Tea Raa MARMARA NEE ACADEMY OF FAMILY PHYSICIANS OF é . Uf i : MALAYSIA AND DISEASE PREVENTION 2020 me Bd HEALTH PROMOTION ! ie ie ie i ie i Te : Tatra aia ace ea NATEACTIVITY 1Janelle Guirguis-Blake, David Meyers, Renee Crichlow, Jane E. Wilson, 8 Sand Charles Carter Key concer w evbencé Baseo + it wei lin Sree conten? Gate mtgeee PREVENTION pots aga |. ihe de EE | Eo, piece 2s fee ele ein i» ay. amp Seer undnaeee? | Sg hm cy sri dian hoy and «Nop sic orice ae cancer ‘dng apts gre stg mabe on Bt ee inning pa ont stone. Berets soa 3 “at 1 Te Bho ed peeanaiot of he US. 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Segara tnt ia Sisanes it oranter cea inna ne meth on i at ea Sia eae cote aa cst Peal lel ee as Sette nee ei ote Seah te del ns adh ce Shaheen enneotn o. REMI nc a can pio ietnncates Ne OST eto Steet nee sc hrs Soap RB can ce dae ete ee pu yr Siena tate seep ep ay ernest eft hoe‘chal ae ig ad bor coining wanes othe pray pean tesco eae “rasan omega feo a ves pone” Sea eet ei at ic rig cette ena rasp en point Sepeson cree bse fy, sein noe 2" Sei eng pv le ty” fetes tia ns? 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Wht bey ae oy ng foredueuiment af oceoprns ign Ree a \etcamend seni ch iin he chao een be supponed ty eee, ta hee mate hiner oo. {evict he bene sneha Aye ‘ine eee eg ange lay geo rh that ‘Seen slim onan niet re erence, 3 Chalenges in Evidence-Based Prevention ‘ieee pveion es Ue iv of eng: ging owt wit srt ae eee (ie, doomenoy the tea te ene ging he msg sas pam te hen re ‘es ping ne iene only, Cosa lena ser alist deemie ih prenine eies te efcive tie and rote te aso es ‘eheion xm pponh ae hs aaa ing coicaneon ing hee totes one Penton ene sind iniee uc execly i hee ol bs pve sev td rane af es inion, muy ities we exe opicon s ‘peal sence mppartig scones Cining pees eee cnn eges Fo: example, ‘ostig gies ee lito et ein sosPopstin atieerea Sosy a Seat ny a ferric Es ee rama wae tes Soe tee Een cumae reer cote eT pheeumteeorns syns flees ond 3905 sera ea ice omens iaanen tag, posmenepal os primary —-Psimenanautal women: esrage ses brogestn or euregen sone ee — Frente once ses aa aia wets ee ei eer - , x ‘caucts ces pees |S SWEAT [i sfc tenth oer ern, Key csi sree ae he lenin a ee tne Ss ee aneanentscey ae aah B) Osbene ey onsen tye wore ay wre i nh hoses eon eee ko races oman eee 0 gue Us renner : "bones fox dn space Cieng ay hve ity ere |p se most fine evi A eit sprch ae eee Nude pieie eyecare | ete marian steed ene cee SREP CSE ieee nto) snd Sting wh | acon propria councag erves we ere whose 1BSneose net psc Benet guns an | ho eed hen ‘roving eb USSTF ne repaid or Tsien ian reign pre ec Wve dutened ed nealveservesand ind et STATISTICAL CONCEFTS IN PREVENTION. lees yc henge ings lok finagaocommaiy | Expressing the Burden of Disease sean sem appar eli eran get ‘Demin sts ec ek ors), mea | PEPIN ad Incidence Seven meses can unl baden of iain se up ween back provi peice. Asse Heer este eble tS daca o |v ermenn Pale the proper deine ep ofho he» canon or Giese a es poi in ie. Fete ped cp 1 TR oor perce tees operon fan ty sere grap of pole vo dep te dw oe en iad eet vod tne may ec he epeny d Erie of see in ppl; Dower ey conta nw eof he de oe pes ped framiagenyan cg pred inden eine he et sinc eh ee tsps see a ning he bren oa See Fertapl HV ptnsenl ere p es Pryce pas uo peo Sede Ochs Sorte aes now ee gt More efecto [eget adhe ing rekon of eel vrs Ste: eh eee oad ante opie My ‘chron haya woah he Sas Tea deaf HV in pn conmonir iene Ta Spetinrearé onmiion sl mess te prog ice heath vera ol tee es py evaonal Mri ith inp he dente hth sf cin ingnd moras eect wes colon ro eh Sees my ave sigh pre bel cna mo, ‘nde dee ny eben ons Qa ‘iin bren ofS a ae an herr fk fee fr i on ors Fi 1 Expressing Screening Test Acuraey Senstvy, Speci. and Prective Valuer ‘When decd whether op nent ito god cesig ee {ecard he poten fe dane pops. ane eee epost eae These Se {Ship mene neal eof the gem be fee “Stn a ope ae 0 eset by ohh ary of seeing or dng te maybe expe Saini ded Shepperton a poplwihe at dove wha pa Thelen ean peste poprian of popevaion te ‘up dode wha haves epee em, Ses pe fey otra ran he even of chon Song vo Poin and eee pedi aves te nose ie seca ofthe ening esd the preva fae hy ‘peste tool it els ean (abe en [sk poe ofp es). The pnt pede ale ‘he propnion af peop wi poe fa ah wo ae he trp order The sgvine prise ae he proper ‘ope wih eet a bose ee oft rg dre jhe pave rece er ipher tn np pee vow he aed ns popuon hes pe ince Cinco ned ores th ia» poplin wi peace af pce a,» pse tx raul bes Fa pete ah ee fart k= pp somal serra pon yt eomiawarcornthscnarat See ogee theo Scuataislastalieats epramraartoralecea Searcy Areata aa 2p 8 SPC me mew Me commnNT ge | isk Factors | ast otra concn ha seein wih ined Thao of ce Fo engl sey ak err des, | teats meet ts enon i dedop dates Me bch iin compucd wit wacarter | Taare ste ua i car nae ie danse os cle Imoling hor sn 9 pres tne fg ‘okt oy isn aks Sep iets bt Nene her ers pep ving robe tides seme emai eis ise iso nor nd etek gy Secon Bik cin fr hcg ah sac nee ge, Ingenio king od ip eel oes er oO induce sbeebs od abr (i 11) ame ‘kteen emailer en bene ‘Hamlin tof psd crankset ed ese nmol chp ony Bry Sone ik ier we evil ct ch el, ‘cl ain snd Bt nd soe ype of Sng beet feed emit ik ites Wobble en ak felon arian ooo feller of deh ate Unie Ses (ae 15) Prove ees els toda choy Noa rtp Ory Se "wher cone preeinn popes isn ct fein tp popes who noir dancer thant of te re yopeian oh ea Ira dea nay oncom oto ar ant hy ronnie! ncn I cpap ‘or pen sangre poop ops Intone ware ‘iy gears hs rtd of te cher or ‘creme pis tr pare oy ‘Shits wired delynepopan i joe pr sh hue ole en Bowe i ak rs ore Fagin comme with «coment Wp rie gm De Aer cnc oc tt wens hgh een Sod petty. rein fra kr or ae i ‘et ino poe pie rae oe dae Yeh ‘cg vio be pss nay anor ve pos te ert ingoant oes rene te dee ns Een prion Weng ee cng fist encne row PREVENTIVE SERVICES BY DISEASE CATEGORY Cancer . nein ee db in Died Sts cased yes ub hexecen ing ee Snecma 508 aves dof ane ch tl of 570300 ene des ‘ee epee 1005 (EE, 10) Cacer ba igen pet elias sory i In), a ‘ees emir’ maton poise Unie Sava od ‘eced te dapat cementite of nee, neve emiion snd he eatode vse fee aS, ‘ sutted 1372910 ow ces of ane wee nga In be ‘aie taste sine of eer gps ona ten an nein ee ween (ACS, 18) (e183 1-8) The Noodle Healy niet he dst sod od fe rel a of ace p28 we S138 sane ei expan ll peace oy ted sue cr ee ies Coloretal Concer eres of Dae Clee cams ite out ox comsnon ‘ant in the United Ser aed tesa aking cae anl eligi evipog ard CHD oes (yen incon sndcoranay so) ‘he sats ot balm sect fone Framing Hest Soya tya at tnt evry tea ouece enna (rosa lon ancora ath). Tse ere vena ok [lisse tant de hahevs nb aatasee dab Use este: Crete Ouse ola ota. roo Sysco esse: i Gres we Eine . ler on ay mean nn nd pe gue m2 ae faces deitmines he Vominghan midy Grom the Nato) Few Dood and Lang hte puch gownptcslassorpuarye-pa) uns iows OEE) a7 (ctonansioeum FH] £27 arse ES ane Nontogin yan enya rapt for Decoy aa pan 159 eters 48 Pavone 23 o wo wo ap a om ape eo Figue 112 US. le apeasuted nave cacy cence ie ays ae Pam {eset rere a bara, OX begun etn aa oon Sees Canes Dene Conlon he ‘eto nd Neral Coe 208) 7 Presale ETD m1 coo ane EE) 212 Pavone FS 22 tons or seesigeniyin 5] a8 expan 78 vaste 25 Lerngi60 89 ene aarti He st pe 0.000 faa vit staged ene cnet 1 Seen ramus acer Wort Gow. Ue Se, (Goce Sela on hese tnd Mery ary ‘Stprnet af stn ad tra Sevan Ce fr Bs (Grol sna Preenon nd Noor Coc tt a6)1p an RUN SRS lunpsrctonene EET 532 (con ae rctn F2T 58 Copas ard uanen0 F736 engage 154 ay sernasel te 30 | ee 0 Tse) | capa x05) 42 er ei macs fae rerun | tiene 2 ob mm mo too | rr fpr 080 fa pr oct0 Fayre 15 US nae ageitd aie cc nr | Fue, US eased ar aha et he aide Mela oe et a See. | TS pinay ater inne Nets fond oc te on : gaia Unie Ss Cnc Sth 0 eee Stuy Cebcact and ont, hlbnn GA Depuinet of | aed Noli. Alt, GO Depart cl tach nd Mat rea ast Cae Beers bate | Sve cre fe Bere Cee een moe (ion snd ten creo, eiwthotwe oe ses 0) gre 5180 ple foal ine | ring remen neonsin ps Rah emit (le ance Sy nw ee 0908 pas Ind. | shen Roepe ed oan era “oe wold ig she hie dene nse ws | emesis resus sve ein Jyerar in Sbyceld pm asa Sh dance ring | etresber i ch leg rowel eran oe inane ae 28 te of ing of tS Puan | alae en her he Spee oct sch pr Gaon) Iecaetcicemenaly mera iO pm ster | pecomytpetred (igren eh £029) ‘iialene son te se Sgro peas. | rommendtion Th UPSTF ron commen sce or ‘he cand yo snl al fan 50% f Dd aoge A | facades men aed wee 8 eran eer Seig (ie eis) ces 0 in Die sine D noe of | fy oii wikis ing eo {isn ete) anc (gre 200) Rk sor | DVL om, sme cloncyy, ae decleead (recess 4 Redes tie wih 2 tory | Sm nee SPST OE) clot ne» hy Sr of hetay oom | The erin Cnr Scey (ACS) eomeds sng eT ccs ita coon pp aed pot | yeah est ce tgesng So wide FOBT shee Nae ee simmers eat ae Clee ee ee een pus fey rete esp ry 5 et, dene cot bela ne 7 Iecuray of Sexing Tes Selif secing with fea | 5 yao ebro wey I yr, Te Aan her tecbbed cg GET vets i eee singand| of andy Pts (APP), Anesean alge Oba TSemedod ues ein tole fe es exited x | Gel ACO) th Aner Calero por eres tna ects ila se spinn | soeretmndnpses a a) = (oe ‘Seteenig Tr ‘olorectal canet #6 increas estoy (6) ba edocs cy (98). producing a sidered peanheney tins | ea aarare oa Saar eect etre weer ete ica | cmc Bepacciimeme cin | Giaieretiresnciaas screening diffi w determine because any paientsbave poles | 2095, and 800 of thee patients wl die fo ths preventable diese molec ger | Baerceiemnner eee at ma | arts oeg euee e mcuistact ome agent | deena mrtctomnade ic emnea!| Eig cena iodo dbacacmmtte | meetaname tearrecicet smh ee ee ee (ree eee rae mere cer | Shed“PRES pre oenemennnn eorsinssy J repre cin in mca af yp 3% The i 2ao- | ey aout rue sein of eres wane een he {ess a0 ad 1b ome nara ebation bs esr SHE hor not en hen ete be eee mayo sp {ent ete gent digas CBE as eee ete ee ponent mame rphy ening wi CAE nd mame ‘empleo ing mop sloe unpre a2) Peri a of tenths scene es poe et ars incl oes flow op tego Fase procedures vce and dnl ee ep Hesvnes of Ely Detin an Interven Ely deeton™|, Txommendlion. The USPST coeds aning meno ‘Serv cone vey even ecrng dys ane | taps own CBT ny? er men a 403 Shiybecc ol dope on the sge 3 prs Maren | ele Ode epiaons ss teommens weg wih ma SH a momen ach dae sae 5 yl oi 1% af | ape they fer oni he age af ion ar een ramen wih tie ine fags serie jas | nt (SPST 100), The AA, ACDG, Aner Coleg oF {ionman a 108) Insacion = sreing pgm wid | Racine (ACH ad ACS eommandcecng wh aE Fp emery eed ati doa | phen BE bang by Th Ann sk els Fee on Prete Rah Cr (CTTPHC) ond he Aran Tord ection oi gre son ade psiverne | Clee of Preventive Messee ACP) retmmend sent ‘hep poemaliovcadTbar Haring | swrafe ik men cp snd uatg women tte the ‘vbraaledeg pete pnd psn pcp da | ape snd yes one pend bn andre fae few wh apne amram oat |_Seening (pee 2). Silman | nog ino 28 pee San Sry wei cles era ioe rt eemendin The USPST mens reing Sr ceia) | denied eae a SEE or COE inp of mmo {Suen ron eh en seal ce snd ec | Y CUSPET AO act of bef seni bined ying eng in Seu of rac ef sl cay by oe ee | ung Cancer Sie iad vein lst ey Dyers ie (SPST | Barden of Diz Lange ib ington ‘Smmen punt ies of tae ip rie owrk wen | dente ihe Ue Si Aces new doe ‘Sterinn yen in worn nh ee has acy far | than 1600 Ses mere tps need ray ‘etza tan (SST a3) The AAFP (282, 205) errr | sesh doped be po debate Ihe recension ‘omen SEER 20 peeling the i kc ith “Thc Ned of COG commend inning seni 3 yu | longed tn cle ner le aang stertwmsnbaans mys rat ope bem op | Dre 206), er ik de Sy tory ‘Shots cpt adon ceed pen cre {es (rn sing used pepsin el ge yee cnn P00). | gece of Seeing ets Cis raphy wih bot Acuna Srning Tess The exited sso sige {enol xpos (2p) ange om Se or 1) Srpate cand efor ie gre les atone cs 200}.The wile dw oo Te eeuray af the newer see- | |.“ hgltes eae stl (eg Tanke. ty PEP) Conplend race (eg PANE. en srthn-et (Soi eg, foie sence deemine habe emost scot comet renga HP ein tienen fr seen, yb ee ‘geome oo wold bene rm mores sig ee ae ee reer eaiincen | Seat ea ae eee ‘ing bung cancer is four timer grester than ihe seaiivty of chest iat spss terete meade pies emetic ieeirceri eas metas ed | vce ae deen ey | ae ence te mt more on 60 eas cere ror bes concerin 200 (SEER, | BAY wih or without sputum eno aed LDCT fave oot been 2002). The rk of breast cancer increases with age hepnning in the Se eae eee ‘Sane eh cans oni dere an | 9 Suh pe ae phy a SS SS | coccecn pret entre Secu breare sireeicens | oopten cr mec SuSE marrage | Srpevea werent Eh anes ae | SSO ae seas Screg te mamma cine bent examination (CBE) an@ | Ovarian Concer Saree Tee | CE pstmt Soe Seen mesa | ier recente Erie tomaneeaenen | Steer aramaueaeentaae React ermcrna ons | i stea eerie ater este Seretine ercieaareerc ams | flees ecaeraetg ica ieee | Sr cork crane Beier | Gaerne cheer Seciear irene manele | srarutcrmnmamtemya Skejisiecstertinleeti™ | Shou Senco | ser ei iy Sais ators | ooo ease 3sine pn fon ri doe | = aR i a sce Tilt dnomalinogca | PEIN NR Tere ‘ellwup Beau We inddene of ortan cnet | opines BESS SAS peice si ologwon mesos: | tc rmue Cas SoleDeoh Se ed mes lthmensincs | ite oie che mybeecinnndlernn Teno: | con ms fe, -SUpGiadseay tence, | a gee |, ae el, Sercteg ie ected | forein, e imoral eg lor ein cance it result ina ib | Sage zhypreesin 2082100 SS Luo as te, OR Wgonr tng moment pn | Rilo anac mg eeaseny ae ee erates | keine cates eto (Gm amergentaien Teaco th wanes iba | eg Las Sey TR tat nny ee er Seana eon pore ce 05 ta et | mu oe af ote Hp hema cna reso ae ne he ed nog oe | Bt nl nn a pao ance sinew pjened rein 200068 reod | ons(RAFP 20% AHA I) Agpraxinsely 6 mile Armesians ang 7 2005 SEER, 202). nsec sees Wh | ye peterson, alhouh 30 of pens we unaware of he Bee ee ann a a et a a oe include Hack race and having 2 irst-degre® ®~ | Cyabyajnn eto 2005). Beyond these nurmbers, the eutcoene of chs ioe en. iho a et _dacase mst be considered: 35% of mpocaria infarctions, 9% of “among "y more ren have 2 dingesi of the cae Ur bears fares, nnd 24% ofpemuture Gemhsare cused by hypeten- SR LUMaReLeicidineatt ane | lender eae sits asin ‘sandy 3% riko dying prone cancer (Hst6 | xis broughout all levels af elevated blond prise, sod risk aahit “increases a pressure iereases(Chobenian eal 2048) (Table 12-6). Fenn cent The shi tino | “pen net ne ea soe Ts De aly SS | ea orop ns nin eine pom Beet Sewer OS) ort act aSngat | Gta stat) trons ctr See omer am wok eseitaycen | ite Na eset oe meen stein ea sion |. Sy Stet enens scat | Weel rng lan lender Tait eS eerie bacon | Slminnetn oar beni ton ieee “Site ena rt | Sac pene vat and dee les thn 60% of prt ans |” pecyracy of Seeing Tes. Ofi-bned merenent | cee ged cel ta eccecee | Astra sacy a rbd ems ee 25, atcnestbepaiterme | Sie yt ltd era aed Beef be Glatm l'tuy uc nd eesti, Sv | lly eye tence pe sr ci ee, pects amar apap | So Si ney porns ree te TOPE TPES rts tome belt | Slut pent pe ene Sea! 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She pieced eat eee, ed ak | eta bh ethene ee “e ‘hediaselar diese (CUSPSTE-200R-O - -: ‘euro aio de 10ES mE A eerearareme RN a a hipeonan SErmlysoye pays, Aan Eee en 5 rears nae ; Seer vcranmape Tecoma apn ee race ee Santas = "8 a i asi coy Sn HNN ay pa ty apa SEE ere theta ore Socata aa ay Pree eeouafetattivne petcuenitesorrhae mea r inarighrti anata ase Beg Rie vee maps Exvhutscemectetelces 5 itn ei ee it te Eocene aetna hecg ne SiG iigmtetecatics Saunier semi rma imines Senet at ence ema Secranl moments coer gee tte, a Sec a tte Snecaraannanea Soop Neer . Hise nats cae Srammnneetier este Seca ca cetaeela eee ey ea a eis eee re ete nercieetia eimai erie meacrariae icra cme Belov esmimansum aetna ere Sree eee eae aetepmineacaed oa ih icriencleartag ss iecctay en ee spy CRs a iy wrap aie ape Se SR, ‘a singe sate neo n eg reese ce CHD inh wih sha ‘nc poe OSAP m8 ‘Abdominal Aortic Aneurysm Suen of Disa. Approximate 500 pol de eh yar of Sidon one neler thangs. Ants ncurn ott dle neend aah of wie eine 205), jr iki age {63 err la sohing 00 cetera cine ae ‘ea ty nee rin ned ot ain {Uststf05hsmar sro otewr reared ML ‘eploan mone adds sig wo), sewn Soren Tests hod ise tht enna aR naan ad pein “snopes Ppl smi koe epic ‘eninge (OSPIPE 9) wet Aen et Sr ood nae port tho tes ering 205) st ge oop ste yh. be monies need ntpet oe ‘adele can es 50 Sco TS fs (csrre feces of Et Deon ed erent Seeing o> rams eece AaAspce nry ong me be er Ivete ros ee op aed ects ip ween mare ny nee Fa ing bec hey do derog AA lr os een ‘she ot shows beret fr wns aap 9) Scing en eae ter my, gel A pi ie eit ot ea i ad Pk ‘nr campeon armen a ee S05) ean. TheUSPSTE econ ening lo Aa thy bowen he opel 8 nd Sys esac ies monn fr or spin soy ses spe [owp rae old ceo opi cae {nt women (SPT, 05, Te Sey oe Spy ‘mend sing nen ge 85a wes eG [yt err CHD, wl ann aes gS a es ya nh ‘re a é ‘A anerhndrie err aneey i Salanaene as aeNA a Coronary Heart Oseace aren efDizuse. CADi te ig ervey ot US en pd ware Thre ais ss he CHD. and aS cos eae Se iin, The ih rolex fed wise A 005) Sond Sherstape nis ceubute (© CD Gee le 1-7). Thee rs em became ln pose rik wore wih he Fang rite! oo Bec f te azote mei ané moray se pet inert idensing CHD in seympoat erecane of Serng Tne Sel seing mening wi ‘set, cacengr 200), re sig 2d a eda py) ong rere. Ci Serine aga ake sea ens kof An vt The eu ering SC saa ft CHD tne Tesi of on ex es oy 108 (07 nd UR pede ae fa 23910 28 Fake ose reas se nse foro pesos nt ae (Pyne 1 200), CT ‘nog cavany ema wel abet debi it Src neu mrs hb on eo eines of Ey Deion ed Intervent. Abe ECC ‘nd exo ines need Sc, e ei 2d yt tee ts nS in gop pein Fc pre re Todt ive tis ie Feiner iad open eure det thse seme pve rms beyond i einges perv pons Bene nig ser the ee th ‘tsi wh he dais ald eer rane sen py dso ent CHD in ps nop oem nin, 0 Ronen 808 ‘cnc don ot spp tea main spleens {le 10) However erected blo CH, pin op deer te rte of CHD (key, 205 UST, ott) Ped dv ure, bol des (Si) 2 ot ean dae (38m) Scking etn, Mood pres {odlpd ones dtd eee lave en shown ne Aecxomendtin. Toe USPSTF werden ws EOS, {scene Ccrning sxe lonrih a ot C3D. Fide iit compere th ens ee ‘Sli ane (USPS 206) spn rophp is ‘rong rend far ds we yet CHD rk 2 3 oF [ever (OPSTE en). The AFP de a ened rine [Stinson hdres rads pr of edi bal i ee ise pref CHD in auto net rept isons St be eae opengl ts ieeGHD SETH a) © : Substance Abuse end Mental Health Tobacco aren of Disease Tbe a pel gee sig Serge pene eh ne Une Syn ‘ia eproniaey 850 deh aoe (CDC, 205. ‘rong sak spi Wf he dee aie Caner ctlonsa des nd 2 oreo ie {eats Saing erg proc ens 0 Ala amo An intel 400 abs sly om ng Cane clnsr est stb ose od Ste pen D0 20) Dupe the no eal een Sonn asus 2S af US le conan sale (C3, ine The ples of akg ihr aang cei {Pou linge Ameen Mae a a ith ‘oer afc dee est 808 nd feo ng bow epee (CDC 23. Seng denen of ik Gov. ingle ‘eng nn goed ya coment + Pes tera tbertsih ctay nen wi "Be pen vo nh ee 3 100). 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Assen ay rage ‘faosag esd gen tases po tng i gs (Eee one wea poset alin he ps es (erect ek oprah (RD BRAG tare aed ord peso 2x fhe pea Pere san ae mee fein 0 aig by PU BN ERY ee ee rr le RENT CRN V2 Seater Task ot of hve Se cloaca og morte sot Ge sic an pecan ors ge a arn ata ot 1 Saucy ts pei en 2 tar hess el a nna Fagbeoome ates Ott are cigs te in sc ped ug ae, 2 are pre es eee oe mtn ey Saree panne Soe ate wane. AES tyes apse eer "oa ng eo arnt et fees sac arg moe ee or terete nrennor opp ee bia a yes en ee om tie i pa dr sch ptt tice ‘etna oe ote ne mabe on Ue Ine! leg, Howton tase ing ne ° ‘Advising the Patient ‘rpc einen ass for pen Whar dng Pee kn avon sve, ppcens exh st Fie tbe we niger par of Bt end mae a nage née a Fone! whe pes ele io aden om conc pen 9 Wh A SRiatanpai and nonacemet eens open Ts eon y ang ave ih rena se 8 Journ ed sellout... eps coe ee ean woe andre ae try ie ‘Sayan teen the pts hyo ne od certain pou nmcoe bol pleat etic, he Tee Fa telecon l be deverd 228060 Sond ‘Agreing withthe Ptin! ‘at ben hpi and phn ape chge i ie Beit and opine poe fang bw mated ‘tan hg oy be cl ois pan opprepscine rsh i yt gra a 00 TEER er or epi nih alpha it pe reece son ener nen. Ph Te Sealare wih pens i comin she post ‘BEE hen pen ae acelin mig eth (eo th pice se ed nr pecs ad ‘tener owe ds. ‘Aaktorslaosstance adnan win ot one of ep it D0 eter come thn ien rten. uch, ites oen dsr vie poi rash be (103 NenSauatng Beton ange nares hea pe re SEdinad oh semen ed ake communi rece ESAS gens ue Seiden nove ee nh) ween in ted media sens to prode airs 1 piste ethos arg meres stance we Fe stl eh pcg gue ek 207 a Be (na i la oie Te eure . ra ay ona Theo oro eae na pS at ti il Pec i i fnons comer pre otmanage pokes Pee Fee ltl cae . Prieto eon gs eta Hour crm win, oy fas ae gs won er sr ann ‘vestacr * Sie auedeet stn eek Sparen Ne neers cee ‘cd tabi td Sugesa ange. meres Sashes to ange a ae oct she eho mas pee ea ‘Stang iu ed wi a9 cl ine, prs Cone ‘crm ence nd poral he soma pace lage, Ppa , . ‘on Sata foe ‘ep couite tenga retin by di cacon ag omsol oen, dnd aog ‘Senior "ements epee Sion epeiny Sere ac SShetcay pl mt tre ag py a awn bed ypc fn SYSTEMS CHANGE Family Physicians within the Health Cor Sytem Fd in tpn pring ae ei ae me rr me iy cee aaa eee SOL re iat ie ng Eerie alee ee savant hore agen tees ts (icone moe ara ig es Sp es Pies iene ray or hat fea Tap Sa dpc ip sali ge econ Picea ae ‘Erdle iy gore ase Tce co no te ete owe ; le prone pint pat ir eT rl es i {Sper eg ee ka oleate scien Tenis eee en Using the Sas Mod n a System Of ie np in te Ss od (Le, a sie ape ai, ‘age easy ely wb en ee wed ‘intel wi esng sn th a to pee sop Te ‘re bo sigs Get ma sige be opty f sds» Bet heal ik cane of erg #0 ‘hector pig ome ae pt 9 Ate fr imomsion ory te Deg el ond physcin ca ave the pti tobe mere pe ‘elves pee pte monn thane or toned ‘eration dation o lel 08 any woe ‘ion tho pi! mote nce comptes aed Seta proms ats eh ge at Beans srisse ‘AangingFolow-up ‘Sehr hang Meany tbe hoi onion, eis fl 1p The snp Fw poe soa te ppc eeng {ic pate ta hepato fon ops he en pce led Wis an ling» note he hare Un ower a lalow ap oul be xeded win» tei er pea apn em the hangs beng anderen, fab fray “ santa phneea few dros shee oah eect Squat popes oreo vi hehe el low. ps fe conc mey ene speedo sues ager Theories and Models of Behavior Change evr hi ais ad mea opps cnet ethers cone nhc dol ear change ees th vty anny poten scene of bherone, ing nections Cle 13) neh ies fo ping fe mesmo hp kins cbs ie opp en ‘oing than india near een bad han iii ey ch ering wie pas mo "Spand bee marines tenon Molar ge eae ede atog le of inter ono indus rn For ele Sap change foe) od in tyes 2 tting pees wih ui sae tt oer ee ge ‘idrein in svefone oun. Theacgee ae ‘re dl bse! ge vgs ble ht aoge ede od publ in aie ape he une kaso een tape een) od some ‘eng nts ache, ey od oecir maior Soe aso or cee Mos ingranoet mene fie FESS ee pti Bsn ifr analysing ven ps cei st td on pam msi tig ms i) re ir cre mane, Fk tis SSNS keconmoniy sap hein ong and rang obonop. “he Chron Care Mode ‘he hai ce od (CO) (Fig 1-8 hs Ben orci Uclemenah or codeine ten Gants mc eT seve ten toe pei) promos Sethy OE itn ad pale work wpe See rece gm (Cg 200, The COMA 12S cnaol denna shea ee pien Oat Te een betwen forme acid pon 8 ea oe hee eam Tbe motel dels bond EE FO mst cane when mesgig es of Se tel cele rms es re ce Gage dson par steromen spor a Te i os (ips 1) At mee he COM dos ee cape ea nein edna ete ak crenata cmb re ‘one To aiden off, he peo of ie OM vd npg iy pene zs od fe feng + Delp 2 iy (eins sae) Aueeing ssi ees pins wi bees ere cae ner sede whem (ereedey spent) + Retna pana pies ea (ieyemnoutty rooms) Aer tacoe yet ode mapa (Gevtcton pe). ee saben of poenn ine ps pe reer bonne i, eh te inn) (238 od va meine tude Lage eg ee | eon ‘are SZ SAE com Fie 198 Te dor ce ode (Bbc em are Ee rose ete angen wheat ioe tae er eon Haan 12, te gu of eon tr elon gi ey ‘sing amok i sing pss emis guile oo bdo nd appt ae ‘Stenger lector Heth Records 4 cna eco veranda for eng | aie pn ee once ot pec ie Fal loconton sens sd eon pert Com sind sb prot ny ai pris proitog yng ad sl espe pe Aethinking the Periodic Health Examination ‘ao te pte bh eniinin an my ns © seme tt es paint a= eral nteane sd dene prem, Bay i oie ses ele fed etn aap Pere in pies Howe, he mvs Send 8 OS "SRS eel sa ope pened eho ee ga esses be pried Gang pl Serine ce fs prea mtr i Tee be leg seeing ibe Hoo) Sint psc craton fen ptormed Ee irene ei eth expanse bat and MeSMlon sem pie) oe lee ge ‘Scene ate pel epost ‘Sei eme cae neste CONCLUSIONS. coweustons Freee ses ul be ed edge indie Pre ik ace pee on coma dis Ao) repeal penn po cn wrk eas 2 o¥ 1: rece ened om bey bt eatin ‘ipo eo meso bene dome cian be rn <1 Health P, 2 ‘romotion Molly J. McCauley and Robert J. McCunney ‘Heath promi, defined as the stoee and art of ping people chage thei ety o move ar Op ‘inal tate of health (1) Oagugh 2 combination ef ef fers to enhance avaceness, eneaurage behavior thane, abd ceste envzorments that sper good bel prosices, has a is pol iniviéval maverent tonard a sae of optimal heal, which i» Solnce of lyse, emotions, soi, spinon, an inlectl lh, in an efoto spp inva ella sl te sap of heat promotion patio day bat ‘led and sve to chnge phy, soi and nor ‘ate cvioenents. Tobe, bie ook fin one wi help op his evi in parapet “The dominant view of health promotion tht ‘emerged he mito e197 wasn rspnse fo 2 growing disiusonment with te limits of mee ine, pressure lo conan heath cre cot pd 30- ial and poial climate tat empiaioe’ selcbelp ‘nd individual core over beats 2). Later the vie son of teal remoton tat was scaled by the stron general inthe 1979 Healthy People Report tthe sage for programs that nt only brovght t= tention tbelpngindvidiels endif Beals tebevs ors bt alse punemaed th importence of psa! ‘nd sci envionment (). The notion of sig be- yond the focus on he individual was enhanced even urbe bythe definition of eal promotions aed by the Wold Health rpaisaton (WHO) in be id= 1980 “Health promotion isa proces of enbling people te increase contol over and prove thet Deals and cepresents 3 mediating stategy berveen people and thei envronment, aytsing peas! ‘hole sad sci] responsibility in beak Q) ‘Ar rent of more thn ovo decades of program rlifeaton, Beals promotion is now ental to worksite programing and ereogniaed as an ite tral prt of sccupationst heal practice. Indeed the work siti viewed at an of te mot popu venues {or promoting health and preventing iseace(3) Ser tal sdies provide evidence tat health promotion {inmly embedded in the fiber of US, busines. One study f0 deermine the prevalence of actviteg sinall wook ses was condoced by American Bish ‘2s Lists, Over 3,000 companis, all having between Sand 99 employees, were survey, Based on he e- Spenser of 78% of those poled, 25% inde tut ‘hey wee offering at leet ene health premeain jo- tam, specifing oceopaionl safey, eadiopal ‘monary resusciation (CPR), and back injry prvese tion a the mest common programs (2). Another sur, the 1994 Natonl Het Interview Survey, ed the responses of 5,219 cespndents who were ‘employed and completed the ston on werk sie asl promotion (3); 43% of the eespondents2e- Jnowledged access to smoking cession programs, 319610 general helt edstion programs, a 339 'o szreenings; 22% idised at they wee partici srs in some program th work ite, However i portant all such studies ae as evidence of he growth of worksite health promotion over he yes the pre tevineat study is and hasbeen the National Heath Promotion Survey, conducted by the United States Office of Disease Preveaion ané Hea Pometin in 1985, 1982, od 199, The 1999 surrey concluded that 90% of werk ses with SD or more employers of {er atleast one eats prometin seit corpared to 81% of worksites in 1992 nd 635 in 1985 (6) Aside fiom documenting the growin and prevalence of eal premetin, the 199 survey canis othe ndersanding of both tbe content and contest of vevkste heath prometin. Consider afew af the survey highligh follows: 231. OCCUPATIONAL, 1549 of companies wan to keep employes hel. 188 hve smoking policies +188 offer health ik apr (RAS) Blood pressure, eles, and cancer seeing se the os avalbeintrventins 19% ep tha senior manage orks emsoyee al near ihe top af its busines pris 54% eprt hat hel cae cons are a concer or resageen + 10% offer nana incentives. 224% ae evalnting the programs “Te average numberof programs offed by an en- ployer is 125). : Given tis erent understanding of prograning ratgaly, there is anethes document at provides = temple fer fue cretion. This complton of be rien heh prometion ani diene reensin ob Jee, Healthy People 201, splice ty the US. Departmen of Heath and Hunn Services. One spe ‘She challenge for he wok sti contined progr tring pry ating 5 tage! for 75% of wok ses Sih 50 or move erplyes to ofc comprehensive eal promotion aetviles wid speci emphass ced on comprehensive design ves sng rogram Dens, Another cholnge it spiny i Cres he numer of mpoyes wh parla, agra ‘ta tng of 73%. Jn canjuncton wits Hey Fo- ie 2010, te federal government wi esablh rake Tig mechan for fn of the leting heal nde tar This wil be vlbl iafoenaton for laming bealh prominin the tre Ithas ben pled hat of pier ese ahs wacking effort ace he py fal asi nd overegiobesiy intr (7) Most cern ie mans isatives of he past 20 years hve fled the growth of worst heal promotien and eaease prevention in the United ‘lve The worksite rivers have been egy ie Tenia. There hae been a esi oo the prof en lyes tonnage est eave costs, decrease asen- lesion, ingrove produc, improve emplyee nor, reruit and rein employees, enkance the Coporste nage and conte to Ie eal and Welbbeing of tele hurn resources. As eh ie [Ened sion of worksite ealh promotion isto por ies interest of eri maragenent (Tae owt news thal theres prowingempiicl evidence that worksite bean pometin i cent tobe tehievement of management gous. Teyughout it Ghaple,coeomeoied evidence of npet and ox comes is ighlste, ‘Grove he number of programs 2 ell 5 ne res for advaning he bel of Aercas MEDICAL SERVICES sre not the ony distinguishing Giereces i beak ‘promotion aver the pst 6 yea Iaplemetaton Tcels have been tested and calege programs fave been elated and elt pubs: ad thei toate fae bean reviewed in order to summarize Frelhiopec, cost stvng, sd implementation fe. tivevess As 4 ceil there i an emerging boty of enone ta serveso spa he progress made in all promotion pave a ehalleage health pro- faving to continue thts flor. Fo those who de- iver ecepationa health services nt wl be ako ‘ssest, etgn, develop, implement, and eveite eli promotion programs, his cope pesens the ost coment view ofthe lowing sues: +The ronal ad justification fr worksite elt promtian + Asyteatic process for geting ted and sting «The sope of comprehensive programs { hmplementain opionr—nhat_works and wha ose Eraltog the effetvenes of healih promotion Theft fing le challenges. ed he oppor [RATIONALE AND JUSTIFICATION FOR WORKCSITE HEALTH PROMOTION ‘over the year intestedatenton has been recta to documenting the eft of wosesite healt romoien progam on Bealb eae casts, 2ban- foram, hesth otcomas, aud employee Dean and ‘wovkrelted atiudes These is pow 2 eomeling body of evidence tat thee are postive res, tere providing sbelantve ainae est preparing, This sevtonpresens an overview of Findings over be past ys. eats Care Costs ‘Recognising hat 94% f te 1989 Nato Heath Promotion Survey respondent indicated that «top ravagerent concer is bells care costs, would lon that tee great interest understanding te potential inpat of hea premesion oo ese os anvolig belth eae cote paid by employer fomplex end punt of an ever-growing. atoal ‘emma (9-11, Carey, 13 cents out of every dob tar spent in he US. cons i spent co healthcare (02), Aamua increases in eal eae. spediog topped fom 12.2% in 1990: 48% in 1997 dt tmployers moving to manages eae plans, low sed icabapecifie infin, and pre et exacted from a12, HEALTH PROMOTION rovders (8). Now, however, the single-digit in eases ae 4 thing ofthe pst, and dovble- digit in ceases are once again the norm. The average heslh plan is expeced 8 cst employers £4853 per em ployee in 2000, represeating an increase of $110 per employee over 1999 (3) Such inresze can only F fc basnessprofitbiliy, with contami inpet ‘onemployecs" benef, wages, ae job security, sh ~ fn not unreasonable fr management ah, “What Will healh promotion programming doe impact ean ate cote” Programs om the 1980 presented ear evidence ‘hat healibpromoion and positive beat behaviors ‘anredoce henth cae coi Lie fer Life Johnson & Johason’ program, documented mean sant inp int east increase er sive programa pateipnts af 42,35 compared lo » $76 intresse fr nopari pans (1). Contol Daa crss sectoral sy of in surance data showed thal emotes experienced 18% igher media elsins nod that people wie hypertn son are 68% more likely o incor elaine in excess of 55000 per yes! (15), More ecet brits canine do the body of "viene that health promotion doe impact on edly ‘ue coss for employers, understanding ta the pe of programming aad ie degre to which heal ks an be inftunced ne eel varibie ‘The cenchsions fom ane grop fsa demos strated thot eu rhea dependet onthe ye of interventon. The Univesity of Michigan’. Heath ‘Management Reseweh Ceter eed US. employes ‘bo were paricipaing in heal promesion programs, and coneloded tht employer in sompreeaive po, rans experienced modeaon in media cots wile ‘employes in owarenestesment prograns, hed medial costs ha eoninoed oe (16). Chiba NA ‘conducted 2 quishexperimetal employe study of 1,194 paricipants and 11,644 nonpartisan, They oneluded that this een oo investment (RON) wes {54.56 0 5, and atid hese recs oe high sk ‘nlervention fcus of tee progam (17). A sod by Proctor and Gamble (P&G) of paicpaling vs. som. atipating employees tal and ifeyierltez ‘medical care cots fund tat they vere sigan trent a13 yeas as compared to basline At bse Jin ttl paisipatvrenparcpant cass vete 2 ierent apd 23 yar porepat cess were 29% lower, P&G conleed tt there was astong ase "im betwee the progrmnd he rss and dened {bat the ey suces fice was oneon ane highs ‘ovnsling (1) ‘The findings fom ev ober sues that dees. brah care costs ae specific to health seks, The 2 HERO stiy is indeed a bench std to lent that t documents, using a age dabes, that igh employees cost employes more money. The ‘200y colle fr moll ri conditions and de ‘mographie confounders in erde: to increase he ear Fiseee levels ofthe estimates. The beslh ene cos $6,026 employes from sx campnits nee exam isk and tose costs were ached for 3 years afer completion of a health rik appraisal. Employees a igh ibn seven ofthe tn ik eblegories had i= nifeany higher expenditures than hase at ow risk Specifically, health care cots were higher for em Playes a high rik fondepession by 10% for sees 46%, snd for hgh Blood glucoee by 35% Indiv. uals witha multiple risk pofile far heat disease had eats 228% higher, or psychosocial problems 147% Aigher, snd for stroke 85% higher (19,20). Nola, there were tee heal sk, when ealyedas ine erden vrables thot did not show evidence of in éreaed helih.cae expendives, They were high hetero, excesive sleahal use, and por auton Fabis (1920) One oer sray of 2898 monicipl omployeesin Birmingham, Albom, fund sini tant difeence in bon hel eve cate snd vie i for those in the cariovzelar diese, psy. hosoeat disease, and maltple risk groups 2. ‘Aside ftom the stds and reviews noted above, ‘he work of Ken Peller over the st 20 year asa forded brah profesional» sours of reference in ‘cameston with he findings fom ley eal and fosteffeveness ostome ses. His reviews and yes have coniibuled significa o en aggre fle undersintingof ine tas tat have formed ne aundation of worksite belts promotensslenee tase. ach of his four summary ales (225) see incly overviews ech evaluation andthe lie period snd. In tim, they highligh te pupove of the ahaton, the study design, sy period and inde inp. Mist reves fennured 24 sos (22) his sees 0823 (23) his tia 26 (4, ands fourth 11 (25), ‘Te oe noble diflzence between he ate ec ews andthe fort stat a the fur the progr ‘nd 19 meet specifi eres o be included. Speci. tally thse programs had tebe comprehensive nae ing, integrated, and consistent wih eerporte objec. tives (25). in summary, all of Peller teviews ory historical perspective of he evolution of he ‘wsech oesign, dia analysis, an intrestion sox pinicton tis thing place in worksite heal ‘romotion. There were postive resuls euring the 1980s, and white there have ben ones and conten ‘hages during the 1990s, th raul connu to be Drsive, Pelletier cotends ia the postive dios1 OCCUPATIONAL BIBDICAL SERVICES from thee sates anno! be eevalily aise = snore," and be eleves tai contin tbe ineasigly posible prove bath cosvefTecivenest se cobs (23) Absesteism ‘Simply sad employees who ae absent from he {ob ve oot reductive employes. Bones ot oni) Ps the hen cae bil fr nil or injored employee br also inca the cot af salary contiation whea ts employe ie absent. Te pct at heath pomo- fon has on aseneism, therefore, i sigan. IF esther employes are absent sey ar eerily rove podutv, However, the extent 10 which his arhble of nerest hat ees tid fr es than the ona}yseof hea care cets and health outcomes. “sie were ery etude hat indicted positive result Jolson & Johason exained obtene io coms of ick bows and found tht Live fr Life per {eins ppt 20 fees hous of ick ive per Year ‘han nonpnicpats (26). Aveiding peyent for 28 days of abrence per employe per yar aces an oo» ‘te employes poplntion wold dramsialy rece payment of slay dollars hata el associated wi pwoduetviy. Like, a 2-year Dupont sy of 1 Ses wit heslh promotion program as compared 0 19 connol sis wit any heals pemoton decir spend a [4% deine in scaess, absence o Bt ity dys atte program ses ed ocly# 8% de- hie at conto sits (7), esleh Oateome (One pense upon which Health promotion pro roms ae jstied ste by to Foes one Fe enable specs of morbidity and morality in he US. The lading causes of death and disease tolay ave been ied to ear ik cts I hs been {imvted tht mony yeare of He els operate (dens 28), andere evidence that he prevalence nd evels of prevenabe sk fore in employed populations ee high (29). Mls dete toward x oeig these rise factors are the extence of worksite health promot, ‘The ft tht cn} hea igs are reduced bas bec the ease fo document AT&T Tot) Life Con ep (TLC) progam repored siplfealy ereater Improvements among soy goyp pecicipans than conte! group parcpants for case Wood pre Sr, serum ele, ype A behavior, and body ‘wether jt yen (00) Aer? years, the sii Kean impromente were msitsne and resus in a derese in belth age 35 well a5 redaced popu thn sores for ttl mortality, Beart tack marin, snd esncer morbid 0). “Ie shove i jst one exemple of he hunted of abishd stds tha reper the bald impact of Feat promotion progcame, Whe his body of Hier oe fr fo extensive lo review compreenstely in bit ahopler, tere are te aolewory review ani ‘desta sunmante the work nhs 278 ovr he st 151020 yer. "Te firs aie repons a sevew of 365 ances covering 11 tne health nen, Exper from exch of the Delthaceae reviewed the published staes ad rated tem forthe igo th stad design (om 190 fo five sus) andthe conlosivenes of the rerals {frm weak to coochsive). Over Ralf of the sis Td fos and Siesta ratings foe design, and a5» Sale the body of Steratue was deemed 10 be i {eve to acceptable fr positive els 02). The Satlrs note hat this compares mes fveabiy 103 1986 review done by Warne eal. (3), who eon- lode tht pied findings were weak. They fr her ote that is body of ear i comarblee nd even serio othe body of eae sporting {he catome of maa inlerventios (2) “Fe stcondarle was review O47 sis end he reals fom 35 progeims. Again the pobliied * ties were rated onthe igor ofthe dy design and the corlusivness of the resus, Tbe authors ean- odes ba sk edoation for hghisk employees ithe reat fstin the content of eompebersve programing; ‘ot sie heath promoson reeves bath sk woe ter the conditions of (2) personal sad consistent eunsling, ab8 (0) suicentpropam duration; + hee ex8 be a eatin optimism stout were esis pomation (4), ig edetion does evenly ant oats! reduction of morbidity and meray, companies emmpoune the shorter benefit of a heir wrk- Foves wih he long-term saving fem reduee eats fave costs ad lization 8 Wl 3 rom Esse ist beece attitudes Toward Health 280 the Company Paciv ines toward he employes 2 pce ingredient of igh merae ia the workforce, were 8 Fahy valedeatcome by key corertececivesio Ihe tarly 1980s. Companies experecig change and trenton ad equally eaocered about i wellbeing te emploees sought to document aide chang. 2612, HEALTH PROMOTION tmployees have» beter eniudetovard heh 2d id crake diferenc o hw they viewed et Work and the company? The answer i ye aod 0. Sotinson & Johnson found» significant tioned improvement in empoyecs at poricipsing Live for Life companies. Mesures were favorable fer organ ‘ationsl commitment, supervision, working tong _ "ons, job competence, pay an fringe bevehis, and jb steusity (65). ATET documented siteinal ‘anges as well, After} year of ongoing Toa Life Concept programming, parcpans reported a belie ‘hat hey coulé affect hirano beat od wee co ‘mtd to change neath behaves (30). Aedionaly, Pastcpants perceived that ATA eed about Het welfare, were enthused aboot thelr work, and were satsied with woking conditions (0) Rowere, ie ostve jbvreated eft etined af yar were ‘Segated at 2 years, likely due tothe organs] ‘nd opertional changes that occured ding that ‘ime. This nding suggests ht, while eth prome- fon can positively influence atiudestonard the anpany, he presence ofa program anna limite the consequences of jblvorttlaed rnston, m- Uiguiy, nd acer, Since those ealy ees, there is very litle dee ‘mentation about stsdes and etsfacton. Anecdo. lly, there ino doabe tat programs colo to levels of sasfston, Wate aching the important artlaion between salsfacon, heath rie and alt eae oss Sods tat document the comela- "ion of these cris) qonitative vale (ttodes and slisfeion) with antitative results wil eon. Uibute signiianty to the fel’ understanding of rogram sitengie and wenkaeaes as wll lo an understanding ofthe eantert of the pogran, pei. ‘ally, the cute nd norms of the woplce is ikl that his ea Seasitve ate for managers espe ly human resources (HR) manages with account. bility fr eats promati program, nd may ex in vy tes soli analyse snd cepering oF sttndes ted saan, ‘A SYSTEMATIC PLANNING FROCESS— GETTING STARTED AND STARTING OVER Given that 90% of companies with 50 or more em ployees ae offering t eat one ests promotion 8 Uv, 5 not they het there are many eompeies ening program for he fist time Bt companies are alays stating over Wih every change inthe company, every new Fading about health risk ot isease, and every new program rye at cares ato favo, sere is an opperaaiy to eel he paring ‘proces. The posible for program scope, the op ows for delve and the potential for targeting not only risks nd diseases bt sea select sues ofthe timployee population ae exemely varied Appopr® se chices depend on the characteris ofthe Emr ployee popu coupled with he goals of bob he rogram and the busines. A systematic planing Process the ley immednte an ongoing sucess. ‘The geting started wepeinlige establishing » vi $n, mission, and geal, and siessng dt. Inthe races) word these steps ae not seqoetal a one ‘nigh! expet Ifmanagementean articulate vision, mission, and goals, itis ely tat da have inf ced the dreaion. And 25 planning proces iti also key that addtional ga wil infuence the ve sion, mission, 2nd goal So te process si unfolds isiteoive eter tan sequent Establishing the Vision, Mission, and Gosts Aline ous of pleming cles description ofthe expectations ofthe bealthprometon pregram is ex ten, The skcholdes, key extetiven, and busi es manages eed to arculte 2 vision forthe fe ‘uri ight o inistion of ar change in the bests promotion programs. How wilh rogram lnk tothe Dusines stategy, how wil it ont fo The man. ‘agement of human sescorss, how wil it enbenes porate imagelposioning? Based on that input ‘om top management, ie mission end goals forthe rogram can be Tormulsted by progam sieff. The mission statement, as very high lve, explain why be program exis aca faetion of he busines. A Final, the goals are brovd statrents bout these ected els of the program. Save the abject se Ling formuck, moch ler when be speciiy of who wil be doing what by wien can be node. Data Cotection Enployee assessment, aking the form of surveys ‘ focas prs, ja good place to begin regulese of wheter hiss a festime eller or arecpeing ef fo The goo understand the wants and needs of ‘he popolton, aswel a theese, clare, soe, ‘nd ganization characteritics.Sochasessnent setvies offer employees an opposite comment uring the develpinent stage, which mayen ne ‘eres and patistion. Focus groupe ia ay ind of ives (among them te senghs and weak nese ofan existing program if thre soe in pace) 2nd highligh the Baris and helpess thet be pro- sam is cucenly facing or my fhce inthe fone,