Winston Salem WellnessWinston Salem Wellness – Winston Salem Health Promotion

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

• How many worksites have done the program?
• What types of employee population was the program offered?
• 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 workers move through stages of readiness to make health behavior changes?
• How do you market the program to staff members?
• What follow-up do you provide?
• How do you make referrals for medical or other supportive services staff members may need?
• How do you know the program works?
• How do you measure participant satisfaction?

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 worksite is in this category, you will need to contract with providers outside your employer.

Large employers 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 issues, 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 workers to the program, take health measurements, collect health-related information, offer initial counseling, and help workers define for themselves what they need and want in a wellness program.
• Wellness counselors work with workers after the screening to help them create and carry out a plan to lower their risks and better their health.
• Wellness instructors instruct 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 workers have a range of health backgrounds that will provide appropriate expertise in the issues to be addressed?
• Have prospective workers functioned well as wellness screeners, wellness counselors, and/or wellness instructors?
• Will this employee include workers 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 workers have a warm, but professional, counseling style when interacting with workers?

An yearly plan for the major wellness programs and activities is a useful management tool. This is an excellent Workplace Wellness Program Committee task. Often an exercise and wellness theme per month is offered to staff members.

Some employers choose to follow a National Health Observances calendar which offers advantages. The materials developed by these various national health employers are very credible. The materials are usually high quality and available free or at a nominal cost.

The company benefits from additional publicity that occurs in various media throughout the community related to the national observance. For planning ideas you may want to utilize the HOPE Publications Wellness Resource Creating Guide available for free at this Web site.

A Health Risk Appraisal (HRA) is occasionally used in conjunction with a health evaluation. 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 serious health issues over time.

Drawing attention to their health risks can help clients cut 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 levels, height, and weight).

For accuracy, it is crucial to get direct measures of Blood Pressure, blood lipids and HDL-cholesterol. The HRA also supplies 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 corporations. Continuing research on HRAs is examining the efficacy of this tool. One of the big benefits of this tool is that it can provide 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 screening performed in Corporate Wellness Programs is heart health assessment.

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

The health professional conducting the evaluation then supplies a consultation and helps set objectives and goals with the colleague.

The backbone of wellness programming at the worksite is health screening. It is the first major activity a employer should do when first starting a wellness program. Health screening 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 (BP) and cholesterol. With computerized cholesterol 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 evaluation 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 monitored.

Reluctant staff members frequently 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 assessment can attract participation rates of 60 percent to 100 percent. These high participation rates have a positive impact on management producing backing for further programming.

Goals are broad-based statements about what the program is expected to do. The intention of the wellness program is to enhance the health of the individual and the employer. 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 who lowered their Blood Pressure
• 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 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 Program Committee must be composed of a cross-section of employees representing various occupations, levels, and subgroups with the company.

A common mistake is filling the Workplace Health Promotion Program Committee with the most health/fitness-conscious people in the business. Don’t rely solely on volunteers to fill a Workplace Health Promotion Program Committee. Make sure that your Workplace Health Promotion Program Committee members have enough authority in the business to run an effective wellness program.

The Employee Health Promotion Program Committee is made up of workers from the worksite. It oversees the wellness program and helps carry it out. The Employee Health Promotion Program 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 Employee Health Promotion Program Committee may meet on a weekly basis until things get going.

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

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

Developing the programs can include:

• Finding space for activities
• Beginning and organizing worksite-wide events such as contests
• Analyzing reports prepared by the program employee and making recommendations

Promoting the program can include:
• Recruiting staff members to take part in evaluation 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 success of the professional employee
• Acting as wellness mentors to fellow staff members

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

Make an announcement through handouts, memos, and gatherings to recruit potential members. Explain the purpose of the Worksite Wellness Program Committee, duties and responsibilities, and the time responsibility.

Recognize your Employee Health Promotion Program Committee volunteers. Allow them to participate in programs at a reduced expense. Have appreciation breakfasts/lunches/dinners. Print names of Employee Health Promotion Program Committee participants on employer 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. Develop awards certificates for members.

The following can be used as a guide for Employee Health Promotion Program Committee size:

• Less than 300 employees   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 important. It includes social standards of expected and accepted behavior called “cultural norms.”

It includes peer support from family, friends, and co-workers. This support 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 employer are:

• staff members communicate openly
• Leaders support diversity and opinion
• staff members have fun
• Policies support wellness
• workers 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 workers as their most significant asset

Effective wellness programs attempt to establish healthy workplace climates. A healthy workplace 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 reward and support wellness efforts within the worksite.

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