1. HEcheck: A Workplace
Health Environment
Assessment

2.  Provide a rationale for organizational
assessment and intervention
 Review the Heart Check odyssey
 Introduce the new organizational
assessment: HEcheck
 Demonstrate HEcheck assessment and
reporting capabilities
 Discuss the future of organizational
assessments

3.  Are systems-based models
 Explain behavior as the interrelationship of
organisms and their environments
*Salis & Owen, Ecological Models of Health Behavior, In:
Glanz et al, Health Behavior & Health Education, 2002.

4. Adapted from: http://www.carbc.ca/HelpingCommunities.aspx

5.  “People will change behavior to
reflect their environments.
Therefore, if you want healthy
people, simply create healthy
environments.”
Thomas Golaszewski

6.  Grew out of NYS Department of
Health’s “Healthy Heart Program” –
Mid 1990s
 Application of Social Ecology
principles
 Research Question: How do you
create healthy workplace
environments?

7. “You can’t manage IT unless you
can measure IT.”
Peter Drucker, Ph.D. (?)

8.  Assessment for organizational support for
employee heart health (structure): policies,
services and facilities; and program
administration
 226 items scored as a dichotomy: 0 or +1
 Contains sections on: organizational
foundations, administrative support,
tobacco, nutrition, physical activity, stress,
screening

9. 200
180 Experimental
160 Control
140
120
100
80
60
40
20
0
-20
Smoking Nutrition Phys Act Screen Adm Sup Total
Golaszewski et al. (1998). An Organization-based Intervention to Improve
Support for Employee Heart, Am J Health Promotion.

10. Costs Associated with Risks
Medical Paid Amount x Age x Risk
$7,123
$5,813
$4,530
$4,401
$7,000
$3,216
$6,000 $4,718
$5,000 $2,098
$3,364
$3,069
$4,000 $2,667 $3,894
$2,480
$2,912
High Risk
$3,000 $1,550
$2,605 Medium Risk
$2,110 $2,200
$2,000 $1,351 $2,941 Non- Participant
$2,081 $1,851 Low Risk
$1,000 $1,523 $1,641
$1,122
$0
19-34 35-44 45-54 55-64 65-74 75+
Edington. AJHP. 15(5):341-349, 2001

11. THE HEART CHECK HEALTH PROMOTION MATRIX
December 2004
Organizational Foundations: This section describes compensation and human resource management elements that indirectly support employee health. Although very
important, they are not usually under the auspices of the health promotion agenda and are therefore listed separately.
9.1.1, 9.1.2, 9.1.3, 9.2.1, 9.2.2, 9.2.3, 9.3.1, 9.3.2, 9.4.1, 9.4.2, 9.5.1, 9.6.1, 9.7.1, 9.7.2, 9.7.3, 9.7.4, 9.8.1, 9.8.2
Smoking Nutrition Physical Activity Stress Screening Administrative Implementation Level
Support
8.1 8.2 8.6.1 8.11.1 1. Start-up:
8.1.1 8.6.3 8.11.2 Structural development, “must do”
8.1.2 8.5 8.6.4 beginning activities, no service
8.1.3 8.5.3 8.6.5 delivery.
8.1.4 8.5.4 8.6.6
8.1.5 8.5.5 8.6.7
8.5.6 8.6.8
3.1.1a 3.4.1 4.1.1 4.5.1 5.3.1 5.7 6.2.2 6.7.1 8.1.7 2. Policy/Environment
3.1.1b 3.5.1 4.1.2 4.5.2 5.3.3 6.7.2 Enhancement:
3.1.1c 5.3.4 5.8 6.5 6.7.3 8.9 Easy policy changes or logical
3.1.2 4.2.1 5.3.6 6.5.1 continuations of the above. Sets up
3.1.3 4.2.2 6.5.2 8.10.1
3.1.4 4.2.3 6.5.3
service delivery.
3.2.1 4.1.3 4.4.1 5.4.1 5.9.1 5.10 6.3.1 6.4 7.1 7.4 8.7.1 3. Beginning Service Delivery:
3.3.11 4.4.2 5.4.2 6.3.2 7.1.1 7.4.1 Information and awareness building
4.2.4 4.4.3 5.4.4 5.11 6.3.4 6.8 7.1.3 7.4.4 8.8.1 activities, relatively inexpensive
3.3.1 4.4.4 5.4.5 5.11.1 6.3.6 programming.
4.3.1 4.4.6 5.4.9 5.11.2 6.3.10 7.6.1 8.12
3.3.4 4.3.2 4.4.10
3.3.6 4.3.4
4.3.6 4.6.1
4.3.10
3.3.2 3.3.9 4.3.3 4.4.5 5.4.3 5.5 5.6 6.1.1 6.3.3 7.1.2 7.2 7.3 8.3 8.7.2 4. Advanced Service Delivery:
3.3.3 3.3.10 4.3.5 4.4.7 5.4.6 5.5.1 5.6.1 6.1.2 6.3.5 7.1.4 7.2.1 7.3.1 8.7.4 More expensive and intrusive than the
3.3.5 3.3.12 4.3.7 4.4.8 5.4.7 5.5.2 5.6.2 6.1.3 6.3.7 7.1.5 7.2.2 7.3.2 8.4 above, broadened service delivery.
3.3.7 4.3.8 4.4.9 5.4.8 5.5.3 5.6.3 6.1.4 6.3.8 7.2.3 7.3.3 8.4.1 8.8.2
3.3.8 4.3.9 4.4.11 5.4.10 5.5.4 5.6.4 6.3.9 7.4.2 7.2.4 7.3.4 8.4.2 8.8.3
3.3.9 4.3.11 5.5.5 5.6.5 6.2.1 6.3.11 7.4.3 7.2.5 7.3.5 8.4.3
3.3.8 5.6.6
3.3.9 5.6.7
3.2.2 5.1 5.2 5.3.2 6.6 7.5 8.1.6 8.7.3 813.1 5. Institutionalization:
5.1.1 5.2.1 5.3.5 6.6.1 7.5.1 8.13.2 Advanced policy development,
5.1.2 5.2.2 6.6.2 7.5.2 8.5.1 8.10.2 8.13.3 relatively expensive, high capital
5.1.3 5.2.3 6.6.3 7.5.3 8.5.2 costs, long term cultural change.
5.1.4 5.2.4 5.9.2 6.6.4
5.2.5 8.6.2
5.2.6

12. THE HEART CHECK HEALTH PROMOTION MATRIX
November 2006
Organizational Foundations: This section describes compensation and human resource management elements that indirectly support employee health. Although very
important, they are not usually under the auspices of the health promotion agenda and are therefore listed separately.
9.1.1, 9.1.2, 9.1.3, 9.2.1, 9.2.2, 9.2.3, 9.3.1, 9.3.2, 9.4.1, 9.4.2, 9.5.1, 9.6.1, 9.7.1, 9.7.2, 9.7.3, 9.7.4, 9.8.1, 9.8.2
Smoking Nutrition Physical Activity Stress Screening Administrative Implementation Level
Support
8.1 8.2 8.6.1 8.11.1 1. Start-up:
8.1.1 8.6.3 8.11.2 Structural development, “must do”
8.1.2 8.5 8.6.4 beginning activities, no service
8.1.3 8.5.3 8.6.5 delivery.
8.1.4 8.5.4 8.6.6
8.1.5 8.5.5 8.6.7
8.5.6 8.6.8
3.1.1a 3.4.1 4.1.1 4.5.1 5.3.1 5.7 6.2.2 6.7.1 8.1.7 2. Policy/Environment
3.1.1b 3.5.1 4.1.2 4.5.2 5.3.3 6.7.2 Enhancement:
3.1.1c 5.3.4 5.8 6.5 6.7.3 8.9 Easy policy changes or logical
3.1.2 4.2.1 5.3.6 6.5.1 continuations of the above. Sets up
3.1.3 4.2.2 6.5.2 8.10.1
3.1.4 4.2.3 6.5.3
service delivery.
3.2.1 3.3.11 4.1.3 4.4.1 5.4.1 5.9.1 5.10 6.3.1 6.4 7.1 7.4 8.7.1 3. Beginning Service Delivery:
4.4.2 5.4.2 6.3.2 7.1.1 7.4.1 Information and awareness building
3.3.1 4.2.4 4.4.3 5.4.4 5.11 6.3.4 6.8 7.1.3 7.4.4 8.8.1 activities, relatively inexpensive
4.4.4 5.4.5 5.11.1 6.3.6 programming.
3.34 4.3.1 4.4.6 5.4.9 5.11.2 6.3.10 7.6.1 8.12
3.36 4.3.2 4.4.10
4.3.4
4.3.6 4.6.1
4.3.10
3.3.2 3.3.9 4.3.3 4.4.5 5.4.3 5.5 5.6 6.1.1 6.3.3 7.1.2 7.2 7.3 8.3 8.7.2 4. Advanced Service Delivery:
3.3.3 3.3.10 4.3.5 4.4.7 5.4.6 5.5.1 5.6.1 6.1.2 6.3.5 7.1.4 7.2.1 7.3.1 8.7.4 More expensive and intrusive than the
3.3.5 3.3.12 4.3.7 4.4.8 5.4.7 5.5.2 5.6.2 6.1.3 6.3.7 7.1.5 7.2.2 7.3.2 8.4 above, broadened service delivery.
3.3.7 4.3.8 4.4.9 5.4.8 5.5.3 5.6.3 6.1.4 6.3.8 7.2.3 7.3.3 8.4.1 8.8.2
3.3.8 4.3.9 4.4.11 5.4.10 5.5.4 5.6.4 6.3.9 7.4.2 7.2.4 7.3.4 8.4.2 8.8.3
4.3.11 5.5.5 5.6.5 6.2.1 6.3.11 7.4.3 7.2.5 7.3.5 8.4.3
5.6.6
5.6.7
3.2.2 5.1 5.2 5.3.2 6.6 7.5 8.1.6 8.7.3 813.1 5. Institutionalization:
5.1.1 5.2.1 5.3.5 6.6.1 7.5.1 8.13.2 Advanced policy development,
5.1.2 5.2.2 6.6.2 7.5.2 8.5.1 8.10.2 8.13.3 relatively expensive, high capital
5.1.3 5.2.3 6.6.3 7.5.3 8.5.2 costs, long term cultural change.
5.1.4 5.2.4 5.9.2 6.6.4
5.2.5 8.6.2
5.2.6

13. Risk 2005 2007 Difference
Safety Belt Use 9.0% 5.4% -3.6%*
Medication for Relaxation 27.1% 23.9% -3.2%
Physical Inactivity 18.5% 15.9% -2.6%
Smoking 9.8% 7.6% -2.2%
Illness Days 30.1% 28.3% -1.8%
Life Dissatisfaction 25.2% 23.9% -1.3%
Perceived Health 17.6% 16.60% -1.0%
Health Age Index 1.9% 0.9% -1.0%
Disease 13.9% 13.1% -0.8%
Alcohol 2.0% 1.3% -0.7%
**Also a significant decrease in recorded absenteeism.

14.  Organizational health support (OHS) can be
measured reliably and accurately.
 Relationships exist between OHS measures and
employee health risks, health culture,
absenteeism, and selected health care costs.
 OHS can be improved relatively easily and cost
effectively.
 Employee health risk profiles stabilize with
organization-focused intervention.
 Most OHS variables remain following
intervention.
 OHS tools can be integrated within a
comprehensive worksite health promotion
intervention

15. Contextual Work Features
(Organizational Leadership, industry type,)
(management style, profitability, etc.)
Worksite Worksite
Structure Culture
Golaszewski et al. (2008). Working Together to Create Supportive Environments
in Worksite Health Promotion, The Art of Health Promotion.

16. Recommendations…
 Develop new tools based on the latest standards
of excellence in WHP
 Consider alternate item construction
 Add organizational health culture
 Refine automated systems accessible on the
Internet
 Develop detailed summary reports
Golaszewski, in:Pronk (Ed.). 2009. ACSM’s Worksite Health
Handbook.

17.  An assessment process of the workplace’s
HEALTH ENVIRONMENT that
supports employee health.
 Online capability
 3 dimensions, 9 sections, 47 constructs and
227 items (variable weights)
 Within dimension/section/construct
scoring
 And more…

18. 3. Medical
Management
2. Risk
Management
1. Foundations

19. Medical Management
Psychosocial
Tobacco Control
Nutrition
Physical Activity
Screening
Culture Change
Commitment
Human Resources Management

20.  Assessment
 Awareness
 Services
 Structural Supports
 Policy Supports

21.  To the online HEcheck…

22.  Expand research activity at
the company-level
 Establish norms for geographic region, health
plan groups, industry type, or other company
demographic
 Link organizational rewards to high scoring
companies, e.g., provide award recognitions,
premium discounts or rate “lock ins”