Posts from — June 2010

Health risk screening programs should be carried out on a one-on-one basis by trained health care experts. 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 treatment status – ascertain whether the participant is under a doctor’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 patron, 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 physician’s care, on any medication, on a prescribed diet, or any other kind of treatment for high cholesterol.    

• Obesity – utilize an accepted method for estimating obesity. for example assess participants height and weight and use the 1959 Metropolitan Life Height/Weight charts or use Body Mass Index (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 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’s 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 client 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 client 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 assessing  levels of stress are available from the Staff Member Health Program.

• Participant release form (see forms) – A release form is required in which the participant allows the 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 – when an assessment of interest hasn’t been accumulated previously, the screening activity must assess levels of interest in programs like –  weight control, smoking 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, sum 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 should include location of the screening, worksite, patron’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.

Program directors or providers should have a background in wellness programming and a specialist health-related degree or certification.    

They should’ve specialistise in content areas, planning, promotion, administration, analysis, and ability to grow a program and tailor the program to the workplace.   

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 must be available from directors and 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,
• program evaluation 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 ought to be provided.

Incentives can be used to raise participation rates, help with completion or attendance at programs, and to help individuals 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. A lot of organizations 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 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 staff member 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 Fitness and health books

   o Videos

• High Cost –     

   o Week-end getaways

   o Dinner for two

   o Clocks

   o Watches

• Others –     

   o Cash

   o Gift certificates

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

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

Once the program is kicked off you might 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 ought to ask the following questions –

• How many worksites have done the program?

• What kinds of worker population was the program offered?

• What educational materials are used?

• Will the program meet the needs of employees?

• What are the techniques used to help change behaviors?

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

• How do you market the program to employees?

• What follow-up do you provide?

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

• How do you know the program works?

• How do you measure participant satisfaction?

When staffing your wellness program you need to consider whether to hire a wellness staff or contract with wellness experts from outside your organization.

Small and medium size worksites don’t normally have a wellness specialist on staff. When your worksite is in this category, you will need to contract with providers outside your company.

Large businesses have several choices. They can hire a staff solely for the wellness 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, program structure, process, and effectiveness need to be addressed. Each of these key questions is discussed in the following sections.

Wellness Business Staff

Health experts become wellness experts when they are trained in the full range of wellness activities. Wellness experts 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 besides to their primary training, they know something about all wellness topics, including use of tobacco, 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 professionals at worksites fall into three broad categories, wellness screeners, wellness counselors, and wellness instructors.

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

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

• Wellness instructors teach courses and minigroups on different health topics.

A wellness program in a small company may be staffed by a single staff individuals who fills all three roles. Larger worksites will use different individuals  to fill these roles.

When picking  staff or picking  among wellness corporations, ask the following questions –

• Do prospective employees have a range of health backgrounds that’ll provide appropriate specialistise in the topics to be addressed?

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

• Will this staff include individuals  from the ethnic and racial backgrounds found in your worker 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 staff members have a warm, but professional, 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. Often an activity and wellness theme per month is offered to staff members.

Some organizations pick 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 generally 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 could want to utilize the HOPE Publications Wellness Resource Planning Guide available for free at this Web site.

A Health Risk (Assessment|Appraisal}  is sometimes used combined with a health testing. 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 disease and quantifies the probable impact for each individual.

An HRA instrument is derived from an understanding of the in a disease. Based on this understanding, useful prediction instruments may 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 clients reduce risk factors which lead to the onset of unnecessary illness and subsequent premature death.

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

For accuracy, it’s vital to obtain direct measures of blood pressure, cholesterol and HDL-cholesterol. the 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|appraisal} 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 may 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 organizations. Continuing research on HRAs is examining the efficacy of this tool.

One of the large advantages of this tool is that it can provide an aggregate group report of a company and could be utilized as an investigation 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 wellness 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, tobacco use, and weight.

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

The backbone of wellness programming at the worksite is medical testing. It is the first major activity a business should do when first beginning a wellness program.

Medical testing is often used in conjunction with the administration of a Health Risk (Assessment|Appraisal} .

The most effective way to screen is to utilize a health expert trained in wellness screening techniques and counseling to privately and individually assess participants.

This wellness professional takes a brief health history and measures blood pressure 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 provides an immediate opportunity to register participants in various health improvement programs based on their interests and identified health risks.

Biometric testing can be done each year and used to monitoring health risks within the worksite.

A medical testing program needs to provide multiple opportunities for participation. the service ought to be provided for all the various shifts of a corporation. the screening program ought to be conducted in highly visible areas so the process can be observed.

Reluctant staff members often like to be able to see what the program is about before they participate. When wellness screeners aren’t busy, they should perform outreach going to areas where staff members gather and attempt to recruit staff members.

When well-planned and promoted, medical screening can attract participation rates of 60 percent to 100 percent. These high participation rates have a positive impact on management producing support for further programming.