Follow-Up

The keys to a successful wellness program are persistent one-on-one outreach and follow-up counseling to encourage health improvement, adherence to treatment regimens, changes in lifestyle behaviors, and to prevent relapse. Periodic outreach and follow-up procedures offer employees with a safety net which keeps them involved in the program and prevents treatment dropout and relapse. Counselors must follow up on employees at least every 6 months throughout the career of the employee at the workplace. The goals and objectives of follow-up are to:

• Involve employees who have health risks in treatment and risk reduction programs.
• Involve all employees in health improvement programs and workplace-wide wellness activities.
• Support employees in carrying out the risk reduction or health improvement activities they have chosen.
• Help employees comply with their treatment regimens.
• Prevent relapse.
• Prevent employees from dropping out.
• Help employees maintain behavior changes.

Follow-up can be conducted in person, by phone, mail, and via computer if the technology is available. Most preferable is an in-person contact. Computer programs which can do case load management are available to help counselors track information and perform follow-up.

Priorities for Follow-Up

People with multiple health risks must be at the top of the list. People in key positions such as union leaders or department heads with health risks must also be contacted early so that they learn what the program is about and can share the information with others. People who need a healthcare evaluation for elevated Blood Pressure (BP) or cholesterol must also be targeted early. Many employees will have seen their doctors as a result of the assessment, but some will need more encouragement to do so. Those with no health risks can be followed up annually. A follow-up counseling session can take 20 to 45 minutes. At minimum, follow-up must include those who were told to seek healthcare evaluation for elevated Blood Pressure (BP) readings, elevated blood lipid readings, or borderline elevated blood cholesterol readings with 2 or more other risk factors. It may include those who were identified as at-risk for one or more of the other major risk factors: at-risk levels of alcohol consumption, being overweight, and having low HDL.

Follow-Up With Physicians

A letter (see forms) must be sent to the physician or clinic of each employee who has elevated Blood Pressure (BP), elevated cholesterol, or is under a physician’s care. The letter must explain the program and must include the employee’s relevant, current health measurements. Along with the letter, send a self-addressed return envelope. Follow-up with the physician must be repeated every 6 months until it is demonstrated that the employee is under satisfactory control. Contacting the physician is important for three reasons:

• The doctors receive employees’ health measurements taken at the workplace.
• You receive the Blood Pressure (BP) and blood lipid readings the doctor takes and information on the treatment the doctor prescribes. Many times the employee does not have this information or does not remember it. The information can be used when counseling the employee.
• Follow-up encourages physicians to pay closer attention to heart disease risk factors among their patients.