Posts from — November 2008

Demographic and technological transformations are changing the nature of work in our society. As these changes occur the comprehensive model of Employee Wellness Initiatives described above will evolve and continue to develop. If current trends continue, the workers of tomorrow will be older, more racially and ethically diverse, increasingly female, and will frequently be located off-site. In the later case, technological advances are making it possible for more and more consultants to conduct their work from their homes. Thus the very character of the worksite will change and so must our efforts to deliver Employee Wellness Programs. As an example, in the future it is likely that a great deal of health education programming will be delivered through personalized interactive multimedia formats, conveniently supplied to any number of workers through telecommunication systems.

As technological innovations increase in the workplace, Company Health Promotion Initiative consultants will face new health related challenges. In the past, some have assumed that technology would make workers more efficient, thereby allowing workers to work less, while being more productive. In reality, increases in technological innovation have simply allowed more of us to take our work with us where ever we go and feel guilty for not being increasingly productive.

This trend may absorb greater amounts of leisure time that is normally devoted to recreation and relaxation. Subsequent increases in fatigue and stress will ensure the continued need for effective Employee Wellness Programs.

When considering the scope of Employee Wellness Initiatives described in this article, many will think of substantial investments made by large corporations. The reality is that 60 percent of individuals working in the United States work for a business of less than 100 workers (U. S. Bureau of Census, 1988). Due to economy of scale, it has been difficult and expensive for small business owners to supply adequate health care insurance and prevention programming for workers.

Company Health Promotion Initiative consultants must understand this challenge and develop the way to overcome these obstacles. The evidence is clear that much more could be done to advance the health of our society through the workplace. As change agents, health educators must work to empower corporations and workers through education of the benefits of Employee Wellness Programs.

Worksites do not exist in a vacuum. They are part and parcel of the community in which they are located. Successful corporate administrators are cognizant of the need for positive community relations and should do what is necessary to promote good will. What better way to bridge relationships than by utilizing existing community Company Health Promotion Initiative services and initiatives whenever possible (e.g., voluntary, private and public health agencies) and providing health related services back to the community. Since the community is also the home of the staff member, an effective mode of health promotion is through programming directed at the larger community. Sponsorship of community related health fairs is one example more are listed below.

• Encourages staff member/employer involvement in the community
Blood drives
Sponsorship of fund raising for community schools and social services
Community recycling initiatives
Youth league sports sponsorship
Job training initiatives
• Media and public relations initiatives advertising a healthy business image
• business newsletters and press releases on health issues to local media
• Environmentally sound use of community resources and waste disposal

At times Employee Wellness Initiatives have been instituted as public relations vehicles intended to enhance the organization image with little concern for improvements in staff member health. Companies who are truly committed to enhancing staff member health and wellness, are corporations who have worked to include Employee Wellness Initiatives into the business’s mission statement. With this commitment, policies and procedures can be written to address short and long term goals of raised staff member health, productivity, and morale. These policies and procedures are critical to the establishment of supportive organizational cultures conducive to staff member health and wellness.

• Active staff member involvement in Company Health Promotion Initiative committees and business decision making
• Availability of flextime work schedules
• No tobacco use policy
• Drug use policy and testing
• Motor vehicle seat restraints and the use of other protective/safety equipment
• Sexual harassment policy
• Family leave initiatives
• Consistent and frequent awards and recognition of staff member work efforts

The environmental conditions of the worksite can be divided into both physical and psychosocial domains, both of which influence the climate and culture of a worksite. The cultural norms of a workplace have been identified as powerful determinants of worker health and behavior (Baum, 1995). Ultimately, workers benefit most from a healthy, supportive; eustressful workplace community was they feel valued and respected. Since adults spend approximately one third of their waking hours at work, one would hope that workers view work as less of a necessity and more of an enjoyable experience.

The climate of a workplace is also more conducive to enhancing health and human performance when the environment is safe, clean, aesthetically pleasing and ergonomically engineered. While some occupations maybe inherently dangerous (e.g., fire fighter, military personnel) all comprehensive Employee Wellness Initiatives should control exposure to unhealthy conditions including: hazardous chemicals, noise, temperature, radiation and other risky conditions. Program examples include:

• Employee Wellness Initiatives grounded in supportive cultural change strategies
• Environmental and safety compliance measures
Lighting
Ventilation
Heating
Control of toxic substances
Noise
Universal precautions
• Ergonomically designed workstations
• Sanitary, clean, well maintained physical environment
• Recycling promoted initiatives
• staff member & management training in emergency procedures

An staff member’s psychological health can never be neglected in a comprehensive model of Employee Wellness Programs. Originating out of a need for alcohol abuse interventions in the workplace, today’s employee assistance programs (EAP) encompass assessment and counseling for substance abuse and dependency, stress related disorders, family conflicts and other individual issues.

Evidence of the need for such initiatives is wide spread. In a national survey conducted by the Northwestern Life Insurance Company (1992) 46 percent of workers reported that their job was very stressful, 34 percent thought about quitting their jobs because of workplace stress, and 14 percent did leave their job because of stress. Alcohol and substance abuse problems and issues of workplace violence and harassment are common areas of concern. For many the only viable treatment solution is the Employee Wellness Program.  Exemplary Employee Wellness Initiatives will include:

• Personalized assessment of staff member concerns
• Treatment choice assistance
• Emphasis on prevention and treatment
• Individual and family counseling initiatives
• Treatment for addictions:
Drugs
Alcohol
Gambling
• Crisis intervention initiatives
• Stress Management Programs
• Ongoing support groups
• Management and staff member training to establish individuals at risk.
• After treatment assistance

Small and large corporations carry a significant proportion of the provision of health care for families in this country by providing health care insurance for their workers. With the escalating increase in health care cost many corporations are attempting to slow the increase of health care insurance premiums by providing innovative cost control initiatives. Greater emphasis is being put on primary prevention to keep workers healthy and secondary prevention to establish and treat health conditions before they can become serious.

At some workplaces, workers are being encouraged to take greater responsibility for their health related behaviors through risk rated incentive packages. Linking wellness to staff member benefits of gain sharing and co-payment cost reductions will provide new opportunities requiring efforts of collaboration between the human resource managers and the Company Health Promotion Initiative specialists. These two sets of consultants may also work together for the ongoing evaluation of cost effective Employee Wellness Programs.

In conjunction with the above initiatives most large corporations also have a nurse or physician on staff to dispense worksite medical and preventive care. Some initiatives have also found it cost effective to provide their own physical therapy programming to assist injured and infirm workers in regaining optimal functioning. A comprehensive selection of health related staff member services and benefits would include the following:

• Free or low cost health screenings provided on site by business clinical personnel or through outside contractors:
Serum cholesterol
Colorectal cancer screen
Blood pressure check
Mammography
Vision and hearing testing
Diabetes
• Referral and follow-up procedures (e.g., Hypertension, Cholesterol, Cancer)
• First Aid and emergency care
• Disease control and prevention initiatives
• Onsite Child and adult care services
• Financial and Pre-Retirement planning
• Continued learning/educational opportunities
• Coordination of business picnics and outings
• Parent-child work visitation initiatives
• Workers compensation/rehabilitation

physical fitness and nutrition initiatives have demonstrated effectiveness in delaying the onset of staff member morbidity while enhancing self esteem, stress management and general feelings of well being. Although many physical fitness and nutrition initiatives are instructional in nature, they should go beyond educational initiatives by providing enabling supports for the adoption of healthy behaviors.

Quality Employee Wellness Initiatives encourage and facilitate participation in daily physical activity for all workers, and when possible retired workers and family menbers. This is accomplished through access to fitness facilities, (preferably on site) and properly supervised exercise classes. In addition a comprehensive program will provide opportunities for Personalized exercise and nutrition prescriptions from certified consultants. Commitment to the model is demonstrated through occupational food services and sales consistent with healthy nutrition. Specific initiatives to include:

• Resistance training
• Flexibility conditioning initiatives
• Healthy cooking classes
• Aerobic conditioning initiatives
• Diet analysis and planning assistance
• Physical rehabilitative initiatives
• Weight/body fat control initiatives
• Team and individual recreational sports initiatives
• Physical fitness assessments and initiatives

Health education is easily integrated into all the areas of comprehensive Employee Wellness Initiatives and it is unlikely that any of the areas could survive without an educational component. It is a key element of every primary, secondary, and tertiary prevention program and a way of promoting wellness and optimal health. A comprehensive health education program must be based on theoretically and scientifically sound principles to ensure effectiveness.

Successful health education initiatives will incorporate adult learning theories and encourage active participant involvement in all aspects of program planning and implementation. Health education efforts should emphasize skill development and the adoption of health enhancing behaviors while being accessible to all workers, their families and retirees. Methods of delivery may include; one on one instruction, group presentations, seminars, workshops, educational media lending library and health literature distribution. Program examples may include:

• Health Risk Assessments / Health Risk Appraisals
• Personalized health prescriptions and behavior change assistance
• First aid and CPR training
• Nutrition education initiatives
• Stress Management Programs
• tobacco use cessation  initiatives
• Cancer and heart disease education
• Blood borne pathogens education initiatives
• Sexual assault prevention initiatives

• Prenatal care
• Safety education initiatives
• Self care initiatives
• Healthy back initiatives
• Family centered initiatives
• Supplies of literature and educational media available for staff member loan

As the field of Employee Wellness Initiatives continues to evolve, the need to define succinctly the components of this comprehensive approach increases. In 1987 Allensworth and Kolbe (1987) expanded the prevailing definition of comprehensive school health to include the domains of Health Instruction, Environmental Health, Health Services, Physical Education, Counseling and Psychological Services, School Food Service, Employee Wellness Initiatives for Faculty and Staff, and the Integration of School and Community Resources.

To promote the health of school age children, prevention specialists have realized that an integrated comprehensive approach is the most effective strategy. Relying only on health education or Physical Education initiatives to foster children’s health has demonstrated limited effectiveness. Consistent health messages delivered by numerous agents increases the possibility of attaining health goals and objectives. A similar model is critical if Employee Wellness Initiatives are to impact positively on the health and performance of all workers.

A comprehensive model of Employee Wellness Initiatives includes the following components; Health Education Strategies, staff member Health Services and Benefits, physical fitness and nutrition Strategies, Company Health Promotion Initiative Policies and Procedures, Counseling and Employee Assistance Programs, a Safe and Healthy Work Environment, and the Integration of Company and Community Resources. This model can be used to evaluate and plan for Employee Wellness Initiatives that are truly comprehensive in nature, focusing on primary, secondary, and tertiary prevention strategies for workers.

One value of a truly comprehensive model is that it is possible to promote a holistic philosophy of staff member health. A productive, healthy staff member is one who is given the opportunity to develop emotionally, physically, socially, intellectually and spiritually. In addition, this model supports the ideals of wellness and optimal health by encouraging worksites to go beyond initiatives designed to only reduce health care costs, prevent disease, or maintain health.

A key factor in the utility of this model is the integration and overlap of responsibilities. Implementation and design are dependent upon the motivation and cooperation of qualified – and ideally – credentialed consultants throughout the administrative structure of a business. Such a model requires consistent communication between health educators, medical staff, human resource managers, physical therapists, industrial hygienists, exercise physiologists, ergonomic engineers, dietitians, occupational therapists, psychologists and independent consultants. Planning must also incorporate active involvement of workers, administrators, family members, and business retirees at all stages of the development, implementation and evaluation stages. All must be committed to the development of a healthy organization where workers are happy and proud to work.

Various professional groups are working to advance the science of Employee Wellness Programs. Health educators have the expertise and training to be leaders in this field. On the basis of theoretical foundations of health behavior and the results of empirical research, we must start to articulate a clear vision of what optimal initiatives should consist of. Components of this model are included below for reference and will be discussed individually in coming posts.

• Health Education
• physical fitness and nutrition Strategies
• staff member Health Services and staff member Benefits
• Employee Assistance Programs and Counseling Programs
• Safe Work Environment
• Health Related business Policies and Procedures
• Integration of business and Community Resources

As the field of Employee Wellness Initiatives continues to evolve, so will the need to define and articulate the dimensions of a comprehensive model of Employee Wellness Programs. A representative model includes the following components; health education initiatives, staff member health services and benefits, physical fitness and nutrition initiatives, Company Health Promotion Initiative policies and procedures, counseling and employee assistance programs, a safe and healthy work environment, and the integration of company and community resources.

A comprehensive approach to Employee Wellness Initiatives will maximize the impact of all interventions by increasing communication between administrators, workers, and staff member families, while encouraging the adoption of a healthy worksite climate and culture. Philosophically, this model supports the ideals of staff member wellness and optimal health by encouraging worksites to go beyond initiatives designed to only reduce health care costs, prevent disease, or maintain health.

A key factor in the utility of this model is the integration and overlap of responsibilities for Employee Wellness Initiatives by various departments and individuals outside and inside the company. As the structure of the workplace continues to change, in the future this dynamic model can be used to evaluate and plan for Employee Wellness Initiatives that are truly comprehensive in nature.

A Comprehensive Model For Employee Wellness Initiatives

According to the National Survey of Worksite Health Promotion Activities (1992) 81 percent of corporations in the United States with 50 or more workers have some form of Employee Wellness Initiatives activity. This result puts us in proximity of the Healthy People 2000 (1990) objective of 85 percent by the year 2000. Why are corporations getting into the business of Employee Wellness Programs? The three most common reasons cited for employer interest in Employee Wellness Initiatives are the desire to control spiraling health care costs, to encourage a healthy productive work force, and as a way of boosting the morale of workers and the image of the company (O’Donnell, 1994).

As the motivations behind Employee Wellness Initiatives differ, so do the extent of a Employee Wellness Initiatives efforts. A program may consist of distributing the occasional health pamphlet on the warning signs of cancer to workers, or it may comprise an elaborate and strategically planned Company Health Promotion Initiative targeted to the specific needs of a company and its workers. Research indicates (O’Donnel & Harris, 1994) that some Employee Wellness Initiatives have been more effective than others in improving health status, but what would a truly comprehensive model of Employee Wellness Initiatives consist of?

Imagine yourself working for the healthiest business possible. What characteristics or Company Health Promotion Initiative strategies would make that organization so healthy? Examine it from a holistic perspective. What does that business do to enhance the social, physical, spiritual, emotional, and intellectual aspects of staff member health? How does that business develop effective health policies and relevant programs that impact all workers? Finally, how does that business demonstrate its belief that workers are the business’s most valued asset?

It is unlikely that any one single of a Company Health Promotion Initiative will be accountable for the positive health outcomes of all workers. Company Health Promotion Initiative have evolved from the occasional fitness center for the exclusive use of business executives, or the sporadic staff member safety program, to a wide range of health enhancing services and initiatives. Company Health Promotion Initiative consultants frequently speak of the importance of cultural change and the need to institutionalize Employee Wellness Initiatives in today’s workplace. This goal can only occur through a comprehensive and integrated approach that impacts on workers through numerous channels.