Employee Health Promotion

Information to evaluate your program comes from regularly gathered assessment and follow-up data of your program that look at process and outcomes of your program. The Worker Health Program has available a computerized case-management system which includes queries that allow simple assessment of process and outcome results at any point in time.

Process Assessment

Process evaluation looks at the Employee Health Promotion ’s influence as seen at various points in time. Information that is gathered from the various forms that wellness employees fill out ought to supply you with the following:

• How many employees were screened?
• How many employees who were referred to a doctor went?
• How many employees who expressed interest in health improvement programs went?
• How many employees who were referred to health improvement programs went?
• How many employees who went to health improvement programs completed them?
• How many employees are in follow-up caseload?

You can use this type of process evaluation to evaluate and learn about the health of your program.

Outcome Assessment

A central intention of the program is to better the health of employees. Information on how to judge how well your program is meeting this intention is called “outcome evaluation” because you are evaluating the end results or outcome of your program. In wellness programs, objectives are gauged by specific (outcomes) behavior changes and reductions in health risk levels. Have employees lowered their Blood Pressure? Have they lost weight? Are they exercising more? Is alcohol consumption at a safe level? For example these are the types of questions you can ask to find out if you are reaching your objectives:

• For employees with elevated Blood Pressure (140 / 90 or higher or on medication) at assessment, what percentage have it under control (below 140 / 90) a year later?
• What is the change in average Blood Pressure levels among all employees with elevated Blood Pressure 1 year after assessment? Two years later?
• For employees with elevated blood cholesterol levels (above 240) at screening, what percentage has reduced their cholesterol to borderline-high levels (200-239)?
• For employees with borderline-elevated blood cholesterol levels, what percentages have reduced their cholesterol to the desirable range (below 200)?
• What is the change in average cholesterol levels among all employees with high and borderline-high blood cholesterol levels 1 year after assessment? Two years later?
• For employees who were overweight at assessment, what percentage have lost 20 pounds or more a year later? Ten pounds or more? What is the average weight loss?
• For employees who were smokers at assessment, what percentages have quit smoking? For at least a year?
• For employees whose level of alcohol consumption put them at-risk at assessment, what percentage have quit drinking alcohol? Are consuming alcohol at levels considered safe by CDC guidelines? Have reduced their drinking, but are still at-risk?
• For employees, what percentages are exercising at least three times a week for at least 20 minutes?
• If fitness levels were gauged, what percentages have improved fitness?

Set a regular time such as every 6 months to look at which employees your program is reaching and how effective it is at supporting them decrease their health risks. Use this information to make new decisions about how to direct your program efforts. Then make the change you need to better your program. Some may feel that evaluation is unnecessary; it is not. Evaluation is a crucial part of a wellness program. You will have to know what is working and what is not. Decision-makers who fund the program need to be updated on the performance of the program. Assessment will offer you with crucial data to maintain and expand the program and convince management to continue to support the program.

The menu approach offers employees a range of options to support lifestyle changes. It allows people to choose the kind of help that suits their schedules and preferences. The four basic types of programs include:

• Classes
• Minigroups
• Guided self help
• Individual counseling

Classes

Classes (8 or more) can be an effective means of providing education and social backing for behavior modification. The length of a class can vary depending on topic requirements. It is not sufficient to offer only classes at a worksite. Many employees are under time constraints with after work commitments and even though they may be interested they simply cannot participate because of their schedules. employees may be very eager to begin a program but because of lack of participants to meet class quotas, the program is canceled. Many national organizations such as the American Heart Association, American Cancer Society, Weight Watchers, etc. offer classes; you ought to have little trouble in identifying a provider for class type programs. You may want to contact your local hospital, health department, or YMCA for possible options. For selecting a vendor to offer a program you may want to review the section on program structure.

Minigroups

When there is not enough interest to create a class, those who are interested in a given health topic can be formed into a minigroup (2 to 7). The minigroup can cover the same content as a class but do so in a less formal manner. Presentation of information and discussion is the primary format of the minigroup.

Guided Self-Help

Most employees do not want formal help in making health changes; they prefer to do it on their own. In guided self-help, the wellness counselors offer backing, materials, and encouragement. Meeting times can be arranged and contact can be made either in person, by phone, or computer. Materials can be made available at the worksite, or mailed to the individual. Some worksites now make information available via intranets or the Internet.

Individual Counseling

One of the most successful ways to help people change and better their health status is counseling (or coaching) on a one-on-one basis. In published research studies, wellness programs which incorporated individual counseling as part of the program process achieved significantly higher participation rates and achieved greater risk reduction/risk elimination than standard group programs. Research studies have shown that individual counseling is both cost effective and cost constructive. A wellness counselor ought to be trained in assessment techniques, for in certain situations, they may be necessitated to both screen people and counsel them. They ought to know how to do the following:

• Review employee health risks
• Contact employees who have health risks.
• Counsel employees on a one-on-one basis, helping them set goals/objectives, solve problems, and get expert help when they need it.
• Help employees follow their treatment recommendations and make lifestyle and health behavior changes.
• Recruit employees into health improvement programs, such as weight loss and tobacco cessation.
• Work with employees on a one-on-one basis using guided self-help.
• Conduct classes and minigroups if necessary.
• Work with Employee Health Promotion Committee members to plan and conduct worksite-wide wellness activities.

Wellness counselors are health generalists; they must have basic knowledge about a wide range of health issues and health risks. Counselors must be able to talk with employees about their healthcare problems and the treatments prescribed by their doctors. They ought to have a great overview of diet, exercise physiology, pathophysiology of disease, pharmacology, psychology, and behavior modification skills.