Work healthy Georgia

Work Healthy
Georgia

Table of Contents

Purpose. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Section 1: Making the Business Case. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
What is Worksite Health?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Why is Worksite Health Important in Georgia?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Why Invest in Worksite Health?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Section 2: Preparing to Improve Worksite Health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Step One: Secure and maintain leadership/ management support and commitment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Step Two: Identify a worksite health champion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Step Three: Establish a worksite health committee. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Section 3: Assessing Your Worksite. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Conduct an Environmental Scan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Review Organizational Policies and Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Assess Your Employees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Worksite Health Assessment Tool* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Section 4: Building Your Plan for Improvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Section 5: Developing Your Policy and Program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Eat.Live.Healthy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Eating Healthy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Physical Activity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Tobacco/ Smoke Free. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Implementing Worksite Policies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Section 6: Employee Engagement and Recognition. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Step One: Involve employees from the beginning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Step Two: Regular and consistent communication. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Step Three: Enroll informal leaders in the program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Step Four: Consider incentives and rewards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Step Five: Recognize employee and program achievements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Section 7: Health Risk Identification Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
The Importance of Screening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Health Fairs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Permanent or Temporary On-site Health Clinics and/ or Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Including Preventive Checkups as a Health Benefit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Health Risk Assessment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Biometric Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Section 8: Appendix. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Policy Building. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Model Worksite Health Policies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Evaluation Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 Additional Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

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Purpose

This toolkit is the second edition to the original Work Healthy Georgia toolkit created in 2012 and is intended to guide you in developing or improving your worksite health policies and programs. The toolkit starts by defining worksite health and explaining how a worksite health program can translate to increased business productivity. It guides you through a systematic and detailed assessment of your worksite, then it assists you in developing an improvement plan for your organization. The Work Healthy Georgia (2nd ed.) toolkit provides step-by-step instructions on developing health-related policies and programs, with sample language for worksite health policies and examples of health programs. It also provides methods of engaging

your employees throughout policy development and implementation, which is critical for program success. There is guidance on workplace health screening and program evaluation, too. The toolkit concludes by listing a multitude of worksite health resources, which will provide a wealth of additional information as you move through each step of developing your health-related policies and programs.
While it is certainly not designed to be the final authority, the Work Healthy Georgia (2nd ed.) toolkit provides an array of strategies and action steps that can be built into your overall health promotion program efforts at any level.

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SECTION 1: Making the Business Case
What is Worksite Health?
Worksite Health is the implementation of science-based programs in a workplace to improve the health of the employees, reduce chronic diseases and increase productivity in the organization. Worksite health programs include policies, benefits, environmental supports, and linkages to surrounding community partners to encourage the health and safety of all employees.
Worksites have the opportunity to promote healthy lifestyles that can reduce or prevent chronic diseases including heart disease, diabetes and certain cancers. This worksite health toolkit offers information, tools and resources for enhancing the health of employees and creating healthier worksite environments.
Employees spend a significant portion of their day at work and commuting to and from work. Their workplace plays an important role in the health decisions they make: what they eat, how much physical activity they can get throughout the day, and if they smoke while at work. Combined with incentive programs, worksites can provide the necessary environment for healthy behavior change, increasing the number of employees with healthy habits.

Why is Worksite Health Important in Georgia?
Many chronic diseases (e.g., heart disease and diabetes) can be prevented through lifestyle, environment and behavior change. Since employees spend on average 50 hours a week at work and eat one-third of their meals during the workday, employers play an important role to positively impact the health-related decisions of their employees through worksite health programs.
Benefits of Worksite Wellness

Reduces direct and indirect related costs due to poor health of the employees. Reduces job-related injuries. Improves employee health and productivity. Improves employee recruitment and retention.
With workplace health programs and policies, there will be greater progress in obtaining a healthier workforce and decreasing the prevalence of obesity and other causes of chronic disease in the state of Georgia. Implementing a worksite health program will decrease absenteeism among employees, increase productivity, improve employees' morale, and save the company money. A worksite-based health program supports changes that lead to healthier behaviors and healthier employees.

Why Invest in Worksite Health?

Investing in wellness can positively affect a company's bottom line. Worksite health programs can promote behavior change in employees, thereby improving health outcomes. Evidence strongly supports the need for programs that encourage employee lifestyle change. Employers who implement worksite health programs have found the following results:

Average 25% reduction in sick leave absenteeism1 Average 24% reduction in healthcare costs1 Average 32% reduction in workers' compensation and disability management claims costs1 Average $5.56 savings-to-cost ratio1 Return on investment for medical cost savings of $3.272 Return on investment for absenteeism reduction of $2.732
Whether the goal is to keep employees healthy or to identify and assist those who have or are at risk for developing preventable chronic diseases, a worksite health program is worth the investment.

1 Baicker, K., Cutler, D., & Song, Z. (2010). Workplace Wellness Programs Can Generate Savings. Health Affairs, 29(2), 304-311.

2 Chapman, L.S. (2012). Meta-Evaluation of Worksite Health Promotion Economic Return Studies: 2012 Update. American Journal of Health Promotion, 26(4),

TAHP1-TAHP12.

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SECTION 2: Preparing to Improve Worksite Health
*Leadership, Stakeholders, Committees and Worksite Health Champions*
To achieve health and wellness goals for your worksite, organizations are encouraged to employ the featured strategies below. These strategies are supported by the Georgia Department of Public Health and the Centers for Disease Control and Prevention.
Step One: Secure and maintain leadership/management support and commitment
It is essential to recognize the role of managers in effective worksite health programs. Their support at the organizational level is essential for implementing and maintaining a systematic approach to worksite health. Organizational leaders can support a coordinated approach to worksite health by
Incorporating health in the company's vision and mission statements, including health goals in improvement plans.
Appointing a coordinator to oversee worksite health (a worksite health champion). Allocating necessary resources to worksite health initiatives. Modeling healthy behavior. Regularly communicating the importance of wellness to organizational staff. If management is not already included in this process, you or other leaders need to get buy-in from members of management. Meet with them one-on-one and let them know the purpose of this plan and what you want to accomplish. Be sure to include the following:
Why a worksite health program is good for business, particularly if you yourself are not a member of organizational leadership;
Why the organization needs a worksite health committee to create and implement the plans for worksite health; How a committee could help accomplish goals; and Who and what is needed to support a worksite health program.
Step Two: Identify a worksite health champion
It is important to select a coordinator, also known as a worksite health champion, to be responsible for organizing meetings and keeping the process moving forward. The worksite health champion helps maintain an active worksite health committee that facilitates worksite health programming and policies in the company. Along with a committee, he or she takes the leadership role in facilitating the actions necessary to achieve successful worksite health initiatives, including policies, programs, activities and resources. This individual can be an employee at any level of the organization; he or she does not have to be a member of organizational leadership.
The coordinator/champion will have a lot of responsibility regarding the new worksite health plan, so this person should be
Organized, A good role model for healthy living, A good leader, Work well with a variety of people, and Motivate people to participate.

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Step Three: Establish a worksite health committee

An effective worksite health program uses a team approach to guide and support programming. This group of individuals will function as a committee. To put together your worksite health committee, find a core group of individuals who have an interest in actively making changes in the organization regarding healthy living. You could start with people who you could comfortably approach to request participation. Then ask them to recruit employees who they think would be beneficial to include in the group. It is important to recruit management and employees from across the organization, including those who will be most affected by new initiatives or programming.

Before you recruit individuals to become a part of your worksite health committee, make sure that you have specific tasks for them to do. Saying that you are organizing a committee is an ambiguous statement; people may not understand what you are talking about. Be specific about the amount of time involved and how meetings could be organized within the current workday.

To recruit members, use the networking capacity of the group. As previously mentioned, management can talk with the employees who work directly with them; they may be more effective since they have a personal relationship with those individuals. Other ways to contact and recruit members of a worksite committee include--

Face-to-face meetings, Phone calls, Emails,

Personal and mass letters/mailings, and Flyers and posters around the worksite.

Holding your first meeting
Once a group is established, plan and hold the first meeting. The meeting time and location should be convenient for the attendees. Set a high-energy, optimistic tone to get buy-in from attendees. The first meeting should include:
Introductions;
An explanation of worksite health and how implementing changes could positively impact all members of a company;
A discussion of the structure of the committee, as well as suggestions from the group about how they envision their possible roles;
A plan to assess your worksite and develop an action plan, including what health behaviors should be a priority;
A review of what tasks should be completed before the next meeting and a list of steps to complete those tasks;
Scheduling AT LEAST the next meeting(s).

After the first meeting, it is important to follow up with attendees, as well as recruit new members if you feel you still need more people. The next goal of the committee is to create and implement the action plan, which is discussed later in this toolkit (Page 12).

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SECTION 3: Assessing Your Worksite
Before you begin planning your program, you must have a good understanding of your worksite's needs and assets. You will collect information on your company and your employees, the physical environment of the worksite, and your available resources. The following types of assessments will serve as the prerequisite for sound planning and the foundation for program evaluation: environmental, company and employee assessments. These assessment strategies are supported by the Georgia Department of Public Health and the Centers for Disease Control and Prevention.
Conduct an Environmental Scan
An effective worksite health program should create a physical environment that provides employees with opportunities to eat healthy foods, be physically active, avoid exposure to tobacco products and secondhand smoke, and promote breastfeeding. As a first step, perform a walkaround review of your facility. Is it equipped to support these workplace health activities?
Note which changes may require more or less resources. Be objective in your examination, and look for creative ways to bridge any gaps identified in the assessment.
Review Organizational Policies and Data
The examination of company policies may require assembling a team to look through records and manuals to collect information on the company that might have an impact on employee health. You may also collect other data, like insurance information, health care costs for your employees, and data from local health departments. These data will give you an idea of the current health status of your employees. Here are some things to look for:
Corporate Policies Examine company policies on topics like tobacco use, rewards for participation in health-related programs, and subsidized cost of public transportation (which adds walking as part of an employee's commute).
Workforce Demographics Think about how these characteristics might relate to the health concerns and needs of your employees.
Benefits Package & Claims Data This can reveal the health services utilized by employees, how often they tend to seek treatment, and from whom. Having this information can help you identify potential areas for interventions.
Assess Your Employees
Benefits of Assessment
Helps identify the strengths, weaknesses and gaps of your organization's current health program initiatives Creates baselines and meaningful goals and objectives Drives planning decisions Establishes the evaluation process
Next, you should assess employee interests and needs. This may take two forms (see Appendix for examples):
Individual Health Risk Assessment This includes questions on personal and family medical history as well as physical examinations and medical tests.
Employee Survey Survey to determine the interests, needs, and willingness of employees to participate in health-related programs.
To begin your assessment, we recommend using The CDC Worksite Health Scorecard. A modified version of the Scorecard starts on the next page. For the full version and detailed assistance on using the worksite scorecard visit http://www.cdc.gov/dhdsp/pubs/docs/hsc_manual.pdf.
Once your scorecard is completed, you will be ready to develop your Action Plan.

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Worksite Health Assessment Tool
The Work Healthy Georgia Health Assessment Tool has been designed to help you collect information about your company and its policies and practices. This is a needs assessment to help your organization inform, educate, and improve the health of you and your employees. It will provide information to guide your decisions about the best ways to create a work environment and culture that encourage your employees to strive for better health.
Worksite Health: Background Information

This tool is used to capture demographic information about your worksite's population.
1. Contact Information: Name:__________________________________________________ Job Title: _____________________________________________ Organization Name: _______________________________________ Address:_____________________________________________ Telephone number: _______________________________________ E-mail address:________________________________________

2. Employee Characteristics:

2a. Number of employees: __________ 2b. Sex qMale qFemale 2c. Age group
q <18 years of age q 18-34 years of age q 35-44 years of age q 45-64 years of age q 65 years of age 2d. Average Age: _________Years of age 2e. Racial/ethnic group: q Non-Hispanic White q Non-Hispanic Black/African-American q Hispanic/Latino q Asian/Asian-American q American Indian/Alaska Native q Native Hawaiian/Pacific Islander q Other___________________________________________

2f. Work Status: qFull-time qPart-time qTemporary 2g. Job Type: qSalaried qHourly 2h. Education level q Less than high school q High school graduate/GED q Some college/technical school q College graduate q Postgraduate/advanced degree

3. Your Organization's Business Type: (Please check the correct answer) q For-profit q Nonprofit/Government q Nonprofit/Other

4. Y our Organization's Industry Type: (Please check the correct answer) q Agriculture, Forestry, Fishing and Hunting q Mining, Quarrying, Oil and Gas Extraction q Retail/Wholesale Trade q Accommodation & Food Services q Professional, Scientific & Technical Services q Transportation, Warehousing & Utilities q Health Care & Social Assistance q Real Estate, Rental & Leasing

q Finance and Insurance_________________________________ q Information q Construction q Educational Services q Manufacturing q Administrative & Support & Waste Management
& Remediation Services q Arts, Entertainment and Recreation q Public Administration q Other Services (Please list):

5. Health insurance coverage provided to employees? qYes qNo
6. Elements of worksite health promotion programs offered at your organization: (Please check all that apply) q Health education (e.g., skills development and behavior change classes; awareness building brochures, posters) q Links to related employee services (e.g., referral to employee assistance programs [EAPs]) q Supportive physical and social environment for health improvements (e.g., tobacco-free policies, subsidized gym memberships) q Integration of health promotion into your organization's culture (e.g., health promotion being part of business' mission statement) q Employee screenings with adequate treatment and follow up (e.g., Health Risk Assessments (HRAs) and biometric screenings)

Please submit completed form to: _____________________________________________________

Thank you for completing the survey. Your cooperation is greatly appreciated. *This form was developed from the CDC Worksite Health ScoreCard:
An Assessment Tool for Employers to Prevent Heart Disease, Stroke, & Related Health Conditions

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Please check the box that corresponds to your response ("Yes" or "No"). At the end of each section, total the number of "yes" responses and write down your subtotal.

Organizational Supports

During the past 12 months, did your worksite:

Yes No

1. Conduct an employee needs and interests assessment for planning health promotion activities?

2.

Conduct employee health risk appraisals/assessments through vendors, on-site staff, or health plans and provide individual feedback plus health education?

3. Demonstrate organizational commitment and support of worksite health promotion at all levels of management?

4. Use and combine incentives with other strategies to increase participation in health promotion programs?

5.

Use competitions when combined with additional interventions to support employees making behavior changes?

6. Promote and market health promotion programs to employees?

7.

Use examples of employee's role modeling appropriate health behaviors or employee health-related "success stories" in the marketing materials?

8.

Tailor some health promotion programs and education materials to the language, literacy levels, culture or readiness to change of various segments of the workforce?

9. Have an active health promotion committee?

10.

Have a paid health promotion coordinator whose job (either part-time or full-time) is to implement a worksite health promotion program?

11. Have a champion(s) who is a strong advocate for the health promotion program?

12. Have an annual budget or receive dedicated funding for health promotion programs?

13. Set annual organizational objectives for health promotion?

14.

Include references to improving or maintaining employee health in the business objectives or organizational mission statement?

15. Conduct ongoing evaluations of health promotion programming that use multiple data sources?

16. Make any health promotion programs available to family members?

17. Provide flexible work scheduling policies?

18.

Engage in other health initiatives throughout the community and support employee participation and volunteer efforts?

Your Worksite's Organizational Supports Section Score:

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Please check the box that corresponds to your response ("Yes" or "No"). At the end of each section, total the number of "Yes" responses and write down your subtotal.

Nutrition

During the past 12 months, did your worksite:

1.

Does your company's primary worksite have a cafeteria, vending machines, or other access to healthy food during working hours (i.e., foods that are lowfat, low-sodium, high-fiber, fruits, vegetables, water)?

2.

Does your company have a written policy that makes healthy food choices available in your cafeteria and/or vending machines?

3.

Are foods and beverages in the cafeteria and vending machines labeled with nutritional information or designated as "healthy" choices?

4.

Are healthy options like fruit, whole grain breads, granola bars, and water available at company meetings and events?

5. Does your worksite have a break room with a refrigerator and microwave?

6.

Does your company have a written policy that permits breastfeeding women to take time off during working hours to express or pump breast milk?

9.

During the past 12 months, did your company provide or promote on-site nutrition education or weight management programs?

10.

During the past 12 months, did your company subsidize employees' participation in community nutrition education programs such as Weight Watchers?

11.

Does your company have any signs or pictures posted around the worksite to encourage workers to eat healthier foods?

12.

Does your company distribute information to workers in company newsletters, emails or other mailings about the importance of eating healthier foods?

Nutrition Subtotal

Yes No

Physical Activity

During the past 12 months, did your worksite:

Yes No

1. Does your company's primary worksite have on-site fitness facilities available to employees?

2. Does your company offer fitness classes on-site (such as yoga, aerobics, stretching)?

3. Does your company subsidize employees' memberships in health clubs/gyms in the community?

4.

Does your company have a policy that allows employees to engage in physical activity during paid work time? (Example: participate in walking groups or fitness classes, use on-site fitness facility, etc.)

5. Does your worksite promote use of walking trails, bicycle racks or stairs?

6.

Does your company provide any other accommodations such as showers and changing rooms to support physical activity at work during break times or in commuting to work?

7. Does your company organize or sponsor employee walking groups?

8.

During the past 12 months, has your company participated in or sponsored a corporate fitness challenge, physical activity event, and/or sports team for employees?

9.

Does your company have any signs or pictures posted around your worksite to encourage workers to be more physically active?

10.

Does your company distribute information to workers in company newsletters, emails or other mailings about the importance of being physically active?

Physical Activity Subtotal

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Please check the box that corresponds to your response ("Yes" or "No"). At the end of each section, total the number of "yes" responses and write down your subtotal.

Tobacco

During the past 12 months, did your worksite:

Yes No

1. Does your company have a written policy restricting use of all tobacco products on-site?

2.

Does your company's primary worksite have a designated area for smoking that is enclosed and has signage posted according to the Georgia Smokefree Air Act of 2005?

3.

Does your company ban the sale of cigarettes and other tobacco products on-site (vendors, vending machines, etc.)?

4. During the past 12 months, did your company provide or promote on-site smoking cessation programs?

5.

During the past 12 months, did your company subsidize employee's participation in community smoking cessation programs?

6.

Does your company have any signs or pictures posted around your worksite to encourage workers to stop tobacco use?

7.

Does your company distribute information to workers in company newsletters, emails or other mailings about the health effects of tobacco use and the importance of cessation?

Tobacco Subtotal

Lactation Support
During the past 12 months, did your worksite: 1. Have a written policy on breastfeeding for employees? 2. Provide a private space (other than a restroom) that may be used by an employee to express breast milk? 3. Provide access to a breast pump at the worksite? 4. Provide flexible paid or unpaid break times to allow mothers to pump breast milk? 5. Provide free or subsidized breastfeeding support groups or educational classes? 6. Offer paid maternity leave, separate from any accrued sick leave, annual leave or vacation time?
Tobacco Subtotal

Yes No

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SECTION 4: Building Your Plan for Improvement

1. Summarize scores 2.Review results and set priority topic areas 3.Build plan for improvement

Once you complete your assessment, you can summarize your scores from each of the sections using the table below.

SUMMARY SCORE TABLE

Topic

Total

Points Possible

Percent Score

Example Organizational Supports Nutrition Physical Activity Tobacco Control Lactation Support

15

20

15/20x100=75%

18

12

10

7

6

TOTAL

Review the results and start thinking about which topic(s) demonstrate your strengths and identify topics that have room for improvement. Consider the following questions before selecting your area(s) for improvement:
Is this topic most beneficial for the employees within my organization? Will it be feasible to create policies and programs for this topic within my organization? Who else should I engage from my organization to ensure this is successful? Can I improve this topic area over the next year?

Once you have determined your priority topic areas you can start building your plan for improvement. Use the table below to draft your improvement plan for the topic areas in which you have selected.

What steps will we take?

When will it be done?

Who will do it?

Who will help?

How will we know it is complete?

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SECTION 5: Developing Your Policy and Program
Eat.Live.Healthy
Obesity Prevention: Eating Healthy and Physical Activity The prevalence of adult obesity in Georgia is at an all-time high. Georgia has the 18th highest obesity rate in the United States, and is among the 10 states with adult obesity prevalence over 30 percent. An additional 35% of Georgia adults are considered overweight. Overweight and obese adults are at greater risk for developing over 20 major chronic diseases, including heart disease, diabetes and cancer.
Obesity also has significant economic consequences. Obesity-related job absenteeism costs employers $4.3 billion a year. The current state of the workforce and worksites are large contributors to this health issue. Data demonstrates that employees spend an average of 50 hours a week at work. The increased use of unhealthy vending machine choices, lack of cafeterias, rise in health insurance costs, and general increase in sedentary jobs have played a contributing role in the rise in overweight and obesity rates.
There is hope. If worksites implement interventions, environmental changes and policies that promote healthy behavior associated with lowered risk of obesity, employees will reduce their risks for chronic disease and Georgia will create a healthier workforce. To reduce overweight and obesity rates among employees, there are two health behaviors that must be addressed: Healthy Eating and Physical Activity. While these are separate health topics, if addressed TOGETHER, the chance of seeing significant changes among employees will be much greater.

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Eating Healthy
Eating healthy is an individual choice, but companies can help their employees make better food choices.
Establish Worksite Policies Companies can develop worksite policies to promote healthy eating in the workplace by offering healthy, appealing, low-cost food options. Employees eat a third of their meals at work; implementing policies that allow for more nutritious choices move employees toward a stronger, healthier life. Policies could include recommending that fruits and vegetables be served at all worksite meetings that have food, requiring vendors to include healthy foods in vending machines and cafeterias, or creating a weekly "produce market" with local farmers.
Create the Policy Form a Policy Workgroup
Forming a policy workgroup ensures that feedback from both managers and employees is provided during policy creation. Consider including cafeteria staff to ensure the policies are feasible and can be successfully implemented in your worksite.
Consider the Extent of the Policy
Every business needs to determine how inclusive the new policies will be. Policies could refer strictly to healthy meetings or be inclusive of cafeterias and food offered in vending machines.
Write the Policy
Although the law does not require employers to provide meal breaks for employees, it is important for you to provide either a paid or unpaid lunch break to ensure that employees have the opportunity to eat throughout the day. To reduce the number of employees who grab food from vending machines or run to get fast food during the day, giving employees at least 30 minutes to eat during a shift will give them enough time to have a substantial meal. Having a written policy such as a lunch break policy will eliminate any confusion regarding the specifics.
Other policy ideas regarding healthy eating can include:
Develop a healthy meeting policy with recommendations on serving fruits and vegetables at all worksite meetings where food is provided.
If you have a cafeteria on-site or bring in outside food vendors, work with management to create policies that address healthy dining options for employees who patronize these options.
For vending machines, create a policy that requires vendors to include healthy foods, including snacks that are low-fat, low in added sugar, low sodium and high in fiber.

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Sample Nutrition Policy Policy Statement: Here is a good place to discuss the rationale behind the policy. Why is this policy important to your organization?
Example: The prevalence of adult obesity in Georgia is at an all-time high. Georgia has the 18th highest obesity rate in the United States. Georgia is among the 10 states with adult obesity prevalence over 30%, with an additional 35% of Georgia adults considered overweight. Overweight and obese adults are at greater risk for developing over 20 major chronic diseases, including heart disease, diabetes and cancer. Changing diets to include healthier food options and a reduction in high sugar, high fat processed foods can reduce the rates of overweight and obese individuals. Since adults consume a significant amount of daily calories during the workday, it is vital that (insert worksite name) has healthy food options and ample breaks to ensure that employees are making better food choices.
Nutrition Guidelines: If you want further justification for the implementation of this policy, you can include parameters set forth by the 2015-2020 Dietary Guidelines for Americans.
Example: A diet rich in whole fruits (not juice), vegetables, whole grains, beans, nuts and seeds, fish, skinless poultry and fat-free/low-fat dairy products promotes health and wellness for individuals. Reducing sodium, saturated fat, red meat, added sugars and processed foods can also decrease risks for chronic disease and adverse health problems. By instituting a worksite health policy that promotes healthy foods and reduces the availability of unhealthy foods, employees will lower their risk of chronic disease, leading to a healthier workforce.
Policy Components The first step in creating a worksite health policy is ensuring that the policy meets the needs of the worksite, the employees, and the worksite environment. A nutrition policy can include a few or all of the components below. Examples:
(Insert worksite name) encourages all employees to eat healthy meals and snacks throughout the workday. Employees are allotted (number of minutes) for meals and snack breaks.
(Insert worksite name) is committed to providing a work environment that encourages and supports employee and workplace health by: Here, briefly list how the worksite is committed to healthier eating. For example, (insert worksite name) will change the foods offered in vending and concession areas to reflect dietary guidelines.
(Insert worksite name) will create an environment that promotes healthy eating in the workplace and encourages employees through: Support from organizational leadership and opportunities for social support. Promotion of healthier food choices. Actions to enhance the worksite environment to increase healthier food choices.
Please see the Appendix for examples of worksite health policies.

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Worksite Health Implementation
Here is where you should discuss the activities that you are going to implement to support your nutrition policy. This is also where you will include information about how employees will be informed of the new worksite health policy pertaining to nutrition.
Examples:
The (insert worksite name) nutrition policy will be posted in stairwells and bulletin boards; will be discussed at meetings; and will be communicated through company wide emails and trainings.
The (worksite health champion or committee) will be responsible for policy and program implementation. Employees interested in participating in the nutrition worksite health initiative can seek additional information
from (the worksite health champion or committee members). They may also access the policy at (anywhere this policy will be made available to employees). T o support the nutrition worksite policy, (insert worksite name) will make the following environmental changes: Here, include any change your worksite will be making, for example, removing processed foods from vending machines,
offering salad bars in cafeterias, changing the food sold at snack kiosks, etc. See Section 5 on Eating Healthy for more information and ideas.
To support the nutrition policy, (insert worksite name) will offer educational opportunities to learn various skills related to healthy eating. Here, describe any educational interventions you are going to provide your employees. For example, offering cooking classes or providing lunch-and-learns.
Note: If making changes to scheduling to encourage healthier eating, here is a good place to make a note of this opportunity.
Evaluation
Here is where you will discuss how you will evaluate the success of your worksite health plan. Suggestions for policy-specific evaluation include employee and employer assessment (see Section 3 of the toolkit); process evaluation (how is implementation going); outcome evaluation (what are the immediate results of the programming); and impact evaluation (were goals met and was behavior sustained over time).
Implement Worksite Policies For tips on how to implement your worksite policy, refer to page (33).

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Establish Supportive Programming
Environmental Changes to Encourage Healthier Food Choices
One of the most effective ways to promote healthy eating to employees is to ensure that they have healthy choices available to them during the workday. Making healthy food choices available and low- cost, as well as working with your cafeteria (or an outside catering service) to provide healthy dining menu options are both great programming improvements that worksites can provide.
Possible Ideas:
Assess employee interest in healthier food options in your workplace (e.g., vending machines, cafeteria, etc.). You can do this using an online survey, individual interviews or an informal meeting. You will get an idea of what your employees want for food options. You can assess what they want in the cafeteria (e.g., a salad bar), the food they want in vending machines (e.g., energy bars instead of candy bars), and what they would like to see in the break rooms (e.g., yogurt or fresh fruit).
At meetings where food is provided, serve fruit and vegetables every time food is offered, and try to serve whole grain options instead of pastries. While you don't need to change everything, be conscious of at least offering low-calories foods with little fat and added sugar.
For companies with on-site cafeterias, food kiosks/snack bars, or outside caterers who come into provide food to employees, healthy menu changes can include providing whole-wheat bread instead of white; offering salads and soups with vegetables; serving food that is steamed, grilled, roasted, or broiled instead of fried; provide healthy beverages such as water, low-fat or fat-free milk, and unsweetened tea or other drinks without added sugars.
If you're providing food on-site using a cafeteria or caterer, publicize new food choices available on the healthier menu. Post signs in different areas around the worksite emphasizing new, healthy food options. Continue to talk about it at meetings and in company emails to encourage participation.
Explore the possibility of weekly farmer's markets with local vendors. If possible, you can even sponsor a company vegetable garden on-site.

If providing on-site food isn't an option for your worksite, providing a space where employees can store and heat-up healthy meals is a great option for companies who want to promote healthier eating among employees. Make sure that these break rooms have at least a microwave and a refrigerator, but also consider a toaster and other small appliances employees can use to prepare healthy food at work.

Individual Behavior Change Programs
As previously mentioned, eating healthy is ultimately up to the individual. Providing behavior change programs that educate and increase the skills of employees will result in healthier eating behaviors.

One option is to offer an on-site weight management program that focuses on healthy eating. Ongoing programs like these can provide employees with a support system and constant encouragement that can motivate them to change eating behaviors. If you don't have an on-site worksite health employee who can lead these programs, research programs available in your area. There may be funding available to subsidize or cover some of the costs of this program. If these programs are not available in your community, consult with a local hospital to see if they have a registered dietitian on staff who would be available to assist in providing this program.
While information is important, having the skills to find and prepare healthy food options is one of the most essential factors in changing eating behaviors. Offering a "lunch and learn" that includes cooking demonstrations and tips on how to purchase healthy food is a great option for employers.
In any worksite healthy eating program, addressing beverage choices is extremely important when promoting healthier food choices as a strategy to reduce obesity. Finding programs such as Rethink Your Drink or other educational programs encouraging water consumption is important for two reasons. First, many beverages have a lot of added sugar and unnecessary calories. Encouraging employees to choose beverages other than soda and other sugar-laden drinks will help them reduce their overall calories and their risk for gaining weight. Second, drinking enough water throughout the day decreases the risk of dehydration. Even mild dehydration can make employees feel tired and reduce their efficiency at work. In addition to ensuring that clean water is easily accessible at work, provide education to staff about the importance of water to their overall wellness, in addition to their weight loss efforts.

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Physical Activity
Adults need at least 150 minutes of aerobic physical activity each week, in episodes of at least 10 minutes. For greater health benefits, adults should increase aerobic physical activity to 300 minutes each week. Many employees spend most of their waking hours at work, giving employers a prime opportunity to encourage employees to increase their physical activity levels throughout the day. Establish Worksite Policies To create a worksite environment that supports physical activity for all employees, design a formal policy that addresses different components of worksite health as it relates to physical activity. It is up to the company to determine what they want to include in their physical activity policies. Create the Policy Form a Policy Workgroup Forming a policy workgroup ensures that feedback from both managers and employees is provided during policy creation. Consider the Extent of the Policy Every business needs to determine how inclusive the new policies will be. An initial policy could require supervisors to inform employees of the available areas for physical activity; a broader policy could require that supervisors allow all employees 30 minutes of physical activity in a workday. Write the Policy Having a written policy will eliminate any confusion regarding the specifics of the policy. For example, as with meal breaks, companies are not required to provide paid or unpaid physical activity breaks to employees; however, one possible policy change is to include a paid or unpaid physical activity break into the employees' schedules to get them moving during the day.
Possible Ideas: Establish and encourage physical activity breaks throughout the workday. Create an incentive program that promotes increased activity levels. Institute the option of flexible work hours to allow for physical activity outside of work.
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Sample Physical Activity Policy Policy Statement: Here is a good place to discuss the rationale behind the policy. Why is this policy important to your organization?
Example:
Many employees spend most of their waking hours at work, giving employers a prime opportunity to encourage employees to increase their physical activity levels throughout the day. Regular physical activity has huge benefits for health and reducing the development and burden of chronic disease, including heart disease, diabetes and some cancers. Employers that promote exercise among their employees have reported greater productivity and less absenteeism. Their employees reduce their risk of illness, obesity, injury and the development of preventable chronic disease.

Physical Activity Guidelines: If you want further justification for the implementation of this policy, you can include guidelines for how much an adult should be exercising weekly/daily.
Example:
It is recommended that adults get at least 150 minutes of moderate-intensity physical activity (e.g., brisk walking, moderate-level bike riding [5-9mph], general gardening), or 75 minutes of vigorous-intensity physical activity (e.g., jogging/running, tennis, swimming laps), or a combination of both per week. Physical activity can be performed in 10-minute increments (10 minutes at a time) over the course of a day and week, allowing individuals to realistically get some physical activity over the course of a workday.

Policy Components
The first step in creating a worksite health policy is ensuring that the policy meets the needs of the worksite, the employees, and the worksite environment. A physical activity policy can include a few or all of the components below.
Examples:
(Insert worksite name) encourages all employees to participate in regular physical activity throughout the workday. Employees are allotted (number of minutes) to participate in physical activity while at work.
Activities at (insert worksite name) that will promote physical activity among staff include: Having staff meetings in which a set amount of time will be devoted to physical activity such as stretching or walking around the premises. Designing alternative, flexible work schedules that accommodate employee physical activity. Dedicating physical activity time, outside of regularly scheduled breaks, that is allocated specifically for exercise. Creating healthy, safe stairwells that will encourage employees to use the stairs instead of elevators. Stairwells will be maintained, safe, visually appealing, well-lit and easily accessible. Implementing walking paths or other areas around/in the worksite that employees can use. These walking areas need to be identified with appropriate signage. Instituting bike facilities and amenities including bike storage, bike racks, and other amenities that will encourage employees to ride their bike to work instead of other forms of transportation.
(Insert worksite name) will create an environment that supports physical activity in the workplace where are all employees are encouraged and supported through: Support from organizational leadership. Encouragement for regular physical activity at work and home. Actions to enhance the worksite environment and increase and encourage employee physical activity opportunities. Worksite provisions of opportunities to receive social support in the workplace to encourage physical fitness.

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Please see the Appendix for examples of worksite health policies.
Worksite Health Implementation
Here is where you should discuss the activities that you are going to implement to support your physical activity policy. This is also where you will include information about how employees will be informed of the new worksite health policy pertaining to physical activity.
Examples:
The (insert worksite name) physical activity policy will be posted in stairwells and bulletin boards; will be discussed at meetings; and will be communicated through companywide emails and trainings.
The (worksite health champion) will be responsible for policy and program implementation. Employees interested in participating in the physical activity worksite health initiative can seek additional
information from (the worksite health champion or committee). They may also access the policy at (anywhere this policy will be made available to employees). To support the physical activity worksite policy, (insert worksite name) will make the following environmental changes: Here include any change your worksite will be making, for example, stairwells, walking paths, and/or bike amenities. To support the physical activity worksite policy, (insert worksite name) will offer educational opportunities to learn various physical activity skills and methods. [Here is where you can discuss the creation of a gym or partnership with a gym].
Note: If making changes to scheduling to encourage physical activity (e.g., implementing a physical activity break, offering flexible work schedules, etc.), here is a good place to make a note of this opportunity.
Evaluation
Here is where you will discuss how you will evaluate the success of your worksite health plan. Suggestions for policy-specific evaluation include employee and employer assessment (see Section 3 of the toolkit); process evaluation (how is implementation going); outcome evaluation (what are the immediate results of the programming); and impact evaluation (were goals met and was behavior sustained over time).
Implement Worksite Policies For tips on how to implement your worksite policy, refer to page (33).
Establish Supportive Programming
Environmental Changes to Encourage Physical Activity
A great way to promote physical activity among employees is by creating a worksite environment that is both encouraging and supportive of employees who choose to be more active.
Possible Ideas:
Install bike racks on-site and near employee entrances. The area should be well lit and situated so that cyclists can ride their bikes directly into the rack. You can promote biking to work by installing showers and lockers in existing restrooms. Offering free or discounted bike helmets and safety gear will encourage bicycle commuters.
Provide clean, safe and appealing stairwells. Paint the stairwells with brighter colors. Put up motivational signs near elevators to encourage employees to take the stairs. Install better lighting in the stairwells. Adding carpet or rubber treading will reduce slippage on the stairs. If the stairwells are more appealing to employees, they will be more likely to use them instead of taking elevators.
If possible, provide on-site fitness opportunities and facilities. Some worksites have the ability to create a space that includes workout equipment that employees can use throughout the day. If this is not feasible, temporarily creating a space for an occasional group fitness class (e.g., aerobics, yoga) will still provide physical fitness opportunities for staff during the workday.
Create outdoor physical activity spaces. Alter your landscaping to include walking trails. Since many people report that walking is their most common and preferred fitness activity, an on-site walking area will encourage them to walk throughout the workday.

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Individual Behavior Change Programs
As with all other health behaviors, it is up to the individual to make the right behavior changes. By offering programming at your worksite that informs, educates, and encourages individuals to participate in more physical activity, they are much more likely to make those important health behavior changes.
Possible Ideas:
Establish employee activity groups. By providing a forum for employees with similar fitness interests, you are encouraging individuals at the worksite to increase their physical fitness inside and outside of the workplace. You can survey your employees to see the types of physical fitness groups they would be interested in (e.g., walking, running, basketball, bicycling, etc.). Once you know what your employees want, offer sign-up sheets or some other method of connecting individuals to one another- a sort of "marketplace" that can be online or on a bulletin board. You can also sponsor local intramural leagues with other employers in the community.
Set up incentives and challenges to encourage physical fitness. Challenges can include tracking steps using pedometers or tracking physical fitness hours performed by employees. Employees can track their participation hours using a special form that you provide; this doesn't require a device. You can reward employees who are consistent with the worksite health program with any incentive that is feasible given your resources. Refer to the Employee Engagement section for ideas on incentives.
Coordinate a partnership with a local fitness facility. It isn't always realistic for companies to build on-site fitness centers, so by establishing a partnership with a local gym, employees will still be given the opportunity to use gym equipment. Ask area fitness facilities if they offer corporate packages or any discount structure for large groups. Encourage employees to join the gym in groups or to attend specific group fitness classes together. It can also be beneficial to find a health club that offers discounted family members so the whole family can participate.

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Tobacco/Smoke Free
The high prevalence of smoking and the severity of associated health risks make tobacco use an important health topic in the workplace. Although studies show that 70% of tobacco users report a desire to quit, people often attempt to quit several times before they are successful. Research shows that tobacco users are two-to-three times more likely to quit successfully when they have help.
Businesses who encourage their employees to quit using tobacco products have the opportunity to help workers get healthier, increase employee productivity, and decrease costs associated with healthcare and health insurance. By making simple changes to the work environment and organizational policy regarding tobacco use, businesses can improve the health of employees while saving the company money.
This section of the toolkit provides guidance on establishing necessary components that guide a business in moving toward a tobacco-free worksite. The components discussed are:

Establish and enforce tobacco-free worksite policies, Establish on-site tobacco cessation programming, and

Add coverage for smoking cessation services to your company's health benefits.

Establish Worksite Policies The Georgia Smokefree Air Act of 2005 became effective July 1, 2005. Prior to this date, there was no state law regulating tobacco use at worksites. Although the law prohibits tobacco use in most public areas, it does not address campuswide restrictions, nor does it restrict the use of "spit" tobacco. Thus, individual steps are necessary to establish a comprehensive tobacco-free policy that does not allow tobacco use, including "spit" tobacco, anywhere on the worksite campus.
A comprehensive tobacco-free workplace policy not only protects non-tobacco users from secondhand smoke exposure, it also makes it easier for tobacco users to quit. Tobacco users who face these restrictions consume less tobacco and quit at a much higher rate than average. By comparison, milder tobacco-free workplace policies have much less impact on quitting rates and very little effect on consumption.
Non-smoking policies can include the purpose of the policy, who is impacted by the policy, identification of where smoking is prohibited at the worksite, penalties of noncompliance, identification of support programming that will be available for smokers who are interested in quitting, and the transition steps, if any that will be in place to implement the new policy.

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Businesses can transition to a tobacco-free workplace by creating a tobacco-free workplace policy and implementing it for employees. There are several actions a business can take to create, implement and enforce a tobacco-free worksite policy.
Create the Policy Form a Policy Workgroup
Forming a policy workgroup ensures that feedback from both managers and employees is provided during policy creation. Individuals who use tobacco should be included in this workgroup. Including tobacco users in the workgroup is important because their cooperation is crucial to the success of policy implementation.
Address All Tobacco Products in the Policy
It is best to include all tobacco products in the tobacco policy due to their health consequences. There are no safe tobacco products, so all should be addressed. However, it is up to the individual worksite to determine what tobacco products will be addressed in the organizational policy.
Consider the Extent of the Policy
Every business needs to determine how inclusive the new policies will be beyond the legal requirements of the Georgia Smokefree Air Act of 2005. Policies could include prohibiting smoking areas, banning smoking in company vehicles, or applying an entirely tobacco-free worksite.

Write the Policy
Having a written policy will eliminate any confusion regarding the specifics of the policy. Included in the appendix section of this toolkit is a template to simplify the process of writing the tobacco-free policy.
Possible Ideas:
Institute a comprehensive tobacco-free (not just smoke-free) policy. The policy should apply to the entire worksite campus, including indoor and outdoor areas, leased or shared facilities, and vehicles.
Policies should also prohibit tobacco use near the entrances to buildings, with the legal clearance footage specified. Keep in mind that the most effective "gold standard" policies do not allow for designated smoking areas or separately ventilated smoking facilities.
Post signage indoors and outdoors to alert employees and visitors of the worksite policy. Communicate and enforce the policy with an integrated, nonpunitive message. For example: "We care about
your health. The company offers the following programs and supports to help you stop using tobacco."

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Sample Tobacco Policy Policy Statement: Here is a good place to discuss the rationale behind the policy. Why is this policy important to your organization?
Example: Smoking and secondhand smoke are known causes of lung disease, heart disease and cancer. Although studies show that 70% of tobacco users say they want to quit, people often need to try quitting several times before they are successful. Tobacco users are two-to-three times more likely to quit successfully when they have help. By encouraging employees to quit using tobacco products, (insert worksite name) has the opportunity to help workers get healthier, increase employee productivity and decrease costs associated with healthcare and health insurance.
Tobacco Guidelines: If you want further justification for the implementation of this policy, you can include guidelines for tobacco use.
Example: No amount of smoking is considered healthy. Smoking is the leading cause of preventable death. More than 16 million Americans are living with a disease caused by tobacco use. Additionally, cigarette smoking is responsible for more than 480,000 deaths per year in the United States. It is important for (insert worksite name) to address smoking in company policy to ensure that smokers have the support they need to quit smoking, and to ensure that non-smokers reduce their exposure to secondhand smoke while at work.
Policy Components The first step in creating a worksite health policy is ensuring that the policy meets the needs of the worksite, the employees, and the worksite environment. A tobacco policy can include a few or all of the components below. Example- Completely Tobacco Free Policy:
(Insert worksite name) is now completely tobacco-free. No use of tobacco products including cigarettes, chewing tobacco or e-cigarettes is permitted within the facilities or on the property of (insert worksite name) at any time.
(Insert worksite name) will provide education and services to all employees interested in quitting smoking. Note: Discuss any changes in health insurance policies that will cover smoking cessation services or reduce rates for nonsmokers. You can also refer the employee to a different policy pertaining to health insurance. Please see the Appendix for examples of worksite health policies.

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Worksite Health Implementation Here is where you should discuss the activities that you are going to implement to support your tobacco policy. This is also where you will include information about how employees will be informed of the new worksite health policy pertaining to tobacco.
Examples:
The (insert worksite name) tobacco policy will be posted in stairwells and bulletin boards; will be discussed at meetings; and will be communicated through companywide emails and trainings.
The (worksite health champion or committee) will be responsible for policy and program implementation. Employees interested in participating in services offered through the tobacco cessation worksite health
initiative can seek additional information from (the worksite health champion or committee members). They may also access the policy at (anywhere this policy will be made available to employees). To support the physical activity worksite policy, (insert worksite name) will make the following environmental changes: remove all ash trays, eliminate smoking areas, etc. To support the tobacco policy, (insert worksite name) will offer learning opportunities and smoking cessation programs. To support the tobacco policy, (insert worksite name) will add coverage for smoking cessation services to the company's health insurance benefits.
Evaluation
Here is where you will discuss how you will evaluate the success of your worksite health plan. Suggestions for policy-specific evaluation include employee and employer assessment (see Section 3 of the toolkit); process evaluation (how is implementation going); outcome evaluation (what are the immediate results of the programming); and impact evaluation (were goals met and was behavior sustained over time).
Implement Worksite Policies For tips on how to implement your worksite policy, refer to page (33).
Establish Supportive Programming
Providing a low- or no-cost tobacco cessation program at your worksite can make participation in such programs even easier for your employees. These initiatives demonstrate that you and your company are committed to making a sincere effort to help employees quit using tobacco. A comprehensive cessation program will include a strategy that addresses the needs of all employees and their dependents.
Creating a Supportive Environment
Work with Georgia Department of Public Health to establish a consistent tobacco-free message for the worksite. This would include removing cigarette receptacles located at the building entrances. Signage should be installed before policy implementation and should be placed at all pedestrian entrances. This will notify employees and visitors that they are entering a tobacco-free campus.
Possible Ideas for Developing Cessation Programming:
Provide tobacco cessation brochures in break rooms, restrooms and other public areas. Communicate the benefits of quitting, as well as the resources and benefits available to employees, in your company newsletter, intranet, and other communication vehicles.
Invite guest speakers from the community to discuss the positive impact of quitting on wellness and good health. Provide health risk appraisals as part of your health fair. Participate in special events like The American Cancer Society's Great American Smokeout, and promote
quitting during optimal times of the year, such as the beginning of a new year, when people have made health-related resolutions. Sponsor an on-site support group for employees who are trying to quit tobacco products and those who have recently quit. There is a 12-step program based on the Alcoholics Anonymous model for tobacco users called Nicotine Anonymous. For more information or how to start a group like this, visit http://www.nicotine-anonymous.org. Develop rewards and incentives for employees who successfully reach their cessation goals.

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Add Coverage for Smoking Cessation Services to Your Company's Health Insurance Benefits

The choice of health plan coverage for smokers can impact how successful employees will be at their attempts to quit using tobacco products. Because most Americans receive their health coverage through employers, finding plans that cover tobacco cessation treatments encourage smokers to use the treatments, increase successful quit attempts, and save employers money. Ideally, the health plan coverage would ensure that evidence-based tobacco treatments that include counseling and medications be made available to employees at no cost.

Smoking cessation programs are most successful when designed to--
Cover the costs of counseling services, Offer FDA-approved drug therapies, including both prescription and over-the-counter medication, Offer counseling sessions over a period of several weeks, and Reduce out-of-pocket expenses for employees who wish to quit using tobacco products.

Possible Ideas:
Contract directly with the American Lung Association, American Cancer Society or with Quitline vendors to offer worksite cessation services to employees.
Include reimbursement accounts so that employees can receive 100% reimbursement for all evidence-based tobacco cessation treatments. Ensure that deductibles, co-pays and coinsurance do not apply. Eliminating financial barriers to quitting facilitates getting more people into treatment.
Communicate to employees the types of cessation benefits that are covered under the company health plan.

When creating your benefits package, use these guiding questions:

1. How does the health plan identify and document tobacco users and tobacco cessation interventions?

2. What tobacco cessation drugs are covered, including frequency of refills covered, covered drug combinations, and the number of quit attempts covered?

3. What type of counseling is covered, how often is it covered, and for what period?

4. What is the plan design for tobacco cessation (e.g., copay, deductibles, etc.)?

5. Are over-the-counter medications covered?

6. Who is eligible for cessation benefits, drugs and counseling?

7. What educational and counseling materials are provided?

8. How does the plan motivate healthcare providers to provide tobacco cessation counseling?

9. Is the benefit promoted to employees, and if so, how?

10. How is the percentage of tobacco users who have received treatment assessed? How is success of tobacco cessation evaluated?

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Breastfeeding
Lactation Support One of the fastest growing segments in the U.S. workforce is mothers. Due to fulltime work and barriers surrounding maternity, average duration of breastfeeding is shorter than recommended. Low-income women are more likely to return to work earlier and have jobs that do not accommodate breastfeeding. If breastfeeding support is offered at a workplace, breastfeeding initiation and duration will increase, leading to healthier babies.
Key Considerations
Many Georgia mothers work for pay. By supporting breastfeeding in the workplace, employers are showing that there is support for a mother's decision to breastfeed and help ensure healthy babies, children, and mothers. If your worksite is considering incorporating breastfeeding or lactation support, there are a few things to consider to have a comprehensive, effective program:
Educate management on the benefits of having a lactation policy in the workplace that follows both state and federal law.
Examine programming that is already in place at similar worksites that can be adopted at your organization. Think about whether your company should incorporate policies and programming that would allow new
mothers to bring their infants to work until they reach a certain age.
What's important is that you consider the needs of the new mothers employed within your organization. It is necessary to consider company policy, state policy, and federal policy when examining this worksite health topic. It is also vital that programming addressing the environment and personal behavior are considered.
Establish Worksite Policies Developing corporate policies to support breastfeeding women is a great way to support breastfeeding in the workplace. As with the other health topics addressed in this toolkit, working with employees and management to ensure that breastfeeding is addressed in worksite health policy will increase support for new mothers who want to continue breastfeeding after they return to work. Knowing that there is support from organizational leadership and policies in place will increase the number of women who participate in this health behavior. It is also important that company policy reflect federal and state legislation regarding breastfeeding mothers, as explained below.
Create the Policy Form a Policy Workgroup
Forming a policy workgroup ensures that feedback from both managers and employees is provided during policy creation. It is crucial to include mothers who have breastfed in the workgroup to ensure the success of policy implementation.
Address Federal and State Laws
Georgia Code- Breastfeeding of Baby- Title 31, Section 31-1-9
The breastfeeding of a baby is an important and basic act of nurture which should be encouraged in the interests of maternal and child health. A mother may breastfeed her baby in any location where the mother and baby are authorized to be.
Georgia Code- Labor and Industrial Relations- Title 34, Section 34-1-6

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As stated in the Georgia Code, an employer (with one or more employee) shall provide reasonable unpaid break time each day to an employee to express breast milk (pump) for her infant child. The employer may make reasonable efforts to provide a room or other location, other than a restroom, where the employee can [pump] in privacy. The break time shall, if possible, run concurrently with any break time already provided to an employee. An employer is not required under state law to provide time under this Code section if to do so would unduly disrupt the operations of the employer. Break Time for Nursing under FFLSA In March 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama. Section 4207 requires that employers with more than 50 employees provide "reasonable break time" and a private place other than a restroom for an employee to "pump" during the workday up until the child's first birthday. Consider the Extent of the Policy Every business needs to determine how inclusive the new policies will be beyond the state and federal laws. Policies could include making breastfeeding acceptable in all areas of your business premises that are open to the public, or creating a dedicated space for breastfeeding mothers to pump such as a lactation room. Write the Policy Having a written policy will eliminate any confusion regarding the specifics of the policy. Possible Ideas:
Employees will be provided with flexible work schedules to accommodate breastfeeding or expressing breast milk.
Mothers will be allowed to bring infants up to six months of age to work. Breastfeeding is acceptable in all areas of your business premises that are open to the public. All staff members are made aware that your business supports the
needs of breastfeeding mothers. A mother who is breastfeeding in an area of the business premises
open to the public will not be asked to move to another area or stop breastfeeding.
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Sample Lactation Policy for Breastfeeding Employees Policy Statement: Here is a good place to discuss the rationale behind the policy. Why is this policy important to your organization?
Example: In recognition of the health advantages of breastfeeding for both infants and mothers, (insert worksite name) strives to provide a supportive environment that enables women to express milk (pump) during work hours. Developing corporate policies to support breastfeeding women is a great way to support breastfeeding in the workplace. The goal is to provide support from organizational leadership, environmental changes and policies that will increase the number of women at the workplace who choose to continue to breastfeed after returning to work.
Breastfeeding Guidelines: If you want further justification for the implementation of this policy, you can include guidelines for breastfeeding recommendations.
Example: It is recommended that infants should be exclusively breastfed for the first 6 months of life to achieve optimal growth and development. Babies should continue to breastfeed for a year while progressively initiating solid foods into their diets. While 75% of new mothers start out breastfeeding, only 13% are still breastfeeding by the time their babies are 6 months old. Since many women come back to work before their infant is 6 months old, it is important that they have options to pump and continue breastfeeding if they choose to do so. By supporting breastfeeding in the workplace, employers are showing that there is support for a mother's decision to breastfeed and help ensure healthy babies, children, and mothers.
Policy Components The first step in creating a worksite health policy is ensuring that the policy meets the needs of the worksite, the employees, and the worksite environment. Breastfeeding policy can include a few or all of the components below. Examples:
(Insert worksite name) encourages all mothers who breastfeed to continue to do so, after returning to work. All breastfeeding employees have (specific number/time) for milk expression breaks in which she can pump.
[Note: it is up to you to specify how these breaks work- if these breaks are a part of their normal breaks/meal times OR if they must use personal leave if time needed goes beyond provided breaks.] (Insert worksite name) has designed a lactation policy in line with the Patient Protection and Affordable Care Act (PPACA), which is explained below. [provide paragraph here] (Insert worksite name) has the following responsibilities in relation to breastfeeding employees: A place to express milk (e.g., a dedicated lactation room); The provision of breastfeeding equipment (e.g., breast pumps provided by the employer); and Giving education to expectant and new mothers and fathers (e.g., classes). Please see the Appendix for examples of worksite health policies.

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Worksite Health Implementation
Here is where you should discuss the activities that you are going to implement to support your breastfeeding policy. This is also where you will include information about how employees will be informed of the new worksite health policy pertaining to breastfeeding employees.
Examples:
The (insert worksite name) lactation policy will be posted in stairwells and bulletin boards; will be discussed at meetings; and will be communicated through companywide emails and trainings.
The (worksite health champion or committee) will be responsible for policy and program implementation. (Supervisors, the worksite health champion, or the committee) is responsible for alerting pregnant and
breastfeeding employees about (insert worksite name)'s lactation support policies and programming. To support the lactation policy for breastfeeding mothers, (insert worksite name) will make the following
environmental changes: Here, include any change your worksite will be making, including the provision of a space where women can pump.
This space must be functional for breast pumping. It cannot be a bathroom.
To support the lactation policy for breastfeeding mothers, (insert worksite name) will provide the following educational and learning opportunities: Here, describe any educational opportunities the worksite will be providing.
Employees have responsibilities regarding the breastfeeding policy and programming, including: Here, list any responsibilities the breastfeeding employee may have if utilizing any component of the lactation policy. Examples include informing supervisors of their needs for appropriate lactation accommodations, keeping the area designated for pumping clean, appropriately labeling their milk when storing it at work, and/or logging breaks taken for lactation.
Evaluation
Here is where you will discuss how you will evaluate the success of your worksite health plan. Suggestions for policy-specific evaluation include employee and employer assessment (see Section 3 of the toolkit); process evaluation (how is implementation going); outcome evaluation (what are the immediate results of the programming); and impact evaluation (were goals met and was behavior sustained over time).
Implement Your Worksite Policy For tips on how to implement your worksite policy, refer to page (33).
Establish Supportive Programming Using Federal and State Regulations to Guide Programming
Making Environmental Changes: Time and Location of Breaks
Employers are required to provide a space at worksites where women can use a breast pump if they are still lactating. A bathroom, even if it is private, is not permissible under the new regulations in the PPACA. The designated worksite location must be functional as a space for pumping. If the space is not dedicated to the nursing mother's use, it must be available when needed to meet the legislation's requirement. A space temporarily created or converted into a space for pumping or made available when needed by the nursing mother is sufficient, but only if the space is shielded from view and free from intrusion by co-workers and the public.
In addition to adherence to federal law, giving lactating mothers a convenient place to breastfeed or pump breast milk can help reduce turnover, as mothers will be more likely to return to work after their maternity leave. If possible, designate a lactation room that is clean, private and comfortable. Include chairs, a sink for washing breast pump parts, and a refrigerator. Remember, this space cannot be a bathroom. If this is not an option at your worksite, consider what space(s) can be used as temporary or makeshift lactation rooms that comply with federal policy.
Action Steps to Support Breastfeeding
A comprehensive breastfeeding program at worksites includes the following components. These components have been shown to have the greatest return on investment for employers who offer breastfeeding support to employees.

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Privacy for milk expression (pumping) As previously explained, this is a requirement under federal law. This space can be a woman's private office if it locks, or employers can offer an on-site, designated room for lactation. See the previous section for more information. Flexible breaks and work options New mothers need to express milk approximately every three hours; this means that they need to pump two-to-three times during a typical workday. Each time they pump, it will take around 15 minutes, not including the time it takes to go to and from the designated lactation area. Therefore, this time needs to be considered in a lactation support plan at work. Education Employer-provided education and resources accessible at work both during and after pregnancy can help women decide if they want to breastfeed, provide information on breastfeeding after they return to work, and assist in balancing the requirements for breastfeeding with their job responsibilities. Offering information to soon-to-be and new fathers is also beneficial; education for male employees and their partners leads to lower absenteeism rates among men, as well as lower health insurance claims. Support A positive, accepting attitude from management, supervisors, and co-workers helps breastfeeding employees feel comfortable and confident to continue breastfeeding after they return to work. Getting Started with a Lactation Support Program Breastfeeding support programs for employees can be adjusted to meet the needs of your worksite. It can be as simple or elaborate as you want it to be, if it complies with appropriate legislation and policies. Program models vary based on the individual companies; however, there are guidelines that can assist when beginning a worksite health program for breastfeeding employees.
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1. Project Piloting Many companies with successful lactation programs start small with a pilot program. This can grow to meet employee needs and interests. For example, you can start with a simple lactation space that can be expanded to include individual education, lactation support, and additional amenities as the program grows.
2. Getting Buy-In Front-line supervisors and managers play an important role as partners to human resources in creating a supportive environment for employees. They can help to assure concerned team members that a breastfeeding-friendly environment is good for the business, in addition to being good for employees.
3. Assess the Need for a Lactation Program Assessing the needs of your employees can help with the justification and support for a lactation program and assist in the planning process. You can include these questions: How many women are likely to be affected by lactation supporting programming? What department should be responsible for the program's oversight? How should space be allocated for a lactation room? What resources are available to equip the lactation room? What program policies should be developed? What type of record keeping may be required by the organization? Where should promotion materials be placed to reach potential users of the lactation program?
4. Determine a "Home" for Your Program Most employers establish an "administrative home" for their lactation program within human resources, aligning it with other departmental services such as-- Employee health benefits, Employee wellness or health programs, and Existing family and work-life programs.
5. Identify Community Resources A variety of community experts can also be brought into the committee or task force to assist in designing a program and lactation policy that will address the needs of your company and employees. These community experts can provide direct services to your breastfeeding employees: Health Professionals: Professionals from hospitals, obstetric, and pediatric care programs can provide valuable
insight and health-related information. Lactation Consultants: An International Board Certified Lactation Consultant (IBCLC) is a credentialed health
professional who can provide direct breastfeeding education and clinical counseling for breastfeeding mothers. Some consultants can assist employers with establishing appropriate accommodations for lactating employees. WIC: The United States Department of Agriculture Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides a nationwide system of nutritionists and breastfeeding support professionals and paraprofessionals. Insurance Carriers: Check with insurance carriers to identify policies and benefits for breastfeeding employees. Insurance companies may cover breastfeeding resources and services such as breast pumps, consultations with a lactation consultant, and breastfeeding supplies. Other additional organizations that could provide resources include The March of Dimes, Healthy Mothers Healthy Babies Coalition, Georgia Breastfeeding Coalition, local hospitals and other healthcare organizations, and the Georgia Department of Public Health.

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Implementing Worksite Policies
There are two main components to consider when implementing a worksite policy- the policy and the programming that supports the policy. These two components can be implemented by the worksite either simultaneously (at the same time) or sequentially (one following another). It is recommended to promote programming prior to policy implementation because it demonstrates that the worksite is taking a supportive stance. However, it is important to adapt this toolkit to the organization and what will be most efficient and effective for the individual workplace.
Announcing the Policy to Employees If the planning committee decided to implement programming before the policy has been implemented, consider announcing to the employees that a policy is coming soon. The announcement should come from a manager, supervisor, or another organizational leader.
A start date for when the policy will take effect needs to be decided either by the planning committee or management, allowing for sufficient time to carry out the communications plan. Allow at least four months to lay the foundation and communicate the plans for the new policy to employees before enforcement or implementation. This will provide enough time to ensure everyone is aware of the policy change, and provides ample time to communicate support and programming for individuals who will be directly affected by the policy. One approach is to plan for policy initiation in combination with national events such as New Year's Day when many individuals are making New Year's resolutions. This will maximize motivation to adhere to the policy change.
Determine How the Policy will be Implemented and Enforced Creating action steps (examples featured below), a timetable, and methods for staff accountability for implementation can increase the probability that organizational employees will embrace the policy.
All employees need to be kept informed about any changes in company policy and how those changes may impact them. In the implementation plan, the changes in the policy should be communicated to employees, along with the programming and support that will be made available to employees. Communicating the new policy or changes to current policies can be done using the intranet, presentations to workers, brown bag lunches, information kits or any other communication channel that is available in the organization.
Action Steps
After setting up a committee to create the policy, set up a committee or task force to oversee policy implementation. This can be the same committee as previously described, or a new committee can be established.
Survey employees about knowledge and concerns about the policy. If this information is collected, concerns about the policy can be addressed prior to implementation.
Create a communication plan as described above.
Make sure that the policy is clear and simple.
Enforcing and Monitoring the Policy Effective policies state who will enforce it. Plans for addressing policy violations also need to be discussed. In the weeks prior to the policy taking effect, organizational leadership should communicate to management their role in enforcing the policy, including specific guidance on how to correct noncompliance, procedures and complaints.
After the policy has been implemented, carefully monitor feedback and any issues related to noncompliance or confusion. Clarify the policy when needed.

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SECTION 6: Employee Engagement and Recognition
To engage employees and encourage active participation in your worksite health program, organizations are encouraged to employ the featured strategies below. These strategies are supported by the Georgia Department of Public Health and the Centers for Disease Control and Prevention.
Step One: Involve employees from the beginning
Involving employees from the beginning will create a sense of shared responsibility and commitment to employee health. This is critical to the overall success of the worksite health program. Employee interests should be considered at all stages of developing your new programs and policies. As mentioned previously, include employees from all levels of the organization on your worksite health committee.
Step Two: Regular and consistent communication
Communication is a critical component of your program. Employees are key stakeholders and should be kept informed of the purpose of your program and the health promotion opportunities available to them.
Promoting your program activities to employees Promoting your activities is a crucial step in the successful delivery of a worksite health program. When carried out properly, a promotion plan informs employees and gets them excited. Here are some ideas:
Visibility - Branding your program is an effective way to create visibility. Develop a name and logo that will be easy to recognize and can be easily linked back to your worksite health program efforts. Use the worksite health program name and logo on all materials.
Find the "hot spots" Identify high traffic areas in your building, such as break rooms, bathrooms, coffee machines, and water coolers. These are the areas you will want to target for your promotional materials. Additionally, designate a central location where employees can learn about and access program information. Make sure that the information is clear, easy to understand, and printed in large enough letters so that people can read it easily.
Diversify Use all channels of communication at your disposal. Company billboards, newsletters, and internet or intranet sites are just a few ways you can diversify your promotional efforts. Other materials include posters, table tents, flyers and emails. Be sure to include the basics: who, what, why, when and where.
Timing of messages Another step to effective promotion is determining the right time to deliver the message. You may want to take advantage of companywide or departmental meetings, luncheons, or social gatherings such as a holiday party or birthday celebration.
Schedule guest speakers Arrange for fitness, nutrition, or stress management experts to offer tips during lunch-and-learn sessions.
The bottom line The best way to ensure high participation is to use as many means and methods as possible. Different people respond to different stimuli, so in most cases, going the extra mile pays big dividends.

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Step Three: Enroll informal leaders in the program
Think about this: If you stripped away everyone's job title, who would people choose to follow? Once you have answered this question, you have successfully identified your company's informal leadership. These are the key people that you want to take part in your program. Leverage their participation by using them as honorary chairpersons.

Step Four: Consider incentives and rewards

Incentives can make or break a program. Realizing that individuals must themselves be determined to change, incentives, awards, and competition provide added motivation to facilitate the process. Incentives can be used to encourage program participation and completion. They can also be used to reward certain behaviors and outcomes.

It is important to offer incentives that are attractive to your employees. Inappropriate incentives may cause employees to lose interest in the program. Consider using a questionnaire ahead of time to get an idea of what incentives motivate your employees.

Gift certificates for local fitness stores Gift certificates to local health food stores Day passes to local fitness club Free massages Water bottles Hats/Visors Walking shoes T-shirts
Gym bags

Incentive Suggestions
Pedometers Fitness monitors Motivational books Healthy cookbooks Exercise videos Health magazine subscription A "well" day off Exercise equipment: dumbbells, resistance bands, ankle weights, yoga mats Food scales

Step Five: Recognize employee and program achievements
Make sure employees are rewarded for their accomplishments in a visible meeting or special ceremony. Plan a celebration to recognize program victories. Advertise the celebration throughout your organization, invite senior level executives, and get them to present the awards.

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SECTION 7: Health Risk Identification Tools
In addition to changing the work environment, creating worksite policies and providing behavior change programming to staff, supplemental screening and prevention programming can be used to offer a more comprehensive employee health program. Screenings and other health assessments can provide employers and employees with specific health information that guides the development of a targeted and successful worksite health program. These health risk identification tools include health risk assessments (HRAs) and biometric screenings, such as body mass index (BMI), blood pressure, cholesterol and glucose level.

The Importance of Screening
Chronic diseases like heart disease and diabetes develop over time. In addition to changing behavior, early diagnosis of these chronic diseases can slow or halt the progression of disease and help an individual avoid costly medical treatments, complications, diminished quality of life, and premature death.
It is imperative that health assessments are followed up with further evaluation, interventions and other worksite health programs. These assessments can be done before a worksite health initiative is implemented to determine employee health status and needs, or they can be offered in conjunction with an ongoing worksite health program. With the latter, employees will learn about their own individual health as behavior changes are being made during program implementation. Assessing or testing employees without appropriate follow up will not lead to appropriate care, reduction of risk, or management of the condition identified.
How Can Worksites Encourage or Include Screenings? The most common barriers to getting routine health assessments are inconvenience and cost. Employees may not have the time, transportation, financial means, or child care to allow them to visit a healthcare provider for appropriate health assessments. Employers can make preventive assessments available to employees who may not have access to them otherwise. If a worksite does not have the resources to employ a healthcare provider, there are cost-efficient ways to provide periodic services.
Examples:
Offer assessments at semiannual health fairs; Engage healthcare professionals to spend a day screening employees; and Include preventive checkups as a health benefit or find an insurance plan that covers preventive screening
with little or no copay.

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Health Fairs
Employee health fairs that include assessments can help employees identify any current illnesses and their risks for serious chronic diseases. You can work with local health professionals to conduct these assessments and provide follow-up counseling and intervention strategies for those identified as being high-risk for disease.
Some ideas for health fairs include:
Incorporating assessments appropriate for both men and women. Using paper screening tools to assess employee risk. Implement health fairs that are tied to health observances such as Diabetes Alert Day and National High Blood
Pressure Education Month. Partner with other businesses or healthcare organizations in your area and offer the fair together. This is a
particularly good strategy for small businesses with few employees and limited resources and space.

Permanent or Temporary On-site Health Clinics and/or Services
On-site health clinics remove time and inconvenience as barriers for getting health checks. An on-site health clinic does not need to be a full-service or full-time health facility. It should, however, give employees access to services like health monitoring (blood pressure, blood glucose check, health education, consultation services, first aid and triage care).

Some ideas for on-site health clinics and/or services: Small businesses with limited space or resources can contract with a medical professional on a semiannual, temporary, or as-needed basis to render these services.
If dedicated clinic space is not an option, convert a conference room or office for use on "clinic days." An actual clinic space is not necessary, but you must have an enclosed room to ensure privacy during a consultation.
Work with a hospital or medical center. They can usually help with occupational health services including health screening and health education.

Including Preventive Checkups as a Health Benefit
Benefit design offers another opportunity to encourage employees to get appropriate preventive health assessments. Consider including annual exams and other age-appropriate assessments at no cost to the employee. This will remove the cost barrier and further encourage employees to get screened.

Some ideas for health benefits include: Work with your health insurance carrier(s) to develop a plan where the information from health assessments can be used to categorize or direct employees to behavior change and disease management programs.
Offer incentives tied to health plans. For example, offer a credit to employees who complete preventive screening and/or health risk assessments.

Health Risk Assessment

A health risk assessment (HRA) is a collection of health-related data that can be used by a medical provider to assess a patient's health risks. Usually in the form of a checklist or questionnaire, an individual answers questions regarding their health behaviors, and then those answers are professionally evaluated to determine health risks and quality of life. The questions on the HRA identify health behaviors and risk factors known only to the individual. Some HRAs also work to identify a person's motivation and readiness to make health behavior changes. A medical professional can review the HRA and provide tailored feedback to help a person reduce his or her risk factors for disease.

As an alternative, some organizations have the resources to hire a full-time worksite health coordinator. Often, these individuals are health educators or other public health professionals who can do HRAs and provide feedback to employees. If this is not an option, bringing in a person once or twice a year to evaluate employees is also a viable possibility for administering and evaluating HRAs.

HRAs are often available through health plans or through third-party administrators. In this toolkit, an HRA is provided

in the appendix and can be used as your worksite's HRA.

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Biometric Screening
Biometric screening is the measurement of physical characteristics such as height, weight, BMI, blood pressure, blood cholesterol, blood glucose, and aerobic fitness of an individual. Unlike HRAs which are questionnaires asking for feedback from a person, a biometric screening includes actual measurements that identify the health status of an individual.
Biometrics screenings can be done at a worksite as a part of an employee health assessment. The data accumulated through these screenings can be used as a starting point to compare with future assessments. Biometric screenings are not a replacement for regular healthcare visits, and are also not a mechanism for diagnosing medical conditions. The purpose of these screenings is to get data to:
Identify health risks for individual employees, as well as the entire employee population.
Structure benefits plans addressing health risks that exist in the employee population.
Implement health interventions that target identified health risks.
Tailor health management programs to employee needs.
Refer individuals to healthcare providers.
While a traditional biometric screening generally does not include blood testing, many worksites are now providing employee screening that includes blood tests. If there is no healthcare professional on staff, employers can bring in a healthcare provider (medical assistant, nurse, etc.) who can draw blood from employees on-site. Some providers can test the blood immediately with a portable blood-testing device. Other providers must send the blood to a laboratory for testing. Doing research about the healthcare organizations or professionals in your area will help you determine who can come to your worksite to perform these tests and which tests they provide. The Georgia Department of Public Health can also assist in this process.

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SECTION 8: Appendix
Policy Building
When creating, or editing worksite health policies for your company, there are general steps to take. These steps are referred to as the ABCs of adopting and implementing a health-related policy.
A: Assess Your Current Policies and Practices Related to Worksite Health Before you begin changing or updating any policy at your worksite, it is important to first assess the current policies you may have in place that relate to worksite health. If you already have policies regarding nutrition, physical activity, tobacco use or breastfeeding for your worksite, now is a good time to review and revise the policies so that they reflect your new worksite health plan.
B: Build Your Plan for Improvement If you already have worksite health policies or are just starting to implement them, now is a great time to build your plan for improving the policies, programs, and health behaviors associated with the policies. There are three steps when building your plan for improvement.
Identify the areas for improvement. You need to identify the health behaviors that you want to address. The assessment from Section Two of the toolkit will show you indicators, meaning the number of people affected and if this is an issue you should consider addressing.
After you have identified the areas for improvement, consider how you specifically want to address these issues during the time you're devoting to the new worksite health initiative. While there may be a lot of health behaviors you want to address, it could be that only addressing one or two is what is realistic for your company. In this step, determine which health behaviors you want to address now and which ones you will address later, given time and resources.
Once you have identified areas for improvement and determined the exact health behaviors you are going to address, build your plan for improvement. When creating a plan for improvement, ask yourself the following questions:
1. What steps will your organization take to address the health issue? 2. When will the worksite health initiatives be done? 3. Who will be responsible for worksite health implementation? 4. Who will help with the new worksite health plan? 5. How will you know if you have reached your goals regarding your worksite health programming?
C: Create, Implement, and Evaluate Your Worksite Health Policy As previously mentioned in the individual topic sections of this toolkit, having a written policy will eliminate any confusion regarding the specifics of the new worksite health policies and programming you're implementing at your worksite. To assist in writing your policies, the following pages contain sample policies for each of the health behaviors addressed throughout the toolkit. Once you have adopted the policy document, be sure to take the steps necessary to implement it. This requires action steps and engagement of stakeholders and staff. Once you have implemented the new policies and programming, evaluate them to ensure you have full implementation and are addressing the issues you wanted to address.

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Model Worksite Wellness Policies
Georgia Model Tobacco-Free Worksite Policy
_____________ (insert agency name) is committed to providing a healthy, comfortable, and productive learning environment for the employees, faculty, and employees of this worksite.
The 2006 U.S. Surgeon General's Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke has concluded that (1) secondhand smoke exposure causes disease and premature death in children and adults who do not smoke; (2) children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory symptoms and slows lung growth in their children; (3) exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer; (4) there is no risk-free level of exposure to secondhand smoke; (5) establishing smoke free workplaces is the only effective way to ensure that secondhand smoke exposure does not occur in the workplace, because ventilation and other air cleaning technologies cannot completely control for exposure of non-tobacco users to secondhand smoke; and (6) evidence from peer-reviewed studies that smoke free policies and laws do not have an adverse economic impact on the hospitality industry. (U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.)
In addition, the 2009 Institute of Medicine Report: Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence states that study results consistently indicate that exposure to secondhand smoke increases the risk of coronary heart disease by 25 to 30 percent.
Lastly, the Georgia Smoke free Air Act of 2005 states that most public places are to be smoke free. The act also states, under "290-5-61-.09 Enforcement
(3) T he enactment of any other local law, rules and regulations of state or local agencies, and local ordinances prohibiting smoking that are more restrictive than the Act areenforceable.
(4) The Act shall not be construed to permit smoking where it is otherwise restricted by other applicable laws.
Authority O.C.G.A. Secs. 16-12-2, 31-2-4, 31-5-9, 31-12A-10, 31-12A-11, 31-12A-12, 31-12A-13.
In light of these findings, ______________________ worksite shall be entirely tobacco-free effective______ [date]. This policy applies to employees, visitors and vendors. The Tobacco Free Policy applies to all _________________ worksite facilities and vehicles, owned or leased, and operated regardless of location.
All tobacco products or products that resemble the use of tobacco are prohibited. Tobacco products are defined to include but are not limited to cigarettes, e-cigarettes, vaping instruments, chewing tobacco, blunts, blunt wraps, pre wrapped blunt cones & tubes, cigars, cigarillos, bidis, pipes, cigarette packages or smokeless tobacco containers, lighters, ash trays, key chains, t-shirts, coffee mugs, and any other items containing or reasonably resembling tobacco or tobacco products. Tobacco use includes smoking, chewing, dipping, vaping or any other use of tobacco products shall not be permitted in any enclosed place, including private residential space within worksite housing. Tobacco use shall also not be permitted in, amphitheaters; or in, and within bleachers and grandstands used for spectators at sporting and other public events. This policy applies to all employees, visitors, and vendors.

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Enforcement for Employees, Visitors, and Vendors. Consequences for employees who violate the tobacco use policy will be in accordance with personnel policies and may include verbal warning, written reprimand, or termination. Visitors and vendors using tobacco products will be asked to refrain while on worksite property or leave the premises. If they refuse, law enforcement officers will be contacted to escort the person off the premises or cite the person for trespassing in case the person refuses to leave the property. In the case of a violation within the building of a worksite, the person is in violation of the Georgia Smoke-free Air Act of 2005 (O.C.G.A. 31-`2a-1 et seq.). Signage will be prominently posted in all visitors' and vendors' areas and worksite and worksite employees and officials will communicate policy to visitors and vendors upon arrival and infractions.
Enforcement at Outdoor Sponsored Events on Worksite Grounds All outdoor worksite sponsored events on worksite (ex. athletic events, meetings or functions by community groups renting worksite property) must be tobacco free. This policy must be clearly stated in all contracts, correspondence and verbal and written announcements to all attendees, visitors, vendors, and contractors.
Opportunities for Cessation The administration will identify and or offer programs and services for employees who are ready to quit tobacco use. The administration will identify and/or offer programs and services for worksite/worksite employees that use tobacco products to support them in complying with the policy that prohibits tobacco use on worksite grounds and during worksite related events.
Copies of this policy shall be distributed to all faculty and employees and shall be included with information given to all admitted employees. Announcements shall also be printed in worksite newspapers to insure that everyone understands the policy. No Tobacco/Smoking signs shall be posted at all building entrances. No ashtrays shall be provided at any location on worksite. Cigarettes shall not be sold on worksite grounds, either in vending machines, the student union, or any area on worksite.
This policy is being announced three months prior to its implementation in order to give tobacco users time to adapt to its restrictions and to facilitate a smooth transition to a tobacco free environment. On-site tobacco cessation programs shall be made available to assist and encourage individuals who wish to quit smoking. Questions and problems regarding this policy should be handled through existing departmental administrative channels and administrative procedures.
The success of this policy will depend on the thoughtfulness, consideration, and cooperation of tobacco users and non-tobacco users. All employees, faculty, and employees share in the responsibility for adhering to and enforcing this policy.
In further recognition of the incompatibility of ____________________ worksite's educational mission and the promotion of tobacco products, effective _____________ date, no tobacco-related advertising or sponsorship shall be permitted on worksite property, at worksite sponsored events, or in publications produced by the worksite. For the purposes of this policy, "tobacco related" applies to the use of a tobacco brand or corporate name, trademark, logo, symbol, or motto, selling message, recognizable pattern or colors, or any other indicia of product identical to or similar to, or identifiable with , those used for any brand of tobacco products or company which manufactures tobacco products.

__________________________________________________ Signature of Chief Administrator

Date:__________________________

Revised on June, 2016. Policy language adapted from the tobacco-free worksite model policy of the Americans for NonSmokers' Rights.



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Model Policy for a Smokefree Workplace
ABC Company Smokefree Policy
ABC Company is dedicated to providing a healthy, comfortable, and productive work environment for our employees.
The 2006 U.S. Surgeon General's Report, The Health Consequences of Involuntary Exposure to Tobacco Smoke, has concluded that (1) secondhand smoke exposure causes disease and premature death in children and adults who do not smoke; (2) exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer; (3) there is no risk-free level of exposure to secondhand smoke; and (4) establishing smokefree workplaces is the only effective way to ensure that secondhand smoke exposure does not occur in the workplace, because ventilation and other air cleaning technologies cannot completely control for exposure of nonsmokers to secondhand smoke. (U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.) According to the 2010 U.S. Surgeon General's Report, How Tobacco Smoke Causes Disease, even occasional exposure to secondhand smoke is harmful and low levels of exposure to secondhand tobacco smoke lead to a rapid and sharp increase in dysfunction and inflammation of the lining of the blood vessels, which are implicated in heart attacks and stroke. (U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.) According to the 2014 U.S. Surgeon General's Report, The Health Consequences of Smoking--50 Years of Progress, secondhand smoke exposure causes stroke in nonsmokers. The report also found that since the 1964 Surgeon General's Report on Smoking and Health, 2.5 million nonsmokers have died from diseases caused by tobacco smoke. (U.S. Department of Health and Human Services. The Health Consequences of Smoking--50 Years of Progress. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.)
Numerous studies have found that tobacco smoke is a major contributor to indoor air pollution, and that breathing secondhand smoke (also known as environmental tobacco smoke) is a cause of disease in healthy nonsmokers, including heart disease, stroke, respiratory disease, and lung cancer. The National Cancer Institute determined in 1999 that secondhand smoke is responsible for the early deaths of approximately 53,000 Americans annually. (National Cancer Institute (NCI), "Health effects of exposure to environmental tobacco smoke: the report of the California Environmental Protection Agency. Smoking and Tobacco Control Monograph 10," Bethesda, MD: National Institutes of Health, National Cancer Institute (NCI), August 1999.)
The Americans With Disabilities Act, which requires that disabled persons have access to public places and workplaces, deems impaired respiratory function to be a disability. (Daynard, R.A., "Environmental tobacco smoke and the Americans with Disabilities Act," Nonsmokers' Voice 15(1): 8-9.)
The U.S. Centers for Disease Control and Prevention has determined that the risk of acute myocardial infarction and coronary heart disease associated with exposure to tobacco smoke is non-linear at low doses, increasing rapidly with relatively small doses such as those received from secondhand smoke or actively smoking one or two cigarettes a day, and has warned that all patients at increased risk of coronary heart disease or with known coronary artery disease should avoid all indoor environments that permit smoking. (Pechacek, Terry F.; Babb, Stephen, "Commentary: How acute and reversible are the cardiovascular risks of secondhand smoke?" British Medical Journal 328: 980-983, April 24, 2004.)

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Unregulated high-tech smoking devices, commonly referred to as electronic cigarettes, or "e- cigarettes," closely resemble and purposefully mimic the act of smoking by having users inhale vaporized liquid nicotine created by heat through an electronic ignition system. After testing a number of e-cigarettes from two leading manufacturers, the Food and Drug Administration (FDA) determined that various samples tested contained not only nicotine but also detectable levels of known carcinogens and toxic chemicals, including tobacco-specific nitrosamines and diethylene glycol, a toxic chemical used in antifreeze. The FDA's testing also suggested that "quality control processes used to manufacture these products are inconsistent or non- existent." ([n.a.], "Summary of results: laboratory analysis of electronic cigarettes conducted by FDA, "Food and Drug Administration (FDA), July22, 2009; http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm173146.htm Accessed on: October 22, 2009.) According to a more recent study, electronic cigarette emissions are made up of a high concentration of ultrafine particles, and the particle concentration is higher than in conventional tobacco cigarette smoke. (Fuoco, F.C.; Buonanno, G.; Stabile, L.; Vigo, P., "Influential parameters on particle concentration and size distribution in the mainstream of e-cigarettes," Environmental Pollution 184: 523-529, January 2014.) Electronic cigarettes produce an aerosol or vapor of undetermined and potentially harmful substances, which may appear similar to the smoke emitted by traditional tobacco products. Their use in workplaces and public places where smoking of traditional tobacco products is prohibited creates concern and confusion and leads to difficulties in enforcing the smoking prohibitions.
Smoke-filled workplaces result in higher worker absenteeism due to respiratory disease, lower productivity, higher cleaning and maintenance costs, increased health insurance rates, and increased liability claims for diseases related to exposure to secondhand smoke.
In light of these findings, ABC Company shall be entirely smokefree effective _______ [date].
Smoking, including the use of electronic smoking devices, hookahs, and marijuana, shall not be permitted in any enclosed company facility. Smoking shall also be prohibited in any outdoor company worksite where two or more employees are required to be in the course of their employment. This includes, without limitation, common work areas, auditoriums, classrooms, conference and meeting rooms, private offices, elevators, hallways, medical facilities, cafeterias, employee lounges, stairs, restrooms, construction sites, temporary offices such as trailers, and vehicles. This policy applies to all employees, clients, contractors, and visitors.
Smoking shall also not be permitted [within a reasonable distance of 25 feet outside entrances, operable windows, and ventilation systems of enclosed facilities where smoking is prohibited or anywhere on the grounds of company facilities, including parking lots].
Copies of this policy shall be distributed to all employees. No Smoking signs shall be posted at entrances to all company facilities and at all applicable outdoor worksites.
This policy is being announced three months in advance in order to give smokers time to adapt to its restrictions and to facilitate a smooth transition to a smokefree environment. Those employees who smoke and would like to take this opportunity to quit are invited to participate in the cessation programs being offered by the company.
The success of this policy will depend on the thoughtfulness, consideration, and cooperation of both smokers and nonsmokers. All employees share in the responsibility for adhering to and enforcing this policy.

__________________________________________________ Signature of CEO or President

Date:__________________________

Americans for Nonsmokers' Rights (2017). Model policy for a smokefree workplace. Retrieved from http://www.no-smoke.org/goingsmokefree.php?id=103

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Policy for Supporting Breastfeeding Employees
In recognition of the well documented health advantages of breastfeeding for infants and mothers, [name of company] provides a supportive environment to enable breastfeeding employees to express their milk during work hours. This includes a companywide lactation support program administered by [name of department].
[Name of company] subscribes to the following worksite support policy. This policy shall be communicated to all current employees and included in new employee orientation training.
Company Responsibilities Breastfeeding employees who choose to continue providing their milk for their infants after returning to work shall receive:
Milk Expression Breaks Breastfeeding employees are allowed to breastfeed or express milk during work hours using their normal breaks and meal times. For time that may be needed beyond the usual break times, employees may use personal leave or may make up the time as negotiated with their supervisors.
A Place to Express Milk A private room (not a toilet stall or restroom) shall be available for employees to breastfeed or express milk. The room will be private and sanitary, located near a sink with running water for washing hands and rinsing out breast pump parts, and have an electrical outlet. If employees prefer, they may also
breastfeed or express milk in their own private offices, or in other comfortable locations agreed upon in consultation with the employee's supervisor. Expressed milk can be stored [in general company refrigerators/in designated refrigerators provided in the lactation room or other location/in employee's personal cooler].
Breastfeeding Equipment [Name of company] [provides/subsidizes/rents] electric breast pumps to assist breastfeeding employees with milk expression during work hours. The company provides [hospital grade pump that can be used by more than one employee/or portable personal use electric breast pump that the employee retains] throughout the course of breastfeeding for the employee. [If using a standard hospital-grade pump, indicate whether the company provides/ subsidizes personal attachment kit or where the employee can purchase the kit.] [Indicate whether breast pumps are also available for partners of male employees.]
Education Prenatal and postpartum breastfeeding classes and informational materials are available for all mothers and fathers, as well as their partners.
Staff Support Supervisors are responsible for alerting pregnant and breastfeeding employees about the company's worksite lactation support program, and for negotiating policies and practices that will help facilitate each employee's infant feeding goals. It is expected that all employees will assist in providing a positive atmosphere of support for breastfeeding employees.
[List other components specific to your company's program]

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Employee Responsibilities Communication with Supervisors
Employees who wish to express milk during the work period shall keep supervisors informed of their needs so that appropriate accommodations can be made to satisfy the needs of both the employee and the company.
Maintenance of Milk Expression Areas
Breastfeeding employees are responsible for keeping milk expression areas clean, using anti-microbial wipes to clean the pump and area around it. Employees are also responsible for keeping the general lactation room clean for the next user. This responsibility extends to both designated milk expression areas, as well as other areas where expressing milk will occur.
Milk Storage
Employees should label all milk expressed with their name and date collected so it is not inadvertently confused with another employee's milk. Each employee is responsible for proper storage of her milk using [company provided refrigerator/personal storage coolers].
Use of Break Times to Express Milk
When more than one breastfeeding employee needs to use the designated lactation room, employees can use the sign-in log provided in the room to negotiate milk expression times that are most convenient or best meet their needs.

U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (2008). The business case for breastfeeding: Steps for creating a breastfeeding friendly worksite Easy steps for supporting breastfeeding employees. Retrieved from https://www.womenshealth.gov/breastfeeding/employer-solutions/policy.html

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Sample Physical Activity Policy
Purpose The _________________________________ supports all employees in engagement in regular physical activity and in making lifestyle choices that promote health and well-being.
Policy The policy of ________________________ will provide up to 30 minutes of the employee scheduled workday to engage in physical activity in support of this philosophy.
Supervisors will encourage and support employees in using their physical activity break in order to decrease employee stress, help prevent overuse patterns from extended sitting and computer use, and help promote caloric expenditure - promoting a healthier BMI.
Employees are responsible for initiating and utilizing the physical activity break in order to promote a healthier lifestyle.
Procedures A maximum of 30 minutes in a given workday will be used to engage in physical activity. Employees are required to work with supervisors to ensure the physical activity break does not impair the agency mission. Physical activity breaks can be taken in the form of:
Three each 5-minute breaks and one 15-minute break. Two each 15-minute breaks. One each 30-minute break. Three each 10-minute breaks. Supervisors will encourage and allow staff to combine the designated physical activity breaks with lunch breaks, not to exceed 60 minutes combined break. These physical activity breaks replace what were previously considered the morning and afternoon breaks. Employees are encouraged to engage in heart healthy physical activity such as walking, jogging, group exercise classes, cycling, dancing, stair climbing, etc. Employees are not permitted to end work early and exercise without returning to their place of employment. However, an employee may be excused to exercise at the end of their workday if they report back to work before their departure for the day. Employees must report to work in the morning prior to taking their 30 minute physical activity break. Employees cannot report to work 30 minutes late to accommodate the exercise before their scheduled arrival time.

__________________________________________________ Authorized Representative

Date:__________________________

Adapted from the Georgia Department of Public Health, Policy # CO-12006, Physical Activity Policy and Procedure, 2012.

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Sample Healthy Meetings Policy
Purpose The purpose of this policy is to promote health and disease prevention by supporting healthy meetings.
__________________________________________is committed to our employees and to providing a work environment that encourages and supports employee and workplace health. Research has demonstrated the association between dietary intake and chronic diseases such as heart disease, diabetes and cancer.
In light of this, ________________________________ believes that food offered on the premises and at off-site company functions, should include healthy food choices that support our employees' efforts to maintain their health and prevent disease.
Policy The policy of ________________________ is to encourage and support the provision of healthy food and opportunities for physical activity during breaks at meetings.
Procedures Where food and beverages are offered:
Water will be offered as a beverage option and sugar-sweetened beverages (regular soda, sweet tea and other drinks with sugar) are discouraged.
The purchase of fruits, vegetables, items that are lower sodium, and items made from whole grains is highly encouraged.
Low-fat or nonfat dairy and soy products and lean or alternative sources of protein will be served when possible. Meeting participants should be given an opportunity to inform meeting planners of dietary needs, restrictions,
or food allergies before events. Physical activity consisting of a brief exercise period is encouraged if space allows.

__________________________________________________ Authorized Representative

Date:__________________________

Adapted from the Georgia Department of Public Health, Policy # FN-06002, Employee Group Meals and Healthy Meetings Policy, 2014.

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Evaluation Overview
Evaluating Your Worksite Health Program The evaluation process is crucial in determining what works and doesn't work in your worksite health initiative. Evaluating your efforts will help you decipher which program elements should be kept, what could be improved, and what needs to be eliminated.
Types of Evaluations There are different types of evaluations that you can do to determine program success. These evaluations are done at different points in the program and serve different purposes. It is up to you to decide which type of evaluation you would like to do. Some organizations only choose one, while others perform all of them.
Process Evaluation
Process evaluation is performed while the program is being implemented. It assesses how a program is being implemented. The purpose of this type of evaluation is to determine if program activities are being implemented as intended. For example, process evaluation includes examining what has already been done in your worksite health plan, what barriers or facilitators have been encountered during program rollout, and what should be changed now before the rest of the worksite health plan is implemented.
Outcome Evaluation
Outcome evaluation is performed immediately following program implementation. This type of evaluation tells you whether the program is effective in meeting the objectives of your worksite health plan. For example, let's say you survey your employees before your worksite health program to see how much fast food they eat weekly. Your outcome evaluation would be examining if this amount of fast food consumption has decreased following the worksite health program rollout.
Impact Evaluation
Impact evaluation measures long-term program effects among your employees. The goal here is to determine the degree to which your program meets its overall goal. It tells you how much change (or lack thereof) occurred as a result of your programming. For example, if you implement a smoking cessation program as a part of your worksite health initiative, your impact evaluation may be measuring if implementation of this program resulted in a decrease in smoking among employees, and if so, by how much. It would also measure if this decrease in smoking was sustained over time.
Evaluation Plan There are many steps when doing a program evaluation. You must decide how much effort you want to put into each step. Not all of them are required when doing a program evaluation, but doing all of them is helpful when completing a comprehensive program evaluation for your worksite health initiative.
1. Introduction and Stakeholder Engagement There are two parts to step 1: describe the purpose of the evaluation and identify who the stakeholders are for the program and evaluation. For the stakeholder part, identify who may be interested in the evaluation results, why they are interested, and how they are connected to the programming being implemented. 2. Questions and Issues Driving the Evaluation In this step, describe the program you are evaluating. If you choose to do so, this is a great time to either refer to a logic model or create one. Identify the need for the program, the context of the program, how far along you are in program rollout, the inputs the organization has put into the program, the central activities of the program, the outputs of the activities, and the outcomes you are hoping your worksite health initiative achieves. 3. Evaluation Design Here, you are identifying the primary focus of the evaluation. What are you trying to demonstrate in your program evaluation? Are you looking to see if knowledge increased, behaviors changed, etc.? This step identifies the major questions you intend to answer through the evaluation.
After this step, you are ready to design your evaluation. There are different methods of evaluation you can use.

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Examples:
Measuring risk behaviors before and after program implementation (e.g., increase in physical activity or fruit/vegetable consumption, or decrease in tobacco usage).
Conducting pre- and post-tests to assess behavior change, changes in knowledge, etc. Using employee surveys to assess satisfaction and capture suggestions about future programs. Comparing absenteeism data before and after program implementation.
Whichever evaluation design you decide to use, ensure that you have a rationale for why you are using the chosen evaluation design.
In your evaluation design, establish how you are going to analyze the data that you are collecting. Are you looking for something simple like improvement in scores between pretest and post-test? Do you want to analyze the average number of employees who perform a certain behavior, requiring you to find means, frequencies, etc.? Or do you have the capability to do high-level statistics using software? The decision is yours, based on your interests, expertise and resources.
4. Data Collection In this step, you will collect the data that will be used in your evaluation. If you are using surveys, distribute and collect surveys. If you are using a pretest/post-test design, distribute and collect your post-tests at the end of program implementation (your pretests should have been distributed and collected at the start of the program). Once the data are collected, organize the data in a way that is useful for you. This can be done using any method you choose; however, the most efficient and popular way this is done is using simple spreadsheet software like Microsoft Excel. 5. Data Analysis and Interpretation Once you have the data collected and organized, the next step is to analyze the data. For example, if you are interested in differences between pre- and post-tests, do that calculation in this step. After the data are analyzed, you need to interpret it. What is the data telling you? For example, did you see an increase in scores between the pre- and post-test? If so, what does this mean to your worksite health initiative? 6. Dissemination of Results In the last step of your evaluation, you need to choose how your evaluation results will be disseminated and communicated to stakeholders. This can be done in a variety of ways, including-- In person meeting, Emails, Written reports, Newsletter article, and Company presentation.
You must also choose when you are going to disseminate the results. Some communicate evaluation findings as the program is being implemented (sharing results as you go). Others choose to wait until all the data have been collected. Again, this is your decision.
Next Steps:
Program evaluations are conducted to help improve, expand and strengthen programs. Completing the program evaluation does not signal the end of the program, but instead, what needs to happen next. The evaluation should help you continue your program, giving you an idea of what worked and what needs to be changed. Consistent attention to evaluation will yield consistent improvements to your program.

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Additional Resources
Preparing to Improve Worksite Health

Category Size of Business

Resource

Notes

Sm Med Lg

Program X X X Manager and Supervisor Support for Worksite Health

Scientific evidence for

Planning

Promotion Programs Integrative Literature Review

management support of

https://www.workhealthresearchnetwork.org/wp-content/up-

worksite health programs

loads/2016/04/Managers-Lit-Review_HCA_March-2016_Final.

pdf

X X X Essential Elements of Effective Workplace Programs and

Policies for workplace health

Policies for Improving Worker Health and Wellbeing, National

programs

Institute for Occupational Safety and Health (NIOSH)

Program design, implementation

http://www.cdc.gov/niosh/docs/2010-140/pdfs/2010-140.pdf

and evaluation

X X X Workplace Health Program Development Checklist, Centers

Checklist for program assess-

for Disease Control and Prevention (CDC)

ment, planning, implementation

http://www.cdc.gov/workplacehealthpromotion/pdf/workplace-

and evaluation

health-checklist.pdf

X X X Worksite Health 101 Training Manual, Centers for

Training manual that covers

Disease Control and Prevention (CDC)

each phase of worksite health

https://www.cdc.gov/workplacehealthpromotion/tools-resources/ program development

training/materials.html

X X X Healthy Arkansas Worksite Wellness Toolkit, Arkansas

Step-by-step instructions

Department of Health

for starting a worksite

http://wellnessproposals.com/pdfs/tool_kits/healthy_arkansas_ health program

worksite_wellness_toolkit.pdf

X X X Worksite Wellness Resource Kit, Wisconsin Department of

Step-by-step instructions

Health Services

for starting a worksite

https://www.dhs.wisconsin.gov/physical-activity/worksite/kit.htm health program

Sample surveys, checklists,

plans, budgets

X

Small Business Worksite Wellness Strategies,

Strategies and checklists

Wisconsin Department of Health Services

specifically for small businesses

https://www.dhs.wisconsin.gov/publications/p0/p00639.pdf

X X X Carefully Crafting an Operating Plan, Wellness Council of America https://www.welcoa.org/wp/wp-content/uploads/2014/06/20070700-ar-aa-operating-plan.pdf

Successful elements of a worksite health plan
Free resource from WELCOA's Absolute Advantage Magazine

X X X 7 Benchmarks of Success, Wellness Council of America https://www.welcoa.org/wp/wp-content/uploads/2014/06/20061211-ar-aa-seven-benchmarks.pdf

The Well Workplace Model Free resource from WELCOA's
Absolute Advantage Magazine

X X X Healthy Workforce 2010 and Beyond, Partnership for Prevention http://www.prevent.org/Publications-and-Resources.aspx

Health promotion source book for employers

X X X Investing In Health: Proven Health Promotion Practices for Workplaces, Partnership for Prevention http://www.prevent.org/Publications-and-Resources.aspx

Guide to assist workplaces of all sizes to choose effective health promotion practices

XX

Leading By Example: The Value of Worksite Health Promotion to Small-and Medium-Sized Employers, Partnership for Prevention http://www.prevent.org/Publications-and-Resources.aspx

Health promotion for small-and medium-sized employers

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Preparing to Improve Worksite Wellness (continued)

Category Size of Business

Resource

Notes

Sample policies
Assessments

Sm Med Lg XXX
XXX

Sample Worksite Wellness Policies
https://www.womenshealth.gov/breastfeeding/employersolutions/policy.html.
http://documents.ottawa.ca/sites/documents.ottawa.ca/files/documents/sp_physicalactivity_en.pdf
http://partnership4health.org/assets/etoFileBrowser/ Healthy-foods-policy_TEMPLATE_2013.pdf
http://www.no-smoke.org/goingsmokefree.php?id=103
Worksite Health Scorecard, Centers for Disease Control and Prevention (CDC) https://www.cdc.gov/workplacehealthpromotion/initiatives/ healthscorecard/index.html

Sample breastfeeding policy Sample physical activity policy Sample nutrition policy Sample tobacco-free policy
Worksite health assessment tool to assess your worksite's current policies

X X X CDC Employee Health Assessment (CAPTURE),

Sample health risk

Centers for Disease Control and Prevention (CDC)

assessment tool to assess

http://www.cdc.gov/workplacehealthpromotion/tools-resources/ the health of employees

pdfs/nhwp-capture-health-assessment-update.pdf

X X X Sample Worksite Health Promotion Interest Survey, Healthy Workforce 2010, Partnership for Prevention http://www.acsworkplacesolutions.com/documents/healthy_ workforce_2010.pdf

Sample survey to assess employees' interests, needs, and willingness to participate in health programs
Survey in Appendix 2

X X X Workplace Health Solutions, American Heart Association

Worksite health assessment

http://www.heart.org/HEARTORG/HealthyLiving/Workplace-

Employee health assessment

Health/Workplace-Health_UCM_460416_SubHomePage.jsp Create account for access

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Developing Your Program/ Policy

Category Size of Business

Resource

Notes

Nutrition/ Physical Activity

Sm Med Lg XXX

Active For Life Online Program, American Cancer Society http://www.acsworkplacesolutions.com/activeforlife.asp
Meeting Well Guidebook, American Cancer Society http://www.acsworkplacesolutions.com/meetingwell.asp

Online Workplace Physical Activity Challenge Program
Resource for incorporating healthy food and physical activity into company meetings

X X X Nutrition and Physical Activity Planner, American Cancer Society Free online assessment of

http://www.acsworkplacesolutions.com/nuPA-Planner.asp

nutrition and physical activity

policies and programs

Assessment report includes

action plan and resources

X X X CEO Brief: Movement, Inactivity, and Workplace Effectiveness, Message to CEOs on

Health Enhancement Research Organization (HERO)

improving workplace

http://hero-health.org/resource-center/hero-ceo-briefs-and-relat- performance via physical

ed-resources/

activity

X X X Physical Activity in the Workplace: A Guide for Employers, Johns Explains why employee

Hopkins Bloomberg School of Public Health

physical activity is important

https://www.workhealthresearchnetwork.org/wp-content/

to businesses

uploads/2016/05/CDC-WHRN-Physical-Activity_Employ-

Methods for employers to help

er-Guide-FINAL.pdf

employees increase physical

activity

X X X StairWELL, Centers for Disease Control and Prevention (CDC) Steps to encourage http://www.cdc.gov/physicalactivity/worksite-pa/toolkits/stairwell/ employees to take stairs and increase activity Includes motivational signs

X

X

X

Workplace Walking Program Kit, American Heart Association

Walking program

http://www.heart.org/HEARTORG/HealthyLiving/WorkplaceWell- implementation manual

ness/WorkplaceWellnessResources/The-American-Heart-As- Flyers and posters for program

sociations-Worksite-Wellness-Kit_UCM_460433_Article.jsp#.

V8R5opgrLIV

X X X Tips for Offering Healthier Options and Physical Activity at

Tips for healthier workplace

Workplace Meetings and Events, Centers for Disease Control

food and increased physical

and Prevention (CDC)

activity

http://www.cdc.gov/obesity/downloads/tips-for-offering-healthier-

options-and-pa-at-workplace.pdf

X X X Step It Up! The Surgeon General's Call to Action to Promote

Describes ways to increase

Walking and Walkable Communities, US Department of Health walking in communities

and Human Services

Special section addresses the

https://www.surgeongeneral.gov/library/calls/walking-and-walk- role of worksites

able-communities/index.html

X X X Physical Activity and Dietary Guidelines, Office of Disease Prevention and Health Promotion http://health.gov/PAGuidelines/ http://health.gov/paguidelines/pdf/paguide.pdf http://health.gov/dietaryguidelines/2015/
X X X Healthy Living, American Heart Association http://www.heart.org/HEARTORG/HealthyLiving/Healthy-Living_UCM_001078_SubHomePage.jsp

Recommendations for diet and physical activity
Multiple resources on healthy eating and physical activity
Recipes and nutrition Working out at work Weight management

Work Healthy Georgia

52 | Page

Developing Your Program/ Policy (continued)

Category Size of Business

Resource

Sm Med Lg

x

x

x

Healthy Meeting Toolkit, National Alliance for Nutrition and Activity https://cspinet.org/resource/healthy-meeting-toolkit

Notes
Detailed guide for planning healthy meetings

X X X Steps to Wellness, Centers for Disease Control and Prevention Guide to implementing the 2008

(CDC)

physical activity guidelines in

https://www.cdc.gov/physicalactivity/worksite-pa/pdf/steps2well- the workplace

ness_broch14_508_tag508_tag508.pdf

X X X Rethink Your Drink, California Department of Public Health

Education on healthy drink

https://archive.cdph.ca.gov/programs/NEOPB/Pages/RethinkYo- options

urDrink.aspx

https://archive.cdph.ca.gov/programs/NEOPB/Pages/RethinkYo-

urDrinkCurriculum.aspx

X X X Walking for Workforce Health Toolkit, Kaiser Permanente https://business.kaiserpermanente.org/thrive/resource-center?topic=exercise#sthash.YR4tpQ5r.dpbs

Detailed guide to creating workplace walking program

X X X Sample Workplace Physical Activity Policy, Middlesex-London Sample workplace physical

Health Unit and Ottawa Public Health

activity policy

http://documents.ottawa.ca/sites/documents.ottawa.ca/files/doc-

uments/sp_physicalactivity_en.pdf

X X X Sample Healthy Food Environment Policy, Blue Cross and Blue Sample workplace

Shield of Minnesota

nutrition policy

http://partnership4health.org/assets/etoFileBrowser/

Healthy-foods-policy_TEMPLATE_2013.pdf

X X X Walking Campaign Tools, Centers for Disease Control and

Communication tools to

Prevention (CDC)

encourage employees to

http://www.cdc.gov/workplacehealthpromotion/tools-resources/ walk more

walking-campaign-tools/index.html

X X X Walkability Audit Tool, Centers for Disease Control and

Tool to assess the walkability

Prevention (CDC)

of your workplace

http://www.cdc.gov/physicalactivity/worksite-pa/toolkits/walkabil-

ity/audit_tool.htm

X Discount Fitness Club Network, Centers for Disease Control

For multisite organizations

and Prevention (CDC)

Guidance on establishing a

http://www.cdc.gov/physicalactivity/worksite-pa/toolkits/fitness- relationship with a national

club/index.html

fitness club network

To increase employee access

to fitness centers across the

country

X X X Farmers Markets, Community Supported Agriculture, and Local Resources to connect

Food Distribution; Centers for Disease Control and Prevention

employees to healthy

(CDC)

fresh produce

https://www.cdc.gov/healthyplaces/healthtopics/healthyfood/

markets.htm

X X X Wholesome Wave Georgia http://www.wholesomewavegeorgia.org/

Farmers markets that double federal nutrition assistance dollars to increase access to healthy, locally-grown foods

X X X Georgia Organics http://georgiaorganics.org/for-farmers/farmers-markets/

Information on Georgia farmers markets
Resources for starting farmers markets

Work Healthy Georgia

53 | Page

Developing Your Program/ Policy (continued)

Category
Tobacco Free

Size of Business
Sm Med Lg XXX

Resource
Quit For Life Program, American Cancer Society http://www.acsworkplacesolutions.com/quitforlife.asp

X X X Freshstart Program, American Cancer Society http://www.acsworkplacesolutions.com/freshstart.asp

Notes
Telephone-based coaching and web-based learning support service for smoking cessation
Free group-based tobacco cessation support program

X X X Freedom From Smoking, American Lung Association

Group and online counseling

www.lung.org/stop-smoking/join-freedom-from-smoking/about- and support program for

freedom-from-smoking.html

tobacco cessation

X X X Georgia Tobacco Quit Line, Georgia Department of Public Health (DPH) www.dph.georgia.gov/ready-quit

FREE, confidential and effective telephone based cessation service to assist Georgians with quitting smoking and all forms of tobacco
Services provided by the Georgia Tobacco Use Prevention Program, Georgia DPH
1-877-270-STOP 1-877-2NO-FUME

X X X Investing in a Tobacco-Free Future: How it Benefits Your Bottom Economic benefits of a

Line and Community, Partnership for Prevention

tobacco-free workplace

http://prevent.org/Publications-and-Resources.aspx

X X X Tobacco Policy Planner, American Cancer Society

Free online assessment tool

http://www.acsworkplacesolutions.com/tobaccopolicyplanner.asp Detailed report, action plan,

and resources to create a

tobacco-free workplace

X X X Model Policy for a Smokefree Workplace, Americans for Nonsmokers' Rights http://www.no-smoke.org/goingsmokefree.php?id=103

Sample tobacco-free policy

X X X Tobacco-Free Workplace Model Policy, Ohio Tobacco Prevention Foundation http://www.noacc.org/documents/OhioTobaccoPolicyInfo.pdf

M odel policy for creating a tobacco-free workplace

X X X Sample Tobacco-free policy, American Lung Association

Sample policy for a

http://action.lung.org/site/DocServer/tobacco-free-workplace.pdf tobacco-free workplace

X X X Save Lives, Save Money: Make Your Business Smoke Free, Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/tobacco/basic_information/secondhand_ smoke/guides/business/index.htm

Benefits to employers for a tobacco-free workplace
Guidelines for developing a tobacco-free workplace

X X X Eat Smart, Move More, NC, Quit Now Workbook

Activities to help employees

http://www.eatsmartmovemorenc.com/NCHealthSmartTlkt/Quit- quit tobacco

NowWrkBk.html

Posters, signs, handouts,

employee resources

Work Healthy Georgia

54 | Page

Developing Your Program/ Policy (continued)

Category
Breastfeeding

Size of Business
Sm Med Lg XXX

Resource
Georgia Breastfeeding Coalition http://www.georgiabreastfeedingcoalition.org/

X X X Breastfeeding, Office on Women's Health, US Department of Health and Human Services http://www.womenshealth.gov/breastfeeding/business-case-for-breastfeeding.html

X X X La Leche League International http://www.llli.org/resources.html
X X X United States Breastfeeding Committee http://www.usbreastfeeding.org/ http://www.usbreastfeeding.org/p/cm/ld/fid=196
X X X Model Policy for Workplace Breastfeeding Support, Office on Women's Health, US Department of Health and Human Services https://www.womenshealth.gov/breastfeeding/employer-solutions/policy.html
X X X Guide to Strategies to Support Breastfeeding Mothers and Babies, Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/breastfeeding/resources/guide.htm
X X X ZipMilk http://www.zipmilk.org/
X X X Healthy Mothers, Healthy Babies Coalition of Georgia https://hmhbga.org/

Notes
Regulations for breast-feeding Newsletter Local breastfeeding coalitions
The Business Case for Breastfeeding, a toolkit for employers and managers
Education for employers Guidance on building a lactation
support program Breastfeeding resources
for employees
General breastfeeding information and resources for families
Breastfeeding and the Law Legislation and policy Resources and support for
mothers, fathers, grandmothers Workplace accommodations to
support breastfeeding Model policy for breastfeeding
support in the workplace
Includes chapter on support for breastfeeding in the workplace
Listings for breastfeeding resources sorted by zip code
Breastfeeding friendly locations Breastfeeding legislation Breastfeeding education

Work Healthy Georgia

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Additional Programming: Health Risk Identification Tools

Category Size of Business

Resource

Notes

Sm Med Lg Prevention X X X and Screening Tests
Occupation- X X X al Health
XXX

Steps for Better Health by Age, Office on Women's Health, US Department of Health and Human Services https://www.womenshealth.gov/nwhw/by-age

Health screening tests for women
Health screening tests for men

Health Maintenance Guidelines for Adults, Cleveland Clinic https://my.clevelandclinic.org/ccf/media/files/Health/health_ maintenance_guidelines.pdf
Stress...At Work, National Institute for Occupational Safety and Health http://www.cdc.gov/niosh/docs/99-101/
National Institute for Occupational Safety and Health http://www.cdc.gov/niosh/ http://www.cdc.gov/niosh/twh/

Information on health risks of stress
Methods and steps to prevent workplace stress
Workplace safety and health topics
Total Worker Health approach

General

X X X Georgia Department of Public Health (DPH)

Resources

http://dph.georgia.gov/

http://dph.georgia.gov/working-on-health

Hazard Identification Training Tool
Training Resources Frequently Asked Questions

X X X Workplace Health Promotion, Centers for Disease Control and Comprehensive guide to

Prevention (CDC)

workplace health promotion

http://www.cdc.gov/workplacehealthpromotion/

X X X Employers Like Me http://employerslikeme.org/

Site for employers to share and learn about providing better health care for employees at better costs

X X X Workplace Health Glossary, Centers for Disease Control

List of workplace health terms

and Prevention (CDC)

http://www.cdc.gov/workplacehealthpromotion/tools-resources/

glossary/glossary.html

Chronic

X X X Heart Disease

Disease

Heart Disease, Centers for Disease Control and Prevention

Resources

(CDC) http://www.cdc.gov/heartdisease/

Educational materials Prevention information Risk Factors of heart disease

X X X Heart Disease Reducing the Risk of Heart Disease and Stoke: A Six-Step Guide for Employers, Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/dhdsp/pubs/docs/six_step_guide.pdf

Example programs for heart disease and stroke prevention for small, medium and large businesses

X X X Heart Disease and Stroke Million Hearts Initiative, US Department of Health and Human Services http://millionhearts.hhs.gov/learn-prevent/index.html

Risks, costs and prevention of heart disease and stroke

X X X Stroke Stroke, Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/stroke/

Educational materials Prevention information Risk factors

X X X High Blood Pressure High Blood Pressure, Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/bloodpressure/

Educational materials Prevention information Risk factors

X X X Diabetes Diabetes at Work, National Diabetes Education Program https://diabetesatwork.org/index.cfm?daw=About&jcKhz=worksite

Prevention and management of diabetes in the workplace

Work Healthy Georgia

56 | Page

Additional Programming: Health Risk Identification Tools (continued)

Category

Size of Business

Resource

Sm Med Lg

X X X Diabetes Stop Diabetes @ Work for Employers, American Diabetes Association http://www.diabetes.org/in-my-community/awareness-programs/ stop-diabetes-at-work/employer-log-in-to-stop-diabetes.html

X X X Diabetes Making a Difference: The Business Community Takes on Diabetes, National Diabetes Education Program http://www.in.gov/isdh/files/MakingDifference.pdf

X X X Diabetes Employer Health Alliance Cooperative Diabetes Toolbox http://www.alliancehealthcoop.com/diabetes/

X X X Cancer Stay Healthy/Find Support and Treatment, American Cancer Society http://www.cancer.org/healthy/index

X X X Asthma and Lung Disease Improve Indoor Air Quality, American Lung Association http://www.lung.org/support-and-community/corporatewellness/create-a-lung-healthy-work.html http://www.lung.org/support-and-community/corporatewellness/

X X X Asthma and Lung Disease Asthma, Environmental Protection Agency https://www.epa.gov/asthma

X X X Arthritis Tools and Resources, Arthritis Foundation http://www.arthritis.org/living-with-arthritis/tools-resources/

X X X Heart Disease, Lung Disease, Blood Disease Resources for the Public, National Heart, Lung, and Blood Institute (NHLBI) https://www.nhlbi.nih.gov/health/resources

X X X Heart Disease, High Blood Pressure, Stroke, Diabetes American Heart Association http://www.heart.org/HEARTORG/Conditions/Conditions_ UCM_001087_SubHomePage.jsp

Notes
Resources for diabetes prevention and management
Customized worksite program
Tools for businesses to reduce impact of diabetes
Includes specific activities for small businesses
Workplace strategies to reduce the burden of diabetes
Cancer education, prevention and screening
Cancer treatment and support
Improve Indoor Air Quality Asthma- Friendly work
environment Help Employees Stop Smoking
Eliminate environmental triggers in the workplace
Arthritis education Tools to manage arthritis
Resources for heart, lung, blood diseases
Resources for sleep disorder Resources for weight loss Information on heart disease,
high blood pressure, stroke and diabetes Multiple resources for diet, exercise, stress and weight management

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57 | Page

References
American Cancer Society (2007). Implementing a Smoke-Free Workplace. Retrieved from http://www.cancer.org/downloads/gahc/hp_strategies_for_promoting_and_implementing_smokefree_workplace.pdf
American College of Occupational and Environmental Medicine (2013). Biometric health screening for employers: Consensus statement of the Health Enhancement Research Organization, American College of Occupational and Environmental Medicine, and Care Continuum Alliance. Retrieved from http://www.acoem.org/uploadedFiles/Public_Affairs/Policies_And_Position_Statements/Guidelines/Position_Statements/Biometric%20Hlth%20Screening%20Statement.pdf
Centers for Disease Control and Prevention (2014). The CDC guide to strategies to support breastfeeding mothers and babies: Support for breastfeeding in the workplace. Retrieved from https://www.cdc.gov/breastfeeding/pdf/strategy5-support-breastfeeding_workplace.pdf
Centers for Disease Control and Prevention (2010). Healthier Worksite Initiative- HWI: Toolkits: Tobacco Implementation. Retrieved from http://www.cdc.gov/nccdphp/dnpao/hwi/toolkits/tobacco
Centers for Disease Control and Prevention (2012). Interim guidance for health risk assessments and their modes of provision for Medicare beneficiaries. Retrieved from https://www.cms.gov/Medicare/Coverage/CoverageGenInfo/downloads/healthriskassessmentsCDCfinal.pdf
Centers for Disease Control and Prevention (2012). Smoking and tobacco use: State highlights. Retrieved from http://www.cdc.gov/tobacco/data_statistics/state_data/state_highlights/2012/states/georgia/index.htm
Center for Disease Control and Prevention (2016). Workplace health promotion: Work@Health. Retrieved from http://www.cdc.gov/workplacehealthpromotion/initiatives/workathealth/about.html
California Department of Public Health (2014). California fit business kit: Worksite program. Retrieved from https://www.cdph.ca.gov/programs/cpns/pages/worksitefitbusinesskit.aspx
Georgia Department of Public Health (2014) Growing fit kit: Wellness policies for Georgia's early care environments. Retrieved from https://dph.georgia.gov/early-care-providers
Georgia Department of Public Health (2014) Physical activity and nutrition toolkit for Georgia public schools and school districts. Retrieved from https://dph.georgia.gov/sites/dph.georgia.gov/files/PAN_toolkit_2.pdf
Georgia Department of Public Health (2011). Work Healthy Georgia. Retrieved from https://dph.georgia.gov/sites/dph.georgia.gov/files/related_files/site_page/WHGAtoolkit_9.pdf
Massachusetts Department of Public Health (2014). How to Build a Tobacco-Free Workplace: An Employer's Toolkit. Retrieved from http://www. mass.gov/eohhs/docs/dph/tobacco-control/employers-toolkit.pdf
New York State Department of Health (2014). Learn more about worksite wellness. Retrieved from https://www.health.ny.gov/prevention/worksite/learn_more.htm
New York State Department of Health (2014). Promoting worksite wellness. Retrieved from https://www.health.ny.gov/prevention/worksite/
PartnerSHIP 4 Health (n.d.) Worksite wellness toolkit: Making wellness worth your while. Retrieved from http://www.health.state.mn.us/healthreform/ship/implementation/worksite/apprps4toolkit.pdf
Robert Wood Johnson Foundation (2014). The state of obesity 2014: Better policies for a healthier America. Retrieved from http://healthyamericans.org/assets/files/TFAH-2014-ObesityReport%20FINAL.pdf
South Dakota Department of Health (2014). Good and healthy South Dakota workplaces. Retrieved from http://www.goodandhealthysd.org
United States Department of Health and Human Services (n.d.). The business case for breastfeeding: Steps for creating a breastfeeding friendly worksite. Retrieved from http://www.womenshealth.gov/breastfeeding/government-in-action/business-case-for-breastfeeding/ easy-steps-to-supporting-breastfeeding-employees.pdf
United States Department of Labor (2016). The Fair Labor Standards Act (FLSA). Retrieved from https://www.dol.gov/general/topic/workhours/breaks
University of Georgia (2014). Obesity initiative. Retrieved from http://obesity.ovpr.uga.edu/obesity-facts/
University of Kansas Work Group for Community Health and Development (2016). Coalition building: Starting a coalition. Retrieved from http://ctb.ku.edu/en/table-of-contents/assessment/promotion-strategies/start-a-coaltion/main
U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/
Utah Department of Health (2013). Keep Your Business Healthy: Utah Tobacco-Free Workplace Policy Toolkit. Retrieved from http://www.tobaccofreeutah.org/pdfs/shsworksitekit.pdf
Wisconsin Department of Health Services (2016). Worksite Wellness Resource Kit: Programming for Your Worksite. Retrieved from https://www.dhs.wisconsin.gov/physical-activity/worksite/2010-step-4.pdf

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Acknowledgments
Content and Development
Catalina Arbelaez Piedrahita, BA Monyette Childs, MD Laura Colman, MPH, PhD Kelsey McDavid, MPH
We would like to thank all the following individuals for their contributions:
Emma Bicego, MA, MPH Shalonda Freeman, PhD, MPH Stephanie Hall, MPH Lana Jones, MPH Kayla Lloyd, MPH, CHES Jean C. O'Connor, JD, MPH, DrPH Kia Padgett, BSN Kia Powell-Threets, MS Kenneth Ray, MPH Allison Smith, MPH, CHES Brittany D. Taylor, MPH
Adapted from 2012 Work Healthy Georgia Toolkit Second Edition, September 2016 This document was developed with support from the Centers for Disease Control and Prevention Cooperative Agreement number NU58DP004801-04.

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Work Healthy Georgia