Posts from — July 2009

A major concern in wellness programming is attracting employees to take part and maximizing participation. When introducing a program, a letter briefly explaining the program signed by the president or CEO is a great endorsement. Utilizing posters, newsletter articles, and flyers are great means of promoting the program. Other promotional methods to consider are e-mail and announcements at employee gatherings. Ask Worksite Wellness Committee participants to recruit participants. Once the program is kicked off you may want to offer an incentive for any employee who recruits another employee to any of the program offerings.

When staffing your wellness program you need to consider whether to hire a wellness employee or contract with wellness professionals from outside your organization. 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 organization. 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 performance 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 topics, including smoking, stress, exercise, and diet. 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, collect 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 employees after the assessment to help them establish and carry out a plan to decrease their risks and improve their health.
• Wellness instructors teach classes and minigroups on different health topics.

A wellness program in a small organization 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 employees have a range of health backgrounds that will offer appropriate expertise in the topics to be addressed?
• Have prospective employees 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?

When selecting a program from a vendor you must ask the following questions:

• How many worksites have done the program?
• What types of employee population was the program available?
• What educational materials are used?
• Will the program meet the needs of employees?
• What are the techniques used to help alter behaviors?
• Does the program help employees move through stages of readiness to make health behavior changes?
• How do you market the program to employees?
• What follow-up do you offer?
• How do you make referrals for healthcare or other supportive services employees may need?
• How do you know the program works?
• How do you measure colleague satisfaction?

A Health Risk Appraisal (HRA) is at times used in conjunction with a health assessment. 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 assess the health risks of an individual. Individuals with a higher number of health risks tend to have more genuine health problems over time. Drawing attention to their health risks can help clients decrease 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 obtain direct measures of Blood Pressure (BP), cholesterol and HDL-cholesterol. The HRA also supports recommendations and indicates what risks are modifiable. Types of measures to assess 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 corporations. Continuing research on HRAs is examining the efficacy of this tool. One of the big advantages of this tool is that it can offer an aggregate group report of a organization and can be utilized as an evaluation 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 assessment performed in Worksite Wellness is heart health assessment. The assessment can include a written heart health test, Blood Pressure (BP) measurement, cholesterol/HDL-cholesterol test, glucose (blood glucose), weight, educational materials specific to diet, nutrition, exercise, cholesterol, smoking, and weight. The health professional conducting the assessment then supports a consultation and helps set goals and objectives with the colleague.

The backbone of wellness programming at the workplace is health assessment. It is the first major activity a organization must do when first starting a wellness program. Health assessment 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 assessment techniques and counseling to privately and individually assess participants. This wellness professional takes a brief health history and measures Blood Pressure (BP) and cholesterol. With computerized cholesterol desktop analyzers, results are obtained in about four minutes. Immediate feedback, consultation, and educational materials are given. 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 assessment can be done on an annual basis and used as a means of monitoring health risks within the workplace. A health assessment program needs to offer multiple opportunities for participation. The service must be given for all the various shifts of a organization. The assessment program must be conducted in highly visible areas so the process can be observed. Reluctant employees often like to be able to see what the program is about before they take part. When wellness screeners are not busy, they must perform outreach going to areas where employees gather and attempt to recruit employees. When well-planned and promoted, health assessment can attract participation rates of 60 percent to 100 percent. These high participation rates have a beneficial influence on management producing support for further programming.

Wellness committees are important in that they establish a sense of ownership in the program, and facilitate various tasks involved in wellness programming at the worksite. The Worksite Wellness Committee must be composed of a cross-section of employees representing various occupations, levels, and subgroups with the organization. A common mistake is filling the Worksite Wellness Committee with the most health/fitness-conscious people in the organization. Don’t rely solely on volunteers to fill a Worksite Wellness Committee. Make sure that your Worksite Wellness Committee participants have enough power in the organization to run an effective wellness program. The Worksite Wellness Committee is made up of employees from the worksite. It oversees the wellness program and helps carry it out. The Worksite Wellness Committee must meet about once a month to review the previous month’s activities and plan future ones. When the program is just starting, the Worksite Wellness Committee may meet on a weekly basis until things get going. Committee participants do not carry out healthcare procedures, counsel clients, or handle confidential health information. Wellness professionals perform these tasks. In general, the Worksite Wellness Committee’s duties fall into three areas: planning, promoting, and supporting to run programs. Beginning the programs can include:

• Finding space for activities
• Beginning and organizing workplace-wide events 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 employees to take part in follow-up counseling
• Organizing promotional strategies using newsletters, signs, bulletin boards, computers, and other media available within the worksite

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 performance of the professional employee
• Acting as wellness mentors to fellow employees

The size of the Worksite Wellness Committee will be dependent on the size of the organization. Pick participants by asking day management to nominate or appoint employees. Make an announcement through flyers, memos, and gatherings to recruit potential participants. Explain the purpose of the Worksite Wellness Committee, duties and responsibilities, and the time responsibility. Recognize your Worksite Wellness Committee volunteers. Allow them to take part in programs at a reduced cost. Hold appreciation breakfasts/lunches/dinners. Print names of Worksite Wellness Committee participants on organization 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. Organize awards certificates for participants. The following can be used as a guide for Worksite Wellness Committee size:

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

Goals are broad-based statements about what the program is expected to do. The goal of the wellness program is to enhance the health of the individual and the organization. Goals like mission statements offer direction in a program. Objectives are specific and provide a means of measurement of the program to determine performance. 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 elevated 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 elevated Blood Pressure (BP) or cholesterol years later

Wellness committees are important in that they establish a sense of ownership in the program, and facilitate various tasks involved in wellness programming at the worksite. The Worksite Wellness Committee must be composed of a cross-section of employees representing various occupations, levels, and subgroups with the organization. A common mistake is filling the Worksite Wellness Committee with the most health/fitness-conscious people in the organization. Don’t rely solely on volunteers to fill a Worksite Wellness Committee. Make sure that your Worksite Wellness Committee participants have enough power in the organization to run an effective wellness program. The Worksite Wellness Committee is made up of employees from the worksite. It oversees the wellness program and helps carry it out. The Worksite Wellness Committee must meet about once a month to review the previous month’s activities and plan future ones. When the program is just starting, the Worksite Wellness Committee may meet on a weekly basis until things get going. Committee participants do not carry out healthcare procedures, counsel clients, or handle confidential health information. Wellness professionals perform these tasks. In general, the Worksite Wellness Committee’s duties fall into three areas: planning, promoting, and supporting to run programs. Beginning the programs can include:

• Finding space for activities
• Beginning and organizing workplace-wide events 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 employees to take part in follow-up counseling
• Organizing promotional strategies using newsletters, signs, bulletin boards, computers, and other media available within the worksite

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 performance of the professional employee
• Acting as wellness mentors to fellow employees

The size of the Worksite Wellness Committee will be dependent on the size of the organization. Pick participants by asking day management to nominate or appoint employees. Make an announcement through flyers, memos, and gatherings to recruit potential participants. Explain the purpose of the Worksite Wellness Committee, duties and responsibilities, and the time responsibility. Recognize your Worksite Wellness Committee volunteers. Allow them to take part in programs at a reduced cost. Hold appreciation breakfasts/lunches/dinners. Print names of Worksite Wellness Committee participants on organization 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. Organize awards certificates for participants. The following can be used as a guide for Worksite Wellness Committee size:

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

Effective wellness programs recognize the significance of building a supportive cultural environment. The worksite culture includes shared values/heartfelt beliefs about what is important. It includes social standards of expected and accepted behavior called “cultural norms.” It includes peer support from family, friends, and co-employees. This support can help one adopt healthy lifestyles. Tools are available to audit a organization. The long-term success of any wellness program is dependent on the corporate culture. Some healthy culture signs in a organization are:

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