This week, OHPE continues the discussion of Workplace Health Promotion began in our August 18th issue, OHPE #170, which is available on the web at http://www.ohpe.web.ca
OHPE #174.1 was compiled by Jodi Thesenvitz of The Health Communication Unit. It includes contributions from Aarti Soni, Workplace Health Promoter at the Haldimand-Norfolk Regional Health Department, from the Heart Health Hamilton-Wentworth's (HHH-W) Workplace Work Group and from
Chris McQueen & Corinne Smith of the Workplace Wellness in Niagara (WWIN) Program.
OHPE #174.2 provides more resources on workplace health (articles, reports, workbooks, conferences, courses and more).
A. Workplace Health Promotion in the Regional Municipality of Haldimand-Norfolk By Aarti Soni, Workplace Health Promoter
At the Haldimand-Norfolk Regional Health Department, we initiated our workplace health program with an extensive literature review. The purpose of this review was to answer the following key questions about Workplace Health Promotion before investing too many limited resources;
1)Why Invest in Workplace Health Promotion programs: What are the Financial Outcomes ?
2)Why Invest in Workplace Health Promotion programs: What are the Health-Related Outcomes ?
3)How is an Effective Workplace Health Promotion Program Developed ?
4)What are the Keys to a Successful Workplace Health Promotion Program?
5)What are the Indicators for Monitoring & Evaluating Workplace Health Promotion Programs?
These questions were answered in a report prepared by Deb Craig-Evans titled; Workplace Health Promotion Programs: A Review of "Why", "How", and "What".
With the background research providing confidence that Workplace Health Promotion programs could have both a financial and health impact if carefully planned, we are now working with three workplaces in the Region to plan and implement pilot programs in their workplace. Our approach is to encourage workplaces to take ownership of the program and adopt the comprehensive model to workplace health promotion (i.e., broad based focus on three components: physical environment, health practices, and social environment). To help ensure active participation by the workplace, we co-sign a contract/ letter of agreement which outlines the simultaneous responsibilities of their Workplace Health Committee and the Health Department Workplace Health Program. The major roles of the Health Department Workplace Health Program will be the provision of an assessment tool, analysis of the assessment, provision of programs promoting healthy behaviours, assistance to resources promoting the physical and social environment, and consultation regarding evaluation. We are currently developing a needs assessment questionnaire which has been adapted from various existing needs assessments. We are aiming to put together an instrument which can be administered in 30 minutes or less, will assess the three components of a comprehensive model, and may be useful as both a program planning and evaluation tool.
We have just began our adventure towards facilitating workplace health promotion programs in Haldimand-Norfolk. Although we have experienced some positive highlights and some barriers thus far, they are not unexpected at this "pilot" stage of development. A positive highlight has been that our pilot worksites are committed to the "comprehensive" model of workplace health with the responsibility and understanding required to implement effective workplace health programs. An interesting barrier we have come across in these early stages is dealing with internal workplace issues (e.g., contract negotiations, internal politics/ culture of the organization), which can cause delays in the planning process. We are finding that these barriers can be overcome with patience and restructuring time lines, working with the existing committees/ schedules of the workplace instead of imposing our own, and helping employees and management learn about the process and keeping them involved at each step.
For more information on the Haldimand-Norfolk Regional Health Department Workplace Health Promotion Program, please contact Aarti Soni at 519-426-6170 ext. 233. A copy of the literature review Workplace Health Promotion Programs: A Review of "Why", "How", and "What" is also available by email (in WP format) at [email protected].
B. Heart Health Hamilton-Wentworth in the Workplace
Heart Health Hamilton-Wentworth's (HHH-W) Workplace Work Group provides support and resources to area workplaces that are planning health promotion programs for their employees. The Group includes representatives from City of Hamilton/Region of Hamilton-Wentworth Social and Public Health Services Division, Hamilton Street Railway (HSR), Workplace Insurance and Safety Board, Family Services of Hamilton-Wentworth Inc., City of Hamilton, Culture and Recreation Department, Hamilton Health Sciences Corporation and the local Occupational Health Nurses Association.
The Work Group began its efforts in 1998 with a mailed survey to all major employers (with at least 100 employees) to determine existing health promotion policies and practices. The survey also helped identify the ways HHH-W Workplace Work Group could assist these organisations in the future. Subsequently, a newsletter, "Do it Well! in the Workplace" was created. In addition, the Work Group also received senior management approval from two organisations, HSR and the Canadian National Institute for the Blind, to proceed with comprehensive heart health workplace wellness pilot projects.
The following is a list of lessons learned from Heart Health Hamilton-Wentworth's experience working with several worksites:
- Senior management better understand the hard costs of chronic diseases in the workplace than intangibles such as increased performance, morale, etc. These hard costs include absenteeism rates, drug costs and short and long term disability. Benefits costs are rising and workplace wellness programs are one strategy to contain those costs.
- It is essential to form a corporate wellness committee representing employees from different departments, different job levels and unionised and non-unionised staff. This provides ownership from all levels within the organisation. It also assists with organisational communication, especially when promoting a survey, new program, wellness policy, etc.
- Developing wellness programs in workplaces must be driven by the employees and workplace environment. At the HSR, many employees are off-site driving buses. To address healthy eating for example, programs must accommodate this reality. A nutritious snack campaign had to ensure that snacks could be left unrefrigerated for several hours.
- Occupational Health Nurses (OHN's) are instrumental to the planning, implementation and sustainability of a program. Although the OHN is responsible for a variety of health and wellness initiatives within the organisation, many are anxious to increase health promotion programs and activities. Support OHN's by providing them with the data and research to make a business case for workplace wellness programs. Through the heart health initiative, we have been able to provide limited staff resources and seed money to get pilot wellness programs off the ground. We hope that the organisations will see the success and popularity of the programs and continue the interest and funding.
- People and workplaces that have been supportive of workplace wellness programs in your community should be recognized. Create a special awards ceremony, highlight the work in public newsletters and media releases, write articles for newspapers, provide a framed certificate or take out a congratulatory advertisement in the Chamber of Commerce publication.
- Take lots of photos. Pictures are the best way to archive the progress of the program. Use the photos to illustrate where the organisation started and where it is today. They will be useful in displays, newsletters, articles and presentations.
- There are no shortages of ideas for workplace health promotion, many of which are low cost. Web-sites, printed resources, literature reviews and trade publications have many useful options. In the two Heart Health Hamilton-Wentworth pilot sites, activities such as walking programs, SummerActive promotions, low fat potluck lunches, lunchtime wellness presentations, support to cafeteria staff, aerobics and yoga sessions and the Food Steps program were implemented with success.
For more information on Heart Health Hamilton-Wentworth's Workplace wellness initiatives, please contact Debra Clarke at 905.546.3511. Email, [email protected].
C. Sharing the Niagara Workplace Experience
Since the change in mandatory guidelines (MHPSG, 1997) , we, and many of our colleagues have been attempting to tackle the workplace as a new site for program delivery. When reviewing the research on workplace health promotion, one thing is certain. It is abundant, not always relevant, rarely Canadian, and less often, conclusive. Consequently, health departments across the province have been left wondering what to do with the workplace mandate. At Niagara, we have been facing the same challenges, and we'd like share some of our story to date.
Building the case for health promotion
Workplace health promotion strategies can be a simple as offering brochures and 'lunch & learns' to every workplace that makes such a request. These awareness-raising approaches sell easily to most workplaces. The research, however, indicates that awareness raising on its own does not change risk behaviours. The greater challenge is selling comprehensive health promotion to workplace health professionals. Comprehensive workplace health promotion includes awareness raising and education, but also addresses the environment and policies in workplaces that support (or inhibit) healthy lifestyles.
The key to selling this comprehensive approach to businesses is to think like a business. We health professionals must set our health promotion hats on the rack and don a business hat instead. It's no secret that businesses operate to maximize profits, productivity, quality and corporate recognition. This means that a strong business case is required to gain support for our programs. This business case must clearly identify how health can have a positive influence on profits, productivity, quality and corporate recognition.
The development of a complete business case has been a very important focus in Niagara. Our team has developed and continually updates a business case for health promotion in workplaces which includes Canadian data, perspectives and successes, along with the research on cost-benefits. Our team will be presenting the most recent version of this business case at the CPHA/OPHA conference in October.
Making initial contact with workplaces
In Niagara, we initially identified Occupational Health Nurses (OHNs) as the most appropriate workplace personnel to connect with. This decision was partly due to the large industrial base here in Niagara and also due to the fact that we already had an established relationship with our local Occupational Health Nurses Association (OHNA). We have since started working with other workplace personnel groups that include Human Resources, Health & Safety, Employee Assistance Programs, and Unions.
Our first step in working with the OHNs was to conduct a focus group to learn where they were in terms of comprehensive health promotion. We invited six members of OHNA to a one-hour breakfast meeting, and asked them questions regarding the health promotion initiatives they were currently doing in their workplace, what they wished they could do, and what barriers they saw to doing more. We then gave a brief overview of "comprehensive health promotion", and asked how we could help them address their issues.
It was clear from the results of the focus group that:
i) their primary role was reactive intervention, with little emphasis on primary prevention;
ii) each workplace was in a different stage of programming;
iii) most workplaces were only involved in awareness raising (pamphlets, etc.);
iv) time and management support were the greatest barriers to doing more;
v) the health professionals understood the value of health promotion but their management did not;
vi) they required help to sell health promotion to management
vii)some OHNs were ready to move forward but their organization was not as enthusiastic;
viii) they wanted an easy-to-use monthly theme package that could be used in the limited time that was available.
Developing a strategy
In response to these results, we have taken the approach of:
a) recognizing where a workplace is on the road to comprehensive health and regardless of where that is;
b)helping them move forward.
To address the different stages and individual needs of each workplace, we developed "Occupational Health" monthly theme packages. The packages include:
- awareness raising material (pamphlets, displays, paycheque inserts, fact sheets, etc.);
- educational material (educational sessions, train-the-trainer opportunities, community links, etc.);
- a list of Public Health and community resources;
- a description of sample environmental supports that workplaces could implement (e.g. a workplace physical activity, possible vending machine changes, bicycle racks, Summer Active challenges, etc.); and
- a sample workplace policy that could be adapted or created to meet the unique needs of the workplace.
Since we offer consultative support, workplaces are beginning to consult with us to implement the environmental supports and policies that will ensure sustainability of smoke-free environments, sun safe environments, nutritious foods, physical activity opportunities, healthy pregnancies in the workplace, just to name a few.
Its important to recognize that the process of moving only a few workplaces toward comprehensive programming has taken nearly two years. We have been discouraged at several points along the way but our team has persevered. Many workplaces have gradually implemented some of the Occupational Health package material, as a trial run, to gain management support. We are currently evaluating the packages to gauge interest, usefulness, relevance and overall quality. We will continue to offer the packages as a tool to reach workplaces at all stages on the road to comprehensive health programming.
We make an effort to keep an open dialogue with all our networks and accept "constructive criticism" along the way. The feedback has been very helpful for altering and creating resources that are workplace friendly. Our strategy of finding out where workplaces currently are moving them forward has been a slow, but rewarding and ultimately successful venture. We hope to continue to make in-roads into workplace territory and will gladly share our experiences with you along the way.
Article submitted by Chris McQueen, BScN, RN. & Corinne Smith, RN., Workplace Wellness in Niagara (WWIN) Program, Regional Niagara Public Health Department.