Planning a worksite health promotion program can be a rewarding experience for company leaders and other employees. Whether a firm decides to develop a comprehensive worksite health promotion program all at once or begin with a just a few ongoing health promotion activities, it will be helpful to use a planning process.
This section presents a simple, 10-step process that can be used by employers of all sizes to increase the success of any health promotion program.
1. Establish a planning committee.
2. Assess the interests and needs of corporate leaders and other employees.
3. Develop mission statement, goals, and objectives and design the program.
4. Develop a timeline and budget.
5. Select incentives.
6. Acquire resources.
7. Market the program.
8. Implement the program.
9. Evaluate the program.
10. Modify the program (continuous quality improvement).
Although these steps are presented in sequential order, some worksites may modify the sequence to suit their unique planning environments. In some situations, individual steps may be completely omitted. For example, managers might allocate a health promotion budget before the planning committee is even established.
1. Establish a Planning Committee
Employee involvement is integral to the planning process. Therefore, a planning committee should be formed as early in the process as possible and include:
The planning committee serves several functions. First, an employee-driven advisory board encourages “buy-in” from both management and potential program participants. The key to maximizing buy-in is to recruit employees who are enthusiastic about the proposed program, as well as those who are indifferent or perhaps even skeptical to serve on the planning committee.
Second, a representative planning committee will help assure that the program is responsive to the needs of all potential participants (possibly including employee dependents and/or retirees).
Third, the committee can be responsible for carrying out or overseeing all of the subsequent steps in the planning process. For example, the full committee or designated sub-committee will likely design and conduct an employee interest survey, select the program name and logo, select specific health promotion activities, and present periodic status reports to senior managers. Committee members can also brainstorm innovative ideas to market the program to co-workers. In general, a group is likely to generate more and better ideas than a single individual.
2. Assess the Interests and Needs of Corporate Leaders and Other Employees
The answers to these questions are important to assure that any health promotion program has a chance to succeed. One of the most important indicators of the success of a health promotion program is senior management support. Are managers willing to take part in the program and encourage others to do so? How much are they willing to budget for the program? What do they see as the benefits of the program for employees and the organization? What kinds of activities are they willing to allow?
Benchmark data from competitors and descriptions of what other organizations are doing can help engender management support.
Of equal importance, the planning committee must consider the needs, interests, and expectations of program participants. This task is commonly accomplished through a brief survey. The questionnaire may ask about employee interest in various types of health promotion activities, the most convenient times and places to schedule activities, and/or suggested organizational changes to promote a more healthful work environment. It might also include a health risk appraisal (HRA) to determine current employee disease risks, ascertain the level of interest in changing unhealthy behaviors, and collect baseline data that can later be used to help evaluate the program (for example, the percentage of employees who smoke or the percentage of employees who consider themselves in good health). Several excellent HRAs are available on the internet.
Finally, since the work environment is so influential, the planning committee may wish to periodically assess (or recommend that others assess) how well the organization is doing to support healthy behaviors on and off the job. Repeating the same survey over several years can help program planners evaluate the impact of specific organizational changes and help maintain management interest in ongoing health promotion activities.
3. Develop Mission Statement, Goals, and Objectives and Design the Program
Once needs assessment data have been collected and reviewed, it is time to develop a mission statement for the program and to set specific goals and objectives.
A program mission statement, like an organizational mission statement, briefly lists the overarching values that drive the venture and the ultimate goals or accomplishments that the project will strive to achieve. It is often a good strategy to develop a mission statement for the health promotion program that closely supports the company mission statement. For example, if a company’s mission is to be “the best” or “among the best” in a particular field, then the mission statement for the health promotion program might read, in part: “Recognizing that employees perform their best when they are healthy, and that optimal employee performance is necessary for the company to be a leader in its field, the health promotion program aims to improve employee health and wellbeing.”
Goals are statements of broad, long-term accomplishments expected from the program. The most effective goals are realistic and reflect the needs of top managers, as well as lower-level employees. Ideally, goals should be measurable, unambiguous, time- limited, and stated in such a way that it is easily possible to determine whether or not they have been achieved. In fact, assessing the achievement of goals is an important part of program evaluation. Examples are:
Objectives are statements of expected short-term accomplishments related to one or more program goals. Like goals, they should be written in such a way that program planners can readily determine if they have been met. For example,objectives that might fall under the first goal statement listed above are:
For each objective, a list of more detailed action-steps must be developed. At this point, the planning committee may wish to obtain the commitment of specific individuals or departments to carry out certain tasks. Program options, including communications, screening and assessment, interventions (e.g., self-study, group classes, telephonic counseling and support groups) are all part of program design. Decisions about hiring program staff and/or selecting vendors often is considered during this planning phase.
4. Develop a Timeline and Budget
Develop a realistic timeline to implement and evaluate the program. The timeline should incorporate any key target dates embedded in program objectives.
Health promotion programs are commonly kicked off or re-marketed at certain times of the year: the start of the year (when people are making new year’s resolutions), the spring and the fall. As much as possible, try to avoid conflicts with established company events and seasonal busy times, such as heavy vacation or holiday periods. Also, allow sufficient lead time to schedule and adequately promote planned events.
The activities themselves should be scheduled at times that are convenient for potential participants. For example, it may be necessary to offer multiple sessions before and after work to meet the needs of shift workers. If family members are invited to participate, evening sessions may be necessary.
Of course, it takes resources to carry out the activities necessary to achieve program goals. Typically, an internal staff person- with input from the planning committee and management-develops a program budget. The budget can include salaries for staff who will implement the program and/or manage health promotion vendors, administrative resources, program materials, and vendor costs. An accurate and comprehensive budget will allow the planning committee to better compare program costs and outcomes during the program evaluation. The total program budget could also be translated into a per employee cost or (eventually) a per participant cost.
In the best of all possible worlds, the planning committee can negotiate a budget that is adequate to accomplish the agreed- upon program goals and objectives. Employee cost-sharing for specific activities is also an option.
5. Select Incentives
Most people know what lifestyle changes they should make, but lack the motivation to do so. Incentive programs attempt to build that motivation by offering individuals external rewards for taking steps in the right direction.
Incentives range from recognition in the employee newsletter for participating in the company baseball team to a certificate of achievement from management for completing a medical self-care class to a small monetary bonus for quitting smoking. They can also include contributions to a “health promotion medical savings account,” merchandise awards (e.g., cups, t-shirts, etc.), extra time off from work, or travel awards. A common incentive for important behavior changes is a risk-rated premium contribution providing a 33% to 50% discount off the employee’s premium contribution for dependent health care. (Non-smoker status is one of the primary attributes used in this risk-rated approach.) Above all, know your audience; an incentive that will appeal to a truck driver may not appeal to an office worker.
6. Acquire Programmatic and/or Human Resources Support
Many high quality program materials are available free or at low cost from voluntary health organizations, local public health departments, and state or national government agencies. In addition, pharmaceutical companies market disease management programs for many conditions, including diabetes, high blood pressure, depression, and weight management. Small employers can often recruit free speakers for health awareness activities (such as a monthly brown bag lunch talk) from local hospitals, public health departments, universities, voluntary health associations, and private physician practices. It may also be practical to offer health promotion programs in cooperation with health plan providers.
7. Market the Program
Marketing a health promotion program is extremely important, both to make people aware that the program exists and to motivate them to take advantage of it. Obviously, company goals and objectives will not be met if few or no employees participate.
The planning process itself can be a powerful marketing tool. For example, broad employee involvement in planning fosters a sense of ownership of the program. Selection of a creative name or theme for the health promotion program often excites interest. A good needs assessment identifies health issues and program activities in which workers are already interested. Dedicated planning committee members are natural program spokespersons.
Beyond the planning process itself, specific marketing techniques will vary, depending on the size of the worksite, the channels of communication available, and the program budget. An endorsement of the program from the company president, executive director, and/or senior manager is an effective marketing technique and is cost- free. E-mail, bulletin board, and/or newsletter announcements are also free or inexpensive. Perhaps the best marketing tools of all, however, are pleased program participants who advertise for you via word-of-mouth.
8. Implement the Program
Program implementation involves putting the plan into action. It may necessitate making arrangements with health promotion vendors, recruiting speakers, negotiating with health plans or health clubs, scheduling health promotion activities, and more. To some extent, implementation, marketing, acquiring resources, and evaluation can all occur simultaneously. A good rule of thumb is to begin the program slowly and to lead off with those activities most likely to succeed.
9. Evaluate the Program
A good program evaluation is not an afterthought, but is built into the planning process and into the budget. Ideally, it looks at information to examine both how well the program is working (process measures) and whether or not it is achieving expected results (outcome measures).
Process measures, such as participation counts and participant evaluations of individual activities, answer many questions about the basic operation of the program.
This information can be used to modify the program to enhance participation and participant satisfaction.
Outcome measures, on the other hand, gauge the extent to which specific program goals have been achieved. Did the prevalence of employee smoking decrease from 30% to 25% by the end of the fiscal year? Did it decrease at all? Did the number of employees who file disability claims because of lower back problems decline from an average of 3/month to an average of 1/month after health promotion activities were in place for 18 months?
Outcome data that demonstrate program success help to secure continued management support for the program. Outcome data that show program goals are not being achieved point to the need for changes.
Generally, if outcomes are not as expected, there are three possible causes.
Whatever the reason(s), this information is valuable and can be used to ensure future program success.
Finally, program costs and outcomes can be compared. For example, if a firm spends $3,600 on a health promotion program that reduces the number of employee sick days from 48/year to 12/year, the company has spent $100 for each day of unused sick leave (not considering any other positive program outcomes). Self-insured firms, those that pay directly for employee healthcare, can also compare program costs to healthcare costs.
10. Modify the Program As Needed
Health promotion programs are not static, but change along with the needs and interests of employees and employers. Both evaluation data and periodic needs assessment surveys provide crucial information to guide program changes. In addition, it is useful to ask people who are not participating in health promotion activities why they are not participating.
Tips to Increase Participation
For more ideas to increase participation, search the online archive of Health Promotion Practictioner articles. Enter the term “participation” for many tips and ideas. http://www.hesonline.com/.
Healthy Workforce 2010: An Essential Health Promotion Sourcebook for Employers, Large and Small.
Copyright © Partnership for Prevention™, 2001-this publication also may be downloaded free of charge on Partnership’s Website www.prevent.org.
