Examples of Policies that Promote Heart–Healthy and Stroke–Free Communities for Employers

Sponsor campaigns to promote awareness of the risk factors for and signs and symptoms of heart attacks and strokes and the importance of calling 9–1–1 immediately when someone is having a heart attack or stroke

The Montana State Heart Disease and Stroke Prevention Program collaborated with Emergency Medical Services and staff from the Montana Department of Public Health and Human Services (MDPHHS) on a multi–phase MDPHHS worksite intervention. Objectives were to 1) increase employees' awareness of signs and symptoms of heart attack and stroke and the need to call 9–1–1, 2) install AEDs in selected MDPHHS buildings and the capitol, and 3) increase the purchase of heart–healthy items in vending machines and snackbars. To address the first objective, health communication messages were sent out weekly to staff through e–mail distribution lists. Educational messages were also displayed in bathrooms, and weekly contests on recognizing heart disease and stroke symptoms were conducted via e–mail. As a result of the intervention, awareness of heart attack signs and symptoms increased significantly among employees.

Prohibit all tobacco use in indoor areas and near building entrances and exits. Reduce exposure to secondhand smoke by implementing smoke–free campus policies. Provide tobacco cessation counseling or access to counseling services. Provide coverage for FDA–approved medications to help employees quit using tobacco

Union Pacific Railroad (UPRR) implemented a "Butt Out and Breathe" program, which incorporated policy changes with activities to raise employers' awareness of the health risks of smoking and provide education, risk identification, and clinical interventions to help them quit smoking. At the beginning of this process in 1987, UPRR’s smoking policy was to prohibit smoking in offices, but smoking rooms were available until 1996. Smoking was not prohibited at all sites and on all equipment until 1999. Smoking cessation services are now available for UPRR employees who are interested in quitting. These services include a readiness review survey, health risk appraisal, self–directed workbooks, telephone counseling, in–person counseling, Internet counseling, health coaches, and periodic assessments. Clinical interventions available through employee health plans include access to prescription drugs to help employees quit smoking and may include nicotine replacement therapy in the future. UPRR's "Butt Out and Breathe" program is having positive results. The proportion of UPRR employees who smoke decreased from about 40% in 1993 to 25% in 2001. The Assistant Vice President credits the company's commitment to smoking cessation for the continuing decline of smoking among employees.

Establish and support a worksite wellness committee

The South Carolina Heart Disease and Stroke Prevention Program collaborated with the University of South Carolina Prevention Research Center to produce Worksite Wellness in South Carolina. This project was a comprehensive assessment of worksite policies and environmental supports for heart disease and stroke prevention and control, including the availability of preventive health screenings. Nine hundred worksites with at least 50 employees responded to the assessment. The most common types of screening offered were for blood pressure and cholesterol.

The project also assessed cardiac emergency preparedness, including the availability of AEDs and CPR training and the presence of signs describing the signs and symptoms of a stroke and providing instructions for contacting 9–1–1. Survey findings revealed that worksites that had wellness committees or coordinators offered a greater number of employee health and wellness services. The state program will use this information to develop worksite wellness activities and evaluation measures.

Negotiate health benefit plan designs that provide reimbursement for preventive services and emphasize quality, cost–effective medical care

North Carolina Prevention Partners developed the BASIC Model Preventive Benefits Initiative, which is designed to increase the number of health plans in the state that cover assessment, counseling, and referral for tobacco use, physical inactivity, and unhealthy eating. The initiative has increased the number of health plans that provide coverage for tobacco use by 100%, for nutrition by 100%, and for physical activity by 50%. Efforts have included training employers in purchasing preventive benefits and making the business case for doing so. "Starting the Prevention Conversation" brochures for tobacco, physical activity, and nutrition have been developed for distribution to physicians' offices. The initiative is now promoting coverage for hypertension and cholesterol control and developing supports to help physicians treat risk factors according to the latest Joint National Committee (JNC7) guidelines and the National Cholesterol Education Program (NCEP ATP III) guidelines.

Date last reviewed: 05/12/2006
Content source: Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion