What Do We Know About Best Program Strategies?
Alongside the key dimensions in the Table, core best practice components represent the heart of program strategies. Typically, the program strategies are thought of at a more actionable level than the dimensions and include aspects of program planning, design, implementation, assessment, evaluation, reporting, and so on. As such, these strategies are inclusive of interventions as witnessed by the presence of the following practices noted in the "best practices component" column of the Table:
- Targeted personalized messaging
- Announcements and updates at staff meetings
- Effective incentive programs
- Multilevel program development
More detail around the design of interventions can be found in the program development and incentive programs components. Intervention program design and development includes identification of programs that generate outcomes, a program mix that reaches all employees-regardless of risk level-and can support individual health needs. They also are scalable over time and integrate behavior change models such as the stages of change construct and the self-efficacy concept that are sustainable over time to allow for adoption and maintenance of new behaviors for employees (4).
Why Is Alignment Between Program Support and Intervention Strategies Important?
The best practice approach allows for a worksite health promotion initiative to be implemented with the support of the appropriate resources, leadership and management structure, data management techniques, and mechanisms that address scalability and sustainability. Not only is this important in the context of ensuring proper implementation but also to ensure ongoing reporting, continued investment, and establishing a trail of program impact, success, and accountability. Merely implementing a variety of interventions without connecting to the larger organization does not follow a sustainable model. Before long, the budget supporting such activity will be in jeopardy, and the program will fall victim to haphazard implementation, poorly planned activities, and constant scrutiny because quality outcomes will be difficult to demonstrate.
Alignment between program support structures and interventions will ensure that the highest level of leadership is updated in a timely manner on program performance and that, through appropriate performance measurement, those responsible for the program receive feedback. In addition, the perceived value of the worksite health promotion program will be higher when a direct relationship is observed between the health of the employees and the core products of the company. However, this involves more than merely linking program and business goals through statements-such linkages and connections must be made explicit through quantification of the outcomes, translated into financial and business terms and measures. The Figure presents a depiction of the relationships discussed in this column.
Measuring Best Practices
To date, few resources are available to measure whether a company is successful in following best practices. Recently, however, the Health Enhancement Research Organization (HERO) developed a Best Practice Scorecard that outlines the critical core components to what constitutes an exemplar health management program and provides a method for practitioners to self-score their program using a predefined scoring mechanism-the Scorecard (5). Some of the core components include executive commitment, corporate culture, participation rates, integration, communication, incentives, health assessment, intervention, and documentation of outcomes. The Scorecard has two sections: the Best Practice Core Components and the Key Outcomes-Benchmarks sections. Using a set of definitions linked to a score, the tool assigns points to each question for both sections, and the total number of points may be interpreted according to a simple comparison to comprehensive programs that have been operational for less than 3 years or for 3 years or more. The HERO Health Management Best Practice Scorecard is available via the HERO Web site at www.the-hero.org and may be downloaded for self-administration. For those worksite health promotion practitioners who are interested in monitoring their program against best practice criteria, the HERO Scorecard is a useful tool to apply a measurement set against the program and monitor progress over time by repeating the completion of the scorecard every year.
1. O'Donnell, M., C. Bishop, and K. Kaplan. Benchmarking best practices in workplace health promotion. The Art of Health Promotion Newsletter
2. Goetzel, R., A. Guindon, L. Humphries, et al. Health and Productivity Management: Consortium Benchmarking Study Best Practice Report. American Productivity and Quality Center International Benchmarking Clearinghouse, Houston, TX 1998. (www.apqc.org
3. Chapman, L. Expert opinions on "best practices" in worksite health promotion (WHP). The Art of Health Promotion Newsletter
July/August 2004, 1-6.
© 2007 American College of Sports Medicine
4. Pronk, N.P. Designing and evaluating health promotion programs. Simple rules for a complex issue. Disease Management and Health Outcomes