Posts from — October 2008

Worksite Wellness Plan communication is important to all aspects of Wellness and preventive medicine and is relevant to:
• Healthcare provider-patient relationships
• An individual’s exposure to, search for, and use of Worksite Wellness Plan information
• Effective counseling and patient education for behavior change
• Content of public health messages and community campaigns

Effective health communication should have these attributes:
• Accuracy: content is valid and error-free
• Availability: delivered or placed where the intended audience can access the information
• Balance: content presents benefits and risks of potential actions
• Consistency: content is locally consistent over time and is also consistent with information from other reliable sources
• Evidence-based: content and methods of delivery are based on relevant scientific evidence
• Reach: content gets to or is available to as many staff members as possible in the target population
• Reliability: content source is credible; content is kept up-to-date
• Repetition: delivery of/access to the content is continued over time, to reinforce the impact with the audience and to reach new members of the target population
• Timeliness: content is provided when the audience is most receptive to, or in need of, the specific information
• Understandability: reading, language levels, and format are appropriate for the specific audience (i.e., Employees, Family Members, Garrison leadership, etc.)

What the research says about health communication
• Health communication best supports Wellness when multiple communication methods are used to reach specific audiences.
• Effective Wellness and communication initiatives should reflect an audiencecentered perspective, and reflect the preferred formats, contexts, and method of communication for the intended audience.

Material adapted from: U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing Office, November 2000.
http://www.healthypeople.gov/document/HTML/Volume1/11HealthCom.htm

Evaluation of successful Workplace Wellness Programs has revealed several primary Worksite Wellness Plan strategies to increase Worksite Wellness Plan effectiveness and impact overall Soldier health.

Strategy #5: Using a small number of targeted priorities maintains Worksite Wellness Plan focus.
• Needs assessment data can be used to identify leading health and wellness needs and also high risk populations.
• Choosing a handful of specific health and wellness needs on which to focus will maximize efficient use of resources.
• Keeping the Worksite Wellness Plan focus small will avoid duplication of other ongoing company Workplace Wellness Programs.

Strategy #6: Use standardized processes whenever possible.

Reduce the amount of variation within your Workplace Wellness Programs by standardizing all the processes needed for Worksite Wellness Plan planning and begination. By way of example:
• Use the same spreadsheet format for data collection so that the columns are in the same order. This way you can compare information more easily.
• Reuse the same forms for enrollment and attendance. Change the heading as needed.
• Look at other Worksite Wellness Plan processes (like registration, evaluation, marketing, etc.). What parts of those processes can be standardized?
• The Wellness and Prevention Initiatives website (http://chppmwww. apgea.army.mil/dhpw/Population/HPPiFunction.aspx) has many standardized Worksite Wellness Plan resources in a variety of topic areas.

Strategy #7: Worksite Wellness Plan delivery methods should be flexible and adapted to population needs.
• Delivery of products and services may depend on: company needs, training requirements, other scheduling considerations (such as work/duty schedules, school scheduling, etc.), participant preference, and/or availability of staff or space.
• Be flexible: the same produce/service delivery methods may not work for every population.
• Some company’s may want services provided to them as close as possible to the company location; other companies may prefer as many services as possible bundled together at once (regardless of location).
• Take wellness and preventive medicine beyond the walls of the company in order to meet leadership and worker needs. Answer the question: “How can we best help leadership and Employees to fulfill their mission?”

Evaluation of successful Workplace Wellness Programs has revealed several primary Worksite Wellness Plan strategies to increase Worksite Wellness Plan effectiveness and impact overall Soldier health.

Strategy #1: Communication with leadership is critical
• Assess leadership priorities.
• Report Worksite Wellness Plan outcomes back to leadership in a timely manner.

Strategy #2: Worksite Wellness Plan planning must be driven by information.
• Determine specific needs of the target population.
• Focus on the health status of the population as a whole to identify the top health concerns.
• Data should drive decisions regarding which health and wellness needs should be addressed first.

Strategy #3: Use electronic information collection and reporting as frequently as possible.
• Centrally collected information in an electronic format is essential for determining population health and wellness needs.
• Electronic reporting is also very valuable when communicating Worksite Wellness Plan outcomes to leadership and other stakeholders.
• Flexible reporting capabilities allow information to be presented as information that can support decision-making, in formats that decision-makers prefer.

Strategy #4: Multidisciplinary collaboration enhances worker health and maximizes available resources.
• Collaboration between health disciplines increases effectiveness of Wellness and preventive medicine interventions.
• Don’t forget to look outside the company for collaboration partners.
• Optimized Worksite Wellness Plan outcomes can be met by coordinating the activities of medical experts, cadre, community agents, and funding sources.
• Bundling services together also provides the additional benefit to units by conserving training and mission time.
Implementing these strategies can improve Worksite Wellness Plan effectiveness and optimize available resources.

Changing health-related behaviors is a difficult challenge. Incorporate the tools below into your Wellness initiatives to assist members in successfully changing health behaviors.

Tool #1: Set effective goals
• Focus on areas that can impact the overall goal.
• By way of example, if the overall goal is to lose weight, the most productive areas to focus on are the activity and dietary changes that will lead to long-term weight loss.
• By way of example, stress management and improving self-esteem may also impact weight loss; however, improving relationships, while a worthwhile topic, will not necessarily impact weight loss.
• Make the goals specific, attainable, and forgiving. By way of example:
• “Exercise more” is too general.
• “Walk five miles everyday” is specific, but may not be attainable.
• “Walk 30 minutes everyday” is specific and more attainable, but is not very flexible.
• “Walk 30 minutes, five days a week” is specific, attainable, and forgiving.
• Use a series of short-term goals to achieve the ultimate goal.
• Short-term goals break big challenges into more easily attained pieces.
• Smaller steps also provide Worksite Wellness Plan members with encouragement and success. These small successes are critical for maintaining motivation towards a long-term goal.

Tool #2: Increase self-awareness
• Self-monitoring is useful for tracking behavioral and environmental cues that trigger a particular behavior.
• Keeping track of behavior status is also useful for times when progress towards a goal is difficult to measure, or when an individual is in a maintenance stage.

Tool #3: Offer rewards and motivation
• Encourage members to reward themselves for achieving small successes on the way to their ultimate goal.
• Remember that rewards don’t always have to be “things.” Words of encouragement and praise can provide powerful motivation when spoken by a teacher, instructor, parent, friend, etc.

Tool #4: Respond effectively to set-backs
• behavior change is conceptually a continuum. However, movement along that continuum is not just in one direction. People can move backwards or forwards or sometimes just stay put. Communicate to members that set-backs, lapses and even staying the same (i.e., maintenance) are common for individuals trying to change behavior.
• Stress is frequently a factor in lapses and relapses. Offer a variety of stress management resources to help members better handle the stress which could trigger a set-back.
• Brain storm to create a list of potential (and probable) obstacles to participant behavior change. Then formulate strategies to meet each of those challenges.
• Improved time management and decision-making skills can be effective ways to overcome behavior change relapses.
• Offer members with information regarding the behavior change process so that they will be better prepared for the challenges they will face. A brief overview of the Stages of Change may be helpful.

The majority of businesses do not have the Worksite Wellness Plan resources to address all of their health and wellness needs at once. Priorities must be set to determine the most pressing health and wellness needs. Use the steps below to prioritize company Wellness needs.

Assess the health and wellness needs of the population.

Collect information about the health and wellness needs in the community. How?

• Community- or target group-specific surveys

Establish health and wellness needs and at-risk populations.

Use the information to identify leading health and wellness needs and also high risk populations. By way of example:
• Obesity and overweight
• Injury prevention
• Self care

Reduce the list.

Not every health need can (or should) be addressed. Use the following questions to determine which health and wellness needs should be addressed first.
• How does the health need impact operational readiness? How big is the impact?
• What are the Upper Management priorities? How does the health need fit into those priorities?
• What are the behavioral factors affecting the health need? What is the evidence that a behavior change will make a difference? Has the behavior been successfully changed by other Workplace Wellness Programs?
• What other social, physical, or environmental factors influence the health need or the target population?
• Is the health need a greater problem at the local level than in the U.S. population as a whole?
• Does the company have the subject matter expertise and resources to address the health need?

Develop Worksite Wellness Plan recommendations.

Only a handful of specific health and wellness needs should be focused on in a given year. Keep the following in mind as recommendations are developed as to which specific health and wellness needs will be addressed:
• Avoid duplication of other ongoing Workplace Wellness Programs whenever possible. Establish Workplace Wellness Programs already addressing the health need and/or the target population.
• Establish and assess available resources. Build on existing services whenever possible.

Use the recommendations to offer tailored, targeted, integrated interventions to address the prioritized list of health and wellness needs. Prioritizing health and wellness needs will keep Workplace Wellness Programs focused, maximize efficient use of resources, and align Wellness efforts with Upper Management goals and priorities.

References
• US Department of Health and Human Services, Planned Approach to Community Health, http://www.cdc.gov/nccdphp/publications/PATCH/index.htm.
• Implementing a Comprehensive Community Wellness and Well Being Program, presentation by CHPPM-EUR at the 2006 Force Health Protection Conference

Keeping the bottom line up front Bottom Line Up Front in Worksite Wellness Plan will help you get and sustain Upper Management support. A Bottom Line Up Front approach will also help you more realistically measure the impact of your Workplace Wellness Program.

The bottom line in Workplace Wellness Programs answer two primary questions:
• How will participant health be improved?
• What’s in it for Upper Management?

The ultimate bottom line: all roads should lead to readiness.
• Always be ready to communicate to leadership the ways that your Worksite Wellness Plan impacts readiness.
• Think like Upper Management: what Worksite Wellness Plan outcomes will be important from a Upper Management point of view?
• Develop line-centered language that communicates those outcomes.
• Ask members how they think a particular Worksite Wellness Plan enhances force readiness. This input is a valuable source of information.

Use the following steps as a Bottom Line Up Front approach to Workplace Wellness Programs.

Step 1: Think about the end of the Worksite Wellness Plan first and plan backwards.
• It has been said, “If you don’t know where you’re going, any road will get you there.”
• Before planning or beginning any part of the Workplace Wellness Program, be able to answer the questions: how will participant health be improved? What’s in it for Upper Management?

Step 2: Establish concrete Worksite Wellness Plan outcomes.
• Establish up front what the Worksite Wellness Plan is working towards.
o By way of example: will members lose weight? Walk more steps? Decrease injuries? Move to another stage of change?
• Establish any processes or procedures that will be improved.
o By way of example: which pharmacy operations will become more efficient? How will record-keeping be streamlined?

Step 3: Determine what will be measured to show that Worksite Wellness Plan goals were achieved.
• Look at what information is really needed to show Worksite Wellness Plan effectiveness. Avoid the temptation to collect every possible piece of data. Choose a handful of important information points and stick to those.
• Think backwards when determining what information to collect – consider how easily follow-up information can be collected when a Worksite Wellness Plan ends. Getting follow-up information is frequently a challenge.
• Only collect information for health behaviors or indicators that the Worksite Wellness Plan actually affected.
o By way of example: if the main Worksite Wellness Plan goal is that members will walk more steps, then it may be better NOT to choose changes in cholesterol level as a Worksite Wellness Plan outcome (unless the Worksite Wellness Plan specifically addresses cholesterol).
• Avoid measuring outcomes that the Worksite Wellness Plan cannot (or did not) affect.

Step 4: Determine what Worksite Wellness Plan elements must be included to move members towards the Worksite Wellness Plan goals.
• The concrete Worksite Wellness Plan outcomes identified in Step 2 are the compass for keeping the Worksite Wellness Plan on track. All Worksite Wellness Plan elements should lead towards that ultimate goal.

Working backwards when planning and beginning Workplace Wellness Programs is really forward thinking. Keeping the bottom line up front is a smart approach to Workplace Wellness Programs.