The first WHPs and Workers' Health Centers (Centros de Referencia em Saude do Trabalhador --CRST) that preceded the SUS focused on treatment, rather than the prevention of health problems and protection of worker safety.
At the beginning of the 1990s, new WHPs were created in various states and municipalities across the country; however, not all were consolidated, some having a short lifespan.
A comprehensive WHP program, which contains five key components; health education, links related to employee services, a supportive work environment, a culture of health promotion and employee screenings with treatment and follow-up, has been found to be more effective than programs not supported by these components (Goetzel, et al., 2014).
A national workplace health promotion survey found that only 6.9% of businesses offered comprehensive WHP programs with the majority of those being larger companies (> 750 employees) (Linnan et al., 2008).
Many factors influence the potential adoption and support of WHP programs.
Small businesses often have specific challenges when exploring the feasibility of offering WHP programs.
The geographic location of businesses can also affect the capacity of businesses to adopt and support WHP programs.
Another study identified factors associated with rural workers' participation in WHP programs.
Additional challenges in rural organizations include effective implementation and measures of success of the WHP programs.
Additional measures included quantitative measures assessing elements of comprehensive WHP, organizational support and qualitative questions related to support and barriers to implementation of WHP.
The five key elements of a comprehensive Workplace Health Promotion (WHP) program were previously mentioned in the literature review.