So you’ve conducted health risk assessments and biometric screenings... great! Now you know everything about your target audience and can get to the business of offering programs that address their risk factors, right?
If you answered yes, Ashley Varol would adamantly disagree. As the University of Cincinnati’s Assistant Director of Fitness and Wellness, Ashley has a Master’s in Health Education and is working on her PhD dissertation; the subject: employee engagement. “We’re trained to meet people on their level. Yet over and over in my research I’ve seen wellness professionals just assuming everything about what their audiences actually want. A program manager or HR says, ‘We have a lot of people who are overweight, so we’re going to offer a weight loss program.’ Or ‘We have a lot of smokers, so let’s do a smoking cessation program.’ But they never look at what stage of behavior change these people are in. Honestly, it’s a crap shoot... they just haphazardly try stuff, but no one is even asking employees if they are interested or would participate.”
Ashley believes needs assessments aren’t done nearly enough. “It’s important to step back and get feedback... even when companies do survey, it’s often randomly thrown together and rarely tested for reliability and validity in any way. They’ll find something online or get a tool another company is using, but they never really talk to their staff to see if it makes sense for their situation. It just seems like a backward way of doing things.”
The HRA looks at an individual’s personal, medical, and lifestyle health risks. But a needs assessment systematically evaluates how the target audience environment (social, work, personal) and perceptions affect ability to participate in a wellness initiative as well as practice healthy lifestyles. The process reveals how a group believes things are versus the way they want things to be. These beliefs represent reality as the group sees it.
A needs assessment should survey a broad cross section and identify wellness needs of subcategories within the population, such as white vs. blue collar, older workers vs. younger, various departments, etc. For instance, a nutrition program for shift workers couldn’t be the same as for day workers because their challenges differ. And single parents would face different exercise challenges than 2-parent homes or childless workers.
Possible topics (and examples) for a needs assessment include:
- Opinions on a particular wellness issue (why personnel in a particular department smoke more than other areas)
- Quality-of-life issue frequency and severity (causes of workplace stress)
- Localized major problems (trends in on-the-job injuries)
- Impact of a rule or condition (challenges to healthy eating with short lunch breaks or reliance on vending machines)
- Positives and negatives associated with adopting a healthier behavior (fear that quitting smoking may affect alertness on the job)
- Criteria for a successful program (desirable incentives to encourage and maintain participation)
- How they learn about what’s going on in the workplace (formal and informal leaders, intranet, marquees, bulletin boards)
- Match of capabilities and resources to needs (prepregnancy education for departments with women of childbearing age)
- Extent employees are using resources (online self-care when making healthcare decisions)
- Rating of program/service effectiveness (websites, newsletters, screenings, seminars, awareness campaigns)
- Suggestions for improving program services.
Ashley feels motivational interviewing techniques show promise for improving employee engagement. “This client-centered counseling style moves individuals toward developing the intrinsic motivation to make a desired behavior change. The one-on-one time really changes how we talk to them. We don’t need to rely on umbrella emails and generic signs; we can meet them on their level. By making the message specific to the individual, they can say, ‘Hey, this really does apply to me.’”
Ashley also sees value in a team approach: “The more people come together to talk about things, the better the results. It’s crucial to have representatives from all areas and demographics — especially in larger organizations — who can share obstacles and what’s important to them. Involve them in the discussion, then have them help promote the program after they return to the workplace. I see teams used to spearhead a program, get people to sign up, or check on participants’ progress. Or maybe they’ll get input on an issue or gauge reception to a program and motivation to join, like a walking focus group.”
Need More Research
Ashley is distressed by the lack of research on wellness programming. “This isn’t a novel process; we should have more hard data on what works and what doesn’t. We also need to know more about the demographics of groups being studied. I’m particularly surprised at how little documentation is available on small companies. Think about it... in a small business, if even 1 person is gone, the economic impact is profound. Yet most of the literature is from medium to large companies.”
Ashley makes a plea for wellness professionals to get involved. “A lot of the big studies are standardized, but they are also more generic. The research is not showing what details make a program work. People are doing great things out there, but not publishing it — so no one hears about the accomplishment. We need more case studies and pilot programs to help define the gold standards in our industry. It doesn’t have to be an elaborate study. If people would take the time to evaluate and document what they’re doing, they might find they have something important to offer.”
Ashley says research doesn’t have to be scary. “If you have a process you’d like to evaluate, look to the local community for help. You’ll probably find, for example, college students who would love to be involved. Work together to get published as a team.”
Recommended Reading From Ashley Varol’s Research
- Anshel, M. H., Kang, M. (2008). Effectiveness of motivational interviewing on changes in fitness, blood lipids, and exercise adherence of police officers: An outcome-based action study. Journal of Correctional Health Care, 14(28), 48-62.
- Goetzel, R. Z., Ozminkowski, R. J. (2008). The health and cost benefits of worksite health promotion programs. Annual Review of Public Health, 29, 303-323.
- Golaszewski, T., Barr, D., Pronk, N. (2003). Development of assessment tools to measure organizational support for employee health. American Journal of Health Behavior, 27(1), 43-54.
- Hughes, M.C., Patrick D.L., Hannon, P.A., Harris, J.R., Ghosh, D.L. (2011). Understanding the decision-making process for health promotion programming at small to midsized businesses. Health Promotion Practice, 12(4), 512-521.
- McLellan, R.K, MacKenzi, T.A., Tilton, P.A., Dietrich, A.J., Comi, R.J., Feng, Y.Y. (2009). Impact of workplace sociocultural attributes on participation in health assessments. Journal of Occupational and Environmental Medicine, 51(7), 797-803.
- Serxner, S., Anderson, D.R., Gold, D. (2004). Building program participation: Strategies for recruitment and retention in worksite health promotion. American Journal of Health Promotion, The Art of Health Promotion, 1-6.
- Speck, R.M., Hill, R.K., Pronk, N., Becker, M.P., Schmitz, K.H. (2009). Assessment and outcomes of HealthPartners 10,000 Steps program in an academic worksite. Health Promotion Practice, DOI:10.1177/1524839908330745.
- Valente, T.W., Pumpuang, P. (2007). Identifying opinion leaders to promote behavior change. Health Education & Behavior, 34(6), 881-896.
- Weiner, B.J., Lewis, M.A., Linnan, L.A. (2009). Using organizational theory to understand the determinants of effective implementation of worksite health promotion programs. Health Education Research, 24(2), 292-305.