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Pronk, Nico Ph.D., FACSM, FAWHP

doi: 10.1249/01.FIT.0000288539.54363.df

Nico Pronk, Ph.D., FACSM, FAWHP, is executive director of the Health Behavior Group and vice president of Health and Disease Management at Health-Partners health system, which provides health promotion, disease prevention, and disease management services for worksites and health plans around the country. Dr. Pronk has published extensively in the health-related scientific literature and is currently an Associate Editor for ACSM's Health & Fitness Journal® and an Editorial Board member of CDC's Preventing Chronic Disease e-journal. Among other public services activities, he currently serves on the Task Force on Community Preventive Services supported by CDC and the Interest Group on Worksite Health Promotion at ACSM. Dr. Pronk received Fellow status for ACSM and the former Association for Worksite Health Promotion (AWHP).

In the May/June 2007 issue of the ACSM's Health & Fitness Journal®, several best practice dimensions for worksite health promotion programs were presented (1). The dimensions outlined included leadership, program management, communication, incentives, measurement/evaluation, and program design. This article will take a more in-depth look at the leadership dimension-leadership roles for promoting health including the support senior management provides to ensure a successful company-wide program.

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Worksite health promotion practitioners know that strong leadership and management support for their program is essential. But exactly who are those strong leaders inside the organization who will provide such leadership? Well, given the fact that most employees at any company are not experts in health promotion, the most visible leaders for health promotion are the worksite health promotion program staff. It all starts with you! You are the expert and can lead by example. Of course, leading by example is only one way to lead, and you probably want some help from others in leadership positions at the company. So what is your role and what would you want those other leaders to do?

Much has been written about leadership roles. There is a multitude of books and resources on leadership you can access at your local library, at the bookstore, or via the Internet. But when it really comes down to it, it is who you are on the inside, your inner self, that will define your ability to influence others. So it may be wise to take some time to reflect on your role as a leader and how you will be most productive in playing that role. Hermann Hesse (2), the German-born novelist and poet, tells us in Siddhartha, that "To change the world, change yourself." Mr. Hesse also teaches us that to lead, you do not necessarily have to be in a position of defined authority or leadership (such as top executives in a company). In Journey to the East (3), he portrays a group on a mythical journey. The main character, Leo, is a servant and is viewed as such by the members of the group. He does the cooking, cleaning, and other menial chores typical of a servant's tasks. The journey, however, is buoyed by Leo's good spirits and optimism, and it proceeds well until Leo vanishes. The group, now without Leo's presence, cannot continue on its own without its servant, and the journey is abandoned. One interpretation of his message is that Leo, although servant, is in fact the journey's leader. The conclusion is that without leadership-in what Robert Greenleaf describes as servant-leadership (4)-success is unlikely.

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Best practices components of leadership in worksite health promotion include strong top management support and identification of champions at the executive/leadership level (1). Hence, it seems absolutely crucial that an approach is in place to continuously identify individuals who support the health promotion vision and, in addition

* are visible across the organization

* are actively involved in specific aspects of the program

* care about the program's impact

* share the vision of a healthy company

* refer to the program in a positive manner

* are willing to support appropriate allocation of resources to the program

* look for ways to integrate the program into the core business goals and objectives of the company.

This list, although not exhaustive, provides some key elements to the crucial role leaders play in supporting a successful and lasting health promotion program. There seem to be some key roles that need to be played to enjoy a successful well-balanced program that has the potential to be around for a long time. As a matter of fact, there is good advice that comes from studies on centenarians that leaders should take to heart. In his book Leadership from the Inside Out, Kevin Cashman reports on a study of 97 active productive individuals older than 100 years that was conducted at the University of Georgia (5). The mastery of the joy of balanced living is what these healthy productive 100-year-olds can teach leaders. This mastery seems to include the following characteristics:

* optimism or having a positive view of the past and the future

* engagement or being actively involved in life-not being a passive observer

* mobility or staying physically active

* adaptability to loss or having the extraordinary ability to stay balanced by adapting to and accepting change and loss and maintaining a zest for living.

The application of these characteristics in the context of leadership can teach leaders what it may take to ensure that the healthy company vision is embedded into daily operations, remains a vital life force for the company, and sustains itself over the long haul.

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So what do you and other identified leaders actually need to do to ensure strong leadership each and every day? Table 1 describes several tasks that may be considered.

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To learn more about leadership and the role of leadership for health promotion, a set of resources is outlined in Table 2. This set of additional resources is not intended to be an exhaustive list, rather, it provides a starting point for those who are interested in learning more about a cornerstone component of best practices in worksite health promotion-leadership.

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1. Pronk, N.P. Aligning program support with interventions for optimum impact. ACSM's Health & Fitness Journal® 11(3):40-42, 2007.
2. Hesse, H. Siddhartha. New York, NY: New Directions Publishing Corporation, 1951.
3. Hesse, H. The Journey to the East. New York, NY: Farrar, Straus and Giroux, 2000.
4. Greenleaf, R. Servant Leadership. Mahwah, NJ: Paulist Press, 1991.
5. Cashman, K. Leadership from the Inside Out. Provo, UT: Executive Excellence Publishing, 1998.
© 2007 American College of Sports Medicine