Integrating Employee Health A Model Program for NASA (2005) / Chapter Skim
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Executive Summary
Executive Summary
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These chronic diseases, including heart disease, hypertension, obesity, diabetes, and cancer are frequently associated with negative lifestyle behaviors such as physical inactivity, 1
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In support of this goal, the Institute of Medicine`s Committee to Assess Worksite Preventive Health Program Needs for NASA Employees was charged to review existing preventive health programs, assess employee awareness of and attitudes toward occupational health programs, and determine whether there are any special risks unique to NASA work environments. The committee further was asked to prepare a report that evaluates and recommends specific options for future worksite preventive health programs, focusing on, but not limited to, nutrition, fitness, chronic disease prevention, and psychological well-being; incentives or methods to encourage employees to voluntarily enlist and sustain participation in worksite preventive health programs; ways to create healthier workplace environments that are conducive to more active lifestyles; intervention options to reduce risk factors for chronic disease; and ways to evaluate the effectiveness of such programs.
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In addition, there is a need to strengthen communication lines between NASA's Headquarters and centers. FINDING 3: The traditional approach to occupational health care leads to segregated rather than integrated health programs (Table ES-1)
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The twenty-first-century American workforce is characterized by increasing demographic diversity, as workers perform a greater number of multidisciplinary jobs with higher degrees of collaborative work and reliance on technology, around-the-clock operations, an accelerated work
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. Concordant with this committee's study charge to evaluate options for preventive health programs, incentives to encourage employee participation, and methodologies to longitudinally track employee health at NASA, the STEPS initiative seeks to improve the dissemination, acceptance, and effectiveness of activities directed at improving worker health through integrated approaches to health protection and health promotion.
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Recommendation 1: A New Vision The committee recommends that the administrator of NASA adopt a new vision for worker health, readiness, and resilience that di rectly links to NASA's mission and includes health as a core NASA value that is implemented through an integrated health and sys tems approach. This vision should extend and apply to the entire NASA workforce and should · clearly articulate a broader perspective of health and how it advances NASA's core mission; · be adopted and adapted by each center director to maximize the alignment with each center's mission and workforce composition; · be promoted and implemented vertically and horizontally within NASA, using participatory strategies to ensure sustained se nior management and organizational commitment and total workforce engagement.
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As a consequence, it does not provide NASA leadership with a compelling reason to commit resources and management attention to employee health needs beyond hygiene components such as injury prevention, exposure and occupational hazard control, regulatory compliance, and emergency response. A mission-driven vision for health should articulate why investment in health and employee-integrated health helps NASA achieve its core mission on time, under budget, and better than expected.
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· Incorporate mission-essential elements of integrated health programs in contracting requirements. In addition to ensuring basic health insurance coverage to all employees and access to preventive services and core fitness and health promotion programs, such ele
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UNDERSTANDING INTEGRATED HEALTH PROGRAMS An integrated approach to improving the health of employees involves going beyond traditional medical or occupational health to include a variety of fitness and wellness programs as integral components to a comprehensive well-being approach. Such a strategy can be targeted on multiple levels, according to a social ecological approach that provides guidelines for thinking about health decisions as being determined by multiple, including environmental and behavioral, systems.
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For contract employees, NASA occupa tional health leaders should identify ways to channel HRA informa tion back to the contracting companies for their use in designing and implementing uniform health care programs, and prioritizing and monitoring longitudinal health and performance status that is consis tent with the NASA vision. The HRA can be used as a basic component to build an agency-wide database of aggregate health data that will inform the design, development, implementation, and evaluation of health programs to meet the needs of NASA employees.
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Individual programs should be made available to employees with stress concerns that address both resilience through integrated health promotion and reduction of individual stress reac tions. At the organizational level, managerial training should be orga nized within NASA and for contractors and civil servants.
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However, observations made by the committee at site visits to selected NASA centers indicate that this type of system is not uniformly in place across the agency or in complete form at the observed centers. Data management is a key concept in the successful implementation, conduct, and measurement of any occupational health program.
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The infrastructure, broadly defined as the personnel, technology, and information needed to support the integrated health programs, should be defined and appropriately supported as a critical requirement for maintaining the value of an optimally functioning workforce. Observations of occupational health programs at NASA, findings from the literature, and comparisons with "best practice" models in the private sector indicate a need for data-driven integration and health management capabilities across NASA and within its centers, so that a truly integrated health management program can be implemented.
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Recommendation 13: Intra-agency Collaboration · NASA should create and initiate a data-management col laborative that includes representatives from all centers as well as Headquarters who are trained and well informed about measure ment and evaluation. At a minimum, the objectives of the collabora tive would include generation and ongoing monitoring of perfor mance data measures; · Initiation of a data-driven exchange of improvement strate gies and tactics for practitioners at the centers; · Provision of input and feedback to center- and agency specific health initiatives; and · Provision of specific recommendations for data manage ment-related resource needs, training, and integration.
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, factors that contribute to pro gram success (e.g., as measured by employee participation rates, or behavior change) , barriers and facilitators that contribute to worker participation in programs -- and how these barriers and facilitators differ by type of worker, center, and other factors -- and factors that contribute to each center's ability to initiate, implement, and sustain integrated health programs.
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. Integrating Occupational Health and Safety and Worksite Health Promotion: State of the Science.
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