The authors used a cross-sectional survey and zero-inflated ordered probit modeling to investigate individual psychosocial-, interpersonal-, organizational-, and community-level determinants distinguishing nonparticipants, low-level participants, and incentive-achieving participants in a single, university-based worksite health program (WHP) that uses insurance premium reductions to incentivize participation. Results from 319 employees suggested two nonparticipant groups. Persons without employer-sponsored insurance, those with negative participation perceptions, and men were more likely to be “never” participants; those who had never met the incentive were potential future participants. Increased confidence was related to incentive achievement; stress was associated with low participation. No interpersonal, organizational, or community factors were significant. When structuring incentives, WHPs should consider determinants of participation, vis-à-vis the incentive.

This study explores the mediation effect of gender role orientation on the influence of sex on coping strategies and how the mediation effects differ across the two cultures of the United States and China. A total of 478 respondents (243 Americans and 235 resident Chinese) participated in this study. Employing Hayes’ (2013) PROCESS for testing moderated mediation models using conditional process analysis, we found that femininity mediated the influence of sex on both emotional and instrumental coping, and the mediation effects were significantly different between American participants and Chinese participants. We also found that national culture moderated the influence of sex on coping strategies when gender role orientation was being held constant. This study adopts an integrated model of sex, gender role orientation, culture, and coping. This model allows us to examine both general and specific relationships among interested variables, which contributes to existing literature in several ways.