on their health. Notably 83.8%, reported that the program increased health awareness among friends and family members. When asked about the support of organization in the overall health of employees 49% responded \u0026lsquo;Very much\u0026rsquo;, 47% said it was \u0026lsquo;Average\u0026rsquo; and 4.1% said \u0026lsquo;Not at all\u0026rsquo;.\u003c/p\u003e\n\u003cp\u003eThe satisfaction level was assessed among the 273 respondents who had previously participated in workplace screening. Overall, 46.2% of the participants (n =126) were highly satisfied with the screening programs, that is, by having a satisfaction score greater than 80%. On the other hand, one third of participants (n = 91) were dissatisfied and had a satisfaction score below 60%. (Figure 2) These results indicate that the majority of the participants had a positive experience regarding the screening programs, though a considerable proportion showed dissatisfaction, hence indicating areas where improvement may be needed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors influencing participation in workplace screening\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA mixed-effects logistic regression with a random intercept for industry was initially fitted to account for the clustered sampling of employees within industries. The estimated variance of the industry-level random intercept was effectively zero (\u0026sigma;\u0026sup2; \u0026asymp; 2.08 \u0026times; 10⁻\u0026sup1;⁸), yielding an intraclass correlation coefficient (ICC) \u0026asymp; 0. This indicates that participation did not cluster by industry, and employees within the same industry were no more similar than those across different industries. Therefore, a standard logistic regression model without cluster adjustment is appropriate. Table 4 presents the factors influencing participation in workplace screening programs, as identified through Binary logistic regression. Variables included were age, gender, education qualification, current designation, years of experience, shift timings, participation in vigorous intensity activities, health insurance, marital status, family history of diabetes and hypertension, education on screening provided by the company, and whether the screening was mandatory. Among these, only years of experience and perceived organizational support to the employees emerged as significant predictors for participation. Specifically year of experience is associated the odds of participating in workplace screening change by 1.127 (p value=0.044). Employees who perceived the companies as very supportive of their health and wellness the odds of taking part in workplace screening programs were 16.9 times (p value = 0.048) higher than those who work for companies that are not as supportive.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study explored organizational characteristics and employee factors influencing participation in NCD screening program across 29 industries and approximately 300 employees. Findings reveal that perceived organizational support and years of experience of an employee significantly predict screening participation, indicating the crucial role of the workplace in health behavior promotion.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eOrganizational support and Participation\u003c/strong\u003e \u003cp\u003eOur study findings shows that the Odds of participate in screening programs at workplace were approximately 17 times higher compared to employees perceiving poor organizational support. This is strongly supported by a study by lier et al which found that organizational support especially by leadership associated with the enrollment rates in workplace health promotion programs[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Similarly, a study by Grossmeier J et al identified organizational leadership support as the strongest predictor of both participation in any wellness activities and perceived organizational support[\u003cspan additionalcitationids=\"CR14 CR15 CR16\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003c/p\u003e \u003cp\u003eMoreover a study Jennifer Altman et al demonstrated a positive correlation between perceived support and wellness program participation, motivation and ability to participate using the workplace support for Health (WSH)[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEmployee Engagement\u003c/strong\u003e \u003cp\u003eThis study identifies that employees were very much interested in preventive health checks which got reflected by high participation as shown by high satisfaction score. And also each additional year of participants experience increase the odds of participation in the screening program by 1.127 times. Very few studies found experience as a factor but literatures suggest that prolonged experience often correlates with greater awareness of workplace resources and trust in leadership, facilitation program engagement[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eScreening uptake and Impact\u003c/strong\u003e \u003cp\u003eParticipation was high with 92% of the employees taking part, which shows accessibility and acceptability of the screening program. This study has brought out the notable impact of workplace NCD screening by highlighting 43.8% of diabetes cases and 45.5% of Hypertension cases were first identified at workplace screening, highlighting their potential in early detection. This finding is aligned with the study done by Seaverson ELD et al. using a longitudinal study\u0026rsquo;s showed that higher levels of program participation are associated with significant reductions in health risk factors[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. In line with this another study find association between participation in wellness programs to health risk reductions such as blood pressure and stress[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eLife style and behaviour change\u003c/strong\u003e \u003cp\u003eApart from the identification of new NCD cases, these screening programs also promoted health awareness. This becomes evident as many participants report feeling encouraged to focus on their health, and many have observed increased health awareness among friends and family after the program. Behavioral change is an important component of NCD management and consistent with the findings from a systematic review showing three out of four screening trials small improvements in health behavior were observed[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Similarly in our study 22.7% of participants reported lifestyle modifications following workplace screening, which shows the potential of such programs to drive behavioral changes. Among those identified with diabetes or hypertension during workplace screenings, 84.4% and 72.7%, respectively, adopted healthier lifestyles. And most of the participants believe that the screening has positively impacted their health.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eProgram satisfaction and Organisational commitments\u003c/strong\u003e \u003cp\u003eEmployee satisfaction was the most important strength of the workplace NCD screening programs, with 72.5% of participants reporting overall satisfaction. They also expressed positive attitudes i.e. 67.4% perceived a positive health impact, and 76.4% mentioned they would recommend the program for others and 83.8% reported increased awareness among their family and friends. This result is consistent with the study that shows effective communication, leadership endorsement, and accessibility are crucial facilitators of program engagements[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. A study by also emphasise the communication, convenience and leadership engagement as key for a successful workplace wellness program implementation[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e \u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003ePolicy Implications and Future Directions\u003c/h2\u003e \u003cp\u003eThe results of this study highlight the importance of integrating workplace NCD screening programs into broader public health policies. This can be achieved through some actionable strategies\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eEnhanced organisational support in terms of policy and actions that can boost participation and perceived value of such health programs.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe industry can shift their focus more on new and contractual employees potentially through regular interaction and workplace culture familiarization\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eBy facilitating early identification of NCDs through convenient, accessible screening programs.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eAlso enhancing program satisfaction and effectiveness by strategic communication, leadership advocacy and reducing logistic barriers.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eThis study presents some limitations such as cross-sectional design limits causal relationship with outcomes. The sample was restricted to industries that provided permission, which may affect the generalizability of the study. Data on behaviour, satisfaction were all self-reported and subjected to recall and social desirability bias. Follow-up study is needed to find the sustainable health benefits and cost effectiveness.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eHigh participation rate, substantial initial case detection and strong employee satisfaction demonstrates that work place NCD screening program in Tamil Nadu\u0026rsquo;s organised sector are both feasible and effective in the short term. Nearly one fourth of the respondents reported life style modifications, and those identified were also diagnosed and adopted healthier behaviours. Perceived organisational support and more experience significantly associated with the participation ratio, highlights the importance of employer engagement.\u003c/p\u003e \u003cp\u003eThe findings of this study are consistent with existing literary evidence, as structured workplace interventions can play a key role in managing the burden of NCDs. And also it supports the integration of workplace NCD screening into state and organisational health policies with targeted strategies to enhance education, convenience and leadership support. Further research should assess the long term health outcomes, impact, cost effectiveness and scalability to inform sustainability that can improve employee wellbeing and organisational productivity.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eDPH \u0026ndash; Directorate of Public Health\u003c/p\u003e\n\u003cp\u003eMNC \u0026ndash; Multinational Corporation\u003c/p\u003e\n\u003cp\u003eNCD \u0026ndash; Non-Communicable Diseases\u003c/p\u003e\n\u003cp\u003eSPSS \u0026ndash; Statistical Package for Social Sciences\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for the study was obtained from the SRM-IST (IEC) Institutional Ethics Committee (Reference Number: 0059/IEC/2024) and Tamil Nadu DPH Scientific Advisory Committee. Written informed consent was obtained from all participants before data collection. Confidentiality and anonymity of participant data were strictly maintained throughout the study, adhering to ethical research principles.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. But restrictions apply to the availability of these data, which were used under licence for the current study and so are not publicly available. The data are, however, available upon request and with the permission of Directorate Public Health (DPH), Tamil Nadu, India.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOperational Research Program—Tamil Nadu Health System Reform Program (TNHSRP) Coordinated by Indian Institute of Technology Madras (IITM), Chennai.\u003c/p\u003e\n\u003cp\u003eThe authors gratefully acknowledge the financial support by School of Public Health, Faculty of Medicine and Health Sciences, SRMIST, Kattankulathur for bearing the defrayed costs of publishing this article\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eD.K. G.V., and P.M., conceptualised and designed the study. S.K., B.M., and K.C. collected and analysed the data. P.M. B.M. S.K., K.C., wrote the drafted the manuscript text along with tables and figures. All 6 authors reviewed and revised and finalised the manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank S Uma, I.A.S., Former Project Director, Thiru. M Govinda Rao, I.A.S., Project Director, Operational Research Program, Tamil Nadu Health System Reform Program (TNHSRP), Ministry of Health and Family Welfare, Government of Tamil Nadu for funding this study; Shobha, Expert Advisor, RCH, TNHSRP, and V R Muraleedharan, Department of Humanities and Social Sciences, Indian Institute of Technology Madras, Chennai, for organizing regular project review meetings, providing input, and administrative support.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNoncommunicable diseases n.d. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (accessed September 10, 2025).\u003c/li\u003e\n\u003cli\u003eUnderstanding epidemiological transition in India - PubMed n.d. https://pubmed.ncbi.nlm.nih.gov/24848651/ (accessed September 10, 2025).\u003c/li\u003e\n\u003cli\u003ePrevalence of Noncommunicable Disease (NCDs) risk factors in Tamil Nadu: Tamil Nadu STEPS Survey (TN STEPS), 2020 - PMC n.d. https://pmc.ncbi.nlm.nih.gov/articles/PMC11078398/ (accessed December 11, 2025).\u003c/li\u003e\n\u003cli\u003eEinarson TR, Bereza BG, Acs A, Jensen R. 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Am J Health Promot 2019;33:1002\u0026ndash;8. https://doi.org/10.1177/0890117119838800.\u003c/li\u003e\n\u003cli\u003eWhite JC, Hartley S, Ozminkowski RJ. Association Between Corporate Wellness Program Participation and Changes in Health Risks. J Occup Environ Med 2015;57:1119\u0026ndash;26. https://doi.org/10.1097/JOM.0000000000000531.\u003c/li\u003e\n\u003cli\u003eDeutekom M, Vansenne F, McCaffery K, Essink-Bot M-L, Stronks K, Bossuyt PMM. The effects of screening on health behaviour: a summary of the results of randomized controlled trials. J Public Health (Oxf) 2011;33:71\u0026ndash;9. https://doi.org/10.1093/pubmed/fdq050.\u003c/li\u003e\n\u003cli\u003eMattke S, Liu H, Caloyeras J, Huang CY, Van Busum KR, Khodyakov D, et al. Workplace Wellness Programs Study. Rand Health Q 2013;3:7.\u003c/li\u003e\n\u003cli\u003eGrossmeier J, Castle PH, Pitts JS, Saringer C, Jenkins KR, Imboden MT, et al. Workplace Well-Being Factors That Predict Employee Participation, Health and Medical Cost Impact, and Perceived Support. Am J Health Promot 2020;34:349\u0026ndash;58. https://doi.org/10.1177/0890117119898613.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1: Demographic characteristics of the participants (n=296)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"557\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge in Years (Mean \u0026plusmn; SD)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eAge groups\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e19-28\u003c/p\u003e\n \u003cp\u003e29-38\u003c/p\u003e\n \u003cp\u003e39-48\u003c/p\u003e\n \u003cp\u003e49 \u0026amp; above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e(36.17 \u0026plusmn; 10.06)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e76 (25.7)\u003c/p\u003e\n \u003cp\u003e118 (39.9)\u003c/p\u003e\n \u003cp\u003e62 (20.9)\u003c/p\u003e\n \u003cp\u003e40 (13.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e143 (48.3)\u003c/p\u003e\n \u003cp\u003e153 (51.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eState\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eTamil Nadu\u003c/p\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e282 (95.3)\u003c/p\u003e\n \u003cp\u003e14 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation qualification\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003cp\u003ePrimary /Secondary\u003c/p\u003e\n \u003cp\u003eHigher Secondary / Diploma\u003c/p\u003e\n \u003cp\u003eUndergraduate and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e17 (5.7)\u003c/p\u003e\n \u003cp\u003e122 (41.2)\u003c/p\u003e\n \u003cp\u003e99 (33.4)\u003c/p\u003e\n \u003cp\u003e58 (19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEmployment status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eFull-time\u003c/p\u003e\n \u003cp\u003ePart-time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e238 (80.4)\u003c/p\u003e\n \u003cp\u003e58 (19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDesignation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAdmin\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNon-admin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e37 (12.5)\u003c/p\u003e\n \u003cp\u003e259 (87.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal years of Experience\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1-3 years\u003c/p\u003e\n \u003cp\u003e4-7 years\u003c/p\u003e\n \u003cp\u003e8-15 years\u003c/p\u003e\n \u003cp\u003eAbove 15 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e75 (25.3)\u003c/p\u003e\n \u003cp\u003e85 (28.7)\u003c/p\u003e\n \u003cp\u003e74 (25.0)\u003c/p\u003e\n \u003cp\u003e62 (20.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShift timings\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eGeneral shift\u003c/p\u003e\n \u003cp\u003eRotational shift\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e164 (55.4)\u003c/p\u003e\n \u003cp\u003e132 (44.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWorking overtime\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e66 (22.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e223 (75.3)\u003c/p\u003e\n \u003cp\u003e73 (24.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eInvolved in Vigorous physical activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 180px;\"\u003e\n \u003cp\u003e54 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTABLE: 3 Satisfaction in workplace screening\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"567\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConvenience of scheduling\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMore convenient\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNormal (Not difficult nor convenient)\u003c/p\u003e\n \u003cp\u003eMore difficult\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e130 (47.6)\u003c/p\u003e\n \u003cp\u003e129 (47.3)\u003c/p\u003e\n \u003cp\u003e14 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConvenience of location\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMore convenient\u003c/p\u003e\n \u003cp\u003eNormal (Not difficult nor convenient)\u003c/p\u003e\n \u003cp\u003eMore difficult\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e129 (47.3)\u003c/p\u003e\n \u003cp\u003e131 (48.0)\u003c/p\u003e\n \u003cp\u003e13 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConvenience of waiting time\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMore convenient\u003c/p\u003e\n \u003cp\u003eNormal (Not difficult nor convenient)\u003c/p\u003e\n \u003cp\u003eMore difficult\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e127 (46.5)\u003c/p\u003e\n \u003cp\u003e136 (49.8)\u003c/p\u003e\n \u003cp\u003e10 (3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003eRespondents who were interested in future NCD screening (n=296)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e244 (82.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003eRespondents who had concerns in currently conducted NCD screening (n=296)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e55 (18.6)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003eRespondents who believed NCD screening positively impacted overall health (n=273)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e184 (67.4)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003eRespondents who would recommend worksite NCD screening to colleagues (n=296)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e226 (76.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003eRespondents who believe Workplace screening encouraged action towards health (n=273)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e207 (75.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003eRespondents who believe NCD screening raised awareness among friends and family (n=296)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e248 (83.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 415px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrganization support on employees\u0026rsquo; overall health (n=296)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eVery much\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAverage\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNot at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e145 (49.0)\u003c/p\u003e\n \u003cp\u003e138 (47.0)\u003c/p\u003e\n \u003cp\u003e12 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4: Factors influencing participation in workplace screening\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"582\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u0026lt;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e\u0026ge;30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.06\u0026ndash;3.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.455\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e3.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.86\u0026ndash;11.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.082\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational qualification\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eIlliterate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003ePrimary/Secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.02\u0026ndash;5.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.493\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eHigher Secondary/Diploma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.04\u0026ndash;8.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.718\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eUndergraduate and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e1.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.08\u0026ndash;42.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.678\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCurrent designation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNon-administrative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eAdministrative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.21\u0026ndash;7.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.789\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal years of experience\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003e(Continuous)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e1.00\u0026ndash;1.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.044*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eShift timings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eRotational\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eGeneral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.28\u0026ndash;3.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.959\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVigorous-intense activity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.04\u0026ndash;2.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.229\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHealth insurance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.13\u0026ndash;3.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.641\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eUnmarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e3.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.52\u0026ndash;24.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of diabetes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e2.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.60\u0026ndash;12.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of hypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.12\u0026ndash;2.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.391\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAwareness provided by company\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.30\u0026ndash;8.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.589\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMandatory screening\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e3.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.80\u0026ndash;17.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrganizational support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eNot at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003eReference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u0026ndash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eAverage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e8.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e0.53\u0026ndash;151.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e0.129\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 166px;\"\u003e\n \u003cp\u003eVery much\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\"\u003e\n \u003cp\u003e16.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e1.02\u0026ndash;279.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 68px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.048*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e(* Note: All odds ratios are adjusted for age, gender, educational qualification, work designation, work experience, shift timing, physical activity, health insurance, marital status, family history of diabetes and hypertension, awareness provided by company, mandatory screening, and organizational support)\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Non-communicable disease, workplace, screening, early detection, organised sector","lastPublishedDoi":"10.21203/rs.3.rs-8342107/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8342107/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eNon-communicable diseases account for 74% of annual deaths worldwide. Early detection of these conditions is necessary for timely intervention, and prevention. The workplace serves as a suitable environment for screening by reaching large groups of population under risk. However, the effectiveness of its use for the implementation of screening programs depends on employee participant, satisfaction, and health outcomes. Therefore, this study aims to assess the employee satisfaction, participation rates, and factors influencing participation in workplace NCD screening programs along with the short-term outcomes, such as early detection rates.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was conducted across 29 industries from April 2024 to March 2025 in which the workplace NCD screening programs were implemented by the government health department. Information on participants' demographic profile, Morbidity status, overall perception of the screening program, and its impact was collected among its employees. Ethics approval was obtained from SRM IEC.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eA total of 296 employees participated in the study. 92.2% of the respondents had participated in a hypertension or diabetic screening program in the current workplace. Notably 43.8% of those with diabetes and 45.5% with hypertension were initially identified through workplace screening program, and 22.7% of them reported that they have made some lifestyle changes after NCD screening. Overall, two-third of the participants were satisfied with the screening programs. Years of experience and organisations support were the influencing factors for workplace screening programs.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eHigh participation rate, substantial initial case detection and strong employee satisfaction demonstrates that work place NCD screening program in Tamil Nadu\u0026rsquo;s organised sector are both feasible and effective even for a Long run.\u003c/p\u003e","manuscriptTitle":"Implementing Workplace NCD Screening as a Health Systems Initiative: Participation, Satisfaction and Early Health Risk Signals in Tamil Nadu","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-16 10:36:16","doi":"10.21203/rs.3.rs-8342107/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"31f31f46-7348-43e3-87f4-78b587c26ca3","owner":[],"postedDate":"December 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-02T05:53:34+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-16 10:36:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8342107","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8342107","identity":"rs-8342107","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}