Section 6: Evaluation
Step 1: Evaluation Planning
Once a company has conducted assessment and planning of physical activity programs, and developed the specific tasks of implementation for these programs, it is time to develop the evaluation plan. The evaluation plan should be in place before any program implementation has begun.
Metrics for worker productivity, health care costs, heath outcomes, and organizational change allow measurement of the beginning (baseline), middle (process), and results (outcome) of workplace health programs. It is not necessary to use all these metrics for evaluating programs. Some information may be difficult or costly to collect, or may not fit the operational structure of a company. These lists are only suggested approaches that may be useful in designing an evaluation plan.
These measures are designed for employee group assessment. They are not intended for examining an individual’s progress over time, which would raise concerns of employee confidentiality. For employer purposes, individual-level measures should be collected anonymously and only reported (typically by a third party administrator) in the aggregate, because the company’s major concerns are overall changes in productivity, health care costs, and employee satisfaction.
In general, data from the previous 12 months will provide sufficient baseline information and can be used in establishing the program goals and objectives in the planning phase, and in assessing progress toward goals in the evaluation phase. Ongoing measurements every 6 to 12 months after programs begin are usually appropriate measurement intervals, but measurement timing should be adapted to the expectations of the specific program.
Physical activity can lower the risk of many chronic diseases, including heart disease, stroke, type 2 diabetes , high blood pressure , osteoporosis, and some cancers. It has a direct effect on obesity and high cholesterol.
Changes in diet are difficult to relate to direct changes in work productivity, health care costs, or health outcomes. However, the evaluation can include employee’s reported changes in behaviors, knowledge, and skills regarding physical activity. Evaluation of interventions should be conducted in the context of a comprehensive workplace program that includes physical activity, nutrition, and overweight/obesity interventions.
Intervention evidence suggests that even when evaluating direct disease outcomes (e.g., obesity) it will be difficult to separate the effects of physical activity interventions in a comprehensive health program that includes clinical counseling, nutrition education, and physical activity.
One of the best ways to tools you can use to assess how many of your employees are overweight or obese is your Health Risk Appraisal. You can utilize your HRA data to see actual numbers of employees who are overweight or obese and translate those actual numbers into percentages of your workforce. Changes in this percentage over time will give you a big picture indication of whether you are addressing the problem effectively. This is a long-term problem, though, and will take time and a variety of complementary approaches. Specific, interim measures can help determine if you are on the right track with your efforts, and which components of your activities are the most effective.
PDF Developing a Data Dashboard
Step 2: Evaluating Reach
Tracking employee participation and progress is a basic and key way to evaluate your efforts.
- Track attendance of participants in physical activity and weight management programs
Baseline
- List current physical activity options for employees through worksite and identify number of employees using each option. For example:
- Number of classes and participation in these programs
- Availability of educational materials on physical activity
- Number of physical activity-related policies
- Number of environmental strategies such as bike racks, stairwell improvements, changing rooms, walking paths, etc.
- Number of partnerships with community resources for physical activity such as YMCAs, local hospital or health department
- Determine costs of current company programs such as:
- Capital investment in building or facilities
- Staffing, equipment, and space
- fitness programs or discounts
- Conduct survey of employee satisfaction with current workplace supported physical activity programs
Process
- Reassess barriers to employee physical activity
- Document steps taken and progress toward implementing each intervention selected
- List numeric goals 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 classes)
- 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, printed and online educational material, etc
- Identify opportunities for new partnerships with community groups who provide programs (e.g., YMCA, local health department, local hospital, etc.)
- Reassess employee satisfaction regarding workplace supported physical activity programs
Outcome
- Measure reductions in the number and type of employee barriers to physical activity in the workplace
- Assess changes in workplace physical activity programs
- Measure changes in the number of program options for employees through the worksite and changes in employee participation using each option before and after the physical activity program or campaign. Examples:
- Number of new programs developed and offered to employees and participation in these programs
- Number of new educational materials developed and made available to employ
- Number of physical activity-related polices developed and implemented compared to baseline
- Number and type of new environmental support changes made
- Number of new partnerships with community groups created to enhance access and opportunity for employees to be physically active
- Assess changes in program costs from baseline
- New capital investments made
- Increases in staffing or materials needs due to new program offerings
- New incentives or changes in existing incentives based on employee participation
- Assess changes in survey responses for employee satisfaction following implementation of a workplace supported physical activity and compare with baseline
PDF Evaluation Metrics for Physical Activity
Step 3: Evaluating Effectiveness
The effectiveness of programs depends on the intensity of program effort and the use of multiple interventions. A rule of thumb is that the more programs implemented together as a package or campaign, the more successful the interventions will be.
Baseline
- Determine levels of employee physical activity from employee health survey or health
risk appraisal measures . Examples include:
- Determine the percent of employees who currently reach physical activity guidelines
- Determine the percent of employee exercising the recommended number of minutes per day
- Determine baseline percentage of employees with health conditions (program participants versus non-participants) affected by physical activity including type 2 diabetes, high blood pressure, obesity and high cholesterol.
- Determine employee knowledge, attitudes, and beliefs about physical activity.
- Evaluate employer’s current knowledge of the health benefits of physical activity
- Measure employee’s knowledge of current physical activity
- Assess employee awareness of existing workplace programs, policies, and benefits
- Determine the number of employees who are thinking about making changes or state that they want to change their activity level
Process
Outcome
- Assess changes in employee activity levels such as:
- Changes in the percentage of employees reaching activity guidelines
- Changes in the percentage of employee exercising the recommended number of minutes per day
- Changes in health conditions such as cholesterol levels, Body Mass Index (BMI), or blood pressure can assess the effects of improved activity
- Compare changes between program participants before education and other programs are initiated and after operation of these programs
- Assess changes in employee knowledge, attitudes, and beliefs about physical activity
- Assess changes in employee awareness of existing workplace programs, policies, and benefits
PDF Issue Brief on Evaluation
PDF Chenowith Article on Evaluation
Step 4: Evaluating Cost and Productivity
Healthier employees are less likely to call in sick. Companies can sometimes assess sick day use as the most direct measure to determine whether health programs are increasing worker productivity.
Baseline
- Determine the average number of sick leave days per employee over the previous 12 months for health conditions affected by obesity such as type 2 diabetes
- This measure may be less useful if there has been a large increase or decrease in numbers of employees over the past 12 months
- Determine the costs for worker absenteeism including costs of replacement workers, costs in training replacement workers, and loss and delay in productivity
- Determine time employees spend during working hours participating in physical activity related activities or programs
Process
- Re-assess the average number of sick days per employee at the first follow-up evaluation
- Periodic repeats of other baseline measures
Outcome
- Assess changes in the average number of sick days per employee in repeated follow-up evaluations
- Assess changes in time employees spend during working hours participating in physical activity related worksite program
- Assess changes in costs from baseline
Health care cost measures for physical activity
In contrast with the worker productivity costs described above, health care costs are measures of the direct medical expenses of providing employee health care and preventive health programs.
Baseline
- Determine current health care use and costs, including pharmaceuticals, counseling, and inpatient and outpatient care, for the diseases and conditions affected by physical activity. Examples include: type 2 diabetes, high blood pressure, obesity and high cholesterol
- Determine the current health care use and costs for physical activity programs (if covered),
- Determine the health care use and costs of program participants before education and other programs are initiated and after operation of these programs
Process
- Periodic repeats of baseline health measures
Outcome
- Assess changes in health care use and costs from baseline
- Assess changes in the type, use, and costs of employee health benefits related to physical activity programs (if covered)
- Compare health care use and costs of program participants before education and other programs are initiated and after operation of these programs
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