Putting employees in front of Employee Health
Participatory wellness program relies on input
If you want healthier employees, they need to care about improving their health. That truism is the foundation behind a wellness program that is essentially designed by and for employees.
"The people on the front lines are involved in saying, 'These are the health issues that matter to us most and these are ways we'd like to make our workplace a healthier place,'" explains Suzanne Nobrega, MS, project director of the Healthy and Safe@Work Project at the Center for Promotion of Health in the New England Workplace (CPH-NEW) of the University of Massachusetts Lowell.
This participatory approach turns around the usual design of workplace wellness. Employers typically look at the overall health of their population and create interventions to address the problem areas. The Healthy Work Participatory Program asks employees about their priorities and their perceptions of how the workplace impacts their health.
For example, there may be work-related reasons that some employees are unable to attend weight management classes, says Nobrega. Workplace stress may impact personal health choices, such as smoking or overeating. In focus groups, employees discuss workplace hazards, such as ergonomics, as well as job stress and scheduling.
"You're looking at removing some of the barriers to health in the workplace," she says. "You also want to look at opportunities to [create] a workplace environment that promotes health and provides support for employees to improve health."
The project, supported by the National Institute for Occupational Safety and Health (NIOSH), provides a seven-step process and free online tools for employers who want to improve their wellness program with a participatory approach. CPH-NEW is an initiative of UMass Lowell and the University of Connecticut and is a NIOSH Total Worker Health Center, designed to integrate health promotion with occupational health and safety.
The toolkit (www.uml.edu/cphnewtoolkit) includes scripts for a focus group, suggested agendas and activities for committees, and detailed instructions for facilitators.
"You can tailor it as necessary for your own organization and culture," she says.
Managers help drive process
Yet it isn't just a bottom-up structure. A successful program relies on support from both management and staff. The first step is to create a management steering committee to oversee and champion the effort, a "design team" of frontline workers. A facilitator coordinates the tasks and the overall program.
The facilitator works on the wellness program about 10 to 20 hours a week. This position could be assigned to a current employee or could be a role for an outside contractor, Nobrega says.
Frontline workers from different parts of the organization gather to talk about how the workplace supports health as well as to identify barriers to health. "This design team then is really the engine of the whole program," she says. "They're charged with identifying some [goals] to work on."
Employee input also can be gathered through focus groups, she says. The management steering committee signs off on the initial goals and proposed interventions.
The managers set a budget and timeline for the project. The dialogue between the groups is an important part of the program's success, says Nobrega. "There's a shared ownership for safety and health and wellness," she says.
The dialogue between employees and managers about health, safety and wellness helps built trust, she says.
Seeking healthy solutions
In the Healthy Work Participatory Program, wellness is a broad concept that embraces the notion of well-being.
During a pilot test of the program at a real estate firm, coordinators noted that the maintenance workers never participated in the corporate wellness program. When maintenance workers were offered the chance to design their own intervention, they decided to work on communication — to improve their work flow and team work.
"That's what stress management meant to them — it wasn't learning how to meditate," says Nobrega.
"Their ability to come together and talk was very empowering to them," she says. "It told them that the management cared. They felt that they were learning new skills and that they had a voice."
The design team and steering committee use an Intervention Design and Analysis Scorecard (IDEAS), with a set of worksheets and a detailed process, to identify a key health and safety problem and to work through possible solutions.
For example, the online toolkit suggests ways to approach musculoskeletal disorders in health care. Contributing factors could be a lack of access to lift equipment, inadequate staffing, and poor physical fitness of employees.
Interventions could include purchasing more lift equipment, organizing work flow to allow more rest breaks, and health coaching to support healthy eating and activity.
"This toolkit is meant to help give step-by-step guidance to practitioners who want to use participatory approaches in their programs," Nobrega says.
IDEAS uses a continuous improvement system, with evaluation of the impact of the interventions. The ultimate goal is a safer workplace and healthier workers, she says.
