Workplace Health Model

Building a workplace health program should involve a coordinated, systematic and comprehensive approach

A coordinated approach to workplace health promotion results in a planned, organized, and comprehensive set of programs, policies, benefits, and environmental supports designed to meet the health and safety needs of all employees. A comprehensive approach looks to put interventions in place that address multiple risk factors and health conditions concurrently and recognizes that the interventions and strategies chosen influence multiple levels of the organization including the individual employee and the organization as a whole.

Workplace health promotion programs are more likely to be successful if occupational safety and health is considered in their design and execution, In fact, a growing body of evidence indicates that workplace-based interventions that take coordinated, planned, or integrated approaches to reducing health threats to workers both in and out of work are more effective than traditional isolated programs. Integrating or coordinating occupational safety and health with health promotion may increase program participation and effectiveness and may also benefit the broader context of work organization and environment.^1-4

The systematic process of building a workplace health promotion program emphasizes four main steps:

1. an assessment to define employee health risks and concerns and describe current health promotion activities, capacity and needs
2. A planning process to develop the components of a workplace health programs including goal determination; selecting priority interventions; and building an organizational infrastructure
3. Program implementation involving all the steps needed to put health promotion strategies and interventions into place and making them available to employees
4. An evaluation of efforts to systematically investigate the merit (e.g., quality), worth (e.g., effectiveness), and significance (e.g., importance) of an organized health promotion action/activity

The Workplace Health Promotion website is a toolkit for employers containing a collection of guidance, tools, and resources to assist in building or enhancing a workplace health program following the overall process shown in the figure below.  

Step 1- workplace health assessment

A successful workplace health program is one that is targeted to the specific employee population, suiting the worksite, employee needs, and personal and organizational health goals. This information can be gained through the first step in the process - a workplace health assessment. An assessment should aim to capture a picture of the many factors that influence employee health including: individual level factors such as lifestyle choices, the work environment (e.g, physical working conditions and social support), and the organizational level (e.g., culture, policies, and practices). This assessment can take place informally through conversations, a call for input/opinions (such as a bulletin board, opinion box, email requesting ideas), or more formally by using instruments such as an employee health survey or environmental audit. Both current health issues as well as employee interests should be considered when prioritizing program and policy interventions as well as evaluating and making improvements to the workplace health program on an ongoing basis. Involving employees from the beginning will reinforce the shared responsibility and commitment the employee and the organization have to employee health, and the overall success of the workplace health program. The assessment module provides guidelines, tools, and resources for conducting a workplace health assessment.

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Step 2 – planning the program

Next, a careful planning stage should precede any implementation of workplace health programs, policies, benefits or environmental supports. The overall program requires a basic governance structure or infrastructure to administer and manage health promotion activities which can be initiated during the planning phase and recognizes the size and scope of each step may be influenced by factors such as the company’s size, sector, or geographic location.

The enterprise governance structure provides the strategic direction, leadership, and organization necessary to operationalize the program elements. Organizational strategies provide the infrastructure to ensure program objectives are achieved, employee health risks are appropriately managed, and the company’s resources are used responsibility. Organizational strategies include:

• Dedicating senior leadership support to serve as a role model and champion
• Identifying a workplace health coordinator, council or committee to oversee the program
• Developing a workplace health improvement plan with sufficient resources to articulate and execute goals and strategies
• Communicating clearly and consistently with all employees
• Establishing workplace health informatics to collect and use data for planning and evaluation

It is important to remember that a successful program does not necessarily incorporate all potential workplace health strategies. A truly successful program is one whose components are carefully selected, implemented efficiently, and is suited to the employee population. It may be more prudent to focus on one or two policies/programs at first and build on early successes rather than poorly implement several interventions at the beginning.  Workplace health programs also do not have to cost significant amounts of money. Many effective interventions such as health-related policy changes exist that are low-cost which is especially important for small and medium sized employers who may not have lots of resources to dedicate to employee health. The planning/workplace goverance module provides guidelines, tools, and resources for conducting a planning process.

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Step 3 – implementing the program

Most employers, when they think about improving worker health, think of actions individuals can take. Losing weight, quitting smoking, and exercising more are all examples of individual actions that can result in better health. It is important to realize, however, that improving health requires a broad perspective that also includes the environments in which people work, live, and play. A person’s health is a result of both individual actions and the context or environment within which those actions are taken. Employers and employees have many opportunities to influence the work environment to promote health and prevent disease. Changing the environment affects large groups of workers simultaneously and makes adopting healthy behaviors much easier if there are supportive workplace norms and policies. Therefore, it is important for the overall workplace health program to contain a combination of individual and organizational level strategies and interventions to influence health. The strategies and interventions available fall into four major categories:

1. Health-related Programs – opportunities available to employees at the workplace or through outside organizations to begin, change or maintain health behaviors
2. Health-related Policies – formal/informal written statement that are designed to protect or promote employee health. They affect large groups of employees simultaneously
3. Health Benefits – part of an overall compensation package including health insurance coverage and other services or discounts regarding health
4. Environmental Supports – refers to the physical factors at and nearby the workplace that help protect and enhance employee health

The implementation module provides topic specific guidelines, tools, and resources for putting the program strategies and interventions in place.

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Step 4 – determine impact through evaluation

Lastly, worksites should plan to evaluate the programs, policies, benefits, or environmental supports implemented. It is important to assess how well the workplace health program can be sustained over time, how it is received by employees and management, and its return on investment (ROI). While program evaluation is widely recognized as a core function of public health, differences in definition of “good evaluation practice” often lead to evaluations that are time-consuming and expensive, and, most importantly, produce findings that are not employed for program improvement. The evaluation should focus on questions that are relevant, salient, and useful to those who will use the findings and that the evaluation process feeds into a continuous quality improvement loop to improve and strengthen existing activities; identify potential gaps in current offerings; and describe the efficiency and effectiveness of the resources invested. The evaluation module provides general and topic specific guidelines, tools, and resources for evaluating the program’s efforts. 

Using the four step process outlined above as well as the guidelines, tools, and resources provided in this toolkit will allow employers to develop the knowledge and skills needed to begin a workplace health program or make improvement to an existing one. The attached Workplace Health Program Development Checklist [PDF - 105 KB] can be used throughout the process of building a workplace health program to review activities and monitor progress.

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