Organizational Change | Blood Pressure Evaluation Measures

Organizational change measures for blood pressure screening and control1-6

Regular blood pressure screening for employees, along with other health behaviors, requires ongoing support from employers. New programs can be added over time and evaluated periodically for their effectiveness. For best results, recognition of the benefits of blood pressure screening should become an inherent part of organizational change and corporate culture.

Measuring organization change is an assessment of company-initiated programs and policies that affect most employees regardless of their health status (e.g., changes of food options in the cafeteria, establishing walking trails on the company campus). These efforts need to be integrated for greatest effectiveness and will require time for full implementation. Regular measures of employee attitudes and program development are key in determining whether new programs are effective or require further adaptation to prevent continuing investment in ineffective efforts.

Baseline

  • Determine workplace barriers to regular employee blood pressure screening and control programs
  • Assess current workplace supported blood pressure screening and control programs (during the past 12 months) 
    • List current blood pressure screening and control options for employees through worksite and identify number of employees (i.e., participation) using each option. Examples:
      • Number of blood pressure screening and control programs (e.g., on-site screening programs, education seminars, workshops or classes, individual counseling) and participation in these programs
      • A clinical referral and follow-up program including lifestyle counseling for screened employees with high blood pressure
      • Availability of educational materials (e.g., brochures, videos, newsletters) on blood pressure screening and control and health risks associated with high blood pressure
      • Number of communications/media campaigns regarding blood pressure screening and control
      • Number of health-related policies that enhance worksite lifestyle programs to help employees control their blood pressure (e.g., physical activity and nutrition)
      • Number of environmental strategies to support activities for lifestyle change can be used to reduce high blood pressure among employees (e.g., physical activity and nutrition)
      • Number of worksite blood pressure monitoring devices available for employees to perform self-assessments as well as information or training on these devices
      • Number of partnerships with community resources for blood pressure screening and control such as the American Heart Association, local health department, local hospital, etc
    • Determine costs of current company blood pressure screening and control programs such as: 
      • Staffing, equipment, and space
      • Employee time to participate in blood pressure screening programs during work hours (e.g., education, lifestyle counseling)
      • Incentives tied to blood pressure screening programs
      • Costs of current company programs on physical activity, nutrition, alcohol use, stress, type 2 diabetes, and obesity, which are the key worksite-based programs that can affect high blood pressure
    • Conduct survey of employee satisfaction with current workplace supported blood pressure screening and control programs

Process

  • Reassess barriers to employee engagement in blood pressure screening and control programs
  • Document steps taken and progress toward implementing each intervention selected 
    • List numeric goals (e.g., desired increases in employee screening rates) in each form of intervention within a designated time period (e.g., 12 months from startup): 
      • Employee reach (e.g., number of educational pamphlets distributed)
      • Employee participation (e.g., number of desired participants in blood pressure screening)
    • Describe timeline for implementation of each planned intervention (e.g., length of time and timing of tasks to develop, initiate, and conduct a mass campaign)
    • Create a baseline budget for new interventions including classes, instructors, classroom space, materials, incentives, etc
    • Identify opportunities for new partnerships with community groups who provide blood pressure screening and control programs (e.g., The American Heart Association, local health department, local hospital, etc.)
  • Reassess employee satisfaction regarding workplace supported blood pressure screening and control programs

Outcome

  • Measure reductions in the number and type of employee barriers to blood pressure screening and control programs
  • Assess changes in workplace blood pressure screening and control programs including progress in achieving goals and in implementation of each intervention (e.g., length of time and timing of tasks to develop, initiate, and conduct a mass campaign)
    • Measure changes in the number of blood pressure screening and control options for employees through the worksite and changes in employee participation using each option before and after the blood pressure screening and control program or campaign. Examples:
      • Number of new programs developed and offered to employees including the number of employees screened and referred for clinical follow-up and lifestyle counseling if found to have elevated blood pressure levels
      • Number of new educational materials developed and made available to employees
      • Number of new workplace communications/media campaigns such as posters and brochures
      • Number of new workplace policies and environmental strategies regarding blood pressure screening and control (e.g., number of worksite blood pressure monitoring devices available for employees to perform self-assessments as well as information or training on these devices)
      • Number of new partnerships with community groups to enhance access and opportunity for employee blood pressure awareness and screening
    • Assess changes in program costs from baseline (so that a return-on-investment can be calculated) 
      • Increases in staffing or equipment needs due to new program offerings
      • Changes in employee participation time during work hours (e.g., education, lifestyle counseling)
      • New incentives or benefits or changes in existing incentives or benefits based on employee participation
      • Changes in costs of current company programs on physical activity, nutrition, alcohol use, stress, type 2 diabetes, and obesity, which are the key worksite-based programs that can affect high blood pressure
    • Assess changes in survey responses for employee satisfaction following implementation of a workplace supported blood pressure screening and control program and compare with baseline

Depending on goal success, evaluate the need to adjust workplace programs.

References

1.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.

2.  Centers for Disease Control and Prevention. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;48(No. RR-11): 1-40.

3.  Matson Koffman DM, Goetzel RZ, Anwuri VV, Shore K, Orenstein D, LaPier T. Heart-healthy and stroke-free: successful business strategies to prevent cardiovascular disease. Am J Prev Med. 2005; 29(5), suppl. 1:113-121.

4.  Pelletier KR. Clinical and cost outcomes of multifactorial, cardiovascular risk management interventions in worksites: a comprehensive review. J Occup Environ Med. 1997; 29(12): 1154-1169.

5.  Matson Koffman DM, Lanza A, Campbell KP. A Purchaser’s Guide to Clinical Preventive Services: A tool to improve health care coverage for prevention. Preventing Chronic Disease, April 2008; 5(2).

6.  Goetzel RZ, Ozminkowski RJ. Program evaluation. In: O’Donnell MP, editor. Health promotion in the workplace, 3rd edition. Albany, NY: Delmar Thomson Learning; 2002. p 116-165.