Strategies for Implementation

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Strategies for Implementation
GSO Diabetes and Social Responsiblity Programme

• Gayle Crozier Willi, PhD
• International Food and Nutrition Issues
• Nestlé SA

GSO Forum, 25 Sept 2008
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Why workplace initiatives?

• 54 of the population in employment 50 of
  waking hours spent at work
• Structured setting
• Social norms powerful behaviour influence
• Workers go home to influence family and friends
• Many workers can come from groups who are hard to
  reach with health and wellbeing messages (men,
  low SES)

The workplace is prime territory for health
promotion
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Best program practices

• 1. Link to business objectives
• Corporate health policy, top management buy-in
• integration into the organisational structure
• 2. Supportive environment
• social and physical
• links to related programs e.g. screening for
  health risk, disease case management
• corporate culture, social norms, healthy food
  choices in the cafeteria, fitness centres,
  individual counselling
• 3. Engage employees
• employee advisory boards
• collaboration among wellness coordinators and
  employees at every stage of planning,
  implementing, evaluating

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Best program practices II

• 4. Effective communications
• Develop employee knowledge and skills
  substantive health messages via all possible
  means
• 5. Effective incentives
• e.g. cash, reduced medical, program cost rebates,
  non monetary gifts, competitions...
• 6. Evaluation
• Health risk evolution, program acceptance
  (satisfaction, participation, outcomes)
  confidentiality

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Resource implications

• Sustained long term, not short term one-off
• Processes of behaviour change needed - social
  marketing, organisational development
• Evolution of culture, social norms
• Staff time to prepare strategies, plans,
  communications, tools, monitor and evaluate
  effectiveness
• Infrastructure - not necessarily costly

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Challenges are several

• Participation rates are low (mean 20-30)
  Participants tend already to be the most healthy
  educated
• Effectiveness often not/poorly evaluated
  Inappropriate end points - e.g. stress reduction
  intervention and absenteeism endpoint
• Generalisability difficult
• Many different interventions, implementations
  and outcomes leads to difficult interpretation
• Sustainability of programs is generally not
  evaluated/known
• Wellness competes with a full agenda for the
  attention of employers and employees

Bull et al 2003
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Ongoing development is fundamental

• More research on what works (intervention,
  communication)
• More research on with whom it works (motivation,
  participation)
• Disseminate success
• Build capacity
• Find ways to support combined efforts of
  employees and employers
• Public health diplomacy

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What it is all about!

• Work and leisure should be a source of health for
  people
• (Ottawa Charter for Health Promotion, 1986)

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Management engagement

• Management can be engaged on
• demography (dwindling numbers)
• older workers (greater retention)
• direct and indirect costs
• improved staff morale
• improvements in absentee-ism, presentee-ism,
  greater productivity
• need to recuit/retain high quality workforce
• corporate coherence
• corporate image

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Stakeholders need to be engaged

• All workplace stakeholders must be involved
• management
• employees
• unions
• insurance funds
• support staff
• The help of external stakeholders is precious
• international organisations
• governments
• press
• NGOs
• private sector
• academia