Program evaluation outcome example (Results Accountability style) – CDPHP
Worksite health promotion collaboration
In early 2006, the Alaska Section of Chronic Disease Prevention and Health
Promotion (CDPHP) started working with three small businesses to help them
develop comprehensive worksite health promotion programs. The purpose
of this three-year CDPHP pilot project is to learn about components essential
to the success of small business worksite health promotion programs.
CDPHP is providing technical assistance to these companies in conjunction
and partnership with a health insurance company that started including
disease management services in its small business health insurance plan that year.
The customers for this pilot project evaluation are the business leaders and
worksite wellness team leaders of the three companies involved in the project
and the health insurance company. Secondary customers include the
Centers for Disease Prevention and Control (CDC) and others interested in
worksite health promotion.
| Friedman’s Results Accountability method uses a matrix to
group key evaluation questions: |
|
Quantity (numbers) |
Quality (proportions) |
| Effort (process) |
HOW MUCH DID WE DO? |
HOW WELL DID WE DO IT? |
| Effect (product) |
IS ANYONE BETTER OFF? |
| How much change or effect did we produce? |
What proportion of the total was involved in the change or effect? |
| Questions in BOLD are key. |
How much did CDPHP do?
Before starting the pilot project, a group of CDPHP staff designed an evaluation
process which included carefully recording the numbers of contacts and amount of
time that CDPHP spent providing technical assistance to the worksites. The
worksites were asked to keep similar records, but that proved to be very difficult
for them to do, because worksite health promotion tasks were so frequently scattered
throughout a worker’s day and/or were shared by several individuals.
The frequency of contact between the lead CDPHP pilot project staff and the resources
offered to the companies varied, depending on company circumstances and the time
that the company wellness team leaders had available for this work. CDPHP
pilot project staff spent about four hours during quarterly visits with two
worksites, reviewing progress, discussing problems and supporting action on the
next steps forward. The third company had more internal resources; CDPHP had an
initial three-hour visit there, with an additional hour spent on follow-up during
the subsequent year.
How well did CDPHP do it?
Friedman recommends compiling a data development agenda as part of the process
of identifying performance measures. Drafting this sample identified several
questions that CDPHP needs to ask representatives of the pilot project worksites,
including:
- Did they get the help they needed when they needed it?
- Were CDPHP’s expectations of the worksites clear? If not, how could
they have been clarified?
- Was the technical assistance that CDPHP provided helpful?
- What did CDPHP do that was most helpful? Least?
- What do they want in the future?
Is anyone better off?
Worksite health promotion programs can operate on a number of levels, including:
- Efforts to increase employee awareness of healthy behaviors – such
as posters, newsletters and lunch-and-learn seminars,
- Activities that encourage employees to adopt healthier behaviors –
such as sponsoring an employee team, a weight-loss challenge, and
offering fitness club memberships, and
- Changing the work environment or implementing policies that make it
easier for employees to choose healthier behaviors – such as offering
flex time to encourage employees to exercise, establishing a tobacco-free
workplace, and changing meeting-fare from donuts and soft-drinks to
fruits, vegetables and water.
Comprehensive worksite health promotion programs work on all three levels.
To some degree, companies need to make a greater up-front investment in
environmental or policy change than would be required for employee awareness
efforts or sponsoring healthy behavior activities. Consequently, CDPHP
decided to use the number of environmental changes or policies adopted as a
measure of the success of this pilot project.
After one year, six environmental change policies had been adopted. Two
of the three pilot project worksites had made at least one policy change.
Comment
The pilot project generated useful information during its first year.
- The need for commitment to and investment in worksite wellness was underscored
by the significant strides made by one of the worksites, which was already
moving toward worksite health promotion when it joined the project.
- The value of worksite wellness teams was demonstrated when the individual
responsible for health promotion at one of the worksites spent months in
the midst of a response to a company crisis. Although health promotion
activity would have been very unlikely during the crisis, teamwork might
have helped maintain progress that had been made before the crisis happened.
- The merit of strategic planning to the implementation of worksite health
promotion programs. While business planning is central to a company’s
success, the pilot worksites needed assistance when they applied planning
strategies to employee health promotion.
Another important and unanticipated change during pilot project year 1 was the
identification of a partner that sponsored worksite health promotion training
in September 2006 and follow-up in the community where two of the three pilot
project worksites are located. The pilot project sites in this community
have benefited from the development of a group of small businesses that are
working together and supporting one-another in developing comprehensive worksite
wellness programs.
Action Plan
Friedman’s final step in performance accountability is the statement
of an action plan.
CDPHP will continue to support the pilot project worksites, although one of them
has since changed health insurance providers. A fourth worksite was added
in year 2.
CDPHP is developing tools for small businesses to use in their worksite health
promotion programs. These tools are integral parts of current and planned
replications of the small business worksite wellness training and follow-up
meetings that started in September 2006. CDPHP is also seeking small
business worksite health promotion champions in other Alaska communities.
As these champions are identified, plans to replicate the training and follow-up
in those places will be developed.
