Health Wellness ProgramHealth and Wellness Programs and Wellness Program Consulting

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

National guidelines for blood pressure (BP) protocols –  

• Calibration of blood pressure measuring equipment should be done at least annually.

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

• Referral of participants with high blood pressure 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. If on treatment, then inform participant that blood pressure (BP) is under good control today and should continue seeing and following treatment program.

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

   Action -  Recommend that participant have blood pressure 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 among the most effective means to lower blood pressure is to bring weight into normal range and to exercise.

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

   Action –  Refer to doctor for further investigation 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 (BP) 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 weight reduction and exercise when appropriate.

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

   Action -  Recommend obtaining medical examination 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 ought to 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 accurate information.    

• Relationship of high blood pressure and other risk factors, such as family history, smoking, high fat and unhealthy diet, lack of exercise, in the development of cardiovascular illness, including stroke, kidney illness, heart attack, and other diseases.

• Definition and causes of high blood pressure.

• Importance of following prescribed treatment.

Health risk screening programs must 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 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 – sum cholesterol and HDL-cholesterol taken either using a properly tested and maintained table top blood analyzer providing immediate feedback to the client, or sending blood to a laboratory providing feedback using a method that is as effective as immediate feedback.    

• Cholesterol treatment status – ascertain whether the client 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 Body Mass Index (BMI).    

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

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

• Exercise habits – screening questions could  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 customer has diabetes, and whether or not it is currently under control. A blood glucose might  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 patron 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 due to heart illness before age 55.

• Coronary heart disease – ascertain if the patron 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 evaluating  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 health promotion program to draw blood for testing to send information to the participant’s medical care provider when medical risks are identified, and to obtain information from the provider about diagnosis and prescribed treatment.

• Participant interest survey – if an assessment of interest has not been gathered previously, the screening activity must assess levels of interest in health promotion programs such as –  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 must be referred to appropriate sources of diagnosis and possible treatment following nationally or locally recognized guidelines for such referral.

Demographic information ought to include location of the screening, worksite, customer’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.

Health Promotion Program directors or providers should’ve a background in health promotion programming and a specialist health-related degree or certification.    

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

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

An overall policy statement ought to be available from directors and wellness program providers 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,
• wellness program analysis on process and outcomes,
• organization of the worksite for promotion of wellness and changes in corporate culture.

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

Incentives could be used to elevate participation rates, help with completion or attendance at health promotion programs, and to help person change or adhere to healthy behaviors.

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

Everyone who achieves a goal or maintains a behavior ought to receive something. Many organizations also provide incentives merely for participating in events.

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

Wellness Program Incentive Ideas –    

• Free or Low-Cost Incentives-     

   o Certificates

   o Movie passes

   o Recognition in employee newsletter

   o Mugs

   o Water bottles

   o Commendation from upper-level 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

A major concern in health promotion programming is attracting personnel to participate and maximizing participation. When introducing a health promotion program, a letter briefly explaining the health promotion program signed by the president or Chief Executive Officer (CEO) is a great endorsement.

Utilizing posters, newsletter articles, and flyers are excellent means of promoting the wellness program. Other promotional methods to consider are e-mail and announcements at staff meetings. Ask wellness committee members to recruit participants.

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

When choosing  a wellness program from a vendor you ought to ask the following questions –

• Exactly how many worksites have done the health promotion program?

• What kinds of worker population was the wellness program offered?

• What educational materials are used?

• Will the health promotion program meet the needs of employees?

• What are the techniques used to help change behaviors?

• Does the health promotion program help people  move through stages of readiness to make health behavior changes?

• Exactly how do you market the health promotion program to employees?

• What follow-up do you provide?

• How do you make referrals for medical care or other supportive services staff may need?

• Exactly how do you know the health promotion program works?

• Just how do you measure participant satisfaction?

When staffing your health promotion program you need to consider whether to hire a wellness staff or contract with wellness professionals from outside your corporation.

Small and medium size worksites do not generally have a wellness expert on staff. When your worksite is in this category, you’ll need to contract with providers outside your business.

Large businesses have a few choices. They can hire a staff solely for the health promotion program, they can contract with outside wellness providers, or they can use a combination of internal staff and outside providers.

When selecting  a provider some key questions in the areas of staff, health promotion program structure, process, and effectiveness need to be addressed. Each of these key questions is discussed in the following sections.

Wellness Business Staff

Health professionals become wellness professionals when they’re trained in the full range of wellness activities. Wellness professionals are generalists who come from a broad variety of backgrounds and schooling.

They could 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 nutrition.

They also know how to engage and support people  in making and sustaining health improvements and have good people  skills.

Normally, wellness experts at workplaces fall into three broad categories, wellness screeners, wellness counselors, and wellness instructors.

• Wellness screeners introduce staff members to the health promotion program, take health measurements, collect health-related information, provide initial counseling, and help staff members define for themselves what they need and want in a health promotion program.

• Wellness counselors work with workforce after the screening to help them develop and carry out a plan to reduce their risks and improve their health.

• Health Promotion instructors teach courses and minigroups on different health topics.

A health promotion program in a small corporation can be staffed by a single staff person who fills all three roles. Bigger worksites will use different individuals  to fill these roles.

When selecting  staff or selecting  among wellness businesses, ask the following questions –

• Do prospective workers have a range of health backgrounds that will provide appropriate expertise in the topics to be addressed?

• Have prospective staff members functioned well as wellness screeners, wellness counselors, and/or wellness instructors?

• Will this staff include people  from the racial and ethnic backgrounds found in your staff member population?

• Is each staff member comfortable with the range of backgrounds found in your staff member population, and able to communicate effectively with the various social and educational levels of your employees?

• Do workers have a warm, but specialist, counseling style when interacting with employees?

An annual plan for the major wellness programs and activities is a useful management tool. This is an great wellness committee task. Frequently an activity and wellness theme per month is offered to workers.

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

The corporation benefits from additional publicity that occurs in various media throughout the community related to the national observance. for planning suggestions you might want to utilize the HOPE Publications Wellness Resource Planning Guide available for free at this Web site.

A Health Risk Appraisal (HRA)  is sometimes used in conjunction with a biometric testing.  An Health Risk Appraisal (HRA) is a computerized assessment tool which looks at an individual’s family history, health status, and lifestyle.

An Health Risk Assessment (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 at a illness. Based on this understanding, useful prediction instruments could be constructed to assess the health risks of an individual. Person with a higher number of health risks tend to have more serious health problems over time.

Drawing attention to their health risks can help customers reduce risk factors which lead to the onset of unnecessary disease and subsequent premature death.

The questionnaire covers lifestyle habits (such as smoking, seat belt use, and exercise) and physical measures (such as cholesterol, blood pressure (BP) levels, height, and weight).

For accuracy, it’s crucial to obtain direct measures of blood pressure, cholesterol and HDL-cholesterol.  The Health Risk Assessment (HRA) also provides recommendations and indicates what risks are modifiable. Kinds of measures to assess health risks are discussed under Screening Programs.

The impact of a health risk assessment is much greater when it is given in-person, with immediate feedback to the patron. This also provides an opportunity to invite the patron’s participation in continuing health counseling and to gain their written consent to do pro-active outreach to them.

A health age could be computed based on the individual answers to the questionnaire and physiologic factors.  The health age might 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.

Among the big advantages of this tool is that it can provide an aggregate group report of a corporation and could be utilized as an examination 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 health promotion programs is heart health assessment.

The screening 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, cholesterol, smoking, and weight.

The health expert conducting the screening then provides a consultation and helps set goals with the participant.