Follow-Up

The keys to a thriving wellness program are persistent one-on-one outreach and follow-up counseling to encourage health improvement, adherence to treatment regimens, changes in lifestyle behaviors, and to prevent relapse. Periodic outreach and follow-up procedures provide staff members with a safety net which keeps them involved in the program and prevents treatment dropout and relapse. Counselors ought to follow up on staff members at least every 6 months throughout the career of the employee at the worksite. The goals/objectives of follow-up are to:

• Involve staff members who have health risks in treatment and risk reduction programs.
• Involve all staff members in health improvement programs and worksite-wide wellness activities.
• Support staff members in carrying out the risk reduction or health improvement activities they have chosen.
• Help staff members comply with their treatment regimens.
• Prevent relapse.
• Prevent staff members from dropping out.
• Help staff members maintain behavior changes.

Follow-up can be conducted in person, by phone, mail, and via computer if the technology is available. Most preferable is an in-person contact. Computer programs which can do case load management are available to help counselors track information and perform follow-up.

Priorities for Follow-Up

People with multiple health risks ought to be at the top of the list. People in key positions such as union leaders or department heads with health risks ought to also be contacted early so that they learn what the program is about and can share the information with others. People who need a medical evaluation for high Blood Pressure (BP) or blood lipids ought to also be targeted early. Many staff members will have seen their doctors as a result of the evaluation, but some will need more encouragement to do so. Those with no health risks can be followed up each year. A follow-up counseling session can take 20 to 45 minutes. At minimum, follow-up must include those who were told to seek medical evaluation for high Blood Pressure (BP) readings, high blood lipid readings, or borderline high blood cholesterol readings with 2 or more other risk factors. It may include those who were identified as at-risk for one or more of the other major risk factors: at-risk levels of alcohol consumption, being overweight, and having low HDL.

Follow-Up With Physicians

A letter (see forms) ought to be sent to the physician or clinic of each employee who has high Blood Pressure (BP), high blood lipids, or is under a physician’s care. The letter ought to explain the program and ought to include the employee’s relevant, current health measurements. Along with the letter, send a self-addressed return envelope. Follow-up with the physician ought to be repeated every 6 months until it is established that the employee is under satisfactory control. Contacting the physician is valuable for three reasons:

• The doctors receive staff members’ health measurements taken at the worksite.
• You receive the Blood Pressure (BP) and blood lipid readings the doctor takes and information on the treatment the doctor prescribes. Many times the employee does not have this information or does not remember it. The information can be used when counseling the employee.
• Follow-up encourages physicians to pay closer attention to heart disease risk factors among their patients.