Many Canadians cite increased time spent at work as a major reason for inactivity. Many companies are as a result, introducing employee health programs in an effort to correct this dangerous trend.

A 1997 Labour Force study by Statistics Canada showed that an average 7.4 days were missed by each full-time employee in 1997. For a company of 1,000 employees, with an average salary of $190 per day, this translates into $1,400 per employee, per year for incidental absenteeism or a total cost to the company of $1.4 million per year.

Employers are taking notice of these and other alarming statistics and instituting at-work wellness plans for their employees. Large corporations often house exercise facilities right in the office building however all businesses no matter what their size, can benefit from workplace wellness initiatives.
For many small companies, it may not be feasible to establish facilities on the premises but they can make arrangements for their employees to participate in community or health club facilities. They can also use flex-time arrangements so that employees have more opportunities to participate.
Organizations are beginning to be held accountable for ensuring that the environment in which people work fosters health not disease.
To foster wellness, organizations need to understand the precursors to disease, particularly those related to stress.
Wellness is the personal experience of physical and mental health. Home stress and job stress affect wellness ­ and the measure of wellness is usually self-reported health status.
There are three major contributors to wellness:

  • Health practices ­ the voluntary activities of individuals that affect their health
  • Personal resources -- the psychological and social means by which people cope with environmental stress
  • The environment in which they are trying to cope, which includes: their surroundings, the conditions in which they work, their circumstances, as well as the supports and opportunities available to them to maintain or improve their health.

The work environment can help or hinder an individual's efforts to reduce stressors in his/her life.
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Workplace stress or job-related stress can be attributed to employers if:

  • The workplace defeats the employees' sense of control over their work and their health which, in turn, reduces motivation to pursue positive health practices; and
  • The workplace makes it difficult to maintain a healthy lifestyle and pursue positive health practices.

Personal health practices include:

  • Physical activity;
  • Eating;
  • Smoking;
  • Sleeping; and
  • Drinking alcohol.

Wellness is the personal experience of physical and mental health. Home stress and job stress affect wellness ­and the measure of wellness is usually self-reported health status.
There are three major contributors to wellness:

  • Health practices ­ the voluntary activities of individuals that affect their health
  • Personal resources -- the psychological and social means by which people cope with environmental stress
  • The environment in which they are trying to cope, which includes: their surroundings, the conditions in which they work, their circumstances, as well as the supports and opportunities available to them to maintain or improve their health.

The work environment can help or hinder an individual's efforts to reduce stressors in his/her life.

DEVELOPING AN ACTIVE LIVING PROGRAM

A SIX STEP PROCESS:

  • Generate the idea
  • Establish the rationale
  • Form an employee committee
  • Test the feasibility in your organization
  • Check for employee interest
  • Prepare the proposal

These steps are consistent with program and policy development initiatives in any organizational setting. A champion, management team, or group of employees usually generate the idea and then follow this six-step process to put the idea into action.
The following paragraphs highlight the key elements in developing an effective active living program:
Senior executive needs to champion the initiative
Generally speaking, corporate initiatives succeed best when there is a senior executive championing the initiative and a planning team comprised of workers from all levels and areas of the organization reporting to the champion. In a unionized environment, union leadership should also be engaged.
Creating the planning team
There is a need for data from many areas of the organization in developing the Business Case for Active Living. To be effective and sustainable, active living must be incorporated into the organization's planning framework and become part of the structured benefits the company provides for its employees.
To ensure that this integration occurs, people from the following areas in the organization must be included on the planning team:

  • Compensation and Benefits
  • Human Resources
  • Health and Safety
  • Health Promotion
  • Disability Management
  • Finance
  • Internal Communications
  • Union/Employee Association

As well, the team will need some enthusiastic proponents of active living in the workplace to mobilize the energy needed to get a program introduced and implemented.
Criteria that contribute to program success

  • The program meets needs of employees both in terms of their physical health and overall sense of well-being.
  • The process is well-planned, officially introduced and includes a health education component.
  • The program positioning incorporates the idea that employee health and well-being is primarily the responsibility of the employee, with thoughtful and sustained support from the organization and, where appropriate, the union.
  • The organization needs to be seen to be providing access to active living at work as a tool to help employees maintain and improve their health.
  • The program is flexible and allows employees to choose how best to incorporate active living into their daily lives.
  • Individual health management is visibly supported by senior management.
  • Communications activities link wellness programs to overall business goals such as adaptability, resilience, competitiveness, productivity, individual responsibility, etc.

INTEGRATED APPROACH ESSENTIAL TO ORGANIZATIONAL BUY-IN AND PROGRAM EFFECTIVENESS

Much of the discussion in the literature on physical activity in the workplace suggests integration in many forms, including:

  • Integration of active living programs with other workplace wellness programs;
  • Integration of individual, environmental and organizational approaches; and
  • Integration of health promotion/wellness efforts with the overall business strategies of the organization.

All functions within the organization that have an 'investment' in the health of employees should be active in -- and committed to -- the plan.
Program interventions should link with the following internal structures and processes:

  • Communications, Public Relations and Recruiting strategies
  • Training & Development
  • Human Resources strategic plan
  • Compensation & Benefits strategy
  • Occupational Health & Safety strategic plan
  • Disability Management process
  • Food Services plan
  • Budgeting process for Finance & Risk Management
  • Long-term Strategic Plan for the organization
  • Union Collective Agreement

Health promotion initiatives should be integrated into a corporate health strategy featuring three interactive systems:

  1. Job demands and worker characteristics;
  2. Work environment; and
  3. Extra-organizational influences.

ORGANIZATIONS WILL DEMAND MEASURABLE RESULTS

To prove that an active living and wellness program is indeed beneficial to the organization, it is important to establish a benchmark for employee health and wellness before the program begins.
Benchmark research should examine:

  • Employee activity levels before the program is started;
  • Employee health;
  • Current costs of illness to benefit programs;
  • Stress levels;
  • Absenteeism patterns;
  • Employee satisfaction;
  • Retention rates; and
  • Productivity and performance.

After the program has been running for at least a year, follow-up research should be undertaken to measure the short-term results of the active living intervention.

EFFECTIVE COMMUNICATIONS AND EDUCATION -- AN IMPORTANT COMPONENT

  1. Health and wellness have to be incorporated into the organization's internal communications program.
  2. Senior management needs to demonstrate/articulate its support for:
    • Optimal employee health;
    • Individual employee choice and self responsibility in the matter of health; and
    • The company's commitment to support healthy lifestyle choices and productive work environments.
  3. Education, awareness and motivation opportunities should be available to all employees as part of a general strategy. These should focus on:
    • Cardiovascular fitness
    • Musculoskeletal health; including back health, repetitive strain and ergonomics;
    • Stress management; and

Health self-management skills, such as accessing community resources, appropriate use of the health-care system, and self-management of common and/or chronic health conditions.

CORPORATE PHILOSOPHY AS A FOUNDATION FOR EMPLOYEE HEALTH

The following principles and values lay a foundation for a corporate culture that embraces intervention programs like wellness and active living programs:

  • People are an organization's most important resource, and each has a unique, value-adding contribution to make.
  • Concern and care for the health of people is essential to achieve business success.
  • Healthy employees enhance an organization's competitive position.
  • A company with healthy employees has a positive impact on its community and customers.
  • A change in individual employee health metrics can be an early indicator of changes in other aspects of business performance.
  • Optimal employee health is compatible with and supportive of excellence in other aspects of business activity.
  • Health, like other aspects of business, can be managed and self-managed.
  • People adopt values that are emphasized by their organizational leaders.
  • Employee health is an integral part of the business and is built on the belief that all injuries -- and most illnesses -- are preventable.
  • Every employee at every level has responsibility for creating a healthy work environment and promoting healthy lifestyles.

MOTIVATING STAFF TO PARTICIPATE

One of the major challenges organizations face is motivating and sustaining staff commitment to active living interventions. The same can be said for health clubs who have many more members than regular participants.
Ultimately, the organization can only educate and provide the opportunity ­ it is the employee that must choose a more active lifestyle. However, the organization can undertake many activities that help make activechoices easy choices.
Sustained communications/education, encouragement, corporate philosophy and behaviour are the critical factors that influence motivation and sustained participation.
Many of the studies on workplace active living and wellness programs and strategies have small sample sizes and/or low participation rates in the programs.
Most of these studies indicate a need for ways to increase employee participation, and therefore have more impact on employee health, organizational effectiveness and the quality of any research conducted.
Dishman, et al (1998) report from their meta-analysis of published literature that participation rates in workplace active living programs are at best 20-30% of the workplace population.

Measuring outcomes

Typically, performance measurement enables an organization to:

  • Determine if a program has been implemented as planned (process measurement);
  • Determine if a program has met its quality assurance criteria (process measurement);
  • Assess if a program is attracting the volume of participants that it intended (process measurement);
  • Document the individual employee health impacts of a program (impact measurement);
  • Identify the health outcomes of a program as it relates to disability management and absenteeism rates (outcome measurement);
  • Determine the cost benefit of a program (outcome measurement); and
  • Establish whether an ongoing commitment to the program is justified.

PROCESS MEASUREMENTS

Process measurements review short-term program/intervention oriented results — quality control measures aimed at determining if the program/intervention itself has achieved its objectives.
Typical process measurements include:

  • Participation rates;
  • Adherence levels (if a long-term program);
  • Participant satisfaction;
  • Perceived value; and
  • Management commitment.

IMPACT MEASUREMENTS

Impact measurements review medium-term individual employee results. They identify whether or not intended individual health outcomes are occurring on a personal level.
Typical impact measurements may include:

  • Decreased Employee Health Risk ­ usually through health-risk assessments;
  • Improved Health Beliefs and Attitudes ­ through health surveys;
  • Improved Perceived Health Status ­ through health surveys;
  • Readiness for Change ­ through health surveys;
  • Improved Employee Satisfaction, as measured by a questionnaire;
  • Employee perception of greater personal power and control over their work environment, as measured by certain stress indicators;
  • Reduced incidence of new cardiovascular cases in STD and LTD; and
  • Reduced incidence of new musculoskeletal injuries.

OUTCOME MEASUREMENTS

Outcome measurements are longer term, organization-oriented results that indicate whether or not a program is generating the intended economic outcomes for the organization.
Typical outcome measures include:

  • Decreased incidence of illness or injury associated with stress, cardiovascular and musculoskeletal disorders;
  • Reduction in the length of a disability associated with stress, cardiovascular and musculoskeletal disorders;
  • Cost savings in health benefits such as long-term disability, short-term disability (and/or weekly indemnity), Workers' Compensation, and drug utilization associated with stress, cardiovascular and musculoskeletal disorders; and
  • Financial measurements, including cost/benefit analysis and Return on Investment calculations.

MAKING IT WORK WITH ACTIVE LIVING IN THE WORKPLACE

The Canadian Centre for Active Living in the Workplace has produced an excellent resource to help organizations set up and sustain active living programs.
Making it Work is a 'how to' workbook for those in the preliminary stages of program planning and development. It is designed to introduce practical ideas to help you and your organization develop new perspectives and create effective approaches to active living.
This workbook can be obtained by contacting:
The Canadian Council for Health and Active Living at Work (CCHALW)
c/o Canada Safety Council
Ph: 613-739-1535

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