Posts from — July 2010

The Wellness Committee ought to set out a plan for the entire year that outlines accomplishing objectives and objectives, as well as provides details for advertising and marketing and analyzing  the program.

The plan is the detailed map of what kinds of programs will be offered, when and where they will be scheduled, how they will be marketed and assessed, and what the budget is.  

It is important to plan your wellness activities based on your goals and goals, as well as the budget since different strategies will yield different outcomes.  For example, if your objective is to raise awareness on a topic, then distributing  handouts or scheduling a one-time education session may  be appropriate.  

Notwithstanding, when your goal is to change behavior, then different strategies might  be necessary, like ongoing weekly sessions and support groups.  Click here to link to Program Design Choices for additional ideas.

Wellness Program Advertising and Marketing

This is the time to plan your advertising and marketing strategies!  How can you market the wellness program and ongoing activities?  No matter how you decide to, market often, keep it fresh, and remind staff members again and again!  

Consider having an overall kickoff activity to let everyone know about the wellness program.  Senior Level Management should provide the introduction or invitation so that all staff members are aware of their support and leadership in the program.

Possible advertising methods –

• Sending email messages, including reminders

• Posting flyers,

• Displaying bulletin board postings,

• Writing articles,

• Sending letters or

• Sending special invitations.  

Other Wellness Program Considerations –

• is the program promoted to all workers or to a specific target audience?

• Do you have a program champion (someone who is connected with different groups in the organization, and well respected) who can help in your promotion efforts?

• When your marketing and advertising efforts do not seem to be working, do you have a way to revisit and adjust your strategy?

• How’ll you determine success and evaluate your program?  and how will you collect the information needed to evaluate your program?  

Topics most often included in Wellness Programs –

• Nutrition

• Exercise/Exercise

• Tobacco Use Cessation

• Bone Health

• Heart Health

• Healthy Back

• Stress Reduction

• Chronic Condition Awareness and Prevention

• Self-care; Wise Health Care Consumer

• Screening Services (Body Mass Index (BMI), blood pressure, bone density, cholesterol, glucose, posture, vision, and other…)

• Ergonomic Assessments

• Health Fairs

• Kids/family Events

• Others topics that employees have interest in  

The topics and kind of Wellness Program planned depend on the needs and interest, overall goal and resources available.  

Program Design Options include awareness programs such as  pamphlets and/or education sessions, behavior change or modification programs such as tobacco use cessation and weight loss classes, and environmental or organizational support such as no tobacco use policies or healthful selections in vending machines.  

The programs planned also depend on the demographics of your workforce.  When you’ve a young, healthful workforce, you may want to focus the wellness attention on keeping staff members healthful and not need to screen for disease.  

Instead you might want to focus on healthy lifestyle behavior such as exercise and good nutrition to prevent the start of illness.  Click here for more information on strategies for keeping staff members well, identifying illness early, or returning staff members to work who already have a chronic condition.

It’s also important to consider, and plan how you will evaluate the success of your wellness program.  The system needs to be established for tracking certain data and recording events depending on the program goals and desired outcomes.  

Step 7 discusses program evaluation in more detail.   and Step 6 will launch your program!

Program is required to provide appropriate interpretation of cholesterol screening results, including a caution that a single measurement neither excludes nor establishes a diagnosis of their blood cholesterol.

Follow national guidelines –

Total Cholesterol

Desirable cholesterol   < 200 mg/dl

Borderline cholesterol   200 – 239 mg/dl

High cholesterol   > 240 mg/dl

HDL   

Desirable HDL    > 35 mg/dl

Low HDL    < 35 mg/dl

Refer cholesterol screening participants to medical care as follows –    

Total Cholesterol   

< 200 mg/dl    Recheck cholesterol in five years, if history of coronary heart illness or if two or more CHD risk factors are detected refers to risk reduction program or health specialists, as appropriate.

200 - 239 mg/dl    When history of CHD or if two or more other risk factors are detected, refer to medical care or risk reduction service within two months; if no reported history of CVD or less than two other risk factors, reassess cholesterol status within 1-2 years.

> 240mg/dl    Refer to medical care within two months.

HDL   

> 35 mg/dl   When fewer than 2 risk factors and borderline sum cholesterol, refer to risk reduction service, as appropriate. Reassess HDL in 1-2 years.

Provide the following –    

• The relationship of blood cholesterol, high blood pressure, and other risk factors.    

   o Risk factors include –  high blood pressure 140/90 or higher or on hypertension medication; current cigarette smoking; family history of premature CHD; diabetes mellitus; age – male > 45 years, female > 55 years or premature menopause without estrogen replacement therapy.

   o Negative risk factor –  high HDL 60 mg/dl or greater (subtract one risk factor).

   o Risk factors like family history, smoking, high fat or other unhealthy diet, andphysical inactivity lead to the development of cardiovascular disease (CVD).

• Definitions and causes of high blood cholesterol and HDL, desirable levels, the meaning and limitations of a single measurement, the cause of variability, and the need for multiple measurements before diagnosis.    

• Wide range of treatment options, including diet (e.g., importance of controlling fat intake less than 30% of total calories from fat, less 10% saturated fats), less than 300 mg. of cholesterol per day, well-balanced diet, weight maintenance or reduction, exercise, and medication.    

• Importance of following prescribed treatment and expert advice.    

A Wellness Program without goals and goals is somewhat akin to taking a family trip without any planning; you will not know where you are going, how to get there, what you want to do once you’ve arrived, or even whether or not you’ve arrived!  

The trip might end up ok, or it may end up disastrously.  Yet, with a little thoughtful planning, you increase your chances for a successful experience.  Clear goals and goals are needed to plan your wellness program in order to ensure success!

Wellness program objectives and objectives are different from one company to another depending on the population, needs, interests and resources.  Nevertheless, well thought out objectives based on your corporation’s needs assessment will form the foundation of a successful wellness program!

Wellness Program Mission Statement

The first consideration is a mission statement for your Wellness Program. the mission statement is the overall expression of what the Wellness Committee wants to accomplish by starting a wellness program.  

It is important to consider how your Wellness Program fits in with the company mission statement, contributes to the overall mission and supports the company bottom line.  This will integrate your efforts throughout the company operations.  

Here are some examples of Wellness Program mission statements –  

At XYZ Corporation, maintaining an environment that supports staff member health and safety is our underlying value.  It is the mission of the Wellness Program to assist in developing wellness services that fosters and upholds that value.

It is the mission of the XYZ Wellness Committee to foster healthier lifestyle choices to reduce health risk factors, improve overall well-being, and maintain a productive, active work force.

Wellness Program Goals

The objectives and objectives further define your mission and are based on your needs assessment.  Depending on the needs assessment, management expectations and worker interests, examples of objectives can include –  

The goal(s) of XYZ Wellness Program in year XXXX is to –   (one or more of the following examples)

• Reduce absenteeism by one day per employee

• Lower musculoskeletal injuries by 10%

• Decrease unnecessary emergency room visits

• Decrease or contain health care costs

• Improve dietary habits of employees

• Reduce health risk factors  

Wellness Program Objectives

Specific Wellness Program objectives help meet your long-term objectives and vision.  Both short term and long term objectives should be created as the stepping stones to accomplish the objectives and mission.  

In addition to goals for the expected participant outcomes, process goals should also be developed for the program process itself.  For  instance, process goals may include how many workers you want to participate in the programs, how many sessions on a topic will be offered, the type of wellness sessions that will be implemented, etc.

Objectives need to be easily measurable within a set time frame.  Attempt using the SMART formula to create both your long and short-term goals and goals –

• Specific (one behavior or outcome)

• Measurable (one result that could be observed or evaluated),

• Attainable (but also challenging),

• Realistic (do you’ve the resources to achieve?), and

• Time specific (within 3 months – up to 5 years)  

This is the who, what, when, where, why, and by how much method.  For  instance, an objective for a weight loss program that has an overall goal of improving healthful eating and promoting a healthful weight is that –  

Participants (who) will lose an typical of .5 – 1 lbs per week (specific what that is measurable) after the 12 week lunchtime program (time specific what, when and where) for a minimum of 6 lbs weight loss per participant (attainable and realistic).

Or –  

Participants (who) will attend 11 of the 12 sessions (specific what that is measurable) and name at least one healthier eating change after the program (specific what, when, where)

An example of an objective for coaching employees with elevated cholesterol could  be –  

To reduce the total cholesterol (specific what) of high risk workers with cholesterol over 240 mg/dl (specific who) to 200 mg/dl (measurable how much) through one-on-one counseling sessions offered at the worksite (where) by X date (ex, after 6 months) (attainable, realistic and time specific when) to lower the risk factor for heart disease (why).  

And one last example of a process objective for a tobacco use cessation program with an overall goal to assist participants in committing to quit for life –  

By the end of the 4-week use of tobacco cessation program, 10 percent of the participants will have quit use of tobacco.  Each participant will be contacted at 3 months, 6 months and 12 months from the program’s end to determine quit status (process objective) and 10 percent of those who quit will still be smoke free after one year.

You’ve now completed Steps 1 through 4, including establishing your Wellness Committee.  It is now time to plan your wellness activities!

Appropriate medical or allied health professional trained in measurement of blood pressure, referral protocols, and delivering educational messages to participant conducting blood pressure (BP) programs. These wellness programs are required to follow national guidelines.

National guidelines for blood pressure protocols –  

• Calibration of blood pressure measuring equipment must be done at least yearly.

• Two or more measurements of participant’s blood pressure (BP) should be taken.

• Referral of participants with high blood pressure (BP) readings to personal doctor for further analysis.   

Systolic / Diastolic Follow-Up –     

• Normal –    <130 / <85   

   Action –  Recheck in 2 years

• High Normal –    130-139 / 85-90   

   Action –  Recheck in 1 year

Hypertension –     

• Stage 1 (Mild) –    140-159 / 90-99    

   Action –  Confirm within 2 Months.

• Stage 2 (Moderate) –    160-179 / 100-109    

   Action –  Refer to source of care within 1 month.

• Stage 3 (Severe) –    180-209 / 110-119    

   Action –  Refer to source of care within 1 week.

• Stage 4 (Very Severe) –    >210 / >120    

   Action –  Refer to source of care immediately.

Appropriate educational messages –     

• Normal –    <130 systolic and <85 diastolic   

   Action -  No referral. When on treatment, then inform participant that blood pressure (BP) is under good control today and ought to continue seeing and following treatment program.

• High Normal -    130-139 systolic and/or 85-89 diastolic   

   Action -  Recommend that participant have blood pressure (BP) rechecked within 1 year unless under treatment. Advise participant that the readings are in a high normal range that needs rechecking. In the interim, suggest that one of the most effective means to lower blood pressure (BP) is to bring weight into normal range and to exercise.

• High -    >140 systolic and/or >90 diastolic   

   Action –  Refer to physician for further analysis within 2 months unless the level is within urgent, emergency, or isolated systolic hypertension levels. When already on treatment, advise participant of readings and need to get blood pressure to a goal of 140/90 or less.

• Isolated Systolic Hypertension –    140-159 systolic and < 90 diastolic in a participant 65 years of age or older.   

   Action -  Advise participant to inform doctor of readings at next visit and consider advice regarding losing weight and exercise if appropriate.

• Urgent -    180-209 systolic and/or 110-119 diastolic   

   Action -  Recommend obtaining medical investigation within 1 week.

• Emergency -    >210 systolic and/or >120 diastolic   

   Action –  Obtain immediate medical attention.

Provides the following –     

• Written results, referral instructions, and an explanation of blood pressure (BP) levels given to each participant with individualized counseling, including advice about the interval of time advised when the participant must be checked again.    

• Utilizes the recommendations in the Fifth Report of the Joint National Committee on Detection, Examination and Treatment of High Blood Pressure, March 1994.    

• Written and audiovisual materials that are informative, easy to understand, and useful while containing scientifically valid information.    

• Relationship of high blood pressure (BP) and other risk factors, such as family history, tobacco use, high fat and unhealthy diet, lack of exercise, in the development of cardiovascular illness, including stroke, kidney illness, heart attack, and other illnesses.

• Definition and causes of high blood pressure.

• Importance of following prescribed treatment.

Before you begin planning your Wellness Program you need to know where you are now and then decide where you want to go.  Completing a thorough needs assessment is crucial to the success of your wellness program for two reasons –  

• First it ensures that your program activities will be targeted to meet your corporation’s specific needs so that outcomes could be achieved.  

• Secondly the needs assessment provides the information you will need to evaluate the effectiveness of your wellness program.

It’s often tempting to rush the assessment – in particular when time is limited or those with experience already have an idea of needs.  Don’t give in to this temptation!  

It is critical to understand what your business needs are, what management expects, and what staff members want in addition to expect, before you develop a program.  

Consider and gather data on –

• Demographic Information

• Health Risk Factors

• Medical Claims

• Injury Rates and Causes

• Workers’ Compensation Claims

• Short and Long Term Disability Claims

• Absenteeism

• Culture Audits

• Employee perceived needs and health risks

• Management expectations or desired outcomes

There are many ways to assess this information.  Although some of data gathering process might  be time eating, remember that it is nonetheless essential to plan programs that target specific issues.  

This information will be vital to set objectives and for analyzing  program success.  How else can you know when outcomes have been achieved?

Options to help gather the wellness program information –

• Confidential Health Risk (Assessment|Appraisal}s with a Company Group Summary Report click here for more information on Health Risk (Assessment|Appraisal}s or Assessments

• Biometric Testings like cholesterol, blood pressure and blood sugar click here for additional information on health screenings.

• Staff Member Needs and Interest Surveys

• Suggestion boxes placed around the organization

• Focus Groups or hosting a luncheon meeting as a focus group

• Sending out a confidential email questionnaire

• Review records and databases including OSHA logs, first aid reports, insurance costs  

Once your needs assessment is complete, the Wellness Committee can review the results and start planning and prioritizing program choices.  

Planning ought to be based on objectives and identified outcomes, Step 4 of the seven step process!

Health risk screening programs ought to be carried out on a one-on-one basis by trained health care specialists. Health risk measures ought to include the following –

• Blood pressure measurements – at least two blood pressure (BP) measurements taken during the screening episode, using a mercury sphygmomanometers or regularly calibrated aneroids.    

• Blood pressure (BP) treatment status – ascertain whether the participant is under a physician’s care, on any medication, on a prescribed diet, or any other kind of treatment for hypertension.    

• Blood cholesterol measurement – total cholesterol and HDL-cholesterol taken either using a properly tested and maintained table top blood analyzer providing immediate feedback to the customer, or sending blood to a laboratory providing feedback using a method that is as effective as immediate feedback.    

• Cholesterol treatment status – ascertain whether the patron is under a doctor’s care, on any medication, on a prescribed diet, or any other type of treatment for high cholesterol.    

• Obesity – utilize an accepted method for estimating obesity. for  instance assess participants height and weight and use the 1959 Metropolitan Life Height/Weight charts or use BMI.    

   o Identify people  20 percent or more above their ideal weight.

• Smoking status – assess whether the participant currently smokes cigarettes, whether the customer has quit or never smoked, and the number of cigarettes smoked/day.    

• Exercise habits – screening questions might  be limited to frequency and duration exercise. Do participants exercise in a moderately vigorous fashion at least three times per week for 30 minutes or more.    

• Diabetes – whether the patron has diabetes, and whether or not it is currently under control. A blood glucose could  be also done via finger stick and desk top analyzer. A few manufactures make available cassettes which include cholesterol and glucose measurements.

• Cerebrovascular illness or occlusive PVD – ascertain when the customer has had a stroke or other kind of blood vessel illness.

• Family history of cardiovascular illness – ascertain whether any of the participants’ parents or siblings had a heart attack or sudden death as a result of heart illness before age 55.

• Coronary heart disease – ascertain if the customer has had a heart attack or other kind of coronary heart disease.

• Stress – participant’s assessment of stress in work and/or personal life. A series of well-tested and validated questions analyzing  levels of stress are available from the Employee Health Program.

• Participant release form (see forms) – A release form is required in which the participant allows the wellness program to draw blood for testing to send information to the participant’s medical care provider if medical risks are identified, and to obtain information from the provider about diagnosis and prescribed treatment.

• Participant interest survey – when an assessment of interest hasn’t been gathered previously, the screening activity must assess levels of interest in wellness programs like –  weight control, use of tobacco cessation, fitness or exercise, stress management, nutrition, self-care, cholesterol control.

• Health education messages – the screener must review with the participant his/her identified health risks and what they mean to the participant’s overall health, and give the participant a written record of the blood pressure, total cholesterol, and any other physiological measures taken.

• Referral of participants for treatment – participants with elevated risks should be referred to appropriate sources of diagnosis and possible treatment following nationally or locally recognized guidelines for such referral.

Demographic information should include location of the screening, worksite, client’s name, address, social security number, home and work phone numbers, sex, race, birthdate, relevant job information (e.g., hourly or salaried), department number, and work shift.

Establishing an active Wellness Committee provides opportunities for both management and staff member involvement in the program.  The Committee ought to be a team of employees and managers who formally meet to plan activities to promote healthier staff member lifestyles.

Typical Functions of a Wellness Committee –

• Reviewing needs and interests

• Brainstorming program ideas

• Planning activities

• Developing communication plans

• Promoting programs to coworkers

• Serving as champions of the Wellness Programs

• Assisting with evaluation  

Your Wellness Committee must be representative of all levels of the corporation.  Consider all areas of the workforce – multiple sites, shift workers, diversity (race, gender, ethnicity), and departments.  

It’s also important to consider who’ll chair or co-chair the Wellness Committee and whether or not there are the finances to support a wellness manager or occupational health professional, even on a part-time or contractual basis.  Click here for additional information on the benefits of a health professional.  

Depending on your business size and resources, if you already have a business Safety Committee you could want to consider making it the Safety and Wellness Committee.  You can request volunteers or invite staff members to participate.  

The number of Wellness Committee members depends on the size of your company; nevertheless, you need enough members to get the work done and yet not too many to keep it manageable, usually a minimum of 4 members and maximum of 12 to 15 members.  

It’s important to include skeptics of wellness as well and not just those employees already practicing healthful lifestyles.  

Depending on your worksite, consider representatives from the following areas –

• Employee representatives from a cross section of different departments,

• Management/leadership,

• Health and safety professional(s),

• Human resources (HR)  specialist(s),

• Benefits staff or someone from finance,

• Your staff member assistance program (EAP) provider (if applicable), Click here for more information on EAPs

• Medical or occupational health staff (if applicable).

Establish an effective Wellness Committee!  the Wellness Committee should meet regularly with a planned agenda and action items.  Successful Wellness Committees have a shared mission, vision and goals.  

Members need to believe that their participation is worthwhile and appreciated, that their work is important, benefits the organization and coworkers, and they’re recognized for their contributions. Refer to the NC Workplace Programs section for examples of what other businesses have implemented.

Wellness Program directors or providers should’ve a background in health promotion programming and a professional health-related degree or certification.    

They should have professionalise in content areas, planning, promotion, administration, examination, and ability to grow a health promotion program and tailor the health promotion program to the worksite.   

Health Promotion Program providers should’ve a quality assurance program for evaluating  the effectiveness of service personnel, to assess satisfaction of participants, and for personnel training and continuing education.   

An overall policy statement must be available from directors and health promotion program vendors addressing the following issues –  

• Assurance of confidentiality of health data,
• referral to health and medical care for at-risk participants,
• follow-up with referred participants and those at-risk,
• health promotion program evaluation on process and outcomes,
• organization of the workplace for promotion of wellness and changes in corporate culture.

A clear contract or letter of agreement for services must be provided.

As with any program, the two vital elements for the success of your wellness program are  senior level management support and worker involvement.  Senior management sets the vision and provides the resources from which action plans flow.  

Genuine support from senior personnel also lends credibility to the wellness program.  It is key that  upper management be visible supporters and role models for your Wellness Program.

Employees need to be involved on a few levels so that they feel ownership of the wellness program.  Employees are the program stakeholders!  

All staff members should have an opportunity to provide input and feedback through needs and interest surveys and program examination tools.  The information accumulated should be used to plan programs that target those needs and interests to ensure participation, buy-in, and support.

There are a few methods to identify worker needs and interests like –

• Conducting Employee Focus Groups

• Discussing Wellness Interests During Department Meetings

• Distributing and Summarizing a Needs and Interest Survey

• Including an Opportunity to Give Suggestions on Each Investigation Tool  

Any one or combination of a few techniques will ensure that the wellness program meets what employees want.  Click here for a sample Needs and Interest Survey.

Step 3 provides additional information on deciding wellness program needs.  But first, establishing a Wellness Committee can help you involve management and staff members, determine need, and plan your wellness program.

Incentives can be used to increase participation rates, help with completion or attendance at health promotion programs, and to help individuals change or adhere to healthy behaviors.

The purpose of the incentive is to encourage personnel to adopt positive behaviors or maintain an existing positive behavior.

Everybody who achieves a goal or maintains a behavior should receive something. A lot of corporations also provide incentives merely for participating in events.

Stay away from being the “best” or doing the “most.” Encouraging people  to be the best or doing the most promotes excessive behavior, discourages others, and creates elitism.    

The best designed incentive programs are ones which are based on achieving goals that are attainable by most individuals. Recognition, acknowledgment by top management, or special privileges are examples of great intangible incentives.   

Health Promotion Program Incentive Ideas –    

• Free or Low-Cost Incentives-     

   o Certificates

   o Movie passes

   o Recognition in staff member newsletter

   o Mugs

   o Water bottles

   o Commendation from upper management

   o T-shirts

   o Hats

• Moderate Cost Incentives –     

   o Entertainment tickets

   o Sweatshirts

   o Waist packs

   o Subscriptions to health magazines

   o Fitness and health books

   o Videos

• High Cost Incentives –     

   o Week-end getaways

   o Dinner for two

   o Clocks

   o Watches

• Other Incentives –     

   o Cash

   o Gift certificates