Health Wellness ProgramHealth and Wellness Programs and Wellness Program Consulting

Program directors or providers should have a background in wellness programming and a professional health-related degree or certification. They should have expertise in content areas, planning, promotion, administration, assessment, and ability to grow a program and tailor the program to the workplace.

Program providers ought to have 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 should be available from directors and program vendors discussing the following problems: assurance of confidentiality of health data, referral to health care for at-risk participants, follow-up with referred participants and those at-risk, program assessment on process and outcomes, corporation of the workplace for promotion of wellness and changes in corporate culture. A clear contract or letter of agreement for services should be provided.

Stay away from being the “best” or doing the “most.” Encouraging staff members 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 and objectives that are attainable by most individuals. Recognition, acknowledgment by top management, or special privileges are examples of excellent intangible incentives.

Incentive ideas:

• Free or Low-Cost:
   o Certificates
   o Movie passes
   o Recognition in employee newsletter
   o Mugs
   o Water bottles
   o Commendation from management
   o T-shirts
   o Hats

• Moderate Cost:
   o Entertainment tickets
   o Sweatshirts
   o Waist packs
   o Subscriptions to health magazines
   o Health and fitness books
   o Videos

• High Cost:
   o Week-end getaways
   o Dinner for two
   o Clocks
   o Watches

• Others:
   o Cash
   o Gift certificates

Utilizing posters, newsletter articles, and brochures are great means of promoting the program. Other promotional methods to consider are e-mail and announcements at employee meetings. Ask Worksite Wellness Program Committee members to recruit participants.

Once the program is kicked off you may want to provide an incentive for any employee who recruits another employee to any of the program offerings.

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 offered?
• What educational materials are used?
• Will the program meet the needs of staff members?
• What are the techniques used to help modify 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 healthcare or other supportive services employees may need?
• How do you know the program works?
• How do you measure colleague satisfaction?

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

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 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 workers to the program, take health measurements, collect health-related information, provide 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 establish and carry out a plan to reduce their risks and better their health.
• Wellness instructors teach classes and minigroups on different health topics.

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 staff members 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 subject matters 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 workers?
• Do employees have a warm, but professional, counseling style when interacting with employees?

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

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

The organization benefits from additional publicity that occurs in various media throughout the area 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 at times 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 evaluate the health risks of an individual. Individuals with a higher number of health risks tend to have more somber health problems 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 (BP) levels, height, and weight).

For accuracy, it is crucial to get direct measures of Blood Pressure, 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 provides 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 provide an aggregate group report of a employer 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 Company Health Promotion 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 delivering the screening then provides a consultation and helps set objectives with the colleague.

The backbone of wellness programming at the worksite is health evaluation. It is the first primary activity a company must 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 assessment 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 provided. 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 evaluation program needs to support multiple opportunities for participation. The service should be offered for all the various shifts of a employer. The evaluation program should be conducted in highly visible areas so the process can be inspected.

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 ought to perform outreach going to areas where staff members gather and attempt to recruit staff members.

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

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 corporation. Goals like mission statements support 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 elevated 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 (BP) or cholesterol years later