Posts from — March 2009

When staffing your wellness program you need to consider whether to hire a wellness employee or contract with wellness professionals from outside your corporation.

Small and medium size worksites do not usually have a wellness professional on employee. If your workplace is in this category, you will need to contract with providers outside your company.

Large corporations have several options. They can hire a employee solely for the wellness program, they can contract with outside wellness providers, or they can use a combination of internal employee and outside providers.

When selecting a provider some key questions in the areas of employee, program structure, process, and effectiveness need to be addressed. Each of these key questions is discussed in the following sections.

Staff

Health professionals become wellness professionals when they are trained in the full range of wellness activities. Wellness professionals are generalists who come from a wide variety of backgrounds and schooling. They may be nurses, dietitians, health educators, counselors, exercise physiologists, or have other backgrounds. But in addition to their primary training, they know something about all wellness subject matters, including smoking, stress, exercise, and nutrition. They also know how to engage and support people in making and sustaining health improvements and have great people skills.

Generally, wellness professionals at worksites fall into three broad categories, wellness screeners, wellness counselors, and wellness instructors.

• Wellness screeners introduce employees to the program, take health measurements, gather health-related information, offer initial counseling, and help employees define for themselves what they need and want in a wellness program.
• Wellness counselors work with staff members after the assessment to help them establish and carry out a plan to cut their risks and better their health.
• Wellness instructors instruct classes and minigroups on different health issues.

A wellness program in a small corporation can be staffed by a single employee person who fills all three roles. Larger worksites will use different employees to fill these roles.

When choosing employee or choosing among vendors, ask the following questions:

• Do prospective staff members have a range of health backgrounds that will provide appropriate expertise in the issues to be addressed?
• Have prospective staff members functioned well as wellness screeners, wellness counselors, and/or wellness instructors?
• Will this employee include employees from the racial and ethnic backgrounds found in your employee population?
• Is each employee member comfortable with the range of backgrounds found in your employee population, and able to communicate effectively with the various social and educational levels of your employees?
• Do employees have a warm, but professional, counseling style when interacting with employees?

An yearly plan for the primary wellness programs and activities is a useful management tool. This is an excellent Corporate Health Promotion Program Committee task. Often an activity and wellness theme per month is provided to staff members.

Some companies choose to follow a National Health Observances calendar which offers advantages. The materials developed by these various national health companies are very credible. The materials are usually high quality and available no cost or at a nominal cost.

The company benefits from additional publicity that occurs in various media throughout the neighborhood related to the national observance. For planning ideas you may want to utilize the HOPE Publications Wellness Resource Beginning Guide available for no cost at this Web site.

A Health Risk Appraisal (HRA) is occasionally used in conjunction with a health screening. An HRA is a computerized assessment tool which looks at an individual’s family history, health status, and lifestyle. An HRA seeks to identify precursors associated with premature death or serious illness and quantifies the probable impact for each individual.

An HRA instrument is derived from an understanding of the course of a disease. Based on this understanding, useful prediction instruments can be constructed to evaluate the health risks of an individual. Individuals with a higher number of health risks tend to have more genuine health issues over time.

Drawing attention to their health risks can help clients lower risk factors which lead to the onset of unnecessary disease and subsequent premature death. The questionnaire covers lifestyle habits (such as smoking, Safety Belt use, and exercise) and physical measures (such as cholesterol, Blood Pressure (BP) levels, height, and weight).

For accuracy, it is crucial to get direct measures of Blood Pressure (BP), blood lipids and HDL-cholesterol. The HRA also supports recommendations and indicates what risks are potentially modifiable. Types of measures to evaluate health risks are discussed under Screening Programs.

The influence of a health risk appraisal is much greater when it is given in-person, with immediate feedback to the client. This also supports an opportunity to invite the client’s participation in continuing health counseling and to gain their written consent to do pro-active outreach to them.

A health age can be computed based on the individual answers to the questionnaire and physiologic factors. The health age may indicate the individual to be younger or older than their chronological age.

HRA programs are one the most prolific types of wellness activities utilized by businesses. Continuing research on HRAs is examining the efficacy of this tool. One of the big advantages of this tool is that it can support an aggregate group report of a company and can be utilized as an assessment tool.

Detailed information is available from the Society of Prospective Medicine (www.spm.org/desc.html) who publishes a handbook on HRAs.

The most common evaluation performed in Worksite Health Promotion Programs is heart health assessment.

The evaluation can include a written heart health test, Blood Pressure (BP) measurement, cholesterol/HDL-cholesterol test, glucose (blood sugar), weight, educational materials specific to diet, nutrition, exercise, blood lipids, smoking, and weight.

The health professional delivering the assessment then supplies a consultation and helps set objectives and goals with the participant.

The backbone of wellness programming at the worksite is health evaluation. It is the first major exercise a organization ought to do when first starting a wellness program. Health evaluation is often used in conjunction with the administration of a Health Risk Appraisal (HRA).

The most effective way to screen is to utilize a health professional trained in wellness screening techniques and counseling to privately and individually evaluate participants. This wellness professional takes a brief health history and measures Blood Pressure and blood lipids. With computerized blood lipids desktop analyzers, results are obtained in about four minutes.

Immediate feedback, consultation, and educational materials are offered. For those identified at-risk, follow-up appointments can be scheduled at this time. The whole process takes about twenty minutes per individual. The screening also supports an immediate opportunity to register participants in various health improvement programs based on their interests and identified health risks.

Health screening can be done on an annual basis and used as a means of monitoring health risks within the workplace.

A health evaluation program needs to support multiple opportunities for participation. The service ought to be offered for all the various shifts of a company. The evaluation program ought to be conducted in highly visible areas so the process can be observed.

Reluctant staff members often like to be able to see what the program is about before they participate. When wellness screeners are not busy, they should perform outreach going to areas where staff members gather and attempt to recruit staff members.

When well-planned and promoted, health screening can attract participation rates of 60% to 100%. These high participation rates have a beneficial impact on management producing support for further programming.

Goals are broad-based statements about what the program is expected to do. The objective of the wellness program is to enhance the health of the individual and the corporation. Goals like mission statements provide direction in a program.

Objectives are specific and provide a means of measurement of the program to determine effectiveness. There are two types of objectives, process and outcome. Process objectives state the activities that need to occur to achieve a desired outcome.

Examples of process objectives are:
• Number of participants screened
• Number of participants in and completing health improvement programs
• Satisfaction of program participants
• Number of participants who were medically referred and saw their physician
• Number of promotional activities
• Number of participants seen in follow-up

Example of outcome objectives are:
• Number of participants who improved fitness level
• Number of participants who lowered cholesterol level
• Number of participants who lost weight, body fat
• Number of participants who quit smoking
• Number of participants with high Blood Pressure (BP) who lowered their Blood Pressure (BP)
• Number of participants whose initial level of alcohol consumption put them at-risk who are no longer at-risk
• Number of participants with risk factors who saw their physician and are being treated for high Blood Pressure (BP) or blood lipids years later

Wellness committees are valuable in that they create a sense of ownership in the program, and facilitate various tasks involved in wellness programming at the worksite. The Workplace Wellness Program Committee should be composed of a cross-section of workers representing various occupations, levels, and subgroups with the organization.

A common mistake is filling the Worksite Wellness Program Committee with the most health/fitness-conscious people in the company. Don’t rely solely on volunteers to fill a Worksite Wellness Program Committee. Make sure that your Worksite Wellness Program Committee members have sufficient power in the company to run an effective wellness program.

The Employee Health Promotion Program Committee is made up of employees from the worksite. It oversees the wellness program and helps carry it out. The Employee Health Promotion Program Committee ought to meet about once a month to review the previous month’s activities and plan future ones. When the program is just starting, the Employee Health Promotion Program Committee may meet on a weekly basis until things get going.

Committee participants do not carry out health care procedures, counsel clients, or handle confidential health information. Wellness professionals perform these tasks.

In general, the Company Health Promotion Program Committee’s duties fall into three areas: planning, promoting, and supporting to run programs.

Developing the programs can include:

• Finding space for activities
• Creating and organizing worksite-wide programs such as contests
• Reviewing reports prepared by the program employee and making recommendations

Promoting the program can include:
• Recruiting employees to take part in assessment and health improvement programs
• Encouraging workers to take part in follow-up counseling
• Organizing promotional strategies using newsletters, signs, bulletin boards, computers, and other media available within the workplace

Helping to run the program can include:
• Setting up equipment for various activities
• Helping to conduct workplace-wide activities
• Monitoring all activities and reviewing the success of the professional employee
• Acting as wellness mentors to fellow staff members

The size of the Company Health Promotion Program Committee will be dependent on the size of the business. Pick participants by asking day management to nominate or appoint employees.

Make an announcement through flyers, memos, and meetings to recruit potential members. Explain the purpose of the Company Health Promotion Program Committee, duties and responsibilities, and the time responsibility.

Recognize your Corporate Wellness Program Committee volunteers. Allow them to participate in programs at a reduced cost. Have appreciation breakfasts/lunches/dinners. Print names of Corporate Wellness Program Committee members on company communications about the wellness program.

Purchase special T-shirts, caps, and buttons for them. Write letters to supervisors saying that you appreciate the member’s service. Design awards certificates for participants.

The following can be used as a guide for Worksite Wellness Program Committee size:

• Less than 300 staff members   2 to 4
• 300 to 1,000 workers   4 to 6
• 1,000 employees or more   6 to 12

Effective wellness programs recognize the importance of building a supportive cultural environment. The workplace culture includes shared values/heartfelt beliefs about what is valuable. It includes social standards of expected and accepted behavior called “cultural norms.”

It includes peer reinforcement from family, friends, and co-employees. This reinforcement can help one adopt healthy lifestyles. Tools are available to audit a employer.

The long-term success of any wellness program is dependent on the corporate culture.

Some healthy culture signs in a organization are:

• staff members communicate openly
• Leaders support diversity and opinion
• staff members have fun
• Policies support wellness
• employees are encouraged to grow
• employees work together as a group
• staff members’ skills and talents are matched to their jobs.
• Flexible work schedules are available
• Employers consider workers as their most important asset

Effective wellness programs attempt to set up healthy worksite climates. A healthy worksite climate is one which encourages teamwork, cooperation, and empowerment of the individual.

People have a sense of community, a shared vision, and a positive outlook. Policies promote and support wellness efforts within the workplace.

• Effective programs identify ways that organization policies and organization traditions encourage wellness.
• Effective programs work at the group and corporation level to build support for healthy lifestyle choices.
• Effective programs set clear target objectives and goals for the health improvement of the workplace.

An initial health screening can include a survey of workers’ interests as part of the assessment. Effective wellness programs are designed to meet the needs and interests of the workers. The information you need to get from a survey is dependent upon the scope of your program. A sample survey can be obtained in the HOPE Publications Web site. If you plan to modify this sample survey or cultivate your own survey, keep the following hints in mind:

• Ask mostly closed-choice questions, especially if you will be sending the survey to a big number of workers. Closed-choice questions provide specific choices and are easy to tabulate. You may want to use a computer for data entry and analysis.
• Invite comments, suggestions and recommendations, or ask open-ended questions at the end of the survey. Open-ended items are more difficult to summarize.
• Include a brief explanatory cover letter with the survey with the signature of the business president. Make sure to include a statement about confidentiality and anonymity.
• Ask a group of representative workers to review the survey before it is distributed. Find out if the questions will be understood by workers and will not be objected to.
• Include demographic information at the beginning or end of the survey. Consider various ways that you might analyze the responses by demographic characteristics (gender, age, shift, site, department, etc.).

When thinking of who ought to get the survey, a simple rule is if you have under 500 workers, everyone ought to receive one. The public relations benefit of everyone receiving a survey can be important. Over 500 workers, a sample of the work population will suffice. A sample saves on costs and time. You may want to consider hiring a statistician to determine the right sample size for your workplace.

Needs surveys are confidential and anonymous; they do not request information that may identify a person.

Getting backing from management is crucial to the success of the program.

One way to do this is to survey managers (see forms) and conduct interviews with decision-makers in the employer. You can use the surveys here or make up your own. If you decide to do your own, keep the survey short. It shouldn’t take more than ten minutes to complete.

The interview process can also serve as a means of educating management. Provide concise fact sheets on the benefits of wellness programs for management. When surveys and interviews are completed, tally the surveys and write brief summaries of the interviews. Provide these reports to management.

Once completed present a brief executive summary to management. Highlight a few interesting findings that can be used immediately to make decisions about the program.

Utilize charts and graphs to make your points. Prepare a detailed report for Workplace Health Promotion Program Committee participants itemizing each response. Provide a short article about the survey in the business newsletter.

The higher the response the more valid and reliable the results. A minimum response of 40 percent to 50 percent is acceptable.