Rebecca Oakes

HEA 648

10/13/16

Part 1: Problem definition and description

Globally 60% of deaths may be attributed to chronic diseases, a situation that we

know may be improved through physical activity, diet, and smoking cessation; in

addition, globally, 60% of the worlds population is accessible directly or indirectly

through the workplace and 60% of our waking hours are spent at the workplace (Batt,

2008). As a result, this provides increased evidence that by implementing worksite

wellness programs, we are reaching, globally, over half of the adult population while

targeting health disparities such as chronic diseases through being proponents of

elements such as physical activity, diet, and smoking cessation. Engaging in excessive

sedentary behavior time is detrimental even to those who meet current physical activity

guidelines of 150 min of moderate-to-vigorous intensity physical activity per week (Loitz,

2015). What this means is that individuals who perform the recommended amount of

physical activity per week could still be at risk of developing certain chronic diseases

given that they also participate in an excessive amount of sedentary activity.

 The Employee Wellness Program at High Point University aims to impact the

health behaviors of the faculty and staff on campus in such a way that promotes healthy

living and physical activity promotion. Faculty and staff have access to a top of the line

facility that students do not have access to which includes multiple weight-lifting

equipment as well as exercise equipment aimed towards running such as treadmills and

ellipticals. The facility is housed on campus which makes it easy to access for faculty

and staff during the day. It is free to use and includes men and women's showers for

individuals to use before going back to work. The office of the director of the program is

housed within the same building, she has an open door policy where anyone is free to

come in and ask questions regarding exercise, nutrition, or regarding their personal

health goals.

It has long been understood that a physically active lifestyle is important in overall

health and well-being along with reducing the risk for chronic diseases (MacEwen,

2014). Being physically active plays a preventative role in developing cardiovascular

disease, type 2 diabetes, obesity, and some forms of cancer (Loitz, 2015). It is therefore

safe to say that individuals who lead physically active lifestyles have an increased

probability of having better overall health when compared to sedentary individuals.

Unfortunately, few individuals meet physical activity requirements, a national survey

conducted in 2010 found that less than 50% of American adults over the age of 18 met
the physical activity recommendations of the Centers for Disease Control (CDC) for 2.5

hours of moderate physical activity or 1.25 hours of vigorous activity per week (Bale,

2015). Evidence for establishing worksite wellness programs and the scope of

individuals that these types of programs will most likely effect will be provided.

Although some companies have demonstrated their social responsibility by caring

for their workers already, for some it becomes so much easier if there is a strong

economic case (Batt, 2008). What this means is that companies are more likely to be

active proponents of worksite wellness programs if the financial aspect works within

their favor. For example, a worksite wellness program works with employees to achieve

health goals created by the workers themselves. By achieving these goals workers

become healthier than they were additionally; healthy workers are less likely to miss

work which increases productivity in the work place and overall workplace satisfaction.

This turnaround purported by a worksite wellness program is often seen as a deciding

factor for many major corporations. Additionally, cognitive function, workplace

performance, job satisfaction, mood states and quality of life are important

psychological outcomes that may influence a persons performance at work and their

overall well-being (MacEwen, 2014).

To put this into context, my internship will consist of me working within the

Employee Health & Wellness Program at High Point University. My primary task will be
to currently evaluate how the program has impacted the faculty and staff on campus

since its conception in 2013. The program has much data surrounding the health

statistics of its population, faculty and staff at High Point University, which will be

accessible while conducting the evaluation. One of the main focuses of the program is

to not only reach the goals of each individual within the program, but to increase the

physical activity habits of all of these individuals. So, in conjunction with my overall

evaluation I will also be working with the department head to increase the prevalence of

physical activity among faculty and staff on campus. Practitioners are looking for

evidence-based programs and policies built on the best available scientific evidence to

develop and implement successful and cost-effective public health interventions (Loitz,

2015). The program evaluation will be to demonstrate what areas need improvement, if

any, and to determine how the program has impacted the faculty and staff on campus.

As a result, by providing evidence of positive outcomes and improvements,

consideration for program expansion or increased funding are potential outcomes to the

evaluation results.

Given the increasing pace of technological change in domestic, community, and

workplace environments, modern humans may still not have reached the historical

pinnacle of physical inactivity, even in cohorts where people already do not perform

exercise (Hamilton, 2007). In a cluster-randomized control trial performed by Bale et al.

(2014), it was reported that not having enough time was the most important reason for

not using time to exercise, in addition, workload was the strongest barrier to successful

implementation of time, suggesting that future interventions ensure employees and

supervisors address workload issues. This information is important in regards to my

internships target population, mainly to the point that these individuals have heavy

workloads that include both classroom and research commitments as well as

commitment to time spent with family. As a result, it is more than plausible to say that a

lot of these individuals are physically inactive due to previous commitments and

workload. In addition to this, this study also reported that individuals who felt

comfortable taking time off to exercise were much more likely to use the intervention,

which suggests that employees were aware of their job flexibility before the study began

(Bale, 2014). While many professors, especially those with tenure, may feel as though

their job has enough flexibility to allow them to perform exercise while at work, it is

important to note that the staff on campus may not have the same flexibility.

The director of the worksite wellness program at High Point University, acts as a

proponent for physical activity. She works one-on-one with individuals to help them

achieve their health goals and is available to faculty and staff to help them work through

any barriers they may have that keep them from exercising. The mission of the High

Point University Wellness Program is to generate enthusiasm and cultivate excitement

about personal health and wellness, which leads to improved quality of life and helps

build a vibrant and extraordinary work environment.

Some factors and variables that may affect the projects direction include funding,

resources, and time. While it is unclear at this point the allocation of funding given or the

amount of resources at our disposal it is important to consider the time frame in which

the evaluation process is to take place. Additionally, the environment in which we will be

working is the same environment in which these individuals work every day. Faculty and

staff have access to the Employee Health and Wellness Center at any time during the

day and can speak with the director when she is available for one-on-one coaching

appointments. Ethical dilemmas are unclear at the moment, however, one aspect of this

internship to keep in mind is discretion. Working with faculty and staff one-on-one during

health coaching sessions will require anonymity.

 Part 2: Problem Analysis

The observed determinants of physical activity from empirical studies, can be

sorted into the categories of PRECEDE-PROCEED model (Miilunpalo, 2001). The

PRECEDE-PROCEED model for health promotion planning combines the behavior

modification principles and the different determinants presenting them as Predisposing ,

Enabling, and Reinforcing factors (Miilunpalo, 2001). Predisposing factors include

knowledge, attitudes, beliefs, personal preferences, existing skills, and self-efficacy

toward the desired behavior change (Ransdell , 2001). Reinforcing factors include

factors that reward or reinforce the desired behavior change (Ransdell , 2001). Enabling

factors are psychological or emotional or physical factors that facilitate motivation to

change behavior (Ransdell, 2001). As a metaphor, we might think of a planning model

as a general blueprint for something we are trying to build (Crosby & Noar , 2011). For

the purpose of this internship and problem analysis , the PRECEDE-PROCEED model

will be used in order to accurately guide the planning process .

 Individuals intending to begin or maintain a physically active lifestyle often fail to

translate their good intentions into actions (Keller et al , 2016). What this means is that

while individuals may have began to think about becoming physically active , most

individuals do not progress to a point where they become physically active . This is why

the Employee Wellness Program is so important at High Point University . It helps faculty

and staff to take that extra step from pre contemplation to action in order to achieve their

personal health goals. Because this program is so important , it is even more paramount

that it be evaluated in order to ensure that its being effective as well as efficient with its

time, money, and resources. Not only this, but the overall satisfaction of the faculty and

staff could arguably be the most important variable within this evaluation .

Individual Behavior/
Genetics Lifestyle Habits

Work Environment
Health Coaching Physical Inactivity PA
Prevelence Quality of Life

Self-Efficacy
Access
Support from family/friends

Periods of prolonged sitting without standing or light -intensity physical activity

(LPA) acutely and negatively impact circulating blood glucose , blood pressure, and
musculoskeletal pain (Mullane et al, 2016). Workplace environments are ideal for

promoting changes in posture and LPA given the high prevalence of sitting (Mullane et

al, 2016). Many of the individuals within the target population spend the majority of their

day sitting at a desk. Evidence to suggest that sitting, especially in prolonged periods,

only increases the need for individuals to get up and become physically active . By

evaluating the Employee Wellness Program, we will be able to better determine if

issues, such as sitting time, are being positively influenced through current program

mechanisms.

In order to evaluate the effectiveness of the program , it is pertinent that data

concerning the demographic and health data be available . In addition, access to each

individual within the scope of the Employee Wellness Program is also pertinent to the

investigation. While most background information of each faculty and staff member of

High Point University will be readily available to me , it is important to obtain contact

information of each individual in order to effectively communicate and send out surveys

that analyze the overall worker satisfaction and general opinion of the effectiveness of

the Employee Wellness Program.

Through the evaluation process, it is anticipated that we will be able to identify

barriers and/or perceived barriers to individual physical activity within the workplace . If
we can identify areas that are preventing individuals from being physically active we are

better able to implement interventions that address these barriers and , hopefully, help

these individuals to overcome these barriers . Health coaching that is offered within the

Employee Wellness Program would also be better able to cater to an individuals

perceived barriers upon completion of the evaluation . What this means is that the

evaluation will target barriers to physical activity , and secondly, allow us to analyze

potential aids to these barriers which will better help the health coach to tackle barriers

that are brought up by clients.

Better reporting of factors associated with worksite wellness program

participation has been emphasized as key to understanding generalizability of program

outcomes and can inform effective implementation and management of interventions

(Beck et al., 2016). This is extremely important information, in so much as it

emphasizes the need for an evaluation that not only targets barriers to physical activity ,

but that accounts for factors that are associated with program participation . In other

words, what we essentially want to know is why individuals do or do not participate

within the Employee Wellness Program at High Point University , and using that

information to strengthen assets that were identified as well to rectify any areas that

need improvement in order to increase program participation .

 With regards to outcomes for the internship, it is anticipated that by the

conclusion of the evaluation process there will be a better understanding of the

employee and staff on campus level of health as well as their overall satisfaction of the

wellness program. The purpose of any wellness program is to help individuals achieve

their health goals, as such, it is important to know if the program is doing its job. If so,

are their any areas that need to be improved and/or what are some ideas from faculty

and staff that could make the program better serve their needs? These are some ideas

and general information that will be obtained during the survey process. The overall goal

of the evaluation process is to better serve the community in which it target, the faculty

and staff of High Point University. By conducting the evaluation, we will be more

effective at serving the health needs within this community.

Part 3: Internship Activities Plan/Methods

A logic model is a depiction of a program showing what the program or project

will do and what it is to accomplish (Hayes et al, 2011). To be clear, a logic model is a

conceptual roadmap that leads to an understanding of how a project will flow throughout

the course of its existence. The evaluation for this internship will take place within a

worksite wellness setting, or a public health setting. Study results have showed that
researchers and health professionals have used a logic model as a tool to assess their

prevention program because they are held to higher standards of accountability , and

required to demonstrate the effective outcomes of their interventions (Guo, Farnswork,

& Hermanson, 2016).For the purpose of this internship, a logic model will be used in

order to summarize the steps of the internship in such a way that it shows easily what

will be taking place from the beginning of the internship , until its completion.

For the logic model designed above, there are six distinct sections that will be

discussed further. These six sections include the inputs, activities, outputs, short term

(ST) outcomes, medium term (MT) outcomes, and long term (LT) outcomes. Each of

these sections provides a key component to understanding the core qualities that will

construct and deliver the evaluation process for the purpose of this internship . For the

purpose of the discussion, it is best to understand what these sections are to be

comprised of. Inputs include human and financial resources as well as other inputs

required to support the program such as partnerships (McLaughlin & Jordan, 1998).

Activities include all those action steps necessary to produce program outputs

(McLaughlin & Jordan, 1998). Outputs are the products, goods and services provided to

the programs direct customers (McLaughlin & Jordan, 1998). In addition, outputs can

be broken-up to include sections within itself, of which include short-term, medium-

term/intermediate outcomes, and long-term outcomes. Short-term outcomes are

changes or benefits that are most closely associated with or caused by the programs

outputs (McLaughlin & Jordan, 1998). Intermediate outcomes change the result from an

application of the short-term outcomes (McLaughlin & Jordan, 1998). Lastly, long-term

outcomes follow from the benefits accrued through the intermediate outcomes

(McLaughlin & Jordan, 1998).

Input Activities Output ST Outcomes MT Outcomes LT Outcomes

Intern Send out All faculty at Program Program action Individuals

surveys to all HPU awareness learn way in
faculty and staff which to
at High Point improve health
Univeristy

Program Provide health Staff Participant Improved

Director coaching in opinions program effect
order to help
individuals to
reach health
goals

Faculty Asess opinions High Point EWP Increased

of program University participation physical activity

Staff Conduct a High Point EWP Increased

needs Univeristy participation physical activity
assessment

Time Data
interpretation
Technology Computers and Laptop/comp
SPSS to use
uter
during data
SPSS
collection and
analysis

Contact list Using email to Email

send out
evaluation
surveys

Table 1: Program Logic Model for Employee Wellness Program at High Point University

The input for the logic model addresses the need for an intern , the director of the

Employee Wellness Program (preceptor), faculty and staff on campus, time, technology,

and contact lists. It is imperative that the inclusion of the faculty and staff on campus is

considered because they are the individuals that will be providing information about the

effectiveness of the Employee Wellness Program . Faculty and staff will be contacted

through an email contact list provided by the program director in order to send out

surveys via email to each individual who has access to the Employee Wellness Program

(faculty and staff). In addition, qualitative information may also be included through

personal interactions with the faculty and staff on campus. Conversations held with

these individuals may also help to glean understanding of their overall satisfaction and

outlook on the Employee Wellness Program. Time includes the period between January
and May that will be utilized in order to adequately conduct the program evaluation .

Furthermore, time also includes the time in which it takes to fully gather the data that will

be interpreted for the evaluation. The length at which this will occur has still yet to be

determined.

For activities, it is important to send out the survey , that will be developed in

partnership with the program director , to all faculty and staff working at the university .

The survey will be sent out via email. These emails will be obtained from the director of

the Employee Wellness Program who already has the complete email list of all of the

faculty and staff on campus. This should be the most effective way in which we will be

able to reach faculty and staff as they are checking their emails frequently since their

jobs require them to interact and communicate with students and other faculty via email.

During the course of the internship, it is important to continue to provide health coaching

as much as possible in order to appropriately obtain information about its effectiveness

or individual rate of satisfaction with their interactions with the health coach . What this

means, is that while conducting health coaching sessions this would be a great

opportunity to glean additional qualitative information from faculty and staff. This

information would not be obtained during the health coaching session, which would be

separate, but before or after the session given the permission of the individual to be

asked questions in order to obtain feedback about the program. Once obtaining survey
results, it is important to assess and interpret the data in such a way that it is easy to

determine what they survey results contain. Data interpretation will be the responsibility

of the intern and the director of the program. Results will be organized and evaluated

using SPSS and an analysis of the results will be written within a separate document

which interprets the results of the survey findings. Finally , we will be able to conduct a

needs assessment from the information that tells us where program improvements need

to be made.

If the Employee Wellness Program is better able to pinpoint where improvements

need to be made and gauge employee satisfaction, then High Point University is

providing their faculty and staff with a wellness program that works for their health

benefits and is proven to show its effectiveness and demonstrate the value of its

participants opinions. In addition, there are a multitude of program outcomes to be

expected when having conducted the program evaluation. Each one of these outcomes

are impactful for the Employee Wellness Program in that they help to make the program

better as a whole. It will also help to show in the future that if changes to the program

are made, then we will be able to determine how these changes have impacted the

population in which it targets.

The following timeline will help to generalize when stages of the evaluation

process will be taking place:

 January February March April May

Survey
development

Assess survey
results

Conduct
needs
assessment

Evaluation
Results

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