Worksite wellness programs: incremental comparison of screening and referral alone, health education, follow-up counseling, and plant organization.
BACKGROUND
Worksite wellness programs vary considerably in their design.  This study tested four models to compare effectiveness at controlling high blood pressure, obesity, and cigarette smoking.


METHODS
Baseline screening was conducted in four manufacturing plants.  Site 1 offered screening only, with referral recommendations for those found to have CVD risks.  Site 2 also provided health education information and classes.  Site 3 added routine follow-up counseling and a menu of intervention types, and Site 4 added social organization within the plant.  Random samples of 400 to 500 employees were rescreened at the end of three years.


RESULTS
Major improvements in risk levels were found with the addition of routine follow-up counseling and a menu of interventions (Sites 3 and 4, compared with Sites 1 and 2).  More hypertensives entered treatment and showed greater reductions in blood pressure.  Participation in worksite weight loss and smoking cessation programs was significantly increased, and those who participated showed significantly better maintenance of improvements where follow-up was provided.


CONCLUSIONS
The program models that offered short-term interventions promoted through local media suffered in comparison with models that included personal outreach to people at risk, a variety of health improvement intervention modalities, and ongoing follow-up counseling to help people make decisions and sustain health improvements.
Worker Health Program, Institute of Labor and Industrial Relations, The University of Michigan, Ann Arbor 48109.
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D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods / Q000458:organization & administration*; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration*; D006801:Humans; D006973:Hypertension / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration*; D008824:Michigan; D008875:Middle Aged; D017145:Models, Educational; D009765:Obesity / Q000517:prevention & control*; D016272:Occupational Health; D009786:Occupational Health Services / Q000379:methods / Q000458:organization & administration*; D012017:Referral and Consultation; D012307:Risk Factors; D016540:Smoking Cessation