Theory Into Practice
Ideally, by the time youre choosing interventions, youve got your wellness team together, and youve collected data on the wellness needs and interests of your population. You have taken the time to envision your goal and identify objectives. Youve got a budget and plans for evaluating and promoting your program. Your interventions should flow naturally from your data, goals and objectives. You take an objective, like reducing the number of smokers, and research the options in smokingcessation programs, and choose one you can afford.
But it isnt always that clear. The choices in subject and delivery methods can be dizzying. Should you touch on many topics, or focus on one or two? Go high-tech or high-touch? How do you choose?
Base your choices on:
1. What risk factors are prevalent in your population?
Health promotion plans are increasingly tailored to reduce the health risk factors that cost the most in medical claims and productivity. If you do HRAs, your aggregate report should identify prevalent risk factors, and claims analysis from your health care provider can add to your information. Look at group data you collect from screenings, too. And look at your demographics an employee group including many young women may benefit from prenatal care education, while an aging workforce may need heart health interventions.
2. What does senior management want the wellness program to achieve?
Look at the results of surveys and meetings with management. If their goal is short-term cost savings, you may need to focus on programs like self-care to decrease utilization, and disease management to help expensive high-risk individuals cope more effectively with health conditions.
If they are more concerned about employee retention, corporate culture and image, improving morale, and the long-term health of the employees, you may consider a broader range of programming, including stress management on an individual and cultural level, child care initiatives, fitness activities, wellness team competitions, and much more.
3. What do your employees want?
Youll want to provide some programming that matches employee interests as indicated in surveys or focus groups youve conducted. And youll want to promote them aggressively. Visible programs that appeal to many employees establish goodwill and a caring image for your program and organization.
4. How much money and time do you have?
Your resources will determine what interventions you consider. If you have little money, work on bringing community, nonprofit and government resources in to your worksite, and educate workers about whats available out there from the local YMCA to health information and support groups in cyberspace.
5. What does the latest research indicate?
Keeping up with health promotion research can save you years of ineffective, trial and error programming. Read the American Journal of Health Promotion. Look at the results of the HERO research online at www.the-hero.org. Find out whats working.
What Youll Learn In This Online Monograph
Choosing Interventions to Reduce Stress
Youve figured out that stress is a major risk factor in your workplace, and picked stress reduction as a major topic for intervention.
First, do your homework. Find out whats being done in workplaces to reduce stress. Read the AJHP review article on stress management interventions in work settings. Talk to other wellness professionals about whats worked best for them. Look at products available from the government, nonprofit organizations and vendors that may be useful.
Next, use that information to target stress as comprehensively as possible. Use multiple delivery methods some are listed below, add any others you can think of! Remember, offering your message in a variety of ways works best to change behavior.
Printed health information
Paycheck stuffers and brochures can raise awareness of stress symptoms and solutions.
Senior management message
A message from the top that the company is serious about reducing stress legitimizes the program. Its especially helpful if it sets up a vehicle for two-way communication.
Group education
Stress-management classes teaching muscle relaxation and cognitive-behavioral skills are effective.
Self-study programs
Stock your wellness library with relaxation books, tapes and workbooks and advertise them to employees.
Your EAP
Remind employees that your EAP is available and ready to help with stress issues anytime.
Computer-based programs
Screen your favorite health websites for stress information, diagnostic quizzes, and other aids. Provide links on the company Intranet, or hand out the web addresses.
Personal coaching
Meet weekly with employees who want help. Give non-threatening stress reduction homework and check in frequently, perhaps by email, providing support and accountability for their efforts to change.
Support groups
Employees can share their experiences with stress and the problem solving theyve done. You can also refer them to online and community support groups.
Your health care provider
Employees whose stress symptoms may qualify as anxiety disorders can and should be referred for mental health evaluation.
Point-of-decision prompts
Reminders at workstations, lounges, coffee machines, to breathe deeply, take a muscle relaxation break, or to think realistically (Rome wasnt built in a day) can help employees to develop healthier habits. Computers can be set up to flash reminders to workers to stretch every hour.
Corporate policies
Policies providing for flex time and assistance with childcare can make a big difference. Setting up a walking path indoors or out encourages taking healthy breaks.
Worker involvement in the design and evaluation of ongoing stress management programs is preferable to use of outside vendors or consultants.
Recognition for success
Corporate recognition for employees and managers who participate in
programs sends the right message.
Competition
Although this seems antithetical to stress management, you may get the people who need it most if you set up an individual or team competition that involves earning points for stress-reduction activities.
Incentives for participation
Incentives can be awarded for participation in individual events or for cumulative participation in a series of offerings.
Use a similar format to plan any major campaign. Do your research, then plan interventions using every delivery mode available. Be a broken record but broadcast in different languages so that everyone can
understand in their own way.
Behavior Modification and the Matter of Time
In health promotion, we often invest too little and expect too much. To change stubborn behavior patterns, we need to pick a target health behavior and provide a comprehensive, long-term series of interventions.
If youve ever been in sales, you probably know that people rarely buy on the first approach. They have to hear about the product through a variety of media an introductory letter, a phone call, an advertisement, then a sales call before theyll buy.
Its the same in health promotion. You need to give people time to get acquainted with the idea of making changes, and offer a variety of opportunities to jump in and try. The more exposure they have, the more normal it will seem.
EXAMPLE: In the 1950s the idea of NOT letting people smoke in our homes would have seemed the height of rudeness. Today, its he/she who lights up in your home or office whos out of line. That cultural change took many years to accomplish. Awareness programs, the Surgeon General ordered warnings on cigarette packages, stop smoking programs and workplace smoking policy changes followed. Lawsuits against manufacturers and smoking cessation aids and through dogged and continuous effort, smoking rates that span the ages have plummeted drastically.
So if you decide to seriously target a health behavior, go for it with all the arrows in your quiver determine the most effective interventions, and plan for a LONG campaign.
Tips for Choosing Appropriate Interventions
References
Chapman, L., What Newer Forms of Health Management Technology Can Be Used in Programming? The Art of Health Promotion, September/October 1997, Vol. 1, No 4.
Health Promotion: Sourcebook for Small Businesses published by the Wellness Councils
of America and Canada. Call (402) 827-3590 to order.
ODonnell, M., Design of Workplace Health Promotion Programs, 1995. Call (800) 783-9913 to order.