Comprehensive Workplace Health Promotion:

Recommended and Promising

Practices for Situational
Assessment Tools
Version 1.02 March 6, 2006

This resource contains:

• information about 29 recommended and
promising situational assessment tools
• a conceptual look at CWHP, situational assessment
tools and best practice
• guidelines and principles related to situational
assessment tools
• methodological information
• tips on how to select a situational assessment tool

ESOURCE
COMPREHENSIVE WORKPLACE HEALTH
PROMOTION: RECOMMENDED AND PROMISING
PRACTICES FOR SITUATIONAL ASSESSMENT TOOLS
Additional Copies and Copying Permission

This resource is also available on our Web site at www.thcu.ca/workplace.

Additional copies of this resource are available free of charge in Ontario only. Please
direct requests to (416) 978-0595 (phone) or workplace_admin@thcu.ca.

The Health Communication Unit

at the Centre for Health Promotion
University of Toronto
Health Sciences Building,
155 College Street, Room 400
Toronto, Ontario M5T 3M7

Tel: (416) 978-0522

Fax: (416) 971-2443
hc.unit@utoronto.ca
http://www.thcu.ca

Permission to copy this resource is granted for educational purposes only. If you are
reproducing in part only, please credit The Health Communication Unit, at the Centre
for Health Promotion, University of Toronto.

Acknowledgements
Members of The Health Communication Unit’s (THCU) Comprehensive Workplace
Health Promotion Project Team:

• Nancy Dubois – recommended practices lead, consultant, writer

• Ali Kilbourn – project coordinator, writer
• Meaghan Jones – project assistant*
• Berkeley Butler – THCU Workplace Project lead, consultant*
• Brian Hyndman – THCU Workplace Project consultant (evaluation
component)
• Larry Hershfield – THCU manager*
Thanks to those who provided additional feedback to this resource (identified with *)

Thanks to those who participated in usability testing of the online resource.

Recommended and Promising Practices For Situational Assessment Tools i

 The Recommended Practices Review Panel:
• Karen Armstrong, Wellington-Dufferin-Guelph Public Health Unit
• Janet Carr, Ottawa Public Health*
• Jean Anne Farmilo, Ontario Power Generation and New Horizon
System Solutions
• Jean Foster, Canadian Diabetes Association
• Richard Hesch, Brant County Health Unit
• Brian Hyndman, THCU
• Karen Jackson, Trillium Health Centre
• Lindsay Knight, Health Systems Group
• Lisa Kolody, Leamington District Memorial Hospital*
• Michael Koscec, Entec Corporation
• Karen Kuzmich, Brant Community Health Care System
• Shaineez Pirani, Workplace Safety and Insurance Board of Ontario*
• Marion Reeves, Peel Regional Police/Life Fit Associates
• Betty Schepens, Municipality of Chatham-Kent*
• Kelly Skinner, University of Waterloo
• Corinne Smith, Regional Niagara Public Health Department
• Colleen Sweeney, Tri-Fit
• Yvonne VanLankveld, TRW Automotive Health Services*

The Workplace Project Advisory Committee:

• Donna Fraleigh, Chatham-Kent Public Health Department
• Norma Gibson-MacDonald, Canadian Centre for Occupational Health
and Safety
• Richard Hesch, Brant County Health Unit
• Cathy Howard, Kingston, Frontenac and Lennox and Addington Health
Unit
• Raymond Langlois, Peel Health
• Marie Laframboise, Sudbury & District Health Unit
• Frank Mabrucco, Workplace Safety and Insurance Board of Ontario
• Brenda Marshall, Simcoe Muskoka Health Unit
• Geri McKeown, Wellness Matters
• Melissa Warner, Centre for Families, Work, and Well-Being

ii Comprehensive Workplace Health Promotion

Other contributors:
• Stephen Kingston, MediaDoc – design and production (hardcopy and
online)
• Tricia Wilkerson – glossary researcher and writer
• Stephanie Lawrence, The Alder Group – copy editor
• Ontario Ministry of Health and Long-Term Care, Chronic Disease
Prevention and Health Promotion Branch – funder

Disclaimer
The Health Communication Unit and its resources and services are funded by Health
Promotion and Wellness, Public Health Branch, Ontario Ministry of Health and Long-
Term Care. The opinions and conclusions expressed in this paper are those of the
author(s) and no official endorsement by the funder is intended or should be inferred.

Version 1.02 March 6, 2006

Recommended and Promising Practices For Situational Assessment Tools iii

 Table of Contents
Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
Table of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Table of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
1. Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
3. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3.1 The Purpose of the Resource . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3.2 The Rationale for Developing this Catalogue . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3.3 Intended Users of the Resource . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

4. What’s Inside?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

PART I
5. Concepts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
5.1 Comprehensive Workplace Health Promotion (CWHP) . . . . . . . . . . . . . . . . . . . . 9
Aspects of the Comprehensive Workplace Health Promotion Triangle . . . . . . . . . 10
5.2 Situational Assessments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Situational Assessments in the Workplace . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Audience – Who Is Being Assessed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Types of Situational Assessment Tools. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
5.3 The Link to Best Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
The Need for Identifying Best Practice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
This Catalogue in Relation to Other Best Practice Resources . . . . . . . . . . . . . . . . 16
Variations in Terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Limitations of a Best Practice Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
How the Concept of Best Practice Worked for this Project . . . . . . . . . . . . . . . . . 17

6. Principles of Good Practice in CWHP Situational Assessments . . . . . . . 18

6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
6.2 Using the Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
6.3 The Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Designing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Implementing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Evaluating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

iv Comprehensive Workplace Health Promotion

7. Selecting a Situational Assessment Tool . . . . . . . . . . . . . . . . . . . . . . 20
7.1 Consideration #1: Identify the Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
7.2 Consideration #2: Know your Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
7.3 Consideration #3: Who Provides the Information? . . . . . . . . . . . . . . . . . . . . . . 21
7.4 Consideration #4: Level of Evidence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
7.5 Consideration #5: Adoption or Adaptation . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
7.6 Consideration #6: Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

PART II
8. Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
8.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
What Was Involved? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Who Was Involved?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
How Is the Process Described? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
8.2 Timeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
8.3 Process Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
The Review Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Establishing Criteria and Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Gathering Tools and Tool Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Web Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
8.4 The Review Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
8.5 Results of the Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

9. Future Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Endnotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Appendix A: Review Criteria for Situational Assessment Tools . . . . . . . . . . . . . . . . . . 52
Appendix B: Inclusion Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Appendix C: Guidelines for the Review Process . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Appendix D: Literature Search . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Appendix E: Web Application . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Appendix F: Web Instructions for Reviewing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Recommended and Promising Practices For Situational Assessment Tools v

 PART III
10. Tool Catalogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
10.1 Using this Catalogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
General Advice for Using the Catalogue . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Advice for Specific Situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
10.2 Icon Legend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
10.3 Summary of Characteristics of Recommended and Promising Tools . . . . . . . . . . . 72
10.4 Summary of Effective, Plausible and Practical Ratings of Recommended
and Promising Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Table of Figures
Figure 1: Workplace Health Promotion Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . 4
Figure 2: Conceptual Look . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Figure 3: CWHP Triangle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Figure 4: CWHP Planning Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Figure 5: What was Involved? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Figure 6: Visual Timeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Figure 7: Tool Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Figure 8: Decision Tree . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Table of Tables
Table 1: Characteristics of the Types of Situational Assessment Tools. . . . . . . . . . . . . . 15
Table 2: Summary of Characteristics of Recommended and Promising Tools . . . . . . . . . 72
Table 3: Effective, Plausible and Practical Ratings of Recommended and Promising Tools 80

vi Comprehensive Workplace Health Promotion

1. EXECUTIVE SUMMARY
The Health Communication Unit (THCU) at the Centre for Health Promotion, Univer-
sity of Toronto, has been supporting professionals working in the field of comprehensive
workplace health promotion since 1999. A number of sources identified the need to
collect recommended practices for undertaking situational assessments in a workplace,
as part of a planning and monitoring process. This resource provides the results of
a detailed review process in the form of 29 situational assessment tools, 21 of which
are recommended and 8 of which are promising. These tools fall into six types: needs
assessments, health risk appraisals, workplace audits, employee interest surveys, current
practice surveys, and organizational culture surveys.

The resource provides guidelines and principles related to situational assessment tools,
extensive implementation details on the 29 tools, and methodological information for
practitioners interested in conducting their own reviews. The information presented in
the resource is meant to increase the likelihood that practitioners will use effective situ-
ational assessment tools in their work.

Eighteen review panel members were recruited, trained and provided with a web-based
application to examine, in pairs, 35 situational assessment tools (3 – 5 tools each). The
resource provides details on the methodology used, as well as future recommendations
for the project.

2. BACKGROUND
THCU is one of 22 members of the Ontario Health Promotion Resource System, funded
by the Ontario Ministry of Health and Long-Term Care. Begun in 1993, it was developed
to provide training and support in health communication. In 1997/98, the mandate was
expanded to include health promotion planning, evaluation, and policy change. In 2000,
it was again expanded to include sustainability.

Comprehensive Workplace Health Promotion: Recommended and Promising Practices

for Situational Assessment Tools is one part of THCU’s larger Supporting Comprehen-
sive Workplace Health Promotion (CWHP) in Ontario Project that began in 2001. The
purpose of this project has been to contribute to, support and otherwise improve health
promotion activities that assist adults in Ontario’s workplaces in leading healthy lives,
through the provision of services and materials to intermediaries, or those who, in turn,
provide support to workplace health practitioners. The Ontario Ministry of Health and
Long-Term Care has supported this project since its inception, as part of the Ontario
Stroke Strategy.

Based on the recommendations of the Workplace Project Advisory Committee, THCU

elected to focus on the review of situational assessment tools in 2004/05.

Recommended and Promising Practices For Situational Assessment Tools 1

 3. INTRODUCTION
3.1 The Purpose of the Resource
The purpose of this resource is to:

• Provide guidelines and principles related to situational assessment tools.

• Provide a variety of situational assessment tools that have been deemed
recommended or promising by an expert review panel.
• Provide methodological information for practitioners interested in
conducting their own best practice reviews.
• Otherwise assist intermediaries in choosing situational assessment tools
for use in Ontario workplaces.

3.2 The Rationale for Developing this Resource

Situational assessment tools are often an integral part of the early process of health pro-
motion in the workplace. There are many types and multiple versions of tools available
in the field, but practitioners often do not have the time or skills to use them.

THCU designed this resource as a direct response to the significant need to increase the
number of workplace health promotion intermediaries who are aware of and use recom-
mended practices for undertaking situational assessments. This need was identified by:

• conference delegates at THCU’s Workplace Project Conference in June

2004
• regional networks representing most of the public health agencies in
Ontario
• THCU Workplace Project Advisory Committee.

Steps Leading up to the Situational Assessment Project

THCU’s CWHP project has developed a number of resources (these are available for review and down-
loading on our project web site at www.thcu.ca/workplace)
• Workplace Virtual Community (current)
• Evaluating Comprehensive Workplace Health Promotion Info-pack (2005)
• Introduction to Comprehensive Workplace Health Promotion Info-pack (2004)
• Influencing the Organizational Environment to Create Healthy Workplaces Info-pack (2004)
• Workplace Health Promotion Resources Database (2004)
• The Case for Comprehensive Workplace Health Promotion: Making “Cents” of a Good Idea (2003)
• Well Regarded Initiatives for Workplace Health Promotion (2003)
• Conditions for Successful Workplace Health Promotion Initiatives (2003)
• Healthy Workplaces: Tips and Tools for a Comprehensive Approach (2003)

2 Comprehensive Workplace Health Promotion

3.3 Intended Users of the Resource
Although workplace health promotion intermediaries in Ontario are the primary users
of this resource, other workplace health promotion stakeholders may also find this
resource helpful in assisting them with either:

• selecting and implementing a situational assessment tool in an Ontario

workplace
• replicating and adapting the best practice process and methodology
used to generate the tools.

These stakeholders may include:

• workplace health practitioners

• occupational health nurses
• workplace wellness committees
• workplace wellness coordinators
• human resource managers
• union representatives.

This resource is intended for Ontario practitioners, but other practitioners in North
America and internationally may also find it useful.

What is an
Intermediary?
Intermediaries are those who provide (or have the potential to provide) direction and support to people
in workplaces around employee workplace health promotion. Intermediaries may include those in
public health departments, municipal governments, unions, human resource associations, private sector
organizations (for profit), employer organizations, organizations that provide health and/or safety ser-
vices to workplaces, and non-governmental organizations such as community health centres.1

Recommended and Promising Practices For Situational Assessment Tools 3

 4
Figure 1: Workplace Health Promotion Stakeholders

8PSLQMBDF
)FBMUI
1SPNPUJPO
4UBLFIPMEFST

'FEFSBMQSPWJODJBM
8PSLQMBDF
IFBMUI
0OUBSJP
)FBMUI
&EVDBUJPO
BOEPS
0UIFS
TVQQPSUJOH

4VQQPSUJOH HPWFSONFOU
QSPNPUJPO
1SPNPUJPO
3FTPVSDF
HSPVQT
0SHBOJ[BUJPOT USBJOJOH
QSPHSBNT %
EJWJTPOTTUSBUFHJFT SFTFBSDIFST 4ZTUFN PSHBOJ[BUJPOT

.VOJDJQBM
"TTPDJBUJPOT
PG

1VCMJD
IFBMUI)FBSU
$PNNVOJUZ
IFBMUI
HPWFSONFOU
3FHJPOBM
4USPLF
QSPGFTTJPOBMT
*OUFSNFEJBSJFT )FBMUI
$PBMJUJPOT /(0T DFOUSFT $FOUSFT QSPWJEJOH
IFBMUI
EFQBSUNFOUT
JOJUJBUJWFT BOEPS
TBGFUZ
TFSWJDFT


0SHBOJ[BUJPOT
$
6OJPOT
BOE
PUIFS
)VNBO
SFTPVSDF
0XOFSNBOBHFS
QSPWJEJOH
1SJWBUF
TFDUPS

PDDVQBUJPOBM
IFBMUI
PSHT
XIP
BEWPDBUF
QSPGFTTJPOBM
FNQMPZFS

GPS
UIF
IFBMUI
PG
DPOUSBDUPST
BOE
TBGFUZ BTTPDJBUJPOT
 BTTPDJBUJPOT

TVQQPSU
 NFNCFST

1SPGFTTJPOBMT
8PSLQMBDFT +PJOU
IFBMUI
BOE
QSPWJEJOH
IFBMUI 6OJPO
)VNBO
SFTPVSDF
0XOFSTNBOBHFST #
TBGFUZ
DPNNJUUFFT BOEPS
TBGFUZ
TFSWJDFT
SFQSFTFOUBUJWFT QSPGFTTJPOBMT FNQMPZFST
UP
FNQMPZFFT

&NQMPZFFT "

 4VQQPSUJOH
PSHBOJ[BUJPOT
QSJNBSJMZ
QSPWJEF
EJSFDUJPO
BOEPS
TVQQPSU
SFMBUFE
UP
XPSLQMBDF
IFBMUI
QSPNPUJPO

UP
JOUFSNFEJBSJFT
CVU
NBZ
BMTP
PDDBTJPOBMMZ
TVQQPSU
UIPTF

JO
UIF
XPSLQMBDF
PS
HFOFSBM
QVCMJD
 *OUFSNFEJBSJFT
QSJNBSJMZ
QSPWJEF
EJSFDUJPO
BOEPS
TVQQPSU
OPU
OFDFTTBSJMZ
IFBMUI
QSPNPUJPOSFMBUFE

UP
UIPTF
XJUIJO
UIF
XPSLQMBDF
XIP
NBLF
EFDJTJPOT
BCPVU
IFBMUI

QSPNPUJPO
BDUJWJUJFT
CVU
PO
PDDBTJPO
UIFZ
NBZ
BMTP
JOUFSBDU
EJSFDUMZ
XJUI
FNQMPZFFT
 8PSLQMBDFT
JODMVEF
BMM
UIPTF
XJUIJO
UIF
XPSLQMBDF
XIP
EFUFSNJOF
XIBU
JG
BOZ
IFBMUI
QSPNPUJPO
BDUJWJUJFTTFSWJDFT
BSF
QSPWJEFE
UP
FNQMPZFFT

 5IFTF
BTTPDJBUJPOT
QSPWJEF
OFUXPSLJOH
TUBOEBSET
DPOUJOVJOH
FEVDBUJPO
BOEPS
QSPGFTTJPOBM
BEWJDF
POMZ
GPS
UIFJS
NFNCFST
5IFTF
BDUJWJUJFT
NBZ
PS
NBZ
OPU
CF
SFMBUFE
UP

XPSLQMBDF
IFBMUI
QSPNPUJPO
 5IFTF
PSHBOJ[BUJPOT
QSPWJEF
BEWJDF
BOEPS
TFSWJDFT
UP
XPSLQMBDFT
JO
HFOFSBM
JF
OP
QBSUJDVMBS
UZQF
PG
QSPGFTTJPOBM

SFMBUJOH
UP
PDDVQBUJPOBM
IFBMUI
BOE
TBGFUZ

Comprehensive Workplace Health Promotion

4. WHAT’S INSIDE?
This resource has three parts:

• Part I offers a conceptual look at CWHP, situational assessment tools

and best practice, along with principles and guidelines for using situ-
ational assessment tools in Ontario.
• Part II explains the methodology used to determine the tools for the
catalogue, and discusses future recommendations.
• Part III contains information on how to use the catalogue and the actual
catalogue of 29 situational assessment tools, along with implementation
information related to each tool.

Part I – What’s Inside?

Concepts
This resource brings together three important aspects of health promotion – compre-
hensive workplace health promotion (CWHP), situational assessments and best practice.
It is important for practitioners to understand how these three concepts fit together to
form the basis of this resource. CWHP, situational assessments and best practice are
explained, respectively, in sections 5.1, 5.2, and 5.3.

Figure 2: Conceptual Look

3ITUATIONAL!SSESSMENTS

Recommended and Promising Practices For Situational Assessment Tools 5

 Principles of Good Practice
The principles of good practice for using situational assessment tools outlined in section
6 include key aspects to keep in mind when developing, planning, implementing and
evaluating situational assessment tools. Some of these were identified in the literature,
while others were generated by the expert review panel.

Selecting a Situational Assessment

The guidelines described in section 7 discuss six important considerations to keep in
mind when selecting a situational assessment.

Part II – What’s Inside?

The Methodology
The methodology offers a detailed look at the process (both theoretical and logistical)
that was followed in order to generate the catalogue.

Future Recommendations
These recommendations offer perspectives on the review process, situational assess-
ments, and how this resource should be used in the future.

Part III – What’s Inside?

The Catalogue
The catalogue identifies 29 situational assessment tools that have been identified as
“recommended” (21) or “promising” (8). The 29 tools in this package fall into one of six
categories: needs assessments, health risk appraisals, workplace environmental audits,
employee interest surveys, current practices, and organizational culture. The tools have
been summarized to provide the relevant information needed to select a situational
assessment tool.

Tool Comparisons
The catalogue summarizes information and ratings about each tool. A number of charts
present the tools collectively in two ways. Table 2 includes a summary of characteristics
of recommended and promising tools. This “cabin guide” illustrates each tool’s unique
and similar functions by using icons. Table 3 is a summary of the effective, plausible and
practical ratings of the recommended and promising tools. This “star chart” provides a
quick comparison of the tools reviewed.

Tool Summaries
For each tool listed in the catalogue there is a brief summary of its uses, the details of the
development process, and how it has been used. Icons provide helpful identifiers for the
characteristics of each tool. The summaries provide the information needed to decide
whether or not to use the tool, and implementation details that are relevant to potential
users.

6 Comprehensive Workplace Health Promotion

Selected Reviewer Comments
Each tool was reviewed by two expert reviewers. The 18-member review panel is
described in more detail in the methodology section in Part II. Comments from the
reviewers have been included with each tool, in the form of strengths, limitations and
general feedback. It should be noted that the type and length of comments for each tool
varies. This is not a reflection on the tool itself, but a difference in the reviewing style of
each panel member.

Actual Tools
In some cases, when the tool is in the public domain, and therefore not protected by
proprietary rights, the tool itself can be accessed through this catalogue using the online
Resource Listing. In other cases, the source of the tool must be contacted to gain access,
and this contact information has been provided. When a tool is accessed through the
catalogue and used or adapted, keep in mind that it is important to identify this and
acknowledge the source organization.

Supporting Documents
Some tool summaries provide further information about the tool in the form of support-
ing documents. These documents can be accessed using the online Resource Listing.
These documents include such things as PowerPoint presentations, sample final reports,
journal articles related to the tool, analysis documents, and other relevant materials. The
variation in what is available across the tools reflects what the source organization was
willing or able to share with THCU for this project.

Recommended and Promising Practices For Situational Assessment Tools 7

8 Comprehensive Workplace Health Promotion
Part I
5. CONCEPTS
5.1 Comprehensive Workplace Health Promotion (CWHP)
There are three dimensions of comprehensive workplace health promotion (CWHP):

• lifestyle practices (also called voluntary health practices)

• organizational culture (also called organizational change)
• occupational health and safety.

The terminology, as well as the importance that various organizations and workplaces
place on each of the three dimensions, may vary between workplaces. For instance, in
recent years, organizational culture is being recognized as an increasingly important
piece of the workplace wellness puzzle. This understanding is reflected in many of the
situational assessments presented in this resource.

Figure 3: CWHP Triangle

/CCUPATIONAL 6OLUNTARY(EALTH
(EALTHAND3AFETY 0RACTICES

7ORKPLACE

/RGANIZATIONAL
#HANGE

Recommended and Promising Practices For Situational Assessment Tools 9

 Aspects of the Comprehensive Workplace Health Promotion Triangle
• Occupational health and safety – reducing work-related injury, illness,
and disability by addressing environmental issues in the workplace, such
as ergonomics, chemical hazards, and air quality.
• Lifestyle practices (voluntary health practices) – reducing the risk
or incidence of worker illness by addressing individuals’ lifestyle
behaviours through awareness raising, education, supportive environ-
ments, and policy. The terms “voluntary health practice,” “individual
lifestyle practice,” and “healthy lifestyles” are often used interchange-
ably for this factor.
• Organizational change (organizational culture) – improving job
satisfaction and productivity by changing worker attitudes and percep-
tions, management practices, and the way work is organized. These
factors have been shown to have a dramatic impact on employee health
outcomes.2 These factors are also referred to as psychosocial factors or
as part of the psychosocial work environment. 3

More details on CWHP can be found in THCU’s Introduction to Comprehensive Work-

place Health Promotion Info-pack.

5.2 Situational Assessments

It is important in any planning process to:

• understand the current situation from a number of perspectives

• analyze this information
• plan accordingly.

Conducting a situational assessment is part of that plan. As outlined in THCU’s Intro-

duction to Health Promotion Planning workbook:

“A situational assessment influences planning in significant ways – by exam-

ining the legal and political environment, the stakeholders, the health needs of
the population, the literature and previous evaluations, and the overall vision
for the project. The phrase “situational assessment” is intentional – this termi-
nology is used as a way to avoid the common pitfall of only looking at problems
and difficulties and a way to consider the strengths and assets of individuals
and communities. In a health promotion context, this also means looking at
socioenvironmental conditions and broader determinants of health.

This critical and often time-consuming part of getting started on the plan
for your health promotion project involves various forms of data gathering. In
this part of the planning process, we use data to provide answers to a number of
questions we are concerned about. And in doing so, we need to determine the
best ways to find out the answers.”

10 Comprehensive Workplace Health Promotion

 Approaches to Consider When
Conducting a Situational
Assessment

1. Gather the perspectives of key 5. Assess vision and mission statements

stakeholders In addition to examining existing mandates, it is
• Identify individuals and organizations with an also important to look at the following:
interest in this type of project or area of con- • the vision of others involved in the planning
cern. process
• Describe the views of stakeholders around • the vision of your organization
the intended project (who supports it, who is
opposed, and who has clear ideas for it?) • desired directions by managers, politicians,
community leaders
2. Examine the literature and previous • relevant strategic plans.
experience
Specifically, consider the following: 6. Complete a PEEST analysis
• Identify what your own or others’ previous Identify the factors that could potentially affect
experience has revealed. your project:
• Examine the literature for research about proj- • political
ects, communities, and issues related to your • economic
priority issue.
• environmental
• Examine previous evaluation findings of similar
projects. • social

• Review the literature regarding similar types of • technological.

projects and recommendations for designs. Demographic and legal factors might also be
considered here.
3. Collect health-related data about the
priority issue 7. Identify information gaps
Consider collecting the following: Examine all of the information. Are there any gaps,
• demographic data particularly related to an issue addressed by the
project? Identify where additional information can
• morbidity and mortality rates be obtained.4
• health behaviour and practices (if available)
• health status data (including social, economic,
and environmental indicators)

4. Review existing mandates

As part of any situational assessment, it is both
necessary and important to review existing man-
dates, to ensure that the proposed project fits well
with these. Specifically, consider reviewing:
• the mandate of your own organization
• other legislation and regulations
• policies and guidelines
• professional standards and ethical guidelines
• political agendas
• mandates of potential partners and/or
competitors
• budgets for implementation.

Recommended and Promising Practices For Situational Assessment Tools 11

 Situational Assessments in the Workplace
Planning in the workplace is similar to planning in other health promotion settings, such
as schools and communities. Implementing a situational assessment is the third step in
the Comprehensive Workplace Health Promotion Planning Framework (as outlined in
Figure 4.) More information about this framework can be found in THCU’s Introduction
to Comprehensive Workplace Health Promotion Info-pack. This element is a vital part
of most workplace wellness initiatives.

In most cases it is necessary to carry out two other preliminary steps before undertaking
a situational assessment:

1. Create and work with an internal workplace wellness committee that

includes representation from as many areas of the organization as pos-
sible.
2. Secure support from management to proceed with a situational assess-
ment, ideally with some commitment to consider the results and take
related action.

Situational assessments can focus on any aspect of the workplace that affects health,
including on the employees themselves. Consequently, situational assessment tools
relate well to the three aspects of CWHP, and this is reflected in the tool characteristics
listed in the catalogue.

Audience – Who Is Being Assessed?

Basically, there are two audiences involved when conducting a situational assessment in
a workplace:

1. All employees (including management) are assessed to get a thorough

and broad understanding of the overall population.
2. An employer or a committee provides information to get an under-
standing of the overall environmental or organizational aspects of the
workplace.

It is not unusual for a workplace to undertake both of these approaches.

12 Comprehensive Workplace Health Promotion

 Figure 4: CWHP Planning Framework

8P S L Q M B D F

1 S P H S B N

. B O B H F N F O U

&MFNFOU
 &MFNFOU
 &MFNFOU
 &MFNFOU
 &MFNFOU
 &MFNFOU
 &MFNFOU
 &MFNFOU


*OUFSOBM 0CUBJO &TUBCMJTI $POEVDU %FWFMPQ %FWFMPQ 0CUBJO *NQMFNFOU (FOFSBUF

1SPKFDU .BOBHFNFOU )FBMUIZ 4JUVBUJPOBM )FBMUIZ 1SPHSBN
 .BOBHFNFOU 1MBO &WBMVBUJPO
.BOBHFNFOU 4VQQPSU 8PSLQMBDF "TTFTTNFOU 8PSLQMBDF &WBMVBUJPO 4VQQPSU 3FQPSU
$PNNJUUFF 1MBO 1MBO
$PNQPOFOUT $PNQPOFOUT $PNQPOFOUT $PNQPOFOUT $PNQPOFOUT $PNQPOFOUT $PNQPOFOUT $PNQPOFOUT $PNQPOFOUT

1BSUJDJQBUJPO
#VTJOFTT
$BTF
4USBUFHJD

&OWJSPONFOUBM

7JTJPO
0CKFDUJWFT
1MBOT
$PNNVOJDB
,FZ
3FTVMU


5JNF 3FDSVJUNFOU 4DBO
.JTTJPO
1SPHSBNT
1SFTFOUBUJPO UJPO

"SFBT

.POFZ

3FTPVSDFT
5FSNT
PG

/FFET

3JTL

7BMVFT
"DUJWJUJFT
&WJEFODF .BSLFUJOH
*OEJDBUPST

%BUBHBUIFSJOH 3FGFSFODF "TTFTTNFOU

BXBSFOFTT
$BQBDJUZ

3FTVMUT

(PBMT

%FDJTJPONBLJOH
-FBEFSTIJQ
0SHBOJ[BUJPOBM
#VJMEJOH

4USBUFHJFT

FEVDBUJPO

*NQMJDBUJPOT
$IBOHF
4VSWFZ

TLJMM
CVJMEJOH
&WFOUT

,FZ
"VEJFODFT
3FDPNNFOEB

Recommended and Promising Practices For Situational Assessment Tools


TVQQPSUJWF
*OUFSQFSTPOBM
UJPOT

4VTUBOBCJMJUZ "DUJWJUJFT


FOWJSPONFOUT


QPMJDJFT
.POJUPSJOH

*OEJDBUPST
$POEVDU

&WBMVBUJPO

&WBMVBUJPO


QSPDFTT

.FUIPEPMPHZ

3FTPVSDFT

PVUDPNF


JNQBDU

5JNFMJOF


FDPOPNJD

3FTQPOTJCJMJUJFT

*NQMFNFOU


&WBMVBUJPO

13
 Types of Situational Assessment Tools
In this resource, six different types of situational assessment tools are identified. Each
type is distinct, but there are also many similarities across the six. The terminology for
types of situational assessment tools varies from workplace to workplace as well as geo-
graphically, e.g., in Europe, what this resource refers to as a “workplace audit” is known
as a “self-assessment”.

This resource does not represent an exhaustive listing of all types of tools. Tools that
focus on occupational health and safety were omitted because these are readily available
to professionals working in this area.

• Current practice survey – A type of situational assessment tool that collects individual responses
from employees about their current behaviours (e.g., how much they eat/sleep, current levels of phys-
ical activity). Employees self-report their behaviours. Current practice is often combined with other
types of situational assessment tools.
• Health risk assessment – A type of situational assessment tool that collects clinical measures of
health status (e.g., BMI, cholesterol, nutritional analysis, heart rate response to exercise). The assess-
ment of risk is based on clinical report/measures (i.e., it is not self-reported). In most cases, a health
risk assessment requires a professional to administer the assessment to all employees. The health risk
assessment usually results in individualized results and an aggregate report for the workplace.
• Interest survey – A type of situational assessment tool that collects the information from individual
employees about the types of programs and services they are interested in. An interest survey usually
results in an aggregate report for the workplace.
• Needs assessment – A type of situational assessment tool that collects the self-reported needs of
individual employees. Individual employees fill out a needs assessment and identify areas they would
like to focus on. A needs assessment asks for employee opinion and usually results in individualized
results and an aggregate report for the workplace.
• Organizational culture survey – A type of situational assessment tool that collects information from
employees or employers about the organizational working environment. Elements of the organiza-
tional environment include leadership style, management practices, the way in which work is orga-
nized, employee autonomy and control, and social support.
• Workplace audit – A type of situational assessment tool that provides a snapshot in time of what’s
happening in the workplace. The workplace audit collects information about what the workplace
offers employees (e.g., showers, flextime.) One or a small group of individuals from the workplace
provide the information for the workplace audit. The information collected from the workplace audit
could be specific to one or more aspects of comprehensive workplace health promotion (i.e., organi-
zational change, occupational health and safety, lifestyle practices.)

14 Comprehensive Workplace Health Promotion

Table 1: Characteristics of the Types of Situational Assessment Tools

Needs Assessment
Current Practices

Workplace Audit
Interest Survey

Organizational
Culture Survey
Assessment
Health Risk
Survey
Aspects of CWHP
Lifestyle Practice

Health and Safety

Organizational Culture

Who fills it out

Employees

Employer or Committee

What the tool might contain

Asks for employees’ opinions (e.g., how do you feel about your
workplace?)
Takes clinical measures of employees’ health status (e.g., BMI,
heart rate response)

Has a checklist of workplace policies (e.g., nutrition program)

Has questions on self-reported current health behaviours of

employees (e.g., how much do you sleep?)
Asks for employees’ interest in specific areas of self/workplace
improvement (e.g., do you want to eat better?)
Focuses on work-life balance, mental health and stress (e.g.,
how often do you feel anxiety?)
Gives options for wellness practices (e.g., would you like a
walking program?)

5.3 The Link to Best Practice

The Need for Identifying Best Practice
Increasingly, health promotion practitioners are challenged to select approaches that
have evidence of relevant impact and a high likelihood of success. To identify these
approaches many planners will undertake a review of the literature, both published
(often peer-reviewed) and unpublished. This process is not only time consuming, it is
also often duplicated across communities. Catalogues of best practice and systematic
reviews have become popular resources to find this information.

Recommended and Promising Practices For Situational Assessment Tools 15

 Practitioners are able to make better informed decisions when the tools they use have
been reviewed for quality and evidence base. Initiatives such as this catalogue of situ-
ational assessment tools, which provide this evidence base, are often referred to as “best
practices.” Hence, this resource and catalogue has been created.

This Catalogue in Relation to Other Best Practice Resources

Although there are best practice collections on specific topics (such as nutrition pro-
grams for the workplace), there does not appear to be any other Canadian resources that
address one of the major tasks of intermediaries in supporting CWHP – selecting and
implementing a situational assessment tool.

THCU intentionally chose an approach to identifying best practices that was consistent
with other approaches, especially in Ontario, specifically, the Program Training and
Consultation Centre (PTCC) and the Heart Health Resource Centre. For example, the
labels of “recommended” and “promising” in THCU’s review results are consistent with
those of PTCC’s.

Variations in Terms
Although best practice initiatives are needed and helpful, there are tremendous varia-
tions in what the term best practice means among those who identify and promote
them, as well as the practitioners considering using them. There are no widely accepted
cross-organizational standards or guidelines about:

• what constitutes a best practice

• how an intervention or process should be assessed to determine whether
or not it qualifies
• the terms that are used to indicate a best practice.

These terms include “gold standard,” “good,” “better,” “best,” “recommended,” “model,”
and “promising.”

The term originated in the medical/clinical setting where “best practice” was applied
to practice guidelines for medical procedures. In order to be assessed as “best,” there
are requirements for generally rigorous scientific testing protocols such as randomized
control trials (RCT). By design, these experiments occur in very clinical, controlled envi-
ronments and the results are often definitive “cause and effect” statements. However,
this methodology is less common and does not work as well in the ecological world of
health promotion where there are many more variables to consider.

The methodology section (Part II) of this resource provides more detail on the specifics
of THCU’s review process.

Limitations of a Best Practice Approach

Because of the ecological nature of health promotion, it is also difficult, if not impossible,
to assume that when an initiative has the desired effect in one setting, the same effect
will be seen in another setting, however similar (be it a school, a workplace, a home, or
a municipality.) Also, the process of delivering the best practice in another setting will
likely be altered, so it is difficult to ensure that the elements that made it “best” (often

16 Comprehensive Workplace Health Promotion

 referred to as the “integrity” of an initiative) are preserved. These limitations should be
taken into account when using recommended or promising tools in this catalogue, or
any other best practice.

For this catalogue, THCU conducted a substantial but not exhaustive search for potential
tools, so it would be misleading to suggest that all the “best” tools have been compiled.

How the Concept of Best Practice Worked for this Project

Each situational assessment tool in this catalogue has been reviewed for its value and
appropriateness to Ontario workplace health promotion intermediaries and practitio-
ners. Two expert reviewers considered each tool using criteria that assessed effective-
ness (validity and reliability testing), plausibility, and practicality for use in Ontario
workplaces (see Appendix A). Using the criteria, the reviewers identified each tool as
a recommended, promising or not recommended practice. These identifiers have the
following implications:

Recommended: The tool is recommended for use in Ontario workplaces. It is seen as

being plausible and practical for implementation and may or may not have been evalu-
ated (i.e., reliability and validity testing may or may not have taken place) in Ontario
workplaces.

Promising: The tool is identified as a promising practice for use in Ontario workplaces.
It has highly promising aspects of plausibility and practicality and may or may not have
been evaluated (i.e., reliability and validity testing may or may not have taken place).
Because of certain limitations of the tool, reviewers could not “recommend” it; however,
it is seen as a valuable tool to be included in the catalogue – a tool that has “promise.”

Not recommended: The tool is not recommended for use in Ontario workplaces. Due
to both general and specific limitations, the tool is not plausible, practical and may not
have been evaluated. Although the tool may have particular strengths, it was not seen as
appropriate for use in Ontario workplaces. Review panel members assessed and identi-
fied five tools as not recommended practices. Due to confidentiality issues, the results of
these five tools will not be shared.

It is important to note, however, why these five tools were not recommended. Each of the
five tools were not recommended for one or more of the following reasons:

• The tool had limited reference or relevance to CWHP.

• The tool had a limited focus.
• The tool was not easily accessible to Ontario workplaces.
• The survey structure was poor.
• The quality of the questions was poor.
• The analysis/reporting was poor.
• Ease of implementation was poor.

Many of the recommended and promising tools included in this catalogue have the
attributes of the principles of good practice, as outlined below.

Recommended and Promising Practices For Situational Assessment Tools 17

 6. PRINCIPLES OF GOOD PRACTICE IN CWHP
SITUATIONAL ASSESSMENTS
6.1 Introduction
The following principles have been generated by the review panel as part of the larger
review process. These principles reflect aspects that are important to take into account
when using any situational assessment tool in Ontario; they go beyond the type, rating
or characteristic of each individual tool. In addition to the ideas generated by the review
panel, some other principles have been added from relevant literature. In many cases,
the principles capture a “philosophy” of how to use a situational assessment tool.

6.2 Using the Principles

1. When a tool has not been part of this review, apply the principles to an
assessment process to determine whether or not to use it.
2. When a tool is being developed or adapted, use the principles to guide
the process in order to increase the likelihood of success.
3. When a tool is currently in use, review the principles and keep them
in mind to identify possible improvements in a situational assessment
process.

6.3 The Principles

It is recommended that the following principles be considered when designing, plan-
ning, implementing and/or evaluating situational assessment tools.

Designing
• Complement the situational assessment using other sources of data,
such as records of on-the-job accidents or injuries. When other sources
of data exist, researchers can decide whether those sources should be
used instead of a situational assessment or whether there is value in
collecting both sources in order to validate the report.5
• Prior to selecting the tool, provide training to the committee on CWHP
as needed.
• Even if the tool addresses only one of the three aspects of CWHP,
acknowledge all three at the outset.
• Ensure survey questions and instructions are clear and the question
format is consistent.
• State the literacy level of the tools.
• In large workplaces, ensure the analysis process for the results allow for
sophisticated cross tabulations.

18 Comprehensive Workplace Health Promotion

 Planning

• Secure the commitment of senior management within the workplace as

early as possible.
• The implementation process of a situational assessment should be
driven by a workplace committee.6 This committee should have rep-
resentation from all employee groups (e.g., in a complex organization
like a hospital, there should be nursing/physician/housekeeping/other
representation) and union buy-in, in relevant workplaces.
• Ensure appropriate policies and procedures are in place to deal with
sensitive issues.7
• When using surveys for the purposes of establishing a wellness
program, consult with legal counsel well versed in labour, privacy and
employment law.8
• Once the tool has been identified, decide on the report format and
audience (e.g., one report for all employees, an individual report for each
employee, one report for the committee, one report for management).
• To improve the response rate, tell employees about the survey at least
twice before it is distributed.9
• Ensure effective communication throughout the process. A commit-
ment to action based on the results should be made up front.
• Clearly outline the full process and purpose of the assessment process,
including what will happen before and after the survey. Follow-up after
the survey is critical – respondents need to know what happened to the
data and what will happen next.
Implementing
• Voluntary participation is essential for ethical use of health risk apprais-
als and for accuracy in self-reported data.10
• Tools should be easy to implement and still meet the intended objec-
tives. Cost and the necessary time for completion are aspects to con-
sider when selecting a tool. Employers should provide the required time.

Evaluating
• The assessment should be part of a systematic approach to health pro-
motion that is followed by implementation and evaluation.

In addition to the principles above, consult The Effectiveness of Workplace-based Health

Risk Appraisal in Improving Knowledge, Attitudes or Behaviours produced by the Effec-
tive Public Health Practice Project for implications specific to health risk assessments.

Recommended and Promising Practices For Situational Assessment Tools 19

Critical Success
Factors for CWHP 7. SELECTING A SITUATIONAL ASSESSMENT TOOL
1. Senior management
involvement Nine critical success factors when undertaking CWHP, are outlined in THCU’s Case for
2. Participatory plan- Comprehensive Workplace Health Promotion: Making Cents of a Good Idea. One factor
ning specifically relates to strategically selecting an appropriate situational assessment tool:
3. Primary focus on “Tailor the program to the special features of each workplace environment as there is
employees’ needs
a need to respond to the unique needs of each workplace’s procedure, organization and
4. Optimal use of on-
site resources culture.” It is important to keep in mind that because different workplaces have different
5. Integration cultures, their experiences with the same situational assessment tool will also differ. For
6. Recognition that a instance, if a large workplace is planning to conduct a nation-wide situational assess-
person’s health is ment of its company, each workplace location will most likely have different results.
determined by an
interdependent set
of factors The considerations presented below are to help workplaces select the best situational
7. Tailoring to the spe- assessment tool for their situations. In many cases, several tools may be used in a given
cial features of each setting, especially if a long-term, complex workplace health promotion program is being
workplace environ-
ment undertaken, or if very little work in this area has been done in the past.
8. Evaluation
9. Long-term commit- 7.1 Consideration #1: Identify the Purpose
ment.
For more information, It is critical to identify the purpose of the situational assessment before selecting the
refer to THCU’s Case for type of tool to use. Most commonly, a situational assessment tool would be used for one
Comprehensive Work-
place Health Promo- or more of the following:
tion: Making Cents of a
Good Idea
• As a method of engagement for employees so that they are active par-
ticipants in the planning of their own wellness programs.
• As a starting point for creating a healthier workplace.
HELPFUL HINT
• As part of something larger, such as a continuous
In the catalogue, refer to the following sections of
each tool summary for information related to the improvement strategy or a workplace strategic plan.
purpose:
• To collect baseline data to be compared with any
• description
changes that may occur following the implementation of
• type of tool selected initiatives.
• tool construction
• As one of many kinds of input to the planning and
implementation process of a workplace. Other inputs
could include a review of “best practices” and an environ-
mental scan for locally available services to workplaces.
• As a source of workplace-specific data to “make the case” with internal
decision-makers, such as a senior management team or a board of
directors. The data may also be included in a funding or sponsorship
proposal.

20 Comprehensive Workplace Health Promotion

7.2 Consideration #2: Know your Audience
As with any health promotion initiative, knowing your audience is a key success factor.
Different types of situational assessment tools will provide different types of information
about the employees and their workplace, and perhaps even
their home environments. Compile a list of what information HELPFUL HINT
is needed about the audience before selecting a particular tool.
In the catalogue, refer to the following sections of
For instance, it may be important to determine: each tool summary for information related to know-
ing your audience:
• demographic information • type of tool
• behavioural information (about specific health • tool construction
behaviours or in general)
• psychographic information (about attitudes, beliefs,
values).

In addition to information related to individual employees, it is also useful to understand

the workplace environment in which the audience exists. A workplace audit could be
done to determine that environment.

7.3 Consideration #3: Who Provides the Information?

Who is best to provide the information needed? Determine whether the respondents to
the tool should be:

• all employees in a workplace HELPFUL HINT

• one person or a committee with insight into the In the catalogue, refer to the following sections of
each tool summary for information on who should
practices of the workplace complete the tool:
• a sub-set of employees (such as representatives from • intended sectors/sizes of workplace
the union, support staff, various departments, man- • intended users
agement, etc.)

7.4 Consideration #4: Level of Evidence

What level of evidence is acceptable? There may be expectations in a workplace regard-
ing the thoroughness with which a situational assessment has been developed. These
expectations are usually found in the values or principles of a workplace program. If a
workplace requires that a thorough evaluation be completed (i.e., reliability and validity
measured), the tools labeled in this catalogue as “recommended” and identified as having
been evaluated will be the ones of most interest. However, if other forms of evaluation
are acceptable (e.g., process), then tools labeled as “promising” or tools with no evalua-
tion may suffice.
HELPFUL HINT
It is also important to understand that if a situational assess-
ment tool is to be adapted (e.g., the questions or methodology In the catalogue, refer to the following sections of
each tool summary for information related to the
changed), then the reliability and validity measures will likely level of evidence for the tool:
no longer apply, and the tool may not be considered as having
• effectiveness elements
had an evaluation completed.

Recommended and Promising Practices For Situational Assessment Tools 21

 7.5 Consideration #5: Adoption or Adaptation
Adoption or adaptation? Depending on the situation, a workplace may want to either
adopt or adapt a situational assessment tool from this catalogue. If adoption is preferred,
it may be a matter of looking through the catalogue and selecting
HELPFUL HINT which tool has the best “fit” for a particular workplace (taking
into account the purpose, audience, resources, etc.)
In the catalogue, refer to the following sections of
each tool summary for information related to
adopting or adapting a tool: If adaptation of an existing tool is required, then a review of
several tools may be necessary in order to identify the elements
• adapted from/built on
that could be integrated into a new tool. It should be noted that
• restrictions or conditions of access or use
most of the tools in the catalogue do not allow adaptation (most
• customization have proprietary and copyright issues.) If a tool is adapted, it is
important to acknowledge the original source. Also, similar to
the issues of reliability and validity outlined above, because each
tool in the catalogue has been reviewed as a whole, the virtues that made it “recom-
mended” or “promising” may no longer be intact if the tool is disassembled.

7.6 Consideration #6: Resources

What resources are available? Realistic and practical considerations will be important
factors in selecting the best situational assessment tool. These factors may include:

• the costs associated with the distribution, analysis and sharing of results
• whether or not the instrument can be completed electronically, online
or on paper
• how much time is required for employees to complete the assessment.

These resource considerations may depend on whether the situ-

HELPFUL HINT
ational assessment is conducted internally within a workplace or
In the catalogue, refer to the following sections of externally by contractors. Either way, the practical considerations
each tool summary for information related to the
resources needed to use a tool:
that work best for one workplace may not work well for another.
• practicality elements (process, economics, other With these six considerations in mind, proceed to the catalogue
considerations)
of practices to search for and select the tool(s) best suited to your
needs.

For more information on considerations for situational assessments, refer to:

• THCU’s Introduction to Health Promotion Program Planning workbook (specifically Step 3: Identifying Goals, Audiences and
Objectives) for more information on establishing goals and objectives.
• THCU’s Overview of Health Communication Campaign workbook (specifically Step 3: Get to Know Your Audience) for more infor-
mation on audiences.
• THCU’s Introduction to Evaluating Health Promotion Programs workbook and Evaluating Comprehensive Workplace Health Pro-
motion Info-pack for more information on evaluation.

22 Comprehensive Workplace Health Promotion

Part II
8. METHODOLOGY
8.1 Introduction
By presenting the methodology, users of these situational assessment tools should be
able to see the integrity of the process and thus, value the results. Other users may want
to use the review process in their own best practice work and would find the details
regarding the overall methodology useful.

What Was Involved?

There were four elements of work involved in preparing for the review:

1. coordinating the review panel

2. establishing criteria and materials
3. gathering tool information
4. developing the web application.

These four elements were required to implement the overall review process, which in
turn generated the results of the catalogue.

Figure 5: What was Involved?

%LEMENTS 





It should be noted that although these four elements are presented separately, in most
cases, these processes took place concurrently over approximately seven months.

Recommended and Promising Practices For Situational Assessment Tools 23

 Who was Involved? (See the Acknowledgments for a complete list of contributors)
• The Comprehensive Workplace Health Promotion Project Team – three
core team members implemented and coordinated the review of situ-
ational assessment tools, with consultation and support from other
team members.
• The Recommended Practices Review Panel – A team of 18 experts in
workplace health promotion, situational assessments, and best practice
reviewed the 35 situational assessment tools.
• Source organizations/companies – Over 30 organizations and compa-
nies provided permission and the information needed to include their
situational assessment tools in the review process (these will now be
referred to as “sources.”)
• Workplace Project Advisory Committee – Ten members provided guid-
ance and insight throughout the review process.

How Is the Process Described?

The methodology of this project is illustrated in two ways.

• The timeline (8.2) visually illustrates the major elements that occurred
during the seven-month project, to form a representation of the overall
process.
• The process description provides a detailed account of the elements
needed to conduct the review (elements 1 – 4.) An explanation of the
review process follows and then the results of the review are discussed.
The lessons learned noted throughout the methodology are practical
insights gained throughout the review process. They illustrate particular
problems or hurdles that the project team and review panel encoun-
tered. Finally, future recommendations are offered.

24 Comprehensive Workplace Health Promotion

8.2 Timeline
Figure 6: Visual Timeline

%FWFMPQ
8FC
"QQMJDBUJPO

5PPM
4VNNBSJFT
BOE
i3FWJFX
3FBEZw
"QQMZ
*ODMVTJPO
$SJUFSJB
BOE
(BUIFS
5PPM
*OGPSNBUJPO

5PPM
2

"
5FNQMBUF

Recommended and Promising Practices For Situational Assessment Tools 25

 8.3 Process Description
1. Review Panel
Review Panel Recruitment

The project team and the project advisory committee identified a list of potential review
panel members. Out of these potential members, a review panel of 18 members was
formed, and almost all members remained committed to the
Lessons Learned: Review Panel Recruitment process until the end.
The original timeline for the project identified most
of the work to take place between January and May. The review panel included a variety of experts, including:
This timeframe presented an obstacle to many aca-
demics and prevented them from participating. • academics
• health promotion practitioners in public health and
workplaces
• workplace health consultants who have developed tools
• experts in best practice
• workplace representatives.

Nine partnerships were created. These teams worked together throughout most of the
review process. In only three circumstances were the pairings altered – these were due
to time constraints and the need to complete three reviews before the deadline.

Confidentiality and Non-Disclosure

Each review panel member signed a confidentiality agreement, which guaranteed that
the information provided as part of the review process would be treated as confidential
and therefore not shared in any way or used for any other purpose. This was particularly
important because of the propriety nature of some of the tools and in some cases, guar-
anteeing confidentiality was fundamental to gaining access to particular tools.

Non-disclosure agreements were also signed at the request of some of the source orga-
nizations that had particular propriety concerns. These agreements outlined that THCU
would only use the source’s situational assessment information
Lessons Learned: Confidentiality and Non-Dis- for the purposes of the review.
closure
Signing confidentiality and non-disclosure agree-
ments was fundamental to gaining access to some
tools. Several lessons were learned around the
process involved in conducting a recommended
practices review within a university setting. Non-
disclosure agreements had to be approved by the
Research Services Department at the University of
Toronto, which added time to the project.

26 Comprehensive Workplace Health Promotion

 Conflict of Interest and Proprietary Information

Roughly half of the review panel members were developers of situational assessment
tools and/or members of private companies that implemented situational assessments.
This raised a number of issues around safeguarding the source’s propriety information
from a potential competitor. There was also potential conflict of interest for some review
panel members who could have been reviewing their own tools.

Although all review panel members signed confidentiality agreements, extra steps were
taken to maintain the integrity of the review process. These issues were dealt with in the
following ways:

• Review panel members who were tool developers working for private
companies that implement tools were not assigned proprietary tools to
review. They were instead assigned “public domain” tools (from sources
such as Ontario public health agencies and Health Canada). Only those
working in the public domain reviewed proprietary tools.
• If a review panel member was also the source of a tool to be reviewed,
he/she was not assigned that tool to review.

Tele-web Meetings

One of the instruments used throughout the review process to facilitate the review panel
was the tele-web meeting function from Bell Conferencing. This function allowed the
review panel members to connect with one another by phone and Internet at the same
time. The tele-web meetings were invaluable to the process because they allowed the
review panel members across the province to meet together online and provide input to
project materials, review protocol and perform the actual reviews.

A number of specific functions of the tele-web meeting were particularly effective at the
review panel meetings. These included:

• An online function, which allows the “moderator” (the facilitator of the

tele-web session) to walk “participants” (review panel members) through
different web pages online. This allowed the reviewers to see exactly
what the review tool they would be using looked like.
• A polling function, which allows participants to vote on yes/no and
multiple choice questions anonymously. This was particularly helpful
during the “practice review,” when the review panel reviewed a tool
as a group. The facilitator could identify any discrepancies in how the
reviewers were judging each criterion and conduct a discussion accord-
ingly.

Recommended and Promising Practices For Situational Assessment Tools 27

 The web conferencing function was extremely valuable to the review process. The facili-
tation and anonymous polling functions were especially useful for reaching consensus
and making decisions. Tele-web conferencing was used more than ten times throughout
the process. Overall, all the tele-web conferences were well received, with collaborative
input from all reviewers.

Five review panel meetings were held throughout the seven-month process. An average
of 14 members attended each meeting. Members who were not able to attend a meeting
were addressed individually afterwards.

2. Establishing Criteria and Materials

Establishing Review Criteria

Review criteria (see Appendix A) were established by the project team, adapted from
the best practices assessment criteria used by the Heart Health Resource Centre and
the Program Training and Consultation Centre for assessing program interventions.
Foreseeing that many of the tools collected would not have
Lessons Learned: Review Criteria undergone formal evaluation, most of the review focused on
assessing suitability and feasibility. The criteria focused on the
Multiple meetings were needed to establish, revise,
and clarify the review criteria. The reviewers each same three categories used in the previously mentioned reviews:
had many different perspectives and this was quite effectiveness (measuring reliability and validity), plausibility, and
valuable in creating discussion and consensus for practicality.
each criterion. The amount of time required and the
number of revisions necessary was not originally
anticipated; this should be taken into account in
future review processes.

Establishing Inclusion Criteria

The inclusion criteria (see Appendix B) were established to determine each tool’s
appropriateness for review. All of these criteria needed to be met before a tool could be
considered for the more in-depth review. The criteria were initially drafted by the project
team, and incorporated the “must have” characteristics for a tool to be included in the
review process. Review panel members suggested changes. For example, the review panel
decided to discard the requirement that a situational assessment tool must be available
electronically. Some review panel members argued that for some workplaces, paper
copies were preferable, and that tools should not be discarded based on that element of
accessibility alone.

Although the three criteria headings remained intact, the specific criteria under each
heading were significantly altered to reflect situational assessment tools.

Particular criteria were included or discarded to fit with what review panel members felt
were important elements of a strong situational assessment tool. Extensive changes were
also made to the wording, meaning and nuances of particular criteria. These changes
ensured that review panel members understood and were interpreting the review crite-
ria clearly and consistently.

28 Comprehensive Workplace Health Promotion

 Establishing Review Protocol

The review panel established the protocol for the review process and the project team
developed the formal guidelines for the review (see Appendix C), which were then posted
online. The project team developed a decision tree (Figure 8) for the review panel. This
decision tree marked the path that tools would take as they went through the review
process, tracking the results for each section and ultimately leading to the final rating
for each tool.
The Review Criteria (Appendix A)
3. Gathering Tools and Tool Information
The review criteria are comprised of 29 criteria
Tool Searches under three main headings: effectiveness, plausibil-
ity and practicality.
Situational assessment tools were identified through three • Effectiveness is comprised of one criterion
primary avenues: (whether or not validity and reliability has been
measured.)
1. literature search • Plausibility is comprised of nine criteria, under
the headings: evaluation attributes and content
2. Internet search attributes.
3. nominations from the field. • Practicality is comprised of nineteen criteria,
under the headings: process attributes, longevity,
availability and fit.
1. Literature search
The rating options for each criterion are either
“good”, “fair”, “poor”, “info not available”; or in some
A research consultant for THCU conducted an initial litera- cases, “yes” or “no” (e.g., is the tool available online?)
ture search to identify workplace situational assessment tools.
To read more about the methods used in the literature search,
see Appendix D.

2. Internet search

The project team conducted an additional Internet search, using search terms such as
“situational assessment,” “needs assessment,” “health risk appraisal,” and “workplace
audit.”

Recommended and Promising Practices For Situational Assessment Tools 29

 3. Nominations from the field

Nominations from the field came from a number of sources, including:

• Recommended Practices Review Panel

• Comprehensive Workplace Health Promotion Project Team
• Workplace Project Advisory Committee
• CLICK4HP list serv
• Ontario public health regional networks.

The search results were vetted and organized to create a search list of over 125 possible
leads to situational assessment tools.

The results of the tool searches provided a helpful starting point from which to gather
situational assessments for the review. However, many of the results from the literature
search led to dead ends, (e.g., sample assessments in “how-to” workplace health books, or
articles about situational assessments but not the assessments themselves.)

New tools were found through leads and on-going nominations, even as other parts of
the review preparation continued.

Applying the Inclusion Criteria Filter

Many of the 125 search leads were discarded (using the inclusion criteria) for various
reasons, including:

• insufficient contact information regarding the source to access the

information
• time constraints at the source organizations to provide even the
minimal information necessary.
Seventy-six tool leads were discarded at first glance. From the remaining list, 49 were
actively pursued. Twelve tools were discarded upon further examination. Two tools were
designated to review at a later date because of lack of time to review them. Of the origi-
nal 125 tools identified, 35 tools were reviewed. See the tool map (Figure 7) for a visual
representation of this sequence.

30 Comprehensive Workplace Health Promotion

 Figure 7: Tool Map

"MM
5PPMT
$POTJEFSFE
GPS
UIF
3FWJFX


%JTDBSEFE
*OJUJBMMZ (BUIFSJOH
5PPM
*OGPSNBUJPO
 

%JTDBSEFE
VQPO
&YBNJOBUJPO 5P
CF
3FWJFXFE
-BUFS *ODMVEFE
JO
3FWJFX

  

/PU
3FDPNNFOEFE 1SPNJTJOH 3FDPNNFOEFE

Recommended and Promising Practices For Situational Assessment Tools

  


6OQVCMJTIFE 
1VCMJTIFE 
1VCMJTIFE

1SPNJTJOH
5PPM 1SPNJTJOH
5PPMT 3FDPNNFOEFE
5PPMT

31
 Gathering Tool Information

A number of tasks were concurrently completed in order to prepare each situational

assessment tool for the review. These tasks included:

• Confirming the source’s involvement in the review and attaining direct

access for each tool, using a customized letter for each source.
• Gathering additional information and supporting documents about
each tool as per the Q&A template (explained below.)
• Signing the appropriate non-disclosure agreements with various
organizations/companies in order to include their tool in the review was
necessary in some cases.
• Conducting phone interviews with a source representative or in some
cases relying on web/hardcopy information (if a contact person was not
available).

Q&A Template

Once a tool passed through the inclusion criteria, the project team contacted the tool
source for more detailed information about the tool. To facilitate the gathering of this
information, the project team created a Q&A template document. The structure of this
template mirrored the review criteria as much as possible, by providing the review panel
members with the appropriate information needed to review each situational assess-
ment tool.

The Q&A template document went through a number of revisions based on input from
the review panel during the practice review. As the template was revised, the project
team had to go back to the sources for additional information, which required more
time.

Tool Summaries

Once a source had committed to the review, a tool summary was developed for each
tool by gathering enough additional information and supporting documents from the
source (via the Q&A template). The supporting documents (which included letters of
communication, sample reports, cost charts, and PowerPoint presentations) provided
by the sources varied greatly across the tools – some provided between 5 and 10 docu-
ments, and others provided none. Thus, it is important to note that although extensive
efforts were made to ensure that the summaries and supporting documents provided the
same type of information between tools, this was not always possible.

Variations between each tool’s summaries and supporting documents were often due to
the following:

• Propriety concerns – Some sources were hesitant to share some aspects

of their product.

32 Comprehensive Workplace Health Promotion

 • Customization issues – Some sources found it difficult to provide the
appropriate answers to various questions in the Q&A template. Sources
explained that this was because each tool was customized to a particu-
lar workplace, and therefore the answers varied greatly depending on
the workplace site using the tool. As a solution, sources were asked to
provide answers based on what was “typical.”
• Difficulty in finding “old” information – In a few cases where tools had
been created over 10 years ago, but since revised, sources were not able
to locate the original information or documentation (e.g., evaluation
results.)
• Lack of time and motivation on the part of the source to collect the
appropriate documentation.

All of these situations translated into “information not available” to the review panel.
During the information collection process, on the rare occasion that a tool summary
had too many “information not available” fields, the project team discarded the tool
because it didn’t meet the inclusion criteria (i.e., there was not sufficient information
available for the review).

“Review Ready”

The project team ensured that each tool was “review ready”
Lessons Learned: Tool Summaries
before it was assigned for review and distributed with the tool
Building the summaries for each situational assess-
summary and any supporting documents. Preparing each tool
ment tool was the most labour intensive part of pre-
to be “review ready” consisted of: paring each tool for the review. There were several
factors for this, including:•
• Ensuring tool summary information was as complete
• The nature of the questions asked – almost all
as possible. were in-depth questions requiring detailed infor-
mation regarding issues such as testing, imple-
• Making each tool summary as clear and easy to read
mentation, analysis, etc.)•
as possible.
• The length of the Q&A document – it took a long
• Collecting all supporting documents for that tool. time for companies to complete.
• The lack of time sources were able to spend
answering the questions – in some cases, mul-
tiple people from a company/organization had to
contribute to the Q&A document, which meant
weeks before it was completed.
• Coordinating times to connect with individuals
from each source was often difficult and time-
consuming – follow-up interviews via phone with
each company/organization to clarify answers to
some questions were almost always necessary.
In the future, the tool summary template should
be finalized and most importantly, tested, before
collecting all the information from companies/orga-
nizations.

Recommended and Promising Practices For Situational Assessment Tools 33

 4. Web Application
Development of the Web Application

At the outset of the project, the project team suggested a web application as a method of
managing the large amount of information collected for the review process.

The web application has three parts, each of which is described in Appendix E:

1. Online database – an information management system that holds all the

tool information and supporting documents. This is a system organized
primarily by tools. It formed the base for the “external” system database
that now holds the 29 recommended and promising tools.
2. Online review system – the system used by the review panel to assess
each tool assigned to them online.
3. Administrative management – allowed the project team to assign tools,
input information, monitor progress of reviews, and create reports.

Review Panel Input and Feedback to the Web Application

Web orientations were set up to explain the web application and explicitly outline
the review instructions. At these web orientations reviewers were able to individually
practice using the web application with immediate support from the project team. Each
orientation took approximately one hour.

Review panel input to the web application was an integral part of the development process.
This was a role that extended beyond the commitment of the panelists in reviewing tools
– that of helping to shape the system. This input occurred through tele-web meetings
and on-going questions that reviewers brought to the THCU
Lessons Learned: Web Application team. Subsequent revisions occurred throughout the review
As a whole, the web application was very well received process as review panel members became better acquainted
by all review panel members and there were only a few with the application or encountered occasional “bugs” within
instances where the system created significant errors. the system.
The project team found the web application to be a
time-saving and helpful way of organizing and manag-
ing information.
The development of the web application would have
been easier if all materials were finalized before devel-
opment of the system began. Due to time constraints,
however, these processes overlapped, and therefore
caused more revisions than would have otherwise been
necessary.

34 Comprehensive Workplace Health Promotion

8.4 The Review Process
Practice Review

The review panel engaged in a group practice review to ensure that all reviewers were
assessing the tools with clarity and consistency. A sample tool from a public health unit
in Ontario was used for the practice review. This particular tool was chosen because:

• It was in the public domain, resulting in no conflict of interest with any

review panel members.
• More information had been collected about this tool than any others.

The project team distributed the tool, as well as a draft tool summary to reviewers ahead
of time. During two tele-web meetings, the review panel assessed the tool as a group,
using the draft review criteria and the draft tool summary.

Tool Assignments and Reviewer Partnerships

Tools were assigned to particular reviewer partnerships with several factors in mind:
propriety concerns, conflict of interest, length of tool and tool information, scheduling
issues, and the types of tools reviewers had reviewed in the past. In all cases, the project
team attempted to be consistent, fair, and unbiased in their tool assignments.

Review panel members were informed of their tool assignment via email and an
announcement was posted on their web application homepage, which outlined any spe-
cific information needed for the review.

Review, Agree, Finalize, Submit

All information needed for the review was housed in the web application (except in some
particular cases where only hardcopies were available; if this was the case, hardcopies
were couriered to the reviewers) and all reviews were completed online. Reminder
announcements were posted in advance of the submission
dates to prompt review partnerships to finalize and submit Lessons Learned: Review, Agree, Finalize,
their reviews. The review panel members followed the guide- Submit
lines for review (see Appendix C) and the instructions for The average length of time to review each tool took
review (see Appendix F) posted in the web application. longer than anticipated. Some of the challenges
that review panelists encountered were:
Each review partnership was given a two week timeline for • scheduling conflicts
each tool review in which each was to: • minor technical difficulties with the web applica-
tion
• Read the relevant information for the review.
• amount of information required to review.
• Assess the tool individually without their partners.
• Connect with their partners to discuss their review,
either electronically or via phone.
• Come to an agreement for the overall review of the tool.
• Submit the final review.

Recommended and Promising Practices For Situational Assessment Tools 35

 While the review panel partnerships did not have to agree on each individual criterion,
they had to agree on the overall review of the tool (as recommended, promising, or not
recommended), as well as the “on the record” comments for each criterion. If the review
partnership did not agree on the overall review, an impartial third party would have
been brought in to review the tool and break the tie. The third party reviewer would have
been a member of the project team, experienced in workplace health promotion and best
practice; however, a third party was never needed.

Each review panel member reviewed at least three, and up to a maximum of five tools
over a three-month period.

Check-In

About midway through the review process tele-web meetings were scheduled to allow
the project team and review panel members to check-in with each other. The project
team provided an update of overall work completed. Helpful hints regarding the review
process, logistics between partners, and web application solutions were shared between
all review panel members.

Final Decisions

When all the reviews were completed,

the project team prepared the results Lessons Learned: Final Decisions
of the review process. This included: The decision tree (Figure 8) was useful in ensur-
ing that the assessment results of effectiveness,
• Summarizing the results of plausibility and practicality corresponded with the
resulting final label (recommended, promising or
the 35 completed reviews. not recommended.)
• Identifying review trends. The final face-to-face meeting with the review panel
was invaluable in establishing consistency and
• Flagging “problematic” consensus about the review process and the review
reviews. of each tool.

The Decision Tree – (Figure 8)

Figure 8 illustrates all 18 possible combinations of Effectiveness, Plausibility and Practicality. In each case, the overall rating predicted
by the decision tree is indicated. For example, the three routes to recommended are as follows:
1. If a tool is rated “yes” for effectiveness, “good” for plausibility, and “good” for practicality, the review path moves along the far left
side of the decision tree and is recommended.
2. If a tool is rated “yes” for effectiveness, “fair” for plausibility, and “good” for practicality, the review path moves along the middle-
left side of the decision tree and is rated recommended.
3. If a tool is rated “no” for effectiveness, “good” for plausibility, and “good” for practicality, the review path moves along the middle-
right side of the decision tree and is rated recommended.
In addition to predicting specific ratings, the decision tree reveals the underlying logic of best practice ratings. For instance, one can
note that if a tool is rated “poor” for practicality, it is always not recommended.

36 Comprehensive Workplace Health Promotion

 Figure 8: Decision Tree

������������������������������

������������
���� ���� ���� ���� ���� ����
������

������������
� � � � � � � � � � � � � � � � � �
������

Recommended and Promising Practices For Situational Assessment Tools

� �� �� � �� �� �� �� �� �������������� � �� �� �� �� �� �� �� ��

�������� ���������������
�������� ��������������
�������� ��������������������

37
 Problematic Reviews

Seven “problematic” reviews were identified as requiring further discussion at the final
review panel meeting. The decision tree (Figure 8) was used to help identify problematic
reviews. The review was considered problematic if the overall rating predicted by the
decision tree on the basis of the three major criteria headings (effectiveness, plausibility,
practicality) did not align with the overall rating agreed upon by the reviewers. Many
of these discrepancies seemed to stem from a difference of opinion reviewers had in
weighing some criteria.

The problematic reviews were discussed at the final meeting under categories, which
included, but were not limited to:

Issues of cost – Some review panel members felt that a high cost situational assessment
tool inhibited access. Others felt that a high cost tool might ensure quality. The review
panel decided that cost alone not determine a tool as recommended, promising, or not
recommended.

Lack of comprehensive approach (all three components of

Evaluation CWHP, see Figure 3) – Although a comprehensive approach was
Review panel members were also asked for their outlined for specific criterion, a lack of a comprehensive approach
feedback on the overall process at the final meeting. alone could not determine a tool as recommended, promising, or
Informal discussion of the process occurred, which not recommended.
generated positive feedback, citing interesting
learning opportunities, networking, and a well orga- Lack of evaluation – The review panel decided at the onset of the
nized process as some of the highlights of the proj-
ect. After the meeting, the project team posted an project that lack of an extensive evaluation alone could not deter-
evaluation form on the web application and panel mine a tool as recommended, promising, or not recommended.
members had the opportunity to give anonymous
feedback. The seven problematic reviews were discussed and consensus
A formal process evaluation of the project resulted reached regarding each tool. As a result of the review panel dis-
in extremely positive feedback and helpful insights. cussion, six tools were shifted from promising to recommended
and one tool was shifted from promising to not recommended.

8.5 Results of the Review

Thirty-five tools were reviewed and 29 of the 30 that were identified as recommended or
promising are included in this catalogue.

Recommended Tools

The 21 recommended tools represented in this catalogue were identified as such based
on positive ratings for practicality and plausibility. Overall features for the recommended
tools were:

• rating of “good” for majority of criteria

• two-thirds had gone through validity and reliability testing
• overall practicality was rated “good” by at least one reviewer
• the majority had “good” overall plausibility.

38 Comprehensive Workplace Health Promotion

 Promising Tools

The eight promising tools represented in this catalogue were

identified as such primarily based on fairly positive ratings See Table 8.5, a Summary of Effective, Plausible and
for practicality and plausibility. This meant that reviewers Practical Ratings of Recommended and Promising
Tools for a comparative look at the ratings of effec-
felt that the tool had promise, but could not be identified as tiveness, plausibility and practicality for the 29 tools
recommended, usually for one of several specific reasons. In in the catalogue.
most cases, a formal evaluation had not been completed for
the promising tools. Overall features for the promising tools
were:

• lack of comprehensive approach

Permission to Publish
• weak theoretical underpinnings
Thirty tools were rated as recommended or promis-
• limited scope ing; however, one source organization did not feel
comfortable giving THCU permission to publish its
• generic questions/intellectual accessibility promising tool.
• European context/language issues
• fair ease of implementation.

Not Recommended Tools

Five tools were identified as not recommended practices. Due to confidentiality issues,
the results of these five tools will not be shared, nor will the larger list of tools initially
found through the literature search and nomination process. However, the overall fea-
tures for the not recommended tools were:

• limited reference to CWHP

• not easily accessible to Ontario workplaces
• poor structure of survey
• poor quality of questions
• poor analysis/reporting
• limited/not well-rounded focus
• poor ease of implementation.

Recommended and Promising Practices For Situational Assessment Tools 39

 9. FUTURE RECOMMENDATIONS
These recommendations are grouped into the following three categories: review process,
situational assessments, and this resource.

Review Process
• In order to gather the relevant details for each tool included in the
review process, considerable “digging” and dialogue with the source was
necessary. Adequate time and human resources should be set aside for
this task.
• In the future, the tool summary template should be finalized and most
importantly, tested, before the information from sources is collected.
• In terms of establishing the review criteria, practicality issues seem
to be largely for the user to decide. As much information should be
provided around issues such as cost, access, or implementation details,
but these factors should not be reviewed and therefore should not deter-
mine the overall rating.
• Tele-web meetings were very effective in working through the adapta-
tion of the review process. This technology should be pursued for other
advisory group input processes.
• Having a diverse group of reviewers representing the perspectives of
public health, the private sector, academia and workplaces themselves
was beneficial. Each member brought unique values and insights to the
review process. A review panel is critical to the methodology.
• Training for the review panelists was critical. This step should not be
compromised in reviews of this nature.
• The review process appears to have worked well to identify the recom-
mended practices. Once adapted to reflect these recommendations, it
should be promoted to others for use elsewhere through a published
article(s) and/or field dissemination (e.g., OHPE, Click4HP.)

Situational Assessments
• The value of conducting a situational assessment as an important and
early step in the process of starting a workplace wellness program was
reinforced in this exercise. Furthermore, situational assessment tools
were identified as a sound means of regularly “checking-in” with the
workplace once a workplace initiative is in place. Efforts to support
workplace programs should include this element.
• The tools which were most highly valued were those that had been
developed with user input, tested for validity and reliability, and con-
textualized for Ontario. Practitioners developing or adapting situational
assessments should consider these elements in their approach.

40 Comprehensive Workplace Health Promotion

This Resource
• The catalogue of recommended and promising practices should be
updated regularly as additional tools are identified.
• The recommended practices generated in this resource should be inte-
grated into the workplace health management systems within organiza-
tions.

Recommended and Promising Practices For Situational Assessment Tools 41

 GLOSSARY
Algorithms – Formulas of instructions and directions as to how the information gath-
ered by the tool is to be used.

Best practices – Those practices that have been evaluated under controlled conditions
(with or without randomization) and found to be effective. In addition, the practices also
meet the practicality criteria (such as cost effectiveness, availability and fit.)11

BETA testing – The process of testing and improving unfinished software. Beta testing
is most useful when the testers aren’t the original programmers and can provide specific,
meaningful feedback.12

Comprehensive workplace health promotion – An approach to protecting and

enhancing the health of employees that relies and builds upon the efforts of employers
to create a supportive management under and upon the efforts of employees to care for
their own well-being.13

Cost – The tool is available with a cost or fee.

Cultural appropriateness – The delivery of programs and services so that they are con-
sistent with the communication styles, meaning systems and social networks of clients,
or program participants, and other stakeholders.14

Current practice survey – A type of situational assessment tool that collects individual
responses from employees about their current behaviours (e.g., how much they eat/sleep,
current levels of physical activity.) Employees self-report their behaviours. Current prac-
tice is often combined with other types of situational assessment tools.

Determinants of health – Conditions in the psychosocial, socioeconomic, and physical

environments which create conditions for ill health or wellness (i.e., housing, peace and
security, belonging to a community, adequate income, food, clean air, water and soil, safe
working conditions.)15

Effectiveness – This criterion refers to whether the intervention had a positive outcome
or impact evaluation using a good quality research design. 16

Electronic access – The tool is available in an electronic version from the contact.

Employee completion – The tool is completed individually by the employee.

Employer/committee completion – The tool is completed by the employer and/or a

workplace committee.

Employment equity – Equality in the workplace so that no person shall be denied

employment opportunities or benefits for reasons unrelated to ability and, in the fulfill-
ment of that goal, to correct the conditions of disadvantage in employment experienced
by women, aboriginal peoples, persons with disabilities and members of visible minori-

42 Comprehensive Workplace Health Promotion

 ties by giving effect to the principle that employment equity means more than treating
persons in the same way but also requires special measures and the accommodation of
differences.17

Epidemiology – The study of the distribution and determinants of health-related states

or events in specified populations, and the application of this study to the control of
health problems.18

Evaluation – The systematic collection, analysis, and reporting of information about a

program in a way that enables practitioners and others to learn from their experience.
Specifically, program evaluation generates the information needed to guide the develop-
ment of more effective comprehensive workplace health promotion initiatives.19

External implementation – The tool is implemented by someone outside the workplace

(e.g., consultant, company, etc.) The term “external” refers to accessing resources for the
process from outside the workplace. For example, the analysis of a situational assess-
ment tool is done externally.

French – A French version of the tool is available.

Health risk assessment – A type of situational assessment tool that collects clinical
measures of health status (e.g., BMI, cholesterol, nutritional analysis, heart rate response
to exercise.) The assessment of risk is based on clinical report/measures (i.e., it is not self-
reported.) In most cases, a health risk assessment requires a professional to administer
the assessment to all employees. The health risk assessment usually results in individual-
ized results and an aggregate report for the workplace.

Heart Health Resource Centre – The Heart Health Resource Centre (HHRC) pro-
vides support to the 37 community partnerships of the Ontario Heart Health Program
– Taking Action for Healthy Living in Ontario, that plan, deliver and/or evaluate com-
prehensive community-based heart health strategies. The HHRC fosters networking and
communication between peers through the Ontario Heart Health Network as well as its
newsletter and e-mail discussion lists (www.hhrc.net)

Implementation cycle – The process of preparing to distribute the tool to employees,

distributing the tool for data collection, analyzing the results, and working with a well-
ness committee to make decisions about programming.

Incentives – Benefits that motivate an individual or organizational decision maker in

favour of a particular choice.

Intellectual property – The group of legal rights to things people create or invent. Intel-
lectual property rights typically include patent, copyright, trademark and trade secret
rights.20

Interest survey – A type of situational assessment tool that collects the information
from individual employees about the types of programs and services they are interested
in. An interest survey usually results in an aggregate report for the workplace.

Recommended and Promising Practices For Situational Assessment Tools 43

 Intermediary – Those who provide (or have the potential to provide) direction and
support to people in workplaces about how to provide employee workplace health pro-
motion. Intermediaries may include those in public health departments, municipal gov-
ernments, unions, human resource associations, private sector organizations (for profit),
employer organizations, organizations that provide health and/or safety services to
workplaces, and non-governmental organizations such as community health centres.21

Internal implementation – The tool is implemented by the workplace. The term “inter-
nal” refers to resources or processes that are rallied from within the existing resource of
the workplace. For example, the analysis of a situational assessment tool is done in-house
by in-house staff.

Knowledge transfer – Collaborative problem-solving between various groups (e.g.,

between researchers and decision makers, between intermediaries and decision makers,
between intermediaries and practitioners.) Effective knowledge exchange involves
interaction between the groups and results in mutual learning through the process of
planning, disseminating, and applying existing or new research in decision-making.22

Language+ – The tool is available in languages other than English and French.

Large workplaces – Workplaces with more than 200 employees.

Lifestyle practices – One of three aspects of comprehensive workplace health promo-

tion, which generally refers to efforts to change the employees’ behaviour. Examples of
issues to encourage employees to act upon may include tobacco use, alcohol and drug
use, nutrition, immunization and physical activity.23

Long completion time – Tools that take over 30 minutes to complete.

Medium completion time – Tools that take between 10 to 30 minutes to complete.

Medium sized workplaces – Workplaces with between 51 and 200 employees.

Needs assessment – A type of situational assessment tool that collects the self-reported
needs of individual employees. Individual employees fi ll out the needs assessment and
assess areas they would like to focus on. A needs assessment asks for employee opinion
and usually results in individualized results and an aggregate report for the workplace.

No cost – The tool is available for use free of charge.

Not recommended – A level assigned to tools that received low ratings on effectiveness,
plausibility, and practicality.

Occupational health and safety (OHS) – One of three aspects of comprehensive

workplace health promotion, which generally refers to efforts to reduce the physical and
chemical hazards in a work environment with the goal of reducing work-related injury,
illness and disability. Many activities fall under the category of occupational health and
safety, including ergonomics, injury prevention, hazard identification and control, emer-
gency response problems, disability case management, and medical services.24

44 Comprehensive Workplace Health Promotion

 Occupational medicine stations – European organizations responsible for planning
and delivering health services to workplaces. Many have worked extensively with their
local workplaces to implement comprehensive workplace health promotion programs.
The most successful ones formed regional coalitions with Labour and Safety Inspec-
tions, local authorities, media, employers and companies, and even with social insurance
offices or private insurance companies.25

Online access – The tool is available online (on the Internet) from the web site provided
in the contact information.

Organizational culture (organizational change) – One of three aspects of comprehen-

sive workplace health promotion, which generally refers to efforts to change or improve
the organizational working environment. Elements of the organizational environment
include leadership style, management practices, the way in which work is organized,
employee autonomy and control, and social support.26

Organizational culture survey – A type of situational assessment that collects infor-

mation from employees or employers about the organizational working environment.
Elements of the organizational environment include leadership style, management prac-
tices, the way in which work is organized, employee autonomy and control, and social
support.27

Packaged, ready-to-use – The tool is ready for you to use as it is. It does not require any
adjustments or changes to the tool materials.

Paper access – Paper copies of the tool are available from the contact.

Plausibility – This criterion refers to the extent the intervention is likely to be effective
based on formative/process evaluations and content and process attributes.28

Practicality – This criterion refers to the extent the intervention is likely to be effective
in the context of the adopting community. Practicality addresses issues such as cost
effectiveness, availability and fit.29

Program Training and Consultation Centre – The Program Training and Consultation
Centre (PTCC) provides training, consultation, information, networking opportunities,
and referral services related to tobacco control to Ontario health promoters. PTCC is a
resource centre of the Ontario Tobacco Strategy (www.ptcc-cfc.on.ca.)

Promising – A level assigned to tools that received a medium to high rating on plausi-
bility and practicality. These tools may or may not have been evaluated (i.e., reliability
and validity testing may or may not have taken place).

Proprietary – The tool is owned by the developer and as such the developer has imple-
mented restrictions on the tool. The tool cannot be implemented or reproduced without
the consent of the tool developers.

Psychographic – Information about target audiences such as:

• their fundamental values and beliefs

Recommended and Promising Practices For Situational Assessment Tools 45

 • what is most important to them
• some of their key personal characteristics
• where they get their health-related information – which media, interper-
sonal channels, and events are they exposed to
• the organizations and social networks they belong to
• how they spend their time and dollars – what they are interested in and
their lifestyle.30

Psychometric – Properties of the tool such as the distribution of item difficulty and
discrimination indices.31

Public domain – The tool is not owned by any company or person. The tool can be used
without the previous written consent from the developers and may be reproduced.

Public health unit – An organization responsible for the delivery of public health infor-
mation and programs in a defined geographic community. There are currently 36 public
health units across Ontario (for more information visit www.opha.on.ca.)

Quality of life – An evaluation of health status relative to the patient’s age, expectations,
and physical and mental capabilities.32

Randomized control trials (RCT) – An experiment in which investigators randomly

assign eligible subjects (or other units of study, e.g., classrooms, clinics, playgrounds)
into groups to receive or not receive one or more interventions that are being compared.
The results are analysed by comparing outcomes in the groups.33

Recommended – A level assigned to tools that received high ratings on plausibility, and
practicality. These tools may or may not have been evaluated (i.e., reliability and validity
testing may or may not have taken place). 34

Reliability – The extent to which results are consistent over time and an accurate
representation of the total population under study is referred to as reliability. In other
words, if the results of a study can be reproduced under a similar methodology, then the
research instrument is considered to be reliable. 35

Short completion time – Tools that take between 5 and 10 minutes to complete.

Situational assessment – A situational assessment influences planning in significant

ways by examining the legal and political environment, stakeholders, the health needs
of the population, the literature and previous evaluations, as well as the overall vision
for the project. The phrase “situational assessment” is now used rather than the previous
term “needs assessment”. This is intentional. The new terminology is used as a way to
avoid the common pitfall of only looking at problems and difficulties. Instead it encour-
ages considering the strengths of and opportunities for individuals and communities. In
a health promotion context, this also means looking at socio-environmental conditions
and broader determinants of health.36

Small workplaces – Workplaces with fewer than 50 employees.

46 Comprehensive Workplace Health Promotion

 Socio-environmental – Factors such as housing, transport, safety and the work environ-
ment. It is argued that the contexts influence health more so than do the characteristics
of the people in those communities. The context in which people live and work produces
factors that interact in a range of different ways and these local differences should influ-
ence the selection of health promotion strategies.37

Validity – Validity determines whether the research truly measures that which it was
intended to measure or how truthful the research results are. In other words, does the
research instrument allow you to hit “the bull’s eye” of your research object? Researchers
generally determine validity by asking a series of questions, and will often look for the
answers in the research of others. 38

Web application – A web application is software that runs on the Internet. There are
several applications called web browsers that make it easy to access the Internet; two of
the most popular being Netscape Navigator and Microsoft’s Internet Explorer. 39

Wellness committee – The formation of a workplace wellness committee is an impor-

tant step in building a healthy work environment. This group should be responsible for
planning and steering appropriate activities. All key decision makers, representatives of
interests groups, and experts should belong to the group. 40

Workplace audit – A type of situational assessment tool that provides a snapshot in

time of what’s happening in the workplace. The workplace audit collects information
about what the workplace offers employees (e.g., showers, flextime.) One person or a
small group of individuals from the workplace provide the information for the workplace
audit. The information collected could be specific to only one aspect of comprehensive
workplace health promotion (i.e., organizational culture, occupational health and safety,
lifestyle practices) or two or three of these categories.

Recommended and Promising Practices For Situational Assessment Tools 47

 ENDNOTES
1
THCU, An Introduction to Comprehensive Work- 16
Program Training and Consultation Centre, Toolkit
place Health Promotion, Version 1.1. (July 2004), Overview. (July 2004), retrieved from www.ptcc-
p.19. For further discussion on intermediaries, see cfc.on.ca/bpt/bpt-background.cfm#defn.
THCU, Supporting Comprehensive Workplaces 17
Department of Justice Canada, Employment Equity
Health Promotion Literature Review (April 2002),
Act, (1995), retrieved from laws.justice.gc.ca/en/E-
pp. 28–31.
5.401/50293.html.
2
M. Shain and H. Suurvali, Investing in Compre- 18
Definition retrieved from www.cdc.gov/nccdphp/
hensive Workplace Health Promotion, Centre for
drh/epi_gloss.htm.
Addiction and Mental Health, (2001), p. 8.
19
THCU, Evaluating Comprehensive Workplace Health
3
THCU, An Introduction to Comprehensive Work-
Promotion, (March 2005), p.5.
place Health Promotion, Version 1.1, (July 2004), p.
20
4. Definition retrieved from www.sitepoint.com/glos-
sary.php.
4
THCU, Introduction to Health Promotion Program
Planning, Version 3.0 (April 2001), pp. 18–22. 21
THCU, An Introduction to Comprehensive Work-
place Health Promotion, Version 1.1, (July 2004),
5
C. Grant and R. Brisbin, Workplace Wellness: The
p.19. For further discussion on intermediaries, see
Key to Higher Productivity and Lower Health Costs,
THCU, Supporting Comprehensive Workplaces
(1992), John Riley & Sons Inc.
Health Promotion Literature Review, (April 2002),
6
C. Dickie and M. Law, Needs Assessment: Creating pp. 28-31.
Conditions for Success, Health Work and Wellness 22
Canadian Health Services Research Foundation,
Conference, (2001).
Knowledge Transfer and Exchange, (n.d.), retrieved
7
R. Clemens and J. Beyers, Creating Healthy Work- from www.chsrf.ca/knowledge_transfer/index_
places…Issues & Implications for Heart Health e.php.
Partners, (1999), Public Health Research, Educa- 23
THCU, An Introduction to Comprehensive Work-
tion and Development Division, Sudbury & District
place Health Promotion, Version 1.1, (July 2004),
Health Unit.
p.4.
8
C. Grant and R. Brisbin, Workplace Wellness: The 24
THCU, An Introduction to Comprehensive Work-
Key to Higher Productivity and Lower Health Costs,
place Health Promotion, Version 1.1, (July 2004),
(1992), John Riley & Sons Inc.
p.4.
9
D. Chenoweth, Worksite Health Promotion, (1998), 25
The Global Occupational Health Network,
Champaign, IL: Human Kinetics Publishers.
GOHNET Newsletter, Issue 6, (Winter 2003),
10
C. J. Turner, “Health Risk Appraisals: The retrieved from www.who.int/occupational_health/
publications/newsletter/en/gohnet6e.pdf.
Issues Surrounding use in the Workplace”,
American Association of Occupational Health 26
THCU, An Introduction to Comprehensive Work-
Nurses Journal, 43(7), (1995), pp. 357–361. place Health Promotion, Version 1.1, (July 2004),
p.4.
11
Heart Health Resource Centre, International Best
27
Practices in Heart Health, (1998), retrieved from Ibid.
www.hhrc.net. 28
Heart Health Resource Centre, International Best
12
Definition retrieved from www.netc.org/openop- Practices in Heart Health, (1998), retrieved from
tions/appendices/glossary.html. www.hhrc.net.
13
M. Shain & H. Suurvali, (April 2001) as cited in
29
Heart Health Resource Centre, International Best
THCU, An Introduction to Comprehensive Work- Practices in Heart Health, (1998), retrieved from
place Health Promotion, (July 2004), p.2. www.hhrc.net.
14
D. R. Thomas, Evaluating the Cultural Appropriate-
30
THCU, Overview of Health Communication Cam-
ness of Service Delivery inMulti-ethnic Communi- paigns, (April 1999), p.29.
ties, (2002), retrieved from www.evaluationcanada. 31
Definition retrieved from questionmark.com/us/
ca/distribution/20021030_thomas_david.pdf. glossary.htm.
15
THCU, Introduction to Health Promotion Program 32
Definition retrieved from www.oncura.com/glos-
Planning, (April 2001), p.12. sary.html.

48 Comprehensive Workplace Health Promotion

33
Canadian Institutes of Health Research, Random- 38
Ryerson University, Validity, (n.d.), retrieved from
ized Control Trial, (August 2005), retrieved from www.ryerson.ca/~mjoppe/ResearchProcess/Valid-
www.cihr-irsc.gc.ca/e/22388.html. ity.htm.
34
Program Training and Consultation Centre, Toolkit 39
Definition retrieved from www.c-latitude.com/
Overview, (July 2004), retrieved from www.ptcc-cfc. glossary.asp.
on.ca/bpt/bpt-background.cfm#defn. 40
THCU, An Introduction to Comprehensive Work-
35
Ryerson University, Reliability, (n.d.), retrieved place Health Promotion, Version 1.1, (July 2004),
from www.ryerson.ca/~mjoppe/ResearchProcess/ p.14.
Reliability.htm.
36
THCU, Introduction to Health Promotion Planning,
(n.d.), retrieved from www.thcu.ca/infoandre-
sources/planning.htm.
37
Victorian Government Department of Human Ser-
vices, Planning forhealthy communities: reducing
the risk of cardiovascular disease and type 2 dia-
betes through healthier environments and lifestyles
(2004). Retrieved from http://www.health.vic.gov.
au/healthpromotion/downloads/healthy_commu-
nities.pdf

Recommended and Promising Practices For Situational Assessment Tools 49

 REFERENCES
1. Canadian Health Services 9. Garrard, J, Lewis, B, Keleher, H,
Research Foundation. (n.d.). Tunny, N, Burke L, Harper, S &
Knowledge Transfer and Round R (2004), Planning for
Exchange. Retrieved from www. healthy communities: reducing
chsrf.ca/knowledge_transfer/ the risk of cardiovascular disease
index_e.php. and type 2 diabetes through
2. Canadian Institutes of Health healthier environments and
Research. (August 2005). lifestyles, (Chapter 10). Victorian
Randomized Control Trial. Government Department of
Retrieved from www.cihr-irsc. Human Services, Melbourne.
gc.ca/e/22388.html. Retrieved from http://www.
health.vic.gov.au/healthpromo-
3. Centers for Disease Control and tion/downloads/healthy_com-
Prevention. Definition retrieved munities.pdf
from www.cdc.gov/nccdphp/
drh/epi_gloss.htm. 10. Grant, C., Brisbin, R. (1992).
Workplace Wellness: The Key to
4. Chenoweth, D. (1998). Worksite Higher Productivity and Lower
Health Promotion. Champaign, Health Costs. John Riley & Sons
IL: Human Kinetics Publishers. Inc.
5. C-Latitude Ltd. (online glos- 11. Heart Health Resource Centre.
sary). Definition retrieved from (1998). International Best Prac-
www.c-latitude.com/glossary. tices in Heart Health. Retrieved
asp. from www.hhrc.net.
6. Clemens, R., Beyers, J. (1999). 12. Oncura (online glossary).
Creating Healthy Work- Definition retrieved from www.
places…Issues & Implications for oncura.com/glossary.html.
Heart Health Partners. Public
Health Research, Education and 13. Open Options, The North-
Development Division, Sudbury west Regional Educational
& District Health Unit. Laboratory. (online glossary).
Definition retrieved from www.
7. Department of Justice Canada. netc.org/openoptions/appendi-
(1995). Employment Equity Act. ces/glossary.html.
Retrieved from laws.justice.
gc.ca/en/E-5.401/50293.html. 14. Program Training and Con-
sultation Centre. (July 2004).
8. Dickie, C., Law, M. Needs Toolkit Overview. Retrieved from
Assessment: Creating Conditions www.ptcc-cfc.on.ca/bpt/bpt-
for Success. Health Work and background.cfm#defn.
Wellness Conference, 2001
15. Questionmark (online glossary).
Definition retrieved from ques-
tionmark.com/us/glossary.htm.

50 Comprehensive Workplace Health Promotion

16. Ryerson University. (n.d.). Reli- 23. The Health Communication
ability. Retrieved from www. Unit. (April 2001). Introduction
ryerson.ca/~mjoppe/Research- to Health Promotion Program
Process/Reliability.htm. Planning. Version 3.0. Toronto:
17. Ryerson University. (n.d.). ON.
Validity. Retrieved from www. 24. The Health Communication
ryerson.ca/~mjoppe/Research- Unit. (July 2004). An Introduc-
Process/Validity.htm. tion to Comprehensive Work-
18. Shain, M., Suurvali, H. (2001). place Health Promotion, Version
Investing in Comprehensive 1.1. Toronto: ON.
Workplace Health Promotion. 25. The Health Communication
Centre for Addiction and Unit. (March 2005). Evaluating
Mental Health (CAMH). Comprehensive Workplace
19. Shain, M., Suurvali, H. (April Health Promotion. Toronto: ON.
2001) as cited in The Health 26. The Health Communication
Communication Unit. (July Unit. (n.d.). Introduction to
2004). An Introduction to Com- Health Promotion Planning.
prehensive Workplace Health Retrieved from www.thcu.
Promotion, Toronto: ON. ca/infoandresources/planning.
20. Sitepoint (online glossary). htm.
Definition retrieved from www. 27. Thomas, D.R. (2002). Evaluating
sitepoint.com/glossary.php. the Cultural Appropriateness of
21. The Global Occupational Service Delivery in Multi-ethnic
Health Network. (Winter 2003). Communities. Retrieved from
GOHNET Newsletter, Issue www.evaluationcanada.ca/dis-
6. Retrieved from www.who. tribution/20021030_thomas_
int/occupational_health/publi- david.pdf.
cations/newsletter/en/gohnet6e. 28. Turner, C.J. (1995). “Health Risk
pdf. Appraisals: The Issues Sur-
22. The Health Communication rounding use in the Workplace.”
Unit. (April 1999). Overview of American Association of Occu-
Health Communication Cam- pational Health Nurses Journal.
paigns. Toronto: ON. 43(7):357-361.

Recommended and Promising Practices For Situational Assessment Tools 51

 52
Name of SA Tool Reviewed: ___________________________

Internal Coding: _____________________ APPENDIX A:

Date Reviewed: ______________________

Reviewers: __________________ ____________________

Appendices

Type: NA = Needs Assessment WA= Workplace Audit IS = Interest Survey OC = Organizational Culture
HRA = Health Risk Appraisal CP = Current Practices (behavioural, no direct msmt like HRA)

Stage 1 Criteria: Reliability & Validity

Criterion Yes / No Comments
The assessment tool has been tested for reliability AND validity1 in a workplace
setting (not necessarily in Ontario) and BOTH are found to be sound.

Reliability & Validity Rating: YES or NO

1
Reliability is defined as "an indication of the consistency of scores across evaluators or over time." There should be compelling evidence to show that results are
consistent across raters and across scoring occasions. Validity is defined as "an indication of how well an assessment actually measures what it is supposed to
measure." All valid tools are reliable but not all reliable tools are valid.
REVIEW CRITERIA FOR SITUATIONAL ASSESSMENT TOOLS

Comprehensive Workplace Health Promotion

 Stage 2 Criteria: Plausibility2
Criterion Good Fair Poor Info Comments
N/A
Evaluation Attributes
Pilot Testing / Formative Evaluation
o Consultations, focus groups or other valid methods have
been used to assess relevance, comprehension and
acceptability of the approach, material, methods etc.
with representatives of prospective users
Impacts
o Evidence of workplaces in which the tool has been used
where there has been commitment to change as a result
of the survey
Process Evaluation
o Feedback has been gathered and integrated following
some degree of implementation (e.g. employer response,
participant response, practitioner response and/or
provider competency in delivering the assessment)
Meets Expressed Purpose
o The purpose of the tool is clearly stated on the tool AND
the tool appropriately meets this purpose.
o The uses to which the information gained via the tool are

Recommended and Promising Practices For Situational Assessment Tools

clearly stated.
Content Attributes
Theoretical Underpinnings
o The tool is positioned within an overall CWHP
approach. Good = explicitly referenced in tool; Fair = a
CWHP connection is seen within the tool; Poor =
neither.
Relevance

2
Something is considered plausible if it is conceptually supported by previous knowledge.

53
 54
Criterion Good Fair Poor Info Comments
N/A
o Questions included in the tool are relevant to planning a
CWHP initiative
Quality of Questions Asked
o The questions are appropriate for discovering the
answers that are needed for the intended purpose.
Structure / Construction
o Degree of complexity (e.g. similar questions batched
together with headings; skip patterns are clear; changes
to the formats of response categories are minimal; flow
of questions is appropriate)
o Easy to follow for those completing the tool (clear,
simple instructions have been provided)
o Consistent sentence structure used
Confidentiality Addressed
o Issues such as confidentiality, anonymity and privacy
have been addressed explicitly in the tool.
Plausibility Rating: GOOD FAIR POOR

Comprehensive Workplace Health Promotion

 Stage 3 Criteria: Practicality
Criterion Good Fair Poor Info Comments
N/A
Process Attributes
Ease of Implementation for the Respondent
o Time required for the individual to complete
Ease of Implementation
o Distribution (available electronically; pre-survey
communication done
Ease of Implementation
o Data Collection – electronic, clear
Ease of Implementation
o Analysis – tabulation, ability to correlate information,
electronic vs. manual, individual and aggregate,
scanning of results
Ease of Implementation
o Reporting – individual and aggregate summaries; ease of
interpretation; use of visuals (e.g. graphs)
Overall Timeline for full cycle of implementation
(distribution through reporting)
Participation Rates for Completion are strong.
Collaborative Approach
o A participatory approach is possible such that workplace
personnel can help shape implementation, thus

Recommended and Promising Practices For Situational Assessment Tools

developing ownership of the process (such as utilizing
on-site print shops, communication channels)
Supportive Materials
o Good quality materials are available, in addition to the
assessment tool, include such things as pre-survey
communication messages, a recommended process for
analysis and reporting, a “how-to” manual
Longevity
Sustainability
o The tool is one that appears to have longevity in its use
over time within a given workplace, without the need for

55
 56
Criterion Good Fair Poor Info Comments
N/A
on-going significant investment
Future Relevance
o The content of the tool can be expected to maintain
relevance over time within a given workplace
Availability
The tool is ready to use. Y N
Easily accessible to Ontario workplaces
Available entirely on-line or electronically. Y N
Could be posted on or linked from THCU Web site. Y N
Fit
Support
o Necessary resources/supports for implementation are
available to most Ontario workplaces (consider rural,
northern, isolated contexts as well as large urban
environments)
Generalizability/External Reach
o Even though created with a certain group or workplace
in mind, the tool can be used in a variety of contexts
(e.g. different sizes of workplaces).
o The tool is potentially applicable to a wide
range/number of workplaces and organizations
Expertise
o The level of expertise required for implementation is not
a barrier to participation and/or can be implemented by
workplace personnel with minimal training.
Accessibility
o Linguistically & culturally appropriate*
Practicality Rating: GOOD FAIR POOR

Overall Assessment: Recommended Promising Not Recommended

COMMENTS / RATIONALE:

* Ability to communicate effectively, and convey information in a manner that is easily understood by diverse audiences including persons of limited English
proficiency, those who have low literacy skills or are not literate, and individuals with disabilities.

Comprehensive Workplace Health Promotion

APPENDIX B: INCLUSION CRITERIA
CWHP Situational Assessment
“Recommended Practices” Project Inclusion Criteria

In order to be included in the detailed review process, each situational assessment tool will need to meet all of
the following:

Criteria
Criteria Comments
Met?
 yes 1. It is available to workplace practitioners in
Ontario, either electronically or on paper,
 no
either directly from the source or via THCU.
 yes 2. Available in English.
 no
 yes 3. Is workplace-related and falls within the
scope of CWHP.
 no
 yes 4. Addresses at least one of the identified
purposes for a SA tool:
 no
NA = Needs Assessment
WA = Workplace Audit
IS = Interest Survey
OC = Organizational Culture
HRA = Health risk Assessment
CP = Current Practices
F = Feedback Form
 yes 5. There is sufficient, relevant information
available to accompany the tool itself
 no
(person, report, Web site etc.).
 yes 6. As the number of tools accessed grows,
those that address a gap in a type of tool
 no
will be preferred. We are aiming for a
balance across the types of tools to the
degree possible.

Overall Recommendation: 0 Review 0 Discard

Name: _____________________________ Date: ________________

Recommended and Promising Practices For Situational Assessment Tools 57

 APPENDIX C: GUIDELINES FOR THE REVIEW
PROCESS
As the revisions were made to the assessment process, guidelines or principles emerged
that helped to keep the process on track. These guidelines were posted online to assist
review panel members in the review process.

1. Keep in mind the main objective of the review process: to provide work-
place intermediaries in Ontario with a list of recommended practices
to help them perform situational assessments. This will also help in
deciding the final label attached to each tool.
2. Reviewers are asked to assess the tools based on a minimum rating of
75% (generally positive, on the border between fair and good).
3. There should be no value placed on internal versus external supports for
implementing a tool; the understanding should be that internal mecha-
nisms can enhance ownership, and external sources can bring expertise.
4. The tool itself is often “not enough.” The practices and process sur-
rounding the tool is often key to the implementation and value of the
tool. Reviewers are encouraged to look at the sample reports and other
supporting documents in addition to the instrument.
5. Tools assessed as “not recommended” will not be identified.
6. The review panel members can contact THCU workplace staff for any
assistance with the review process and its related methodologies and
technology.

58 Comprehensive Workplace Health Promotion

APPENDIX D: LITERATURE SEARCH
The following literature searches were conducted:

• The database created by THCU was searched for articles described

by the terms “needs assessment” or “health risk assessment” or “case
studies” or “comprehensive workplace health” or “evaluation” or “par-
ticipatory planning.”
• Web sites for Global Medic Inc.; WELCOA; Healthy, Wealthy and Wise;
National Resource Center on Worksite Health Promotion; National
Heart, Lung and Blood Institute; Berkana Institute; European Network
on Workplace Health Promotion were searched, as well as others.
• Google and Google Scholar were searched using the terms “workplace
health” along with “assessment” or “preparation” or “screening” or
“survey.”
• Bibliographic databases were searched, including PubMed, EMBASE,
Conference Papers, Canadian Research Index, CINAHL, Web of
Science, Health and Psychosocial Instruments, PsycINFO.
• Terms used included:
• workplace health
• needs assessment
• population
• planning
• implementing
• mass screening
• multiphase screening
• assess* workplace*
• questionnaire*
• environmental scan
• audit
• HRA
• situational assessment.

Recommended and Promising Practices For Situational Assessment Tools 59

 APPENDIX E: WEB APPLICATION
The web application has three parts, each of which is described below:

1. Online database – an information management system that holds all the

tool information and supporting documents. This is a system organized
primarily by tools. It formed the base for the “external” system database
that now holds the 29 recommended and promising tools.
2. Online review system – the system used by the review panel to assess
each tool assigned to them online.
3. Administrative management – allowed the project team to assign tools,
input information, monitor progress of reviews, and create reports.

1. Online database

The online database houses:

• the situational assessment tools

• the tool summary, using the Q&A template as the base
• supporting documents relevant to that tool

The project team and web designer developed the online database portion of the web
application using the Q&A template and the tool summary document. Eighty fields
were created to house the information needed for the review. The project team then
transferred the information collected from each source Q&A document into the data
fields in the online database. This process ultimately allowed each tool summary to be
housed online.

Icons were developed in order to provide review panel members with quick memory
cues for the components of each tool. The icons that are used in the catalogue are based
on the icons that were used for the review process, such as evaluation, electronic access,
short time completion, etc.

A resource library was also set up in the web application to house all the supporting
documents for each tool. A special function of the resource library and particular fields
in the online database was the ability to sort specific information into “special” catego-
ries (e.g., “Red Flag: Proprietary.”) This allowed the project team to manage proprietary
information in an appropriate manner.

Development of the online database portion of the web application was time-consuming
and detail-oriented. As revisions to the Q&A template and tool summaries were made,
revisions also had to be made to the structure of the online database. During this process
the web application was being continually refined.

60 Comprehensive Workplace Health Promotion

 2. Online review system

The online review system was developed based on the structure of the review criteria.
Review panel members were able to view and review the tool and supporting documents
wherever they had Internet access. Among other benefits, the online system meant that
collaboration between review partners was easier to manage due to a number of unique
system functions:

• Review panel members had their own “homepage” where they could
gain access to project materials, instructions, their partners’ contact
information, and their tool assignments.
• A “notes” function allowed review panel members to post reminder
notes to themselves throughout the review process.
• A “help” function automatically sent an email to the project team
members, asking for assistance.
• A “sharing” function enabled review panel members to review tools
online at the same time.
• In addition to the ability to select a “good/fair/poor” or “yes/no” for
each criterion, two comments functions were available to review panel
members for each criterion rating:
• “On the record” comments – These comments make up the key
reviewer comments that are part of each tool summary. Review
panel members were able to continuously post and edit these com-
ments until a final decision was reached.
• “Off the record” comments – These comments allowed review
panel members to informally discuss specific criterion and to
essentially “chat” about their final decisions (e.g., “This is how I
rated accessibility, but I could be persuaded otherwise – what do
you think?”).
• An automatic “save” function safeguarded the review panel members
against losing valuable review information. (This was put into place
after input from review panel members.)

Recommended and Promising Practices For Situational Assessment Tools 61

 Figure 9: Review Panel Homepage

Figure 10: Online Review

62 Comprehensive Workplace Health Promotion

 The online review system was set up so that review panel members had to finish their
own portion of the review before sharing with their partner, discussing and finalizing
their review of the tool, and submitting a final review to the project team.

As with the online database, as revisions were made to the review criteria, changes also
had to be made to the online review system. This required unanticipated but substantial
time throughout the process for these adjustments.

3. Administrative management

The administrative management component of the web application was the base for the
online database and review system. As the other two components were created, admin-
istrative options were added and customized. Some of these options included:

• Online inclusion criteria – The project team informally filtered each

tool through the inclusion criteria by the vetting of the initial search
lists. Each tool was then formally put through the online filter. If a tool
did not meet the requirements, the system would not allow it to be
reviewed.
• Review panel pairings – Review panel members were paired together
using the online administrative system, making each partner’s contact
information immediately available.
• Tool assignments – The project team assigned tools to review panel
member pairings using the online administrative system ensuring that a
tool could not be assigned twice. Once assigned a tool, the review team
had access to the tool, the tool summary and any supporting documents
in the resource library.
• Posting documents and announcements – The project team posted
documents and announcements to all review panel members, to specific
members and pairings, and to the internal project team.
• View reports – Reports were automatically created by the online system
and allowed the project team to:
• View the collected tools as a tool map report (this function was very
helpful and outlined how many tools had been reviewed, discarded,
and labeled.) (See Figure 11 below.)
• View the outcome of submitted reviews.
• Monitor the progress of all review panel members (e.g., last login
date, review in progress.)

As more functions became needed, more administrative options were added. The
development of the administrative portion was less of a revision process than it was an
updating or expanding process.

The development of the web application resulted in an online information management

system and online reviewing system that will most likely be re-used.

Recommended and Promising Practices For Situational Assessment Tools 63

 In addition, reports containing the completed reviews of all the situational assessment
tools have been created by the web application. In fact, , most of the information in the
web application used for the review process has been translated into the public online
resource and catalogue of tools.

Figure 11: Tool Map Report

64 Comprehensive Workplace Health Promotion

APPENDIX F: WEB INSTRUCTIONS FOR REVIEWING
The following outlines instructions for how to review a situational assessment tool using
the web application. It is designed for the use of review panel members and to provide
instructions and tips along the way. If you have any further questions that these points
do not address, contact Admin Support for both technical and content related queries.

Getting Started
Note: Please keep in mind that you have signed a Confidentiality Agreement in relation
to the Situational Assessment tools and the Review Process. After you have completed
the review of a particular tool, especially proprietary tools, please delete it from your
computer or destroy the paper copy.

1. Click on Your Tools (located at the left menu bar, or at the bottom of
your screen).
2. This will show you which specific SA tool(s) you have been assigned to
review (e.g., Tool X)
3. Click on the Title of the tool. This will open the Basic Information and
Tool Resources related to Tool X.
4. Before you begin the review of Tool X, you should read through all the
information related to the tool, contained in the Tool Summary, which
is accessible on the left menu bar. You should also read through all the
supporting documents related to that tool.
5. The Tool Summary contains: Reliability & Validity, Plausibility,
Practicality, Longevity, Availability, Fit, and Other Comments &
Info. To access each subsection, simply click on the title of that section
in the toolbar to the left of the screen. The order of information in the
tool summary follows that of the Review Criteria.

Tip: To manage the Tool Summary and supporting documents;

the online Review Criteria; and the tool itself, it would probably
be most simple to have the online Criteria as your main screen
and the Tool Summary and supporting documents in a separate
window. To do so, right click on the link to the Tool Summary fi le,
and choose “Open Link in New Window.”
This will help you navigate through all the web pages and docu-
ments associated with the tool, while still reviewing the tool on
your main internet page. In order that you don’t have to open
another browser window, it may be easiest to print off the tool
itself.
Therefore, you are juggling at least 3 documents: the Online Review
Criteria, the Tool Summary and supporting documents (in a sepa-
rate window), and the tool itself - printed out in hardcopy.

Recommended and Promising Practices For Situational Assessment Tools 65

 6. On the right side of the screen, the Tool Resources will be listed (and
this includes the tool itself). This includes such things as Evaluation
results, Implementation Plans, Reports, etc. You should read through
all supporting documents and resources related to the tool, before
you begin your review. In some cases, only hardcopy materials will be
available to you - in this case, the title will still appear in the list, but
would not be “clickable”; instead, these documents will be sent to you by
THCU Workplace Admin.
7. Before you begin the review of Tool X, you should have it available to
you either electronically or on paper. If Tool X is available electronically,
you can download it by clicking on the Title under Tool Resources.
8. When you click on Tool X, you can either save or open the file to your
computer. You may want to print out a copy of the tool (and its support-
ing documents) so it is easier to read and review.
9. Once you have read through Tool X, the Tool Summary, and its Sup-
porting documents, you are ready to review the tool!

Reviewing the Tool

Keep in mind that you are reviewing each tool with a partner. The Web application is
set-up to accommodate both you and your partner’s answers and comments; however,
you must come to agreement about the Overall Assessment of the review.

The process for reviewing a tool works like this: (more detailed instructions follow)

• Read SA tool & related resource materials assigned to you

• Review SA tool individually according to the Review Criteria and using
the Summary of information collected
• Share review results with Partner
• Edit & discuss results with Partner to, ideally, reach consensus on your
overall recommendation
• Submit Final Review

1. You and your partner review the tool separately. To begin the review
of Tool X, click on Review This Tool. This page tells you who you will
be reviewing the tool with. At this point, you cannot see what your
partner’s responses are. There is also space here to add Notes to yourself
regarding that particular tool (these notes will appear only to you on
your Home Page, under Your Tools).
2. Make sure to read the Principles & Guidelines for Review also located
on the Review This Tool page. These guidelines are to help you review
the tool fairly and to ensure (as much as possible) that all review panel-
ists are reviewing tools according to the same principles.
3. Before you begin to review any tool, make sure to read the Review
Criteria all the way through. The Review Criteria can be downloaded
off your main Home Page, under Project Documents.

66 Comprehensive Workplace Health Promotion

 Note: You can only “share” your tool review with your partner once
your portion is complete. You cannot see your partner’s “shared”
review if you have not completed and “shared” your own. Once you
have “shared” your responses with your partner, they cannot be
“un-shared.”
4. To begin the review of Tool X, click on Stage 1: Reliability & Validity,
located on the left menu bar. As you work through the review, you will
pass through Stage 2: Plausibility, Stage 3: Practicality, Overall, and
finally, Share & Notes.
5. Read through each Criterion carefully and relate each question to the
tool in review. You will also want to refer to the Tool Summary and any
supporting documents that may accompany the tool.
6. Once you have made a decision about each criterion, input your answers
directly into the Web application. Your answers will either be Yes or
No, or Good, Fair, Poor, or Info N/A. You won’t see your partner’s
responses for each criterion until you have “shared” your tool review.
7. There are two comments functions:
• One comments box is the On the Record comments regarding you
and your partner’s decision about each criterion. These comments
must be agreed upon by both of you and finalized once the review
of the tool is complete. You won’t see your partner’s responses in
the comments box until you have “shared” your tool review. These
comments will be very helpful in summarizing insights about the
tool when it is written up for use by practitioners, should it end up
in the “recommended” list.
• The other comments box is the Off the Record comments, which
you and your partner can use to discuss each criterion. These
comments are only meant to be a dialogue between you and your
partner, and will not be part of the final report. You won’t see your
partner’s responses in the comments box until you have “shared”
your tool review.
Note: You must press SAVE before you change your Web page
(e.g., before you go “back” on your web browser). If you don’t press
SAVE, the information you have entered into the Review will not be
saved!
8. When you have completed your own review of the tool, you are then
ready to “share” your responses with your partner (and vice versa).
Even if you have “shared” your review, you will not be able to see your
partner’s answers if they have not yet completed the review. To “share”
your responses with your partner, go to Share + Notes, and check off
“share.”
9. Now that you are both “sharing” the review of the tool, you have entered
into the collaborative stage, where you can read each others On the
Record and Off the Record comments, edit your answers, and discuss/
argue your various points.

Recommended and Promising Practices For Situational Assessment Tools 67

 10. Although you and your partner might not (and don’t have to) agree on
each criterion, you must come to an agreement for the Overall Assess-
ment of the tool.
11. If you and your partner cannot come to agreement regarding the
Overall Assessment of the tool, contact Admin Support, and we will
bring in a third party to review the tool and break the tie; they will do
this prior to looking at your results and comments.
12. You don’t have to review the tool all at once. If you make sure to SAVE
all your information, you can come back to the tool and keep reviewing
it at a later time.
13. Once you have completed the review of the tool, you can go back
and edit your review over the next few days (whether or not it is in
the “sharing” stage). After a set time (of which you will be notified),
the review of the tool will be closed, and you can no longer make any
changes. Admin Support will notify you if your deadline to finish is
approaching.
14. Once both of you have decided on your final answers (On the Record
comments included), you can now Submit the tool to THCU. Keep
in mind that we will have the ability to go back to the tool and re-edit
should there be problems that come up later on. All changes must be
agreed upon by both partners. The final review version of the tool must
be agreed upon by both partners, but just SUBMITTED by one.
15. If you have any problems, questions or comments, please direct them to
Admin Support.

68 Comprehensive Workplace Health Promotion

Part III
10. TOOL CATALOGUE Information not
Available
10.1 Using this Catalogue It should be noted
that in a few instances,
General Advice for Using the Catalogue information is not avail-
able for particular tool
There are various methods you can use to find the tools you are looking for in this cata-
characteristics (e.g.,
logue. While you’re looking for a tool, keep in mind the Principles of Good Practice in cost – many source
CWHP Situational Assessments (section 6) and Selecting a Situational Assessment Tool organizations were
(section 7). wary to put a definitive
“price tag” on their tool,
The tools in this catalogue are listed in alphabetical order, with a clearly marked recom- as the cost can vary
depending on many
mended or promising label. Although the online resource has the capability to perform factors including the
various searches (keyword and target), this print resource simply supplies the tool amount of customiza-
summaries in alphabetical order. In some cases, the tools themselves and additional tion required.) When
resources are accessible free of charge and can be downloaded from the online resource, information is not avail-
able in the catalogue,
using the Resource Listing.
try contacting the
developers or distribu-
The icons in each tool summary represent the main characteristics and types that tors of the tool to find
describe each tool. Use the icon legend to familiarize yourself with the meanings of each out more (contact
of the icons. information is available
in the tool summaries).

Advice for Specific Situations

I’m Not Sure What I’m Looking For
Simply browse the tool summaries, particularly the tool description and tool construc-
tion information.

I’m Looking for a Specific Type of Tool, or a Tool with Certain Characteristics
Find the icon(s) that represent your search (in the icon legend). Then, flip through the
various tool summaries to find the tool(s) that are represented by your selected icon(s).

I Want to Compare Tools

Use Table 2: Summary of Characteristics of Recommended and Promising Tools. It
illustrates the characteristics of each tool in relation to the other tools.

I Want to Compare the Effective, Plausible and Practical Rating of One Tool to
Another
Use Table 3: Summary of the Effective, Plausible and Practical Ratings of the Recom-
mended and Promising Tools. It illustrates how the Review Panel reviewed each tool in
comparison to the other tools.

Recommended and Promising Practices For Situational Assessment Tools 69

 10.2 Icon Legend
Icons have been attached to particular tool characteristics to assist in identifying the
attributes of each tool. The icons are used in Table 2: Summary of Characteristics of
Recommended and Promising Tools, as well as in each tool summary. (See the glossary
for definitions of these terms.)

Type of Tool
Current Practices Survey Health Risk Assessment

Interest Survey Needs Assessment

Organizational Culture Survey

Rating
Recommended Promising

Evaluation
Validity/Reliability evaluation conducted

Access
Cost No Cost

Public Domain Proprietary

Made in Canada

Electronic Access Paper Access

Online Access

Language + (languages other than French

English and French)

70 Comprehensive Workplace Health Promotion

 Aspects of Compreshesive Workplace Health Promotion
Organizational Culture Occupational Health and Safety
/#

Lifestyle Practices

Implemention information
Employee Completion Employer/Committee Completion

Completion time over 30 minutes Completion time of 10-30 minutes

Completion time of 5-10 minutes

Internal Implementation (imple- External Implementation (implemented

mented by the workplace) by someone outside the workplace – e.g.,
consultant, company, etc.)

Recommended and Promising Practices For Situational Assessment Tools 71

10.3 Summary of Characteristics of Recommended and Promising Tools
Table 2: Summary of Characteristics of Recommended and Promising Tools

Needs Assessment
Current Practices

Workplace Audit
Tool Available at

Interest Survey

Organizational
Culture Survey
Assessment
Health Risk
Additional
Tool

Resources

Survey
Rating

THCU
BWell Employee Interest Survey

Connex Health Risk and Productivity

Assessment (CHRPA©)

Employee Engagement Survey

Employee Feedback System (©EFS)

Employee Health Survey

Health at Work Needs Assessment

Questionnaire

HEALTH MONITOR TM

Healthy Hospital Employee Survey

(©HHES)

Heart Check

HeartWorks Survey

Improving Your Workplace Employee

Survey

NQI Employee Healthy Workplace Survey

Organizational & Individual Health Survey

Organizational Health Audit

Organizational Health Survey

Personal and Organizational Quality

Assessment (POQA)

Personal Wellness Profile TM

72 Comprehensive Workplace Health Promotion

 Needs Assessment
Current Practices

Workplace Audit
Tool Available at

Interest Survey

Organizational
Culture Survey
Assessment
Health Risk
Additional
Tool

Resources

Survey
Rating

THCU
Questionnaire for Self-Assessment

SF-36v.2

STORM Index (Strategic Organizational

Management Index)

StressMap®

TRALE Explorer (Online) & TRALE Backpack

(Paper)

Wellness Checkpoint

Work Positive Risk Assessment

Questionnaire

Workplace Health Needs and Risks Survey

Workplace Health Promotion Quality

Assessment Questionnaire

Workplace Overview Tool

Workplace Physical Activity Framework

(WPAF)

Workplace Wellness Survey

Recommended and Promising Practices For Situational Assessment Tools 73

Table 2: Summary of Characteristics of Recommended and Promising Tools CONT’D

Electronic Access
Made in Canada
Public Domain

Online Access
Paper Access
Proprietary
Conducted
Evaluation
Tool

No Cost
Cost
BWell Employee Interest Survey

Connex Health Risk and Productivity

Assessment (CHRPA©)

Employee Engagement Survey

Employee Feedback System (©EFS)

Employee Health Survey

Health at Work Needs Assessment

Questionnaire
HEALTH MONITOR TM

Healthy Hospital Employee Survey

(©HHES)

Heart Check

HeartWorks Survey

Improving Your Workplace Employee

Survey

NQI Employee Healthy Workplace Survey

Organizational & Individual Health Survey

Organizational Health Audit

Organizational Health Survey

74 Comprehensive Workplace Health Promotion

 Electronic Access
Made in Canada
Public Domain

Online Access
Paper Access
Proprietary
Conducted
Evaluation
Tool

No Cost
Cost
Personal and Organizational Quality
Assessment (POQA)

Personal Wellness Profile TM

Questionnaire for Self-Assessment

SF-36v.2

STORM Index (Strategic Organizational

Management Index)

StressMap®

TRALE Explorer (Online) & TRALE Backpack

(Paper)

Wellness Checkpoint

Work Positive Risk Assessment

Questionnaire
Workplace Health Needs and Risks Survey

Workplace Health Promotion Quality

Assessment Questionnaire

Workplace Overview Tool

Workplace Physical Activity Framework

(WPAF)

Workplace Wellness Survey

Recommended and Promising Practices For Situational Assessment Tools 75

Table 2: Summary of Characteristics of Recommended and Promising Tools CONT’D

Health and Safety

Lifestyle Practices

Employer/Comm-
ittee Completion
Organizational

Occupational
Language +

Completion
Tool

Employee
Culture
French
BWell Employee Interest Survey
/#

Connex Health Risk and Productivity

Assessment (CHRPA©) /#

Employee Engagement Survey

/#

Employee Feedback System (©EFS)

/#

Employee Health Survey

/#

Health at Work Needs Assessment

Questionnaire /#
TM
HEALTH MONITOR

Healthy Hospital Employee Survey

(©HHES) /#

Heart Check
/#

HeartWorks Survey
/#

Improving Your Workplace Employee

Survey /#

NQI Employee Healthy Workplace Survey

/#

Organizational & Individual Health Survey

/#

Organizational Health Audit

/#

Organizational Health Survey

/#

Personal and Organizational Quality

Assessment (POQA) /#

76 Comprehensive Workplace Health Promotion

 Health and Safety

Lifestyle Practices

Employer/Comm-
ittee Completion
Organizational

Occupational
Language +

Completion
Tool

Employee
Culture
French
Personal Wellness Profile TM

Questionnaire for Self-Assessment

/#

SF-36v.2

STORM Index (Strategic Organizational

Management Index) /#

StressMap®
/#

TRALE Explorer (Online) & TRALE Backpack

(Paper) /#

Wellness Checkpoint

Work Positive Risk Assessment

Questionnaire /#

Workplace Health Needs and Risks Survey

/#

Workplace Health Promotion Quality

Assessment Questionnaire /#

Workplace Overview Tool

/#

Workplace Physical Activity Framework

(WPAF) /#

Workplace Wellness Survey

/#

Recommended and Promising Practices For Situational Assessment Tools 77

Table 2: Summary of Characteristics of Recommended and Promising Tools CONT’D

Completion Time

Completion Time

Completion Time

Implementation

Implementation
10 - 30 min.

5 - 10 min.
Tool

30 + min.

External
Internal
BWell Employee Interest Survey

Connex Health Risk and Productivity

Assessment (CHRPA©)
Employee Engagement Survey

Employee Feedback System (©EFS)

Employee Health Survey

Health at Work Needs Assessment

Questionnaire
HEALTH MONITOR TM

Healthy Hospital Employee Survey

(©HHES)
Heart Check

HeartWorks Survey

Improving Your Workplace Employee

Survey
NQI Employee Healthy Workplace Survey

Organizational & Individual Health Survey

Organizational Health Audit

Organizational Health Survey

Personal and Organizational Quality

Assessment (POQA)
Personal Wellness Profile TM

78 Comprehensive Workplace Health Promotion

 Completion Time

Completion Time

Completion Time

Implementation

Implementation
10 - 30 min.

5 - 10 min.
Tool

30 + min.

External
Internal
Questionnaire for Self-Assessment

SF-36v.2

STORM Index (Strategic Organizational

Management Index)
StressMap®

TRALE Explorer (Online) & TRALE Backpack

(Paper)
Wellness Checkpoint

Work Positive Risk Assessment

Questionnaire
Workplace Health Needs and Risks Survey

Workplace Health Promotion Quality

Assessment Questionnaire
Workplace Overview Tool

Workplace Physical Activity Framework

(WPAF)
Workplace Wellness Survey

Recommended and Promising Practices For Situational Assessment Tools 79

10.4 Summary of Effective, Plausible and Practical Ratings of Recommended
and Promising Tools
The purpose of the Star Chart is to provide a summary of overall ratings (related to effectiveness, plausibility
and practicality) for potential users that will help them to identify the situational assessment tools that may best
meet their unique needs and requirements. Users are also encouraged to refer to the individual tool summaries
for more specific information about each of the situational assessment tools rated below. The number of stars
represents the total score of each reviewer for each major review criteria heading.

At the time of the review, a number of situational assessment tools either had not been evaluated, or did not
provide enough information to allow the evaluations to be rated. Under the effectiveness rating (below) we have
identified these tools by specifying “I.I.”, meaning “Insufficient Information” was available. Given that the major-
ity of tools provided insufficient information, none of the overall ratings were impacted by this designation.

'PVS
TUBST

HPPE
GSPN
CPUI
SFWJFXFST
4VNNBSZ
4DBMF
5ISFF
TUBST

HPPE
GSPN
POF
SFWJFXFS
GBJS
GSPN
POF
SFWJFXFS
5IFSFGPSF
UIF
UPQ
TDPSF
GPS
BOZ
UPPM
JT
GPVS
TUBST

B
iHPPEw
SBUJOH

5XP
TUBST

HPPE
GSPN
POF
SFWJFXFS
03
GBJS
GSPN
CPUI
SFWJFXFST GSPN
CPUI
SFWJFXFST
5ISFF
TUBST
XPVME
FRVBM
B
SBUJOH
PG
iHPPEw
GSPN

0OF
TUBS

GBJS
GSPN
POF
SFWJFXFS
"/%
QPPS
GSPN
POF
SFWJFXFS POF
SFWJFXFS
BOE
iGBJSw
GSPN
UIF
PUIFS
SFWJFXFS
5XP
TUBST
XPVME

/P
TUBST

QPPS
GSPN
CPUI
SFWJFXFST FRVBM
B
SBUJOH
PG
iGBJSw
GSPN
CPUI
SFWJFXFST
BOE
TP
PO

Table 3: Effective, Plausible and Practical Ratings of Recommended and Promising Tools
Tool Name Effectiveness Plausibility Practicality Overall
Organization Rating Rating Rating Rating
BWell Employee Interest Survey Recommended
Buffett Taylor & Associates Ltd
Connex Health Risk and Productivity
Assessment (CHRPA©) Recommended
Connex Health Consulting
Employee Engagement Survey
I.I. Recommended
Entec Corporation
Employee Feedback System (©EFS) Recommended
Workplace Health Research Unit, Brock University
Employee Health Survey I.I. Promising
Simcoe Muskoka Health Unit
Health at Work Needs Assessment
Questionnaire I.I. Recommended
Haldimand-Norfolk Health Unit
HEALTH MONITOR TM Recommended
Summex Health Management
Healthy Hospital Employee Survey
(©HHES) Recommended
Ontario Hospital Association, in partnership with
Workplace Health Research Unit, Brock University
Heart Check
New York State Department of Public Health, Recommended
Healthy Heart Program
HeartWorks Survey I.I. Recommended
Regional Niagara Public Health Department
Improving Your Workplace Employee
Survey Recommended
NRC + Picker Canada

80 Comprehensive Workplace Health Promotion

Table 3: Effective, Plausible and Practical Ratings of Recommended and Promising Tools
CONT’D

Tool Name Effectiveness Plausibility Practicality Overall

Organization Rating Rating Rating Rating
NQI Employee Healthy Workplace
Survey I.I. Recommended
National Quality Institute
Organizational & Individual Health
Survey I.I. Recommended
Entec Corporation
Organizational Health Audit I.I. Promising
Tri Fit Inc.
Organizational Health Survey I.I. Recommended
Entec Corporation
Personal and Organizational Quality
Assessment (POQA) Promising
HeartMath LLC
Personal Wellness Profile TM Recommended
Wellsource, Inc.
Questionnaire for Self-Assessment
European Network for Workplace Health I.I. Promising
Promotion (ENWHP) ENWHP Secretariat
SF-36v.2 Promising
QualityMetric Incorporated
STORM Index (Strategic Organizational
Management Index) Recommended
Workplace Consultants Inc.
StressMap® Recommended
Essi Systems Inc.
TRALE Explorer (Online) & TRALE
Backpack (Paper) Recommended
TRALE, Inc.
Wellness Checkpoint I.I. Recommended
InfoTech Inc.
Work Positive Risk Assessment
Questionnaire I.I Recommended
NHS Health Scotland
Workplace Health Needs and Risks
Survey Recommended
Health Canada
Workplace Health Promotion Quality
Assessment Questionnaire
The National Centre for Workplace Health I.I. Promising
Promotion, The Nofer Institute of Occupational
Medicine, Lodz, Poland
Workplace Overview Tool
City of Hamilton, Public Health & Community I.I. Promising
Services Department
Workplace Physical Activity Framework
(WPAF) Recommended
The Alberta Centre for Active Living
Workplace Wellness Survey Promising
Centre for Families, Work and Well-Being

Recommended and Promising Practices For Situational Assessment Tools 81

TOOL LISTINGS
The 29 tools are presented below, in alphabetical order based on ORGANIZATION.
Workplace Physical Activity Framework (WPAF) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
The Alberta Centre for Active Living

BWell Employee Interest Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Buffett Taylor & Associates Ltd

Workplace Wellness Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

Centre for Families, Work and Well-Being

Connex Health Risk and Productivity Assessment (CHRPA©) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102

Connex Health Consulting

Employee Engagement Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

Entec Corporation

Organizational Health Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116

Entec Corporation

Organizational & Individual Health Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

Entec Corporation

Questionnaire for Self-Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128

European Network for Workplace Health Promotion (ENWHP) ENWHP Secretariat

StressMap® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Essi Systems Inc.

Health at Work Needs Assessment Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

Haldimand-Norfolk Health Unit

Workplace Overview Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

City of Hamilton, Public Health & Community Services Department

Workplace Health Needs and Risks Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152

Health Canada

Personal and Organizational Quality Assessment (POQA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160

HeartMath LLC

Work Positive Risk Assessment Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166

NHS Health Scotland

Wellness Checkpoint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172

InfoTech Inc.

Heart Check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

New York State Department of Public Health, Healthy Heart Program

82 Comprehensive Workplace Health Promotion

HeartWorks Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
Regional Niagara Public Health Department

Workplace Health Promotion Quality Assessment Questionnaire . . . . . . . . . . . . . . . . . . . . . . . . . . 190

The National Centre for Workplace Health Promotion, The Nofer Institute of Occupational Medicine, Lodz, Poland

NQI Employee Healthy Workplace Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196

National Quality Institute

Improving Your Workplace Employee Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202

NRC + Picker Canada

OHA Healthy Hospital Employee Survey (©HHES) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208

Ontario Hospital Association, in partnership with Workplace Health Research Unit, Brock University

SF-36v.2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
QualityMetric Incorporated

Employee Health Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224

Simcoe Muskoka Health Unit

HEALTH MONITOR TM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230

Summex Health Management

Employee Feedback System (©EFS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236

Workplace Health Research Unit, Brock University

TRALE Explorer (Online) & TRALE Backpack (Paper) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242

TRALE, Inc.

Organizational Health Audit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248

Tri Fit Inc.

Personal Wellness Profile TM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254

Wellsource, Inc.

STORM Index (Strategic Organizational Management Index) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260

Workplace Consultants Inc.

Recommended and Promising Practices For Situational Assessment Tools 83

Workplace Physical Activity Framework (WPAF)
Alberta Centre for Active Living

RECOMMENDED
Description
Organizational Culture
The Workplace Physical Activity Framework
(WPAF) is for workplaces to assess their ability to
promote and support physical activity to workplace Workplace Audit
employees. When used over time, the WPAF can
show where resources can be best used for workplace
physical activity promotion in order to create a cycle Validity/Reliability Evaluation Conducted
of continuous improvement.
No Cost
Tool Construction
45 questions. Sections include: Public Domain
Part 1. Groundwork: Management and Employee
Commitment; Environment and Needs Assessment.
Part 2. Construction: The Individual Level: Made in Canada
Knowledge, Attitude, and Skills; The Social Level:
Enhancing Relationships; The Organizational Electronic Access
Level: Leadership, Capacity, Will, and Infra-
structure; The Community Level: Assets and
Partnerships; The Policy Level: Current Physi- Online Access
cal Activity Policies and Drafting New Policies.
Part 3. Detailing: Program Administration; Safety
and Risk Management. Organizational Culture /#

Additional Resources Lifestyle Practices

Development of an Ecological Assessment Tool for a
Workplace Physical Activity Program Standard. Employer/Committee Completion

WPAF Program Standard (which contains the tool

itself) Completion Time over 30 minutes

Contact Information Internal Implementation

Education Coordinator
The Alberta Centre for Active Living
11759 Groat Road
Edmonton Alberta
T5M 3K6
www.centre4activeliving.ca

84 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2003

Adapted From/Built On
A literature search was done to compile best practices in workplace physical activity. The WPAF is modeled
after the OHS (occupational health and safety) partnerships program audit. The Checklist of Health Promotion
Environments at Worksites (CHEW) instrument (Oldenburg, Sallis, Harris, & Owen, 2002), was also consulted
for guidance. For more information on the development of the WPAF, see the Development of an Ecological
Assessment Tool for a Workplace Physical Activity Program Standard. This additional resource can be accessed
through the online Resource Listing. Researched and developed by: Ron Plotnikoff, PhD, Associate Professor,
University of Alberta; Allan Fein, MSc (PhD Cand.), University of Toronto; Leah Milton, BN, Workplace Health
Consultant; Tricia Prodaniuk, BPE (Master’s Cand.), University of Alberta; Val Mayes, HBOR (Master’s Cand.),
University of Alberta.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
The WPAF can be completed by a representative from HR, a wellness manager, a CEO, a representative from
Occupational Health and Safety, a departmental manager, or a combination of people from these areas.

Known Users
Alberta Health and Wellness, Heart Health Coalitions in Southwestern Ontario, and the South Australian
Physical Activity Strategy, Office for Recreation and Sport, South Australian Government.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace implements the tool on its own.

2. Workplace staff involvement

Individual employees may be asked for input in completing the tool to validate answers in the audit.

Recommended and Promising Practices For Situational Assessment Tools 85



Workplace Physical Activity Framework cont’d

3. Workplace leader involvement

Whomever is completing the tool will require workplace leader support and input to complete the WPAF.

4. Collaborative aspects
No information available.

Time Involved
1. Time to complete tool
Approximately 30 minutes to complete the tool per person or in a group.

2. Time from distribution to presentation of results

Since only one copy of the tool is completed, the time varies based on how long it takes from completion of the
tool to the presentation of results.

3. Recommended implementation cycle

Intended implementation cycle is annually.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: No

The person or people who complete the audit also analyze or score it. This takes very little time, as it consists
of simply tallying up the YES votes.

2. Process to analyze
Electronic: No

Manual: Yes

The audit has a very simple scoring system; the number of YES answers is tallied for each section.

3. Time to analyze
No information available.

4. Outcome of analysis
The outcome of analysis could be just the score sheet, but it is recommended that the person or people who
complete and score the audit also write up a summary of the results.

86 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: $0
Cost per unit/respondent: $0
Workplace Resources Used
Time given to selected employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
The survey is contained within the WPAF Program Standard, which provides detailed instructions on how to
complete and score the WPAF. This additional resource can be accessed through the online Resource Listing.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

The person or people who complete the WPAF must be familiar with the programs and policies of the workplace,
or have that information easily accessible to them.

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
The WPAF can be downloaded in PDF format from the Alberta Centre for Active Living Web site for free (www.
centre4activeliving.ca). The WPAF can also be accessed through the online Resource Listing.

Restrictions or conditions of access or use

If the tool is used or adapted, please credit the Alberta Centre for Active Living.

Recommended and Promising Practices For Situational Assessment Tools 87



Workplace Physical Activity Framework cont’d

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

The results obtained through the various research and development components of the project strengthened
content validity as key stakeholders, experts, and workplaces provided substantial guidance on the WPAAT and
Program Standard.

Reliability: Yes

Inter-rater reliability was high, with the strongest agreement emanating from a large worksite department (50
employees) with a difference of 3 out of 45 points. A small worksite (8 employees) reported a difference of 6/45
points, a very large workplace (3800 employees) revealed a difference of 8/45 points, and a multi-site municipality
(170 employees) had a difference of 17/45 points. The multi-site nature and diversity of workers in the municipal-
ity is likely the cause for the higher difference in scores for that workplace as the assessors worked in different
departments. This further supports employing the Workplace Physical Activity Assessment Tool (WPAAT) for
separate departments within large organizations. All WPAAT scores across all the worksites followed the same
directional trend. For example, if one assessor provided a low rating at the individual level, the other paired
assessor did as well, even if their scores differed by one or two points.

Formative Testing
Pilot testing: Yes

Consultations: Yes

Focus Groups: Yes

Process Evaluation
During development, feedback was given by reviewers (practitioners, stakeholders). Since development, however,
the Alberta Centre for Active Living (who distributes the tool) has provided the tool for free and is available to all
on their website. The have not been able to do any process evaluation because they have not received the funding
to adequately track the tool. They have not, therefore, conducted any formal or informal process evaluation.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The K.R. McLeroy et al. (1988) ecological model is mentioned as one of the theoretical underpinnings to the tool,
as well Rogers’ (1995) Diff usion Theory.

88 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
This is an excellent audit tool for workplaces to use to assess their ability to promote and support physical activity to
workplace employees.

Questions follow a logical sequence that one would use in planning a comprehensive workplace health initiative.

Tool is readily accessible to workplaces from any location since the file is downloadable from the internet. Audit tool
is available online for free and there is no cost to purchase, implement, or analyze it. It should be accessible to all large
and small businesses, provided they have internet access.

The tool allows the workplace to complete the audit annually or whenever the organization goes through a significant
transition. It can help an organization to develop and maintain a workplace physical activity program by creating a
cycle of continuous improvement.

Limitations
The tool would be stronger if there was an explicit reference to a CWHP approach at the beginning of the program
standard or audit tool.

Supporting documents indicate that the reading level is approximately grade 12, which may be a little high for some
workplaces. The tool is not available in any languages other than English, and has not been reviewed for cultural appro-
priateness.

General Comments
The tool addresses two important components of a comprehensive workplace health approach; lifestyle practices
(physical activity) and organizational culture. There is some reference to occupational health and safety under the
section of the audit tool that deals with safety and risk management.

Recommended and Promising Practices For Situational Assessment Tools 89

BWell Employee Interest Survey
Buffett Taylor & Associates Ltd.

RECOMMENDED

Description
Current Practices
This tool is used to gain insight into demographics
and health interest areas of a particular employee Interest Survey
group. It can also gauge barriers to participation and
the varying employee perceptions of an organiza-
Organizational Culture
tion’s culture.

Tool Construction Validity/Reliability Evaluation Conducted

1 section on over 30 topics of interest; 1 section on

Cost
organizational culture; Logistics questions on time
and program preferences.
Proprietary

Made in Canada

Electronic Access

Paper Access

Online Access

French

Organizational Culture /#

Contact Information Occupational Health and Safety

Janet Young Lifestyle Practices

Buffett Taylor & Associates Ltd.
605 Brock Street North,
Employee Completion
Suite 200
Whitby, ON
L1N 8R2 Short Completion Time

www.buffetttaylor.com Internal Implementation

90 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1998

Adapted From/Built On
None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
Buffett Taylor & Associates’ 30+ client organizations, all Canadian.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace implements the tool with Buffett Taylor’s help and support.

2. Workplace staff involvement

A member of the workplace’s staff would become the appointed head of the initiative. This might be a workplace
wellness coordinator or manager, or someone from human resources, etc.

3. Workplace leader involvement

Workplace leaders are asked to market and support the initiative and to provide work time to employees for
completion of the survey.

Recommended and Promising Practices For Situational Assessment Tools 91



BWell Employee Interest Survey cont’d

4. Collaborative aspects
Collaboration can happen with Public Health and with in-house experts in client organizations (i.e. Commu-
nications department, IT). For example, a Public Health unit can help with add-on HRA components. Public
Health units are also given the opportunity to collaborate with Buffett Taylor. Buffett Taylor can and has worked
some of the Public Health units’ questions into the survey at the request of the workplace and Public Health
unit. Other collaboration with Public Health can come in the form of a Public Health employee sitting on a
workplace’s Wellness Committee.

Time Involved
1. Time to complete tool
Approximately 10 minutes per employee.

2. Time from distribution to presentation of results

Typically takes 3 months. This includes a marketing period of 2 weeks that follows the development of the report
and precedes the presentation of results.

3. Recommended implementation cycle

Annually. This allows the employer to re-assess the same areas in order to measure change in areas of interest and
other measurable outcomes (like questions targeted to extract opinions in regards to organizational culture).

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Buffett Taylor analyzes the data.

2. Process to Analyze
Electronic: Yes

Manual: Yes

The data is typically analyzed with Buffett Taylor’s proprietary data collection tool. However, if a client has a
specialized request that the data collection tool is not equipped to deal with Buffett Taylor does perform manual
analysis.

3. Time to Analyze
Typically takes one week.

4. Outcome of Analysis
An aggregate report is prepared by Buffett Taylor and then subsequently presented to the workplace’s Steering
Committee and the Management team. The results are also kept on file to aid in programming and benchmark-
ing exercises.

92 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Printing of survey when administered on paper and time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
There are no supporting materials that accompany the tool, but Buffett Taylor provides consulting advice, mar-
keting support, and IT support to the workplace.

Customization
Tool can be modified slightly to reflect nuances of the workplace.

Questions can be added or omitted.

Skills required to implement, and to analyze and report

For implementation, not applicable. Buffett Taylor completes the steps.

For analysis and reporting, not applicable. Buffett Taylor completes the steps.

Languages: English, French

Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Buffett Taylor and Associates Ltd. (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted.

Recommended and Promising Practices For Situational Assessment Tools 93



BWell Employee Interest Survey cont’d

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

The survey was internally tested by Buffett Taylor, first in 1998 and then subsequently each year it has been
re-tested. It was initially tested with a sample group of 30 respondents.

Reliability: Yes

The results indicate reliability. Buffett Taylor has found that they get the information they are looking for, but
that it changes slightly as well – because it is interest that is being measured, and interests can shift or change.

Formative Testing
Pilot testing: Yes

The survey was pilot tested with Buffett Taylor’s own staff in 1998.

Consultations: Yes

A committee of experts was informally consulted after original development.

Focus Groups: No

Process Evaluation
Buffett Taylor evaluates the following things each year:

• Year to year comparison (tracking of responses). This compares interest areas (have they
changed and if so, why?) and compares areas of participation between departments or work-
places within one client organization.
• Barriers to completion.
• User satisfaction level with process.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Employee interest, workplace theories, planning strategies, and general principles of health promotion.

94 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
Survey is easy to follow and has a consistent format.

Very practical tool though it is mainly an employee interest tool as opposed to a tool for assessing Health and Safety or
organization climate/culture.

Broad scope of healthy life style related topics.

It is a very practical tool.

Report is succinct and good for program development.

Limitations
No comments provided.

General Comments
Includes employee health interests and health and lifestyle questions that are relevant to planning a wellness program.
It contains a wide variety of questions related to CWHP.

Buffett does provide support for implementation and also encourages workplaces to contact local health unit for
implementation.

Recommended and Promising Practices For Situational Assessment Tools 95

Workplace Wellness Survey
Centre for Families, Work and Well-being

PROMISING

Description
Current Practices
The Workplace Wellness Survey is designed to
provide individuals and organizations with insight
Organizational Culture
into their well-being and to facilitate and support
a change process toward healthier individuals and
organization. Validity/Reliability Evaluation Conducted
Tool Construction
Cost
54 questions. Topics covered include: organizational
values; questions about your job; health and safety
concerns; work-life balance; personal life (care
Proprietary
giving, nutrition, smoking, alcohol consumption,
physical activity, sleep); and general information. Made in Canada

Paper Access

Online Access

Organizational Culture /#

Lifestyle Practices

Employee Completion
Contact Information
Peter Hausdorf, Ph.D. Completion Time over 30 minutes

Department of Psychology
University of Guelph Internal Implementation
Guelph, Ontario
N1G 2W1
phausdor@uoguelph.ca
Phone: 519-824-4120 ext. 53976
Centre for Families, Work and Well-Being
http://www.worklifecanada.ca/

96 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2002

Adapted From/Built On
Developed through the Centre for Families, Work and Well-Being at the University of Guelph. Several tools are
used including CARNET (support measures), Hoppock (for job satisfaction), SLOAN (WIL/LIW -- work life
conflict measures).

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific, though it has been used primarily in health care and municipal government environ-
ments.

Intended Users
All employees are encouraged to complete the survey.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with the help and support of the Centre for Families, Work and Well-Being (CFWW) and the
Community Heart Health Network (HHN).

2. Workplace staff involvement

A staff member of the organization will act as “champion” for the survey. This person then organizes as neces-
sary to advertise the survey in advance and act as a contact person for those who have questions about the
survey, supported by the Heart Health Network. However, the survey is designed, posted, and data collected by
the CFWW.

Recommended and Promising Practices For Situational Assessment Tools 97



Workplace Wellness Survey cont’d

3. Workplace leader involvement

At least two meetings are held between organization representatives (usually managers), a representative of
CFWW and a representative of HHN. At the first meeting, organization representatives are provided a prec-
edent survey and asked to review it. A discussion then takes place as to what they would like to have included
in the survey and what they would like to have removed. At the second meeting, the representatives are asked
to confirm that the revised survey is appropriate. Again, discussions are held as to items they would like to have
included or removed. The organization representatives must provide their approval on the final version of the
survey before it will be administered.

4. Collaborative aspects
The survey is a joint effort between the CFWW and the HHN. The CFWW occasionally conducts organizational
surveys using a version of the tool separately from the HHN.

Time Involved
1. Time to complete tool
Approximately 30 minutes per employee.

2. Time from distribution to presentation of results

Approximately 6 weeks.

3. Recommended implementation cycle

Every 3 years or after major changes in programming or structural changes in the workplace.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

The survey is analyzed by CFWW grad students, staff and faculty.

2. Process to Analyze
Electronic: No

Manual: Yes

Manual analysis using SPSS.

3. Time to Analyze
Typically takes 2 weeks on a part-time basis.

98 Comprehensive Workplace Health Promotion

4. Outcome of Analysis
Graduate students in Industrial/Organizational and/or Social Psychology create a report summarizing all of the
questions included in the survey, which is then presented to a panel from the organization (managers, board of
directors, union reps, etc.). The report includes findings from the survey and suggestions for actions to address
any issues that arose. There is a standardized report and presentation format. For each client, a graduate student
conducts the analysis (checks response rates, cleans the data, confirms reliabilities) and prepares the data files to
be used for all reports (individual, unit, and organizational).

B. ECONOMICS
Total Cost: $5,000 - $10,000 (depending on number of reports).
Cost per unit/respondent: $10 (plus a minimum survey set-up fee of $2,000), employees usually complete
the survey on work time.

Workplace Resources Used

Printing of survey when administered on paper and time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
There is technical support available when placing the tool on the Web site and, in some cases, retrieving the data.
No training is required; however, action planning concepts are discussed in the organizational presentation.

Customization
Tool can be modified slightly to reflect nuances of the workplace.

Skills required to implement, and to analyze and report

No information available on the skills required for implementation.

For analysis and reporting, the following skills are required:

• Data analytic skills;

• psychometric knowledge;
• statistical knowledge;
• knowledge of statistical software (typically SPSS);
• knowledge of WORD, EXCEL, POWERPOINT;
• attention to detail and ability to interpret and see patterns in data.

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: Yes. It is currently at a grade 12 reading level.

Recommended and Promising Practices For Situational Assessment Tools 99



Workplace Wellness Survey cont’d

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Dr. Peter Hausdorf (See contact information above).

Restrictions or conditions of access or use

Yes. The tool must be used through Dr. Peter Hausdorf.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

There has been some structural equation modeling conducted by Peter Hausdorf and an MA student, Melissa
Warner, in 2003.

Reliability: Yes

Overall the results of reliability testing were good. The work demands scale, however, scored Cronbach alpha less
than 0.7. This scale was developed with items drawn from a larger job stress measure but the reliabilities were
low. To address this issue, they have since developed a new measure of workload because if its importance. It
contains four items (1. I have too much work to do; 2. My job requires me to work very fast; 3. My job leaves me
with little time to get everything done; 4. I don’t have time to take an occasional break). Cronbach alpha is.76.

Formative Testing
Pilot testing: No

Consultations: Yes

Consultations were held with various faculty experts and extensive consultation with dieticians and others.

Focus Groups: Yes

Measures were developed or selected in the first two workplaces, with workplace focus groups.

Process Evaluation
Internal evaluation was conducted through the HHN with the help of graduate students at one of the sites. There
are also periodic informal reviews with workplaces on implementation of plans developed through the survey
process.

100 Comprehensive Workplace Health Promotion

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Individual behavior change and healthy workplace theories.

SELECTED REVIEW PANEL COMMENTS

Strengths
The tool covers all of the domains of CWHP: health and safety, lifestyle practices and organizational culture. The good
aspects are the articulation of how the employee perceives the workplace environment, managers, supervisors, and
co-workers and identifies trouble spots for action. The Work-Life profile is quite good in focusing on both individual
and general workplace needs.

The Work-Life profile is quite good. Individuals should find it useful - it provides a reason to make some positive health
changes.

The highlights of the tool were the collaborative structure and way of reporting data that could lead to changes if
everyone felt included.

Limitations
The reviewers had some concerns that questions about the employees’ personal life might be considered intrusive, and
not be answered.

Definitely cannot be used with low literacy employees or employees with limited English in its present form.

The chief drawback of the tool was the validity of the questions.

General Comments
It seems that the tool is a ‘work in progress’ that will continue to undergo modification as its application increases.

Recommended and Promising Practices For Situational Assessment Tools 101

Connex Health Risk and Productivity
Assessment (CHRPA©)
Connex Health Consulting

RECOMMENDED
Description
Current Practices
The tool assesses individual and organizational health
needs, interests, and preferences; identifies program pri- Interest Survey
orities; and it provides a baseline for future measurement.

Tool Construction Needs Assessment

Section 1: About You - 5 questions (age, sex, type of
work, rate your health, barriers to improving health) Organizational Culture
Section 2: About Your Lifestyle Habits – 40 questions
(lifestyle habits, stage of change and interest in programs Validity/Reliability Evaluation Conducted
for BMI, nutrition, activity, sleep, work and home stress
and coping, what could employer do to decrease stress
social, shift work, smoking, alcohol) Cost
Section 3: About Your Health – 46 questions (family
history of diseases, current diagnosis of diseases, dis- Proprietary
eases requiring medication, self care practices for annual
medical, dental, know your cholesterol and blood pres- Made in Canada
sure, self examinations, risk factors for asthma, COPD,
osteoporosis, and impact of disease on productivity and Electronic Access
personal activity levels)
Section 4: About Your Work and Home Life – 12 ques-
Paper Access
tions (marital status, dependent children, Work interfer-
ence with Family, Family interference with Work, impact
of parenting/care giving on work and personal health) Online Access
Section 5: Mental Health – 5 questions (family history,
symptoms, risk factors for anxiety/bipolar)
Section 6: Health in Your Workplace – 10 questions (air French
quality, business culture, job satisfaction, recommend
workplace) Organizational Culture
Section 7: About Your Interest in Workplace Health /#
Programs – 11 questions (interest level, specific program
interest, delivery format preference, time preference, bar- Occupational Health and Safety
riers, willingness to volunteer, willingness to pay a fee,
manager support for employee participation)
Lifestyle Practices
Contact Information
Employee Completion
Denise Balch, President
Connex Health Consulting Long Completion Time
3228 South Service Road, Suite 104
Burlington, ON, L7N 3H8 External Implementation
www.connexhc.com

102 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2002

Adapted From/Built On
Recognized tools and standards have been inserted in specific sections of the tool.
Below is a summary, but not complete list of those tools:

Health Canada -- Body Mass Index and Waist Circumference

Canada’s Food Guide to Healthy Eating
Canada’s Physical Activity Guide to Healthy Active Living
Dr. Martin Shain’s Business Health Culture Index (BHCI)
Cage Questions from Pub Med for Alcohol
Work Productivity and Activity Impairment Questionnaire -- General Health (WPAI-GH) from the Gold
Book (Mercer and IHPM)
Lung Association -- 30 Second Asthma Test
COPD Patient Administered Questionnaire Initial Assessment
The Osteoporosis Society of Canada -- questions on osteoporosis
Canadian Mental Health Association -- What’s Your Stress Index
Canadian Mental Health Association -- What are the signs of Depressive Illness?

USERS
Intended Sectors/Sizes of Workplaces
Medium to large workplaces (> 200+ employees)*

* A small group HRA is under development.

Intended Users
All employees are encouraged to complete the survey.

Known Users
Connex Health Consulting is the National Quality Institute’s preferred provider.

Recommended and Promising Practices For Situational Assessment Tools 103



Connex Health Risk & Productivity Assessment cont’d

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Connex Health Consulting, with the help and support of the workplace.

2. Workplace staff involvement

The workplace’s healthy workplace committee or a core team of workplace representatives helps determine cus-
tomizations, distribution logistics, promotional strategies, and incentives. Connex also encourages workplaces
to involve their employees in a “Name our Healthy Workplace Program” contest, which offers a prize for the best
suggested name. This is a promotional activity and gets the employees directly involved early on.

3. Workplace leaders involvement.

Leaders are to approve, encourage, and support the completion of the tool. As well, the CEO typically initiates
the process with an introductory letter and would advise managers to support the initiative.

4. Collaborative aspects
Collaboration might include:

• NQI refers clients to Connex who are interested in an HRA.

• Public health materials are used in some cases for Connex’s client launches.
• Service providers are used for some program delivery.
• Nurses (provided by Connex) are used for screening clinics.
• Pharmaceutical companies are used for disease management programs.

Time Involved
1. Time to complete tool
Approximately 40 minutes per employee.

2. Time from distribution to presentation of results

Typically between 2-3 months. This is affected by the number and location of workplace satellite locations,
diversity of population, access to computers, the communication process (i.e. a workplace’s ability to approve
and produce communication) and the approval process.

3. Recommended implementation cycle

Every 2-5 years.

104 Comprehensive Workplace Health Promotion

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Connex analyzes the data.

2. Process to Analyze
Electronic: Yes

Manual: Yes

The data is analyzed electronically with Connex’s custom software, but commentary and final recommenda-
tions are provided manually. As well, if the tool has been completed in hardcopy format, Connex has to enter in
the data manually for the workplace at a cost of $25/hr.

3. Time to Analyze
Typically takes 3 weeks.

4. Outcome of Analysis
Both aggregate and individual reports are available. The aggregate report is presented to the Wellness Commit-
tee or whatever team Connex has been in contact with at the workplace. The results are presented via power
point with recommendations for programming to core team and Wellness Committee based on identified needs,
interests, and stages of readiness. After results are provided the client typically receives a proposal for program-
ming and they sign a contract to provide the priority programs that satisfy their needs and budget. It includes
aggregate data per question and graphs. For the online version, individual reports are available immediately after
the tool has been completed.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Printing of survey when administered on paper and time given to employees to complete survey.

Recommended and Promising Practices For Situational Assessment Tools 105



Connex Health Risk & Productivity Assessment cont’d

C. Other Considerations
Supports for Implementation (materials and training)
If a workplace is implementing the survey with Connex’s support, no supporting materials are needed. Connex
is involved in every aspect of the implementation process and they also provide the orientation of stakehold-
ers, training of wellness committee, and consultation with senior executives. If someone wants to use the tool
without Connex’s support, however, the wholesaling of Connex’s products/service process would have to be
negotiated.

Customization
Tool can be modified slightly to reflect nuances of the workplace.

Skills required to implement, and to analyze and report

For implementation, not applicable. Connex completes all of the steps.

For analysis and reporting, not applicable. Connex completes all of the steps.

Languages: English (French can be made available)

Tested for Cultural Appropriateness: Yes
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Connex Health Consulting (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Reliability: Yes

106 Comprehensive Workplace Health Promotion

 Each tool that Connex selected (to be part of the Connex Health Risk Assessment) was previously validated.
Other measures were often based on Canadian National Standards. For instance, sections like blood pressure
and cholesterol are based on standards published by the Canadian Medical Association, Health Canada, etc.

Formative Testing
Pilot testing: Yes

The tool was piloted in two workplaces. The pilot test was conducted by Connex and Connex has worked exten-
sively with these workplaces prior to implementation and after.

Consultations: Yes

Medical and consultative advisory panel assisted in selecting the survey questions, overall review of survey,
question standards and final consensus of approval.

Focus Groups: Yes

Process Evaluation
Survey responses are evaluated by Connex for each employer. There is also feedback on the survey from users
(employer and employee) that provides data for ongoing evaluation of tool. Initial employee feedback deemed it
satisfactory. There is also annual process evaluation that is conducted by Connex’s ongoing advisory panel.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Philosophy of a healthy workplace (healthy lifestyles and job satisfaction improve health, reduce chronic disease,
absenteeism and improve productivity), James Prochaska’s Stages of Change, and Health Belief Theory.

Recommended and Promising Practices For Situational Assessment Tools 107

 SELECTED REVIEW PANEL COMMENTS
Strengths
Well-researched tool with many valid methods.

18 evidence-based survey tools are referenced in the CHRPHA - all have been tested for reliability and validity.

Layered pre-survey communication promotes survey in a positive manner.

Well-defined analysis done by Connex.

Limitations
There are many very specific questions - some participants may be intimidated by the complexity of information
asked.

May be a limited tool in workplaces with limited access to online resources.

General Comments
Provides combined picture of employee and organizational health with recommendations for workplace health pro-
gramming (includes budget projections).

108 Comprehensive Workplace Health Promotion

Recommended and Promising Practices For Situational Assessment Tools 109
Employee Engagement Survey
Entec Corporation

RECOMMENDED

Description
Organizational Culture
The Employee Engagement Survey is used to improve
employees’ working experiences and thereby
Needs Assessment
increase their satisfaction, motivation, commitment
and performance.
Validity/Reliability Evaluation Conducted
Tool Construction
5 sections, which include the following topics: My Cost
Department; My Manager; Corporate Practices and
Policies; Mission and Values; and Personal Thoughts
Proprietary
and Feelings. There are also 3 open-ended ques-
tions.
Made in Canada

Organizational Culture /#

Paper Access

Online Access

French

Medium Completion Time

Contact Information Employee Completion

Michael Koscec
President External Implementation
Entec Corporation
283 Danforth Avenue
Suite 318
Toronto, ON
M4K 1N2 Canada

Toll Free: 1-888-858-8174

www.EmployeeOnlineSurvey.com

110 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1999

Adapted From/Built On
The Emotional Engagement Survey was built on the Organizational Health Survey (Entec Corp). Through input
from psychiatrists and other research, existing psychometric tools were added onto the Organizational Health
Survey:

• Dr. Herbert J. Freudenberger’s 15 point burnout scale. Dr. Freudenberger was a research psy-
chologist who first coined the phrase “burnout” and wrote the book “Burnout: The High Cost
Of High Achievement.
• Dr. Stephen Stahl’s measurements for depression and substance abuse. Dr. Stahl is a psychiatrist
from the University of Southern California who is credited for identifying neuro-chemicals that
are associated with mood and behaviour.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
Atlantic Blue Cross Care, Banana Republic, Enbridge Consumers Gas, Durham Region, Gap Inc. Canada, Geor-
gian College, North York General Hospital, Old Navy, York University.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Entec, with the help and support of the workplace.

Recommended and Promising Practices For Situational Assessment Tools 111



Employee Engagement Survey cont’d

2. Workplace staff involvement

Individuals (everybody in the workplace, from top to bottom) are involved at the post survey action planning
and implementation phases (such as implementation planning workshops).

3. Workplace leader involvement

Senior managers review the tool and provide minor amendments to the wording to ensure the tool reflects the
nuances of their business. They are also involved in the pre-survey communication process through discussions
with their staff to ensure that there is complete understanding and opportunity for questions to be answered
regarding the survey, the process and the outcomes. Entec always obtains senior management commitment for
follow up action. Commitment is secured in writing. Entec will not implement the survey if there is no commit-
ment before starting.

4. Collaborative aspects
Outside of collaboration between Entec and the workplace, there is no other collaboration. If there is a union,
the union is brought into the process at the very beginning to ensure that they are a partner in the project.

Time Involved
1. Time to complete tool
Approximately 10 minutes per employee.

2. Time from distribution to presentation of results

Varies between 8-10 weeks. This is dependent on the number of employees and whether a paper or an internet
survey is used. This time includes the preparation of the final survey report including recommendation for
follow up action.

3. Recommended implementation cycle

Every year or two.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Entec completes all aspects of the analysis.

2. Process to analyze
Electronic: Yes

Manual: Yes

Entec scans paper copies of the completed surveys using high speed scanners. For online copies, the internet
survey data drops into the database automatically and all of the data is analyzed electronically. Both custom
software and SPSS are used to prepare the statistical reports.

112 Comprehensive Workplace Health Promotion

3. Time to analyze
Four weeks.

4. Outcome of analysis
Statistical reports are generated by a research analyst based on specific instructions for the project. A profes-
sional consultant with expertise in organizational development, strategic management and leadership prepares
the survey report. Reports are prepared that provide results by job levels and job functions. For example, in a
hospital, this type of analysis will provide data for different levels of managers, various union groups (Ontario
Nurses Association - ONA, Services Employee International Union - SEIU) non-union positions, part-time, full-
time etc., as well as by all the divisions and departments. This type of analysis is provided for every organization
and it reflects their unique job level or job function structure. Reports are generated to provide data starting
from the top and than layered down the organization to the individual work units. For example, a report will
show the results for an individual Vice President (i.e. his or her total group) then for each Director in that group
cascading down to Managers and Supervisors, while maintaining confidentiality.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
No supports needed because the survey is implemented by Entec.

Customization
Tool can be slightly modified to reflect the nuances of the workplace.

Skills required to implement, and to analyze and report

For implementation, not applicable. Entec completes all steps.

For analysis and reporting, not applicable. Entec completes all steps.

Languages: English, French

Tested for Cultural Appropriateness: No
Tested for literacy level: No

Recommended and Promising Practices For Situational Assessment Tools 113



Employee Engagement Survey cont’d

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Entec Corporation (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted. As well, senior management of a workplace must commit to follow up implementation.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

The psychometric portions of the tool were previously tested. For example, Dr. Freudenberger’s scale had under-
gone comprehensive testing and was subsequently used in clinical practice with over 100,000 patients. The
Employee Engagement Survey did not undergo formal validity testing. However, Entec conducted testing in
concert with their clients, where they compared the survey results to the key business performance indicators
used by the organization. There is a direct “link to business results and employee commitment” with all of the
client organizations Entec has worked with.

Reliability: Yes

The reliability testing was conducted by the Research Services Unit at Georgian College. The questions in the
survey had a reliability quotient that ranged form 0.88-0.96.

Formative Testing
Pilot testing: Yes

Consultations: Yes

Focus Groups: No

Formative testing comprised a rigorous process that included focus groups, modeling, followed by focus groups,
testing, pilots, and then introduction into the market.

Process Evaluation
Response rates have been between 82%-95% and where the surveys were repeated in an organization in subse-
quent years the response rates were always higher than in the preceding years. Due to these very high response
rates it was determined that process evaluation was not necessary.

114 Comprehensive Workplace Health Promotion



Employee Engagement Survey cont’d

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The tool references the role of emotional well-being within the context of the organizational practices and lead-
ership behaviour.

SELECTED REVIEW PANEL COMMENTS

Strengths
Average 90% response rate, which is excellent.

Limitations
No comments provided.

General Comments
Entec conducted testing with clients - business performance indicators used by the organization. Vigorous testing
done with focus groups.

No formal validity testing conducted. It was tested with clients. Reliability quotient was 0.88 to 0.96.

The tool references the role or link between emotional well-being and organizational practices and leadership
behaviour.

Statistical reports are developed. A professional consultant with expertise in organizational development, strategic
management and leadership prepares the survey report.

Recommended and Promising Practices For Situational Assessment Tools 115

Organizational Health Survey
Entec Corporation

RECOMMENDED

Description
Organizational Culture
The Organizational Health Survey is used to improve
employees’ working experiencing and thereby
Needs Assessment
increasing their satisfaction, motivation, commit-
ment and performance.
Validity/Reliability Evaluation Conducted
Tool Construction
4 sections, which include the following topics: My Cost
Department; My Manager; Corporate Practices and
Policies; and Mission and Values. There are also 3
Proprietary
open-ended questions.

Organizational Culture /#

Paper Access

Online Access

Made in Canada

French

Medium Completion Time

Contact Information
Employee Completion
Michael Koscec
President External Implementation
Entec Corporation
283 Danforth Avenue
Suite 318
Toronto, ON M4K 1N2
Canada

Toll Free: 1-888-858-8174

www.EmployeeOnlineSurvey.com

116 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1996

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
ACT Canada Inc.; Almag Aluminum; Atlantic Blue Cross Care; ATC Frost Magnetics; Guelph Hydro; Hamilton
Community Care Access Centre; International SEMATECH (Austin Texas); Laser Networks; London Hydro;
Novopharm; Scarborough Hydro (now part of Toronto Hydro); Soft Signs Inc.; The Hospital for Sick Kids Foun-
dation.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Entec, with the help and support of the workplace.

2. Workplace staff involvement

Individuals (everybody in the workplace, from top to bottom) are involved at the post-survey action planning
and implementation phases (such as the implementation planning workshops).

Recommended and Promising Practices For Situational Assessment Tools 117



Organizational Health Survey cont’d

3. Workplace leader involvement

Senior managers review the tool and provide minor amendments to the wording to ensure the tool reflects the
nuances of their business. They are also involved in the pre-survey communication process through discussions
with their staff to ensure that there is complete understanding and opportunity for questions to be answered
regarding the survey, the process and the outcomes. Entec always obtains senior management commitment for
follow up action. Commitment is secured in writing. Entec will not implement the survey if there is no commit-
ment before starting.

4. Collaborative aspects
Only the client organization is involved. If there is a union, the union is brought into the process at the very
beginning to ensure that they are a partner in the project.

Time Involved
1. Time to complete tool
Under 10 minutes per employee.

2. Time from distribution to presentation of results

Typically between 8-12 weeks.

3. Recommended implementation cycle

Either annually or every two years.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Entec completes all analysis.

2. Process to analyze
Electronic: Yes

Manual: Yes

Entec scans paper copies of the completed surveys using high speed scanners. For online copies, the internet
survey data drops into the database automatically and all of the data is analyzed electronically. Both custom
software and SPSS are used to prepare the statistical reports.

3. Time to analyze
Four weeks.

4. Outcome of analysis
Statistical reports are generated by a research analyst based on specific instructions for the project. A profes-
sional consultant with expertise in organizational development, strategic management and leadership prepares
the survey report. Reports are prepared that provide results by job levels and job functions. For example, in a

118 Comprehensive Workplace Health Promotion

 hospital, this type of analysis will provide data for different levels of managers, various union groups (Ontario
Nurses Association - ONA, Service Employee International Union - SEIU) non-union positions, part-time, full-
time etc., as well as by all the divisions and departments. This type of analysis is provided for every organization
and it reflects their unique job level or job function structure. Reports are generated to provide data starting
from the top and than layered down the organization to the individual work units. For example, a report will
show the results for an individual Vice President (i.e. his or her total group) than for each Director in that group
cascading down to Managers and Supervisors, while maintaining confidentiality.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Printing of survey when administered on paper and time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
Not applicable. Entec implements all steps.

Customization
Tool can be slightly modified to reflect the nuances of the workplace.

Skills required to implement, and to analyze and report

For implementation, not applicable. Entec completes all steps.

For analysis and reporting, not applicable. Entec completes all steps.

Languages: English, French

Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Entec Corporation (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted. As well, senior management of a workplace must commit to follow up implementation.

Recommended and Promising Practices For Situational Assessment Tools 119



Organizational Health Survey cont’d

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Entec conducted testing where the survey results were compared to the performance of the organization,
however no formal validity testing was done. For example, Entec surveyed three electric utilities of similar size
and similar customer profile (ratio of residential to business customers). There was a direct correlation between
the survey results and the financial performance of each utility. It was evaluated as a whole, rather than question
by question.

Reliability: Yes

The reliability testing was conducted by the Research Services Unit at Georgian College. Entec waited to conduct
the reliability testing until they had a large employee number. This was done two years later by the Research
Services Unit at Georgian College with a client of 3,500 employees. There was a paper written on three utilities
and presented at the American Water Works Association (an association of water and electric utilities) Annual
Conference in Chicago in 1998.

Formative Testing
Pilot testing: Yes

Consultations: No information available.

Focus Groups: Yes

All of the testing was conducted during the development stage. This comprised a rigorous process that included
focus groups, modeling, followed by focus groups, testing, pilots and then introduction into the market.

Process Evaluation
Response rates have been between 82%-95% and where the surveys were repeated in an organization in subse-
quent years the response rates were always higher than in the preceding years. Due to these very high response
rates it was determined that process evaluation was not necessary.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The team of experts and academics came up with the model. The model initially started out as an organizational
health model, based on leadership behavioural research and basic organizational development principles.

120 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
This is an excellent tool to assess organizational culture.

Questions are concise and straightforward.

There is evidence of a high response rate with this survey (averaging 82% to 95%).

There are several pre-scripted, pre-implementation communication messages that are available for organizations to
use. Directions for implementation are easy to follow and self-explanatory.

There is also a requirement for commitment by senior administration to enter into an agreement with Entec that ensures
follow-up mechanisms and strategies are part of the actual plan.

Limitations
The link to a comprehensive wellness strategy is not well defined.

There has been no formal review of the survey for literacy and cultural appropriateness.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 121

Organizational & Individual Health Survey
Entec Corporation

RECOMMENDED

Description
Current Practices
The Organizational & Individual Health Survey is
used to improve employees’ working experiencing
and thereby increasing their satisfaction, motivation, Organizational Culture
commitment and performance. In order to meet
this purpose, the tool uses the following methods to
obtain specific data from employees: Validity/Reliability Evaluation Conducted
• Establishes a benchmark of best practices in an
organization Cost
• Measures employee engagement
Proprietary
• Measures leadership capability

• Identifies the nature of workplace practices at the Made in Canada

department level
Paper Access
• Identifies the nature of corporate practices that
impact all employees equally

• Measures mission and organizational values Online Access

• Measures the emotional well-being of employees

French
Tool Construction
Organizational Culture /#
5 sections, which include the following topics: My
Department; My Manager; Corporate Practices and
Policies; Mission and Values; and Personal Thoughts Employee Completion
and Feelings. There are also 3 open-ended ques-
tions.
Completion Time of 5 – 10 minutes
Contact Information
External Implementation
Michael Koscec
President
Entec Corporation
283 Danforth Avenue, Suite 318
Toronto, ON M4K 1N2
Canada
Toll Free: 1-888-858-8174
www.EmployeeOnlineSurvey.com

122 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2002

Adapted From/Built On:

The Organizational & Individual Health Survey emerged as a part of an evolutionary process that was designed
to improve the Organizational Health Survey. Through input from psychiatrists and other research, existing
psychometric tools were added onto the Organizational Health Survey, first Dr. Herbert J. Freudenberger’s 15
point burnout scale. Dr. Freudenberger was a research psychologist who first coined the phrase “burnout” and
wrote the book “Burnout: The High Cost Of High Achievement.” A year later a measurement for depression and
substance abuse were added. These were based on the work of Dr. Stephen Stahl a psychiatrist from the Univer-
sity of Southern California who is credited for identifying neuro-chemicals that are associated with mood and
behaviour. This completed the tool so that four organizational factors: department/local practices, leadership
behaviour, corporate practices and mission and values were measured together with depression, burnout and
addiction, all in one integrated and seamless tool.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
Atlantic Blue Cross Care, Banana Republic, Enbridge Consumers Gas, Gap Inc. Canada, Georgian College,
Hamilton Community Care Access Centre, Old Navy, York University.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Entec, with the help and support of the workplace.

Recommended and Promising Practices For Situational Assessment Tools 123



Organizational and Individual Health Survey cont’d

2. Workplace staff involvement

Individuals (everybody in the workplace, from top to bottom) are involved at the post-survey action planning
and implementation phases (such as the implementation planning workshops).

3. Workplace leader involvement

Senior managers review the tool and provide minor amendments to the wording to ensure the tool reflects the
nuances of their business. They are also involved in the pre-survey communication process through discussions
with their staff to ensure that there is complete understanding and opportunity for questions to be answered
regarding the survey, the process and the outcomes. Entec always obtains senior management commitment for
follow up action. Commitment is secured in writing. Entec will not implement the survey if there is no commit-
ment before starting.

4. Collaborative aspects
Only Entec and the client organization are involved. If there is a union, the union is brought into the process at
the very beginning to ensure that they are a partner in the project.

Time Involved
1. Time to complete tool
Approximately 10-15 minutes.

2. Time from distribution to presentation of results

Typically between 8-12 weeks.

3. Recommended implementation cycle

Either annually or every two years.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Entec completes all analysis.

2. Process to analyze
Electronic: Yes

Manual: Yes

Entec scans paper copies of the completed surveys using high speed scanners. For online copies, the internet
survey data drops into the database automatically and all of the data is analyzed electronically. Both custom
software and SPSS are used to prepare the statistical reports.

3. Time to analyze
Four weeks.

124 Comprehensive Workplace Health Promotion

4. Outcome of analysis
Statistical reports are generated by a research analyst based on specific instructions for the project. A profes-
sional consultant with expertise in organizational development, strategic management and leadership prepares
the survey report. Reports are prepared that provide results by job levels and job functions. For example, in a
hospital, this type of analysis will provide data for different levels of managers, various union groups (Ontario
Nurses Association - ONA, Service Employee International Union - SEIU) non-union positions, part-time, full-
time etc., as well as by all the divisions and departments. This type of analysis is provided for every organization
and it reflects their unique job level or job function structure. Reports are generated to provide data starting
from the top and than layered down the organization to the individual work units. For example, a report will
show the results for an individual Vice President (i.e. his or her total group) than for each Director in that group
cascading down to Managers and Supervisors, while maintaining confidentiality.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Printing of survey when administered on paper and time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
Not applicable. Entec implements all steps.

Customization
Tool can be slightly modified to reflect the nuances of the workplace.

Skills required to implement, and to analyze and report

For implementation, not applicable. Entec completes all steps.

For analysis and reporting, not applicable. Entec completes all steps.

Recommended and Promising Practices For Situational Assessment Tools 125



Organizational and Individual Health Survey cont’d

Languages: English, French

Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Entec Corporation (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted. As well, senior management of a workplace must commit to follow up implementation.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

The psychometric portions of the tool were previously tested. For example, Dr. Freudenberger’s scale had under-
gone comprehensive testing and was subsequently used in clinical practice with over 100,000 patients. The
Organizational & Individual Health Survey did not undergo formal validity testing. However, Entec conducted
testing in concert with their clients, where they compared the survey results to the key business performance
indicators used by the organization.

Reliability: Yes

The reliability testing was conducted by the Research Services Unit at Georgian College. The questions in the
survey had a reliability quotient that ranged form 0.88-0.96.

Formative Testing
Pilot testing: Yes

Pilot testing was conducted during the development of the tool. The tool was tested in several organizations and
assessed by the team and the senior management of these organizations.

126 Comprehensive Workplace Health Promotion

 Consultations: Yes

Consultations were conducted during the development of the tool. Entec assembled a team of professional rep-
resenting a wide variety of disciplines.

Focus Groups: Yes

Process Evaluation
Response rates have been between 82%-95% and where the surveys were repeated in an organization in subse-
quent years the response rates were always higher than in the preceding years. Due to these very high response
rates it was determined that process evaluation was not necessary.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The tool references the role of emotional well-being within the context of the organizational practices and lead-
ership behaviour.

SELECTED REVIEW PANEL COMMENTS

Strengths
Very good participation rates - anywhere from 82% to 95%.

Implementation seems very straightforward.

Limitations
Evaluation of this tool does not qualify a “yes” under the validity criteria [although reliability testing was conducted,
formal validity testing was not done].

General Comments
Use of this tool would be the first step in any project that involved developing and introducing new training programs,
health promotion programs or change programs.

The tool has not been formally tested for literacy levels but questions are short and simple. It has been used in organi-
zations with multiple nationality companies with fairly low levels of education. The response rate has been very good
despite these factors.

Recommended and Promising Practices For Situational Assessment Tools 127

Questionnaire for Self-Assessment
European Network for Workplace Health Promotion (EHWHP)

PROMISING

Description
Organizational Culture
The tool should be used to analyze the current status
of workplace health promotion activities within an
Workplace Audit
enterprise/organization with a view to start/improve
workplace health promotion activities.
No Cost
Tool Construction
27 questions. Sections include: Workplace Health Public Domain
Promotion and Corporate Policy; Enablers; Human
Resources and Work Organization; Workplace
Health Promotion Planning; Social Responsibilities; Paper Access
and Workplace Health Promotion Implementation.
Online Access

Additional Resources Language + (other than English and French)

EFQM: Introducing Excellence French

Questionnaire for Self-Assessment (tool itself)

Organizational Culture
[Access online tool at www.enwhp.org] /#

To access the tool from the ENWHP website click Employer/Committee Completion
on “WHP in your Company! Questionnaire for Self
Assessment. Put it to the test!”
Long Completion Time

Contact Information Internal Implementation

Dr. Reinhold Sochert
External Implementation
European Network for Workplace Health Promo-
tion (ENWHP)
ENWHP Secretariat
European Information Center
Kronprinzenstr. 6D-45128 Essen

www.enwhp.org

128 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1998

Adapted From/Built On:

The questionnaire for Self Assessment is based on the model of the European Foundation for Quality Manage-
ment (EFQM: Introducing Excellence – this additional resource can be accessed through the online Resource
Listing) and was especially adapted for the assessment of health promotion measures. It incorporates both
scientific expertise on the effects of workplace health and practical experience of a wide variety of organizations
that have already been successful implementing workplace health promotion.

USERS
Intended Sectors/Sizes of Workplaces
Medium to large sized workplaces (> 51+ employees).

Intended Users
Occupational Health and Safety experts, Human Resources experts and others who have minimal knowledge of
workplace health promotion.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace implements the tool.

2. Workplace staff involvement

Occupational Health and Safety experts, Human Resources experts, and/or Wellness Committee complete the
tool.

Recommended and Promising Practices For Situational Assessment Tools 129



Questionnaire for Self Assessment cont’d

3. Workplace leader involvement

Workplace leaders may be involved in completing the tool or providing critical information for the tool’s comple-
tion.

4. Collaborative aspects
The Self-Assessment often takes place together with service providers of workplace health promotion, such as
Public Health Units or private consultants.

Time Involved
1. Time to complete tool
Approximately 30 minutes per group or person completion.

2. Time from distribution to presentation of results

Typically between 3-4 hours for an organization/unit/workplace.

3. Recommended implementation cycle

Before starting and after finishing at least mid-term activities, such as a 2-year workplace health promotion
program.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: No

2. Process to analyze
Electronic: Yes

Manual: Yes

Analysis of the data is automatically provided and integrated when using the online questionnaire. When a
workplace is working with a hard copy, it can tabulate the numbers manually. There is a small introduction at
the beginning of the hardcopy and there is a guide for assessing the results of analysis.

3. Time to analyze
Analysis is available immediately if tool is completed online. No information available on time to analyze paper
version.

4. Outcome of analysis
The outcome of analysis is a score in the form of a percentage. It shows areas of organizational strengths and
organizational weaknesses.

130 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: $0
Cost per unit/respondent: $0
Workplace Resources Used
Time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
No supporting materials are necessary for the online version of the tool. The hardcopy version comes with
instructions and a guide for analysis.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

For implementation and for analysis and reporting the following skills are needed:

• Quality management skills

• Project management skills
• Social competence
• Professional skills in occupational health & safety, workplace health promotion and human
resources
• Experience in assessing strengths and weaknesses of a workplace
• One should be onsite and come in contact with workers and employees
• Organization skills
• Work science skills

Languages: English, French, Czech, Danish, Dutch, Finish, German, Greek, Icelandic, Italian, Norwegian
Portuguese, Spanish, and Swedish.

Tested for Cultural Appropriateness: No

Tested for literacy level: No

Recommended and Promising Practices For Situational Assessment Tools 131



Questionnaire for Self Assessment cont’d

D. Access
Packaged, ready-to-use: Yes
How to access
Available on ENWHP’s website (www.enwhp.org) or in hardcopy upon request from ENWHP. To access the tool
from the ENWHP website click on “WHP in your Company! Questionnaire for Self Assessment. Put it to the
test!” The tool can also be accessed through the online Resource Listing.

Restrictions or conditions of access or use

None.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

Formative Testing
Pilot testing: Yes

Tested in 3 companies in the metal and trade sector and the public administration sector. The aim was to test
the acceptance of the instrument and the use as a starting point for internal discussions.

Consultations: Yes

3-4 hour meetings each, in which 2 occupational health and safety experts, 1 human resource manager and
1 European works council were represented besides 2 representatives of BKK* who were in the function as
consultants.

* BKK stands for ‘Betriebskrankenkasse’, a German word that translates into Company Health Insurance
Funds.

Focus Testing: No

Process Evaluation
No information available.

132 Comprehensive Workplace Health Promotion

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The Excellence Model from the European Foundation of Quality Management.

SELECTED REVIEW PANEL COMMENTS

Strengths
The purpose of the tool as a means of analyzing the current status of workplace health promotion activities within an
organization with a view to starting activities was very clear.

The questions are appropriate for an organizational culture audit. Very straightforward and to the point.

We found the questions to be logical, ordered and with a good flow.

This tool was created with the potential to reach and be used by a wide range of workplaces. This is a very strong point
of this tool.

Limitations
As reviewers, we felt the uses of the information to be gained from the tool were not as explicit. Some additional direc-
tion at this stage would have been very helpful to the discussion it would or should have initiated.

Some of the terminology used is different from what might be used in a Canadian tool but those with any background
in health promotion would not have difficulty understanding the meanings.

Our concern for potential Ontario users is that support for northern or isolated areas may be minimal or non-existent.
However, with access to the internet and some guidance providing direction to useful supports, possible sources of
help can be accessed.

General Comments
For widespread use in the Canadian context, it would need some minor revisions. It is possible that companies might
use it as another measure to gauge their starting point and it might be an interesting exercise for Canadian companies
whose parent company resides in Europe. This would allow for comparisons to be drawn with their counterparts.

Although we do not have much information on the impact that the tool has had, the fact that the Dutch NCO use it for
their audits and over 1000 companies have logged on to use it speaks to the potential it might have. As reviewers with
workplace health promotion experience, we intuitively feel that it is being used by large numbers because word has
spread on its positive effect.

The tool clearly is aimed at the organizational culture part of the CWHP approach. It has very solid theoretical underpin-
nings being based on the Excellence Model of the EFQM. All potential users of the tool are encouraged to visit the
EFQM website in order to better understand the origin or basis of the tool.

This tool is used for auditing purposes primarily and therefore, the person filling it in may be challenged depending
on their level of expertise. It is recommended that the person having the task of completing the tool be familiar with
health promotion terminology and concepts. The tool has not been formally tested for literacy levels but questions
are short and simple. It has been used in organizations with multiple nationality companies with fairly low levels of
education. The response rate has been very good despite these factors.

Recommended and Promising Practices For Situational Assessment Tools 133

StressMap®
Essi Systems Inc.

RECOMMENDED

Description Current Practices

The StressMap® is designed to assess one’s respective Needs Assessment

stress strengths and stress vulnerabilities by looking
at 21 stress factors, or scales. In other words, it is to
Organizational Culture
gain a personal snapshot, or profile of one’s person at
a particular point in time. Team Map® and Program
Design Tool turn the individual StressMap® into a Workplace Audit
needs assessment.
Validity/Reliability Evaluation Conducted
Tool Construction
4 parts, with 21 stress points covered. Part 1: Your
Cost
Environment/Pressures and Satisfactions; Part 2:
Coping Responses/Assets and Liabilities; Part 3: Proprietary
Inner World/Thoughts and Feelings; Part 4: Signals
of Distress. Paper Access

Online Access

Language + (other than English and French)

French

Organizational Culture /#

Occupational Health and Safety

Contact Information
Lifestyle Practices
Martha Evans

staff@essisystems.com Employee Completion

Essi Systems Inc. Employer/Committee Completion

70 Otis Street
San Francisco, CA
94103 USA
Medium Completion Time

www.essisystems.com Internal Implementation

134 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1985

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey. It can also be completed by workplace teams, divisions,
departments, management, etc.

Known Users
AT&T, Coca-Cola Company, Stanford University, Ontario Hydro, Dow Chemical Corp, BP Canada, Pfizer Phar-
maceutical, Banff Management Centre, Hewlett Packard, and American Red Cross.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace. It can be implemented in a number of ways: as an individual assessment, as a workplace needs
assessment on an individual basis, or with 1 trainer to every 3 participants.

2. Workplace staff involvement

Distribution can be by a department head, team leader, or other.

3. Workplace leader involvement

Distribution can be by a department head, team leader, and the tool should be completed by workplace leaders
as well.

Recommended and Promising Practices For Situational Assessment Tools 135



StressMap cont’d

4. Collaborative aspects
Collaboration can come in the form of pairing StressMap® with other situational assessment tools for a more
comprehensive look at the workplace (for example, an HRA). Also, StressMap® can be combined with “stress
mastery” courses that focus on the cognitive psychosocial aspects of stress.

Time Involved
1. Time to complete tool
Approximately 30 minutes per employee.

2. Time from distribution to presentation of results

Time to complete the tool and have individual results is approximately 50 minutes - 30 minutes to complete the
tool and 20 minutes for each respondent to complete his or her own analysis. No information available on how
long it takes from distribution to presentation of aggregate results.

3. Recommended implementation cycle

For 3 months - 3 rounds of 21 days (implement tool, wait 21 days, implement tool, etc.). After 3 months, imple-
ment the tool 6-12 months later.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: Yes

Respondents complete their own analysis, but if the workplace wants aggregate results, it can choose to analyze
the data on its own or have Essi Systems complete it.

2. Process to analyze
Electronic: Yes

Manual: Yes

All analysis is completed manually. The outcomes of each Map are plotted on an 11 x 17 grid. The electronic
version is completely printable.

3. Time to analyze
For individual results, approximately 50 minutes. For aggregate results, no information available.

4. Outcome of analysis
Individual and aggregate reports.

Individual:
The feedback to the employee is instant. No need to return any portion of the StressMap® to Essi or the sponsor-
ing department. The instruments come with a complete interpretation guide that explains the definition for
each scale, how it is related to the subject (stress, resiliency, EQ – emotional intelligence) and offers behaviorally
written tips for improving their performance on each scale. The outcomes of each Map are plotted on an 11 x 17

136 Comprehensive Workplace Health Promotion

 grid that graphically represents one’s performance strengths and vulnerabilities. Each scale is plotted accord-
ing to four performance zones from Optimal, Balance, Strain and Burnout depending on one’s scores for each
scale.

This is completed by the employee in the form of “connect the dots” (i.e., creating a line through each plotted
scores on the StressMap®).

Aggregate:
Aggregate analysis can only be completed if the workplace purchases the Program Design Tool at an additional
charge. The analysis of the Program Design tool can be completed by Essi Systems or by the workplace. Employ-
ers can access composite data online.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: ·
01-24 ---- $15.95 (per person, US)
25-99 ---- $13.95
100-299 ---- $12.95
300-499 ---- $11.95
500-999 ---- $10.95
1000+ ---- $9.70
Program Design Tool is an additional cost. Any analysis completed by Essi Systems is an additional cost.

Workplace Resources Used

Time given to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
Although they are a part of StressMap®, the Interpretation guide and the Grid Map could be considered sup-
porting materials. On Essi Systems’ website one can also find materials available on stress. As well, in some
implementations, certified instructors are available to assist workplaces.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

8th grade reading level.

Recommended and Promising Practices For Situational Assessment Tools 137



StressMap cont’d

Languages: English, French, Spanish, Dutch, Clasic Arabic rtuguese, Spanish, and Swedish.
Tested for Cultural Appropriateness: Yes
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Essi Systems or one of its distributors/certified instructors. (See contact information above).

* Two distributors of the tool in Ontario are the Health Systems Group and Pathways Health Promotion.

Restrictions or conditions of access or use

The tool is copyrighted.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Validity testing was conducted in 1998 by Essi Systems with the help of a grant from the National Institutes of
Health in the United States. The StressMap© was cross validated with the Maslach Burnout Inventory (MBI), the
US Government symptomology Checklist, and others.

Reliability: Yes

Extensive reliability testing and test-retest reliabilities have been done. This testing was conducted prior to
publication of the instrument in 1985, again in 1992 when Essi Systems created a shortened version of the instru-
ment for organizational profiling, and again in 1997 when the EQ Map© was created.

Formative Testing
Pilot testing: Yes

In 1984 StressMap® was pilot tested with 8 client companies. That group included Apple computers, Blue Cross
Blue Shield, a local hospice, a local health club, and the school system in the Bay area (San Francisco). The tool
was tested with a sample group from each organization. The individuals who completed the tool were then

138 Comprehensive Workplace Health Promotion

 debriefed so that Essi Systems could get direct feedback on the user friendliness, understandability, etc., of the
tool. Two years later the same kind of testing was done with a client company in Canada, using representatives
from both east and west coasts.

Consultations: Yes

Consultations were a part of the pilot testing that occurred in 1984.

Focus Testing: No

Focus groups were a part of the pilot testing that occurred in 1984.

Process Evaluation
The StressMap® was subjected to rigorous testing before publication, including satisfaction surveys, telephone
follow-ups, etc. for the end users as well as with administrators and sponsors in both the US and Canada. Every
two years the tools are reviewed for accuracy and to make sure that they can be statistically or scientifically
substantiated through data. The process evaluations are completed by Essi Systems.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Self care for self-empowerment and self-responsibility.

SELECTED REVIEW PANEL COMMENTS

Strengths
The tool is comprehensive in scope. Can be used as needs assessment, workplace audit, measure of organizational
culture, and record of current practices.

Strong in the mental health area as it relates to strengths and weaknesses of individuals’ stress skills.

The survey is well-structured and easy to follow and complete. Easy to do, interesting and engaging.
Limitations
The theoretical underpinnings of the tool are based on research conducted in the 1960s and 1970s, and, therefore, may
not reflect current knowledge in the field.

It is not a sufficient tool for implementing a comprehensive workplace health promotion program.

Reading level may be a little high for respondents with low literacy skills/ESL.
General Comments
It is specifically for those workplaces that are focusing on stress/distress and want to empower employees to deal with
their own issues.

Questions are geared to individual and not specifically to the workplace.

Linkage between external work stressors and possible changes in work environment could only be analyzed by pur-
chasing the aggregate data option.

Recommended and Promising Practices For Situational Assessment Tools 139

Health at Work Needs Assessment
Questionnaire
Haldimand-Norfolk Health Unit

RECOMMENDED
Description
Current Practices
With a comprehensive approach, it is intended to
measure the workplace health, personal health, and Interest Survey
organizational needs of a workplace.
Needs Assessment
Tool Construction
55 questions. Sections include: General Health; Organizational Culture
Nutrition; Physical Activity; Smoking and Alcohol;
Social Work Environment; My Health and My Job; No Cost
Physical Work Environment; Employee Interest; and
Your Profile. There is also a 30 question version of
only mandatory questions available. Public Domain

Made in Canada

Additional Resources Paper Access

Electronic Access
Sample Profile Report

Health at Work Needs Assessment Questionnaire Organizational Culture /#

(tool itself)
Occupational Health and Safety

Lifestyle Practices
Contact Information
Employee Completion
Giovanna Ferrara
Workplace Health Promoter
Haldimand-Norfolk Health Unit Medium Completion Time
P. O. Box 247
12 Gilbertson Drive External Implementation
Simcoe, Ontario
N3Y 4L1

Phone: 519 426-6170 Fax: 519 426 9974

www.haldimand-norfolk.org
giovanna.ferrara@haldimand-norfolk.org

140 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2000

Adapted From/Built On:

“Workplace Health Needs and Risk Inventory” from Health Canada and the Centre for Mental Health and
Addiction.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey, but sometimes departments within an organization com-
plete the tool, or random samples are completed in large workplaces.

Known Users
13 workplaces to date have used the survey.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The health unit, with the help and support of the workplace.

2. Workplace staff involvement

The workplace’s health committee is involved in helping to add/omit questions in the tool before implementa-
tion, formulating an implementation plan, and implementing the tool. They are the people that the results are
presented to as well.

3. Workplace leader involvement

Workplace leaders and employee unions (if applicable) need to approve the tool and its use in their workplace.
They are often given the option to add further questions that may pertain specifically to that workplace.

Recommended and Promising Practices For Situational Assessment Tools 141



Health at Work Needs Assessment Questionnaire cont’d

4. Collaborative aspects
If a workplace uses the survey outside of the Haldimand-Norfolk region, the workplace is advised to collaborate
with another public health unit and with health unit staff that are knowledgeable in Workplace Lifestyle Pro-
grams.

Time Involved
1. Time to complete tool
Approximately 25 minutes per employee.

2. Time from distribution to presentation of results

Between 1 - 1½ months.

3. Recommended implementation cycle

Every 3-5 years.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

2. Process to analyze
Electronic: No

Manual: Yes

3. Time to analyze
4-6 weeks.

4. Outcome of analysis
A profile report (this additional resource can be accessed through the online Resource Listing) is presented to
the Workplace Health Committee. From there, the health unit staff assists the committee to use the data to
help plan and implement a 3-5 year plan that will address the top 5 needs for that workplace, including BHCI.
Individual employee reports are not provided.

B. Economics
Total Cost: $0
Cost per unit/respondent: $0 – no direct cost, however, employees usually complete the survey on work
time.

Workplace Resources Used

Printing of survey when administered on paper and time given to employees to complete survey; workplace
wellness committee member time to manage the process.

142 Comprehensive Workplace Health Promotion

C. Other Considerations
Supports for Implementation (materials and training)
No supporting materials are available. The health unit staff is always available as a support to guide the work-
place through the process. (The health unit provides promotion posters leading up to the implementation date
and assists in a “kick off ” event).

Customization
Questions can be added or omitted.

Tool can be slightly modified to reflect the nuances of the workplace.

Skills required to implement, and to analyze and report

For implementation, it is helpful to have some planning knowledge and knowledge about CWHP.

For analysis and reporting, one needs to be familiar with calculating Stress and Satisfaction Offset Scores
(SSOS), Business Health Culture Index (BHCI) and also relating those figures to: Self-related Health; Absence
from work; Fairness and Respect at work; Stress; and Trouble sleeping, through formulas designed for those
specific questions.

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact the Haldimand-Norfolk Health Unit (See contact information above). The tool can also be accessed
through the online Resource Listing.

Restrictions or conditions of access or use

It is recommended that the tool be implemented with the Haldimand-Norfolk Health Unit or a workplace’s local
Public Health Unit.

If the tool is used or adapted, please credit the Haldimand-Norfolk Health Unit.

Recommended and Promising Practices For Situational Assessment Tools 143



Health at Work Needs Assessment Questionnaire cont’d

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

80-90% of the Health at Work Needs Assessment Questionnaire is adapted from Health Canada’s survey, which
has been tested for reliability and validity.

Formative Testing
Pilot testing: Yes

The tool was tested in three pilot workplaces in 2000. The testing was conducted by the Haldimand-Norfolk
Health Unit staff.

Consultations: No

Focus Groups: No

Process Evaluation
Since the tool is customized to a degree, most feedback regarding the tool comes during the planning meeting
held with the workplace, instead of after implementation. Workplaces have expressed satisfaction with this
process. Workplaces do consider their response rate as part of the process evaluation.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Comprehensive workplace health promotion, Behaviour change theory, Stress Satisfaction Offset Scores (SSOS),
and the Business Health Culture Index (BHCI).

144 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
No comments provided.

Limitations
The tool is easily accessible, but not all workplaces can access the support of this health unit for implementation and
analysis (if they are not in the health unit’s region).

General Comments
The purpose and use of the info are expressed verbally, not explicitly on the tool.

The connection to CWHP is referenced in supporting documentation.

Recommended and Promising Practices For Situational Assessment Tools 145

Workplace Overview Tool
City of Hamilton, Public Health & Community Services
Department

PROMISING
Description
Workplace Audit
The Workplace Overview Tool is designed to help
workplaces identify and keep track of existing sup-
No Cost
ports and policies at their workplace. This informa-
tion can be used to plan activities, programs and
policies. Public Domain
Tool Construction Made in Canada
53 questions. Sections include: Background
Information; Psychosocial Environment; Physical Electronic Access
Environment; and Health Practices (which includes
Smoke-Free Living, Food Choices, Physical Activ- Organizational Culture /#
ity, Alcohol and Other Drugs, Immunizations, and
Other Health Topics).
Occupational Health and Safety

Additional Resources Lifestyle Practices

Workplace Overview Tool (tool itself))

Employer/Committee Completion

Long Completion Time s

Contact Information
Internal Implementation
Lisa Beaudoin
Workplace Health Promotion Specialist
City of Hamilton
Public Health & Community Services Department
71 Main St. West
Hamilton, ON
L8P 4Y5

Phone: 905-546-2424 ext. 3065

Fax: 905-546-3658
E-Mail: lbeaudoi@hamilton.ca
Website: www.hamilton.ca/phcs/Healthy-Work-
place/default.asp

146 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2002

Adapted From/Built On
Regional Niagara Public Health Department’s Environmental Scan.

USERS
Intended Sectors/Sizes of Workplaces
Medium to large workplaces (> 51+ employees).

Intended Users
The Workplace Overview Tool is completed by the Workplace Wellness Committee member(s). This team is
typically made up of employees from the following categories: human resources, occupational health and safety,
and departmental heads or representatives.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with the help and support of the public health unit.

2. Workplace staff involvement

A Workplace Wellness Committee or a single committee member complete(s) the tool.

3. Workplace leader involvement

Workplace leaders are informed of the results of the completed tool by the wellness committee member(s) that
completed it. Typically this happens in a scheduled meeting between workplace leaders and the committee.
As well, workplace leaders may sit in on the meetings with the public health unit that happen previous to the
implementation of the tool, and after its completion.

Recommended and Promising Practices For Situational Assessment Tools 147



Workplace Overview Tool cont’d

4. Collaborative aspects
Collaboration typically happens when Public Health staff review and give feedback on the results of the tool to
the workplace wellness committee and the workplace leaders.

Time Involved
1. Time to complete tool
Approximately 30 minutes for the Wellness Committee to complete the tool.

2. Time from distribution to presentation of results

From the time the wellness committee sits down to complete the tool to when the results are discussed it can
take up to a couple of hours, depending on how familiar the members of the committee are with the information
the tool asks for. It takes another couple of hours for communicating this information to the workplace leaders,
and for the meeting with the public health unit.

3. Recommended implementation cycle

It is recommended that that workplace implement the tool again if it moves to a new location, or if there has been
a lot of changes in the workplace (policies, internal structure, programs, etc.). It should be used again at these
times because the tool is meant to provide an overview of the workplace and changes in geographic location or
internal structure can affect the answers given on the tool

Analysis Involved
1. Analysis completed by
In-house: Yes

External: No

Analysis is performed by the workplace wellness committee member(s) who complete the tool.

2. Process to analyze
Electronic: No

Manual: Yes

Analysis simply requires reviewing the tool to see what exists and what does not exist in the workplace, what
needs to be built on and what needs to be built.

3. Time to analyze
No information available.

4. Outcome of analysis
There is no formal report. In lieu of a report, the wellness committee discusses the completed survey and what
should be done with its findings. As well, the City of Hamilton Public Health Department offers a free consulta-
tion on how to proceed based on the results of the Workplace Overview Tool if the workplace needs assistance.

148 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: $0
Cost per unit/respondent: $0
Workplace Resources Used
Printing of survey when administered on paper and time given to employees to complete survey; workplace
wellness committee member time to manage the process.

C. Other Considerations
Supports for Implementation (materials and training)
If the tool is being implemented in the region, the City of Hamilton Health Department’s public health nurses
are available to help the workplace interpret the results. If not, workplaces are encouraged to seek out the advice
and support of their own Public Health Unit/Department.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

For implementation, no specific skills are required but it is recommended that those members of the workplace
wellness committee have a thorough combined knowledge of the workplace, its policies and programs, or that it
has easy access to that information.

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact The City of Hamilton Public Health Department (See contact information above). The tool can also be
accessed through the online Resource Listing.

Restrictions or conditions of access or use

The City of Hamilton Public Health Department would like to be involved in the implementation of this tool
so that discussion regarding approaches to dealing with the findings can be informed by a health promotion
specialist. The tool can be modified with recognition of its sources: both the City of Hamilton Public Health
Department and the Regional Niagara Public Health Department.

Recommended and Promising Practices For Situational Assessment Tools 149



Workplace Overview Tool cont’d

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

Formative Testing
Pilot testing: No

Consultations: No

Focus Groups: No

Process Evaluation
There has been no formal process evaluation. Feedback does come from workplaces, but it is informal.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
General principles of health promotion, with an emphasis on environmental supports and policies.

150 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
This is a simple tool that could be used in a variety of settings by a Wellness Committee.

The tool’s goal is simply stated, the ease of implementation is good, and it is a low cost method of taking an inven-
tory of current health practices and OHS within a company.

Limitations
A concern is that the tool has not been tested for reliability.

The tool may not be applicable to larger/more complex organizations.

The reviewers were not always certain exactly what some of the questions were asking. This requires more clarity
of terms used (e.g., smoking cessation policy – is this a “no smoking” policy? Also, what is meant by “frequently”
used?).

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 151

Workplace Health Needs & Risks Survey
Health Canada

RECOMMENDED

Description
Current Practices
The Workplace Health Needs and Risks Survey was
developed to assist organizations with assessing the Health Risk Assessment
health needs and risks of their workforce. The Workplace
Health Needs and Risks Survey is part of Health Canada’s
Workplace Health System, a guide to comprehensive
Needs Assessment
workplace health promotion.
Organizational Culture
Tool Construction
47 questions. Sections include: Rating Your Own Health;
Validity/Reliability Evaluation Conducted
Feelings About My Health and My Job; Shift Work;
Physical Activity; Worry, Nerves or Stress; Sleep; Seeking Cost
Help; Nutrition; Someone to count on; Smoking, Alcohol,
Medication and Other Drugs; Safety; Your Background;
Public Domain
and How Your Employer Can Help.
Made in Canada
Additional Resources
Paper Access
Workplace Health - Discovering the Needs
Workplace Health System Online Access

Contact Information Language + (other than English and French)

Developer: Health Canada French
Policy & Workplace Health Strategies Bureau
Workplace Health and Public Safety Programme
171 Slater Street, 9th Floor P.L.3709D Organizational Culture /#
Ottawa, Ontario, K1A 0K9
Occupational Health and Safety
General inquiries: 613-954-8857
http://www.hc-sc.gc.ca/ewh-semt/occup-travail/work-
travail/index_e.html Lifestyle Practices

Distributor: Health Canada (see above) and Employee Completion

Silico Global Information Systems Inc.
1445 Woodroffe Avenue
Ottawa, Ontario, K2G 1W1 Medium Completion Time

Phone: 613-727-0465 Fax: 613-727-5003 Internal Implementation

www.silicoglobal.com silico@silicoglobal.com

152 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1985. Most recent revision 2003.

Adapted From/Built On:

The earliest version of the questionnaire was a much longer instrument that focused far more on “lifestyles” and
personal health practices as influences on health. Successive versions, though shorter, have shifted in emphasis
so that there is now more of a balance among what are called the “Three Avenues to Wellness” in the Workplace
Health System, namely, Personal Health Practices, Personal Resources and Environment. The first prototype was
developed in 1985, the second in 1986. A third version - the one used most widely until now - became available
in 1990. “The Survey (2003)” is the most recent version of the Health Needs and Risks Survey used in Step 3 of
the Workplace Health System’s 7 step implementation plan. This is the fourth version of the instrument.

USERS
Intended Sectors/Sizes of Workplaces
Recommended for medium to large workplaces (> 100+ employees).

Intended Users
All employees within an organization are encouraged to complete the survey. If a self-governing branch/depart-
ment is able to act independently on survey results, it can also administer the survey apart from the whole
organization.

Known Users
No information is available regarding specific users; however, Silico Global (the primary distributor) averages
15-20 client organizations a year.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace itself, using the supportive materials that accompany the survey. The Workplace Health Needs
and Risks Survey is step 3 of 7 of the Corporate Health Model in the Workplace Health System, a guide to
comprehensive workplace health promotion.

Recommended and Promising Practices For Situational Assessment Tools 153



Workplace Health Needs & Risks Survey cont’d

2. Workplace staff involvement

The workplace decides how involved staff will be in the implementation of the survey.

3. Workplace leader involvement

In the Workplace Health System materials that support the survey, it is emphasized very strongly that there
should be representation from the union and senior management.

4. Collaborative aspects
Public Health Departments are the most common partners with Health Canada. Sometimes third parties are
involved for future analysis with a particular workplace’s data.

Time Involved
1. Time to complete tool
15-30 minutes per employee.

2. Time from distribution to presentation of results

Typically, it takes 8-11 weeks from the time of gaining commitment up to generation of the report: 2 weeks for
distribution; 3 weeks for collection; 2 weeks for the assessment; 2 weeks for the analysis; 2 weeks for the report-
ing.

3. Recommended implementation cycle

Recommended implementation cycle is every 2-3 years.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Health Canada has funded the development of a software program and automated report specifically designed
to provide a cost-effective method to analyze the survey results. Access to this system is currently available
through an Ottawa-based consulting company called Silico Global Information Systems Inc. Companies are in
no way obligated to use Silico Global services. However, companies would need to develop (in-house or via an
external computer programming contractor) a computer program that can perform complex data analysis.

2. Process to analyze
Electronic: Yes

Manual: Yes

Silico Global performs an IT System Data capture. Data analysis and reporting is automated.

3. Time to analyze
2-4 weeks (approximately).

154 Comprehensive Workplace Health Promotion

4. Outcome of analysis
The outcome (in the form of a report) is created by the system according to a set of decision rules built into the
program. A Profile Report is generated for the client. This is a fully scripted report, which includes an Executive
Summary, a General report, and Health and Safety reports. Some scripts within the report are activated by
various responses in the survey.

B. Economics
Total Cost: Determined by number of respondents and reports requested by client.
Cost per unit/respondent: ·$2/respondent (for analysis only).
Workplace Resources Used
Printing costs and time given to organize the distribution and completion of the survey.

C. Other Considerations
Supports for Implementation (materials and training)
The entire Workplace Health System is available and recommended as part of the supporting material available.
This includes the Corporate Health Model and the Survey implementation guide: Workplace Health - Discover-
ing the Needs. All of the Workplace Health System tools are available through Health Canada’s Workplace
Bureau Web site. These additional resources can also be accessed as web links through the online Resource
Listing.

Customization
Tool can be slightly modified to reflect the nuances of the workplace.

Questions can be added or omitted.

Skills required to implement, and to analyze and report

For implementation, the following skills are required:

• Workplace Health background & Project management

• Communication and promotion (skills as opposed to knowledge)

For analysis and reporting, the following skills are required:

• Although the analysis is completed by a computer program and a report is provided that gives a
description/analysis of the workplace/ organization, someone must be able to interpret the find-
ings. The organization decides what to do with the data and analysis, and what actions it wants
to take. The implementation plans need to be prepared by the client through an organizational
committee or by consultants with a workplace health background.

Recommended and Promising Practices For Situational Assessment Tools 155



Workplace Health Needs & Risks Survey cont’d

Languages: English, French. Unofficial translations into Chinese and Portuguese.

Tested for Cultural Appropriateness: Yes
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
Contact the Policy & Workplace Health Strategies Bureau, Health Canada or Silico Global Information Systems
Inc. (See contact information above).

Restrictions or conditions of access or use

Workplaces must be committed to act on results.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Reliability: Yes

All questions were independently tested for validity and reliability. A Technical Report called “Origins and
Characteristics of the Survey” describes the research background of the instrument and how key derived vari-
ables such as the Stress Satisfaction Offset Score and the Multiple Health Risk Score were developed.

Formative Testing
Pilot testing: Yes

Conducted by Health Canada, the original version (circa 1986) was piloted in 6 sites. A dozen new pilot sites
(1996-1999) informed changes to the 2003 version.

Consultations: No information available.

Focus Groups: No information available.

156 Comprehensive Workplace Health Promotion

Process Evaluation
Process evaluation has been done by Health Canada in conjunction with Martin Shain and Helen Suurvali at
the Centre for Addiction and Mental Health over a period of many years (1986-1999). Two independent reviews
were done by Danielle Pratt and Alium Consulting in Ottawa. These evaluations found that to make it useful,
the survey must be done in context of the Workplace Health System. The survey has also been tested from the
IT aspect (with Silico Global).

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The various theoretical underpinnings that have affected this tool are general principles of health promotion,
behaviour change, control/demand/effort/reward, population health, and comprehensive workplace health pro-
motion.

Recommended and Promising Practices For Situational Assessment Tools 157



Workplace Health Needs & Risks Survey cont’d

SELECTED REVIEW PANEL COMMENTS

Strengths
Reliability and validity testing was very comprehensive and therefore a practitioner should be confident with this
tool.

Practitioners/committees should consider this tool if a comprehensive health approach is desirable.

This tool is extremely user friendly and includes all components required to start comprehensive programming.

The reviewers believe that this tool has excellent characteristics that potentially set it apart from others. These include
the extensive supporting materials through to the detailed analysis report that enable users/customers to develop an
outstanding program.

The ‘stage of change’ model underpins some of the questions in the tool, providing for an opportunity to implement
relevant programming.

The instructions included are clear and concise for the end user.

This survey can be customized to meet the unique needs of the customer. Several questions can be tailored to unique
situations in a respective workplace.

There are many supporting materials that encourage a participatory approach.

Health Canada has made significant ongoing investments in this tool to maintain its relevance and practical use.

Limitations
Public Health partnerships with Health Canada and the use of this Workplace Health System tool/approach appear
to have waned over time. This does not necessarily account for the total decline in completion rates; therefore other
barriers to completion need to be examined (e.g. increased workloads, lack of time).

The reviewers have concerns regarding the level of support that would be available for northern, rural or isolated
communities.

General Comments
Practitioners/committees should be sure to explain how the demographic information will be reported and that confi-
dentiality and anonymity will be maintained; particularly in the smaller workplace setting.

158 Comprehensive Workplace Health Promotion

Recommended and Promising Practices For Situational Assessment Tools 159
Personal and Organizational Quality
Assessment (POQA)
HeartMath LLC

PROMISING
Description
Health Risk Assessment
The tool is designed to measure stress indicators,
positive and negative effects at the individual level,
Needs Assessment
and organizational culture/climate at the group
level.
Organizational Culture
Tool Construction
85 questions. 4 sections, which include: General Validity/Reliability Evaluation Conducted
Information; A list words describing feelings; A
list of words describing the way people think about
Cost
themselves at times; and Questions about feelings
and experiences over the last month.
Proprietary

Paper Access

Online Access

Language + (other than English and French)

French

Organizational Culture /#

Contact Information
Employee Completion
Rollin McCraty
HeartMath LLC Medium Completion Time
14700 West Park Avenue
Boulder Creek, California Internal Implementation
95006 USA

www.heartmath.com

160 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1995

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
Shell, Motorola, Intel, FBI, California Department of Corrections.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with the help and support of HeartMath LLC.

2. Workplace staff involvement

The tool can be administered by a Wellness Manager, Chief Medical Officer, or a researcher from the work-
place.

3. Workplace leader involvement

Management support is important in receiving good participation numbers. This support can come in the form
of filling out surveys, participating in distribution, pre-implementation communication, etc.

4. Collaborative aspects
The workplace collaborates with HeartMath LLC.

Recommended and Promising Practices For Situational Assessment Tools 161



Personal and Organizational Quality Assessment cont'd

Time Involved
1. Time to complete tool
Approximately 15 minutes per employee.

2. Time from distribution to presentation of results

Approximately 2 weeks.

3. Recommended implementation cycle

HeartMath typically implements the tool a first time, then after 6 weeks, then after 6 months to see how the
program’s progress is doing. Then it can be used in following years for time-over-time comparison.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

HeartMath analyzes both online and print versions of surveys.

2. Process to analyze
Electronic: Yes

Manual: Yes

Analysis of online version is completed electronically. Analysis of the print version is completed using an NCR
scanner.

3. Time to analyze
Analysis of the data is automatically provided and integrated when using the online tool. No information avail-
able on time to analyze print copies.

4. Outcome of analysis
Aggregate reports and sometimes sub-reports. No individual reports are available.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: Approximately $1 US/per unit for blank forms, but the cost is also often
dependent upon context.

Workplace Resources Used

No information available.

162 Comprehensive Workplace Health Promotion

C. Other Considerations
Supports for Implementation (materials and training)
There are some supporting materials available, but not on a commercial basis.* When HeartMath licenses the
instrument to another company or organization HeartMath helps the workplace set this up. HeartMath will be
re-designing the tool sometime in 2005, and as part of that process, create a manual to make it easier for others
to use the tool on their own.

* HeartMath did not create this tool for commercial purposes with the intention to sell it or have it as a “product.”
It was created because it was needed for research purposes.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

No information available on the skills required for implementation.

For analysis and reporting, the following skills are required:

• Familiarity with EPI-Info is helpful

• Familiarity with Workplace Health Promotion
• Report writing skills, research skills
• Background in data entry and analysis
• Epidemiology is helpful

Languages: English, French, Korean.

Tested for Cultural Appropriateness: Yes
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact HeartMath LLC (See contact information above).

Restrictions or conditions of access or use

Yes. The tool is copyrighted, but HeartMath is willing to license it to others.

Recommended and Promising Practices For Situational Assessment Tools 163



Personal and Organizational Quality Assessment cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

There has been face validity testing, factor analysis, scale reliability and some cross correlation of scales to other
instruments.

Reliability: Yes

The POQA (revised) was distributed to a sample of working adults at several job levels, who commented on
the clarity and phrasing of the items on the questionnaire. The format was then revised to provide better face
validity. Next, the dimensions were reconfirmed by factor analysis. The two to six items representing each of the
dimensions were then subjected to internal consistency analysis on a population of 1568 working adults, using
Cronbach’s coefficient alpha (a). Alpha coefficients for all scales achieved acceptable reliability scores ranging
from a low of .65 on the Goal Clarity dimension to a high of .90 on the Fatigue dimension.

Formative Testing
Pilot testing: Yes

Consultations: Yes

Focus Groups: Yes

All formative testing was completed in late 1990’s and was conducted by IHM (Institute of HeartMath), Heart-
Math LLC, and Hunter Kane (a resource management company).

Process Evaluation
Results from the completed surveys have shown that the tool measures what it is intended to and it demonstrates
that relational issues (i.e. positive or negative working relationships with co-workers, etc.) in a workplace are a
major source of stress and organizational incoherence.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
It is based on the theory that individual “coherence” and self-management skills drive the overall organizational
climate of a workplace, and, vice-versa, that organizational climate affects individual variables in an organiza-
tion.

164 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
Very well-researched and comprehensive tool.

Short and simple.

Limitations
Interactive and electronic learning systems may not be available in all workplaces. Participants may need to use heart
monitors to track heart rhythms - may be prohibitive in some workplaces.

May not be affordable by smaller workplaces or those with minimal access to electronic technology.

May present a barrier to those with poor levels of literacy.

General Comments
The tool appears more suitable for large product or service driven organizations.

Recommended and Promising Practices For Situational Assessment Tools 165

Work Positive Risk Assessment Questionnaire
NHS Health Scotland

RECOMMENDED

Description
Organizational Culture
The Work Positive Risk Assessment Questionnaire is
a self-completion questionnaire for employees. It is
designed for use within small and medium sized indi- No Cost
vidual businesses, to provide managers with a measure of
employee stress. The measure provides a score on a range
of salient structural and work organizational influences Public Domain
with potential to contribute to workplace stress. The
questions are designed to address aspects such as ‘job
design’ and ‘workload’. The tool is intended to be used Electronic Access
as “stage two” within the greater Work Positive package,
which was designed to operate as a voluntary scheme for
small and medium sized enterprises to assist managers Paper Access
in assessing and controlling risks associated with work-
related stress.
Organizational Culture
Tool Construction /#

1 open-ended question and 67 statements (agree/disagree)

that cover various aspects of organizational culture.
Employee Completion

Internal Implementation
Additional Resources
Work Positive Risk Assessment Questionnaire
(tool itself)
Work Positive Web site
(which holds supporting materials)

Contact Information
NHS Health Scotland
Woodburn House
Canaan Lane, Edinburgh, EH10 4SG Scotland

Phone: 0131 536 5500 Fax: 0131 536 5501

NHS Health Scotland is a new special health board bringing
together the Public Health Institute of Scotland (PHIS) and
the Health Education Board for Scotland (HEBS)

workpositivefeedback@health.scot.nhs.uk
http://www.hebs.com/workpositive/
www.hebs.org, www.phis.org.uk
http://www.healthscotland.com/

166 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2002

Adapted From/Built On:

The tool was built upon established stress audit tools and principles of effective health and safety management
(developed by the British Health and Safety Authority, 1997).

USERS
Intended Sectors/Sizes of Workplaces
Small and medium sized workplaces. This is based on the premise that smaller organizations are less likely to
have in-house experience or knowledge suitable for dealing with stress control and management.

Intended Users
All employees are encouraged to complete the survey.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace implements the tool, and also does the analysis and reporting.

2. Workplace staff involvement

Workplace managers are involved in promotion and a workplace manager from a range of departments is typi-
cally the person who analyzes the tool Representatives of the workplace form a steering committee (they may
help in distribution and promotion).

3. Workplace leader involvement

It is highly recommended that the CEO of a workplace be openly involved by signing an information cover letter
that accompanies the tool and also signing off on promotional memos about the tool.

Recommended and Promising Practices For Situational Assessment Tools 167



Work Positive Risk Assessment Questionnaire cont'd

4. Collaborative aspects
One form of collaboration that might happen occurs when the workplace chooses to have the data analyzed by
an outside agency. This would create a deeper level of confidentiality for the employees of a workplace, but it
moves outside of the tool’s original intended purpose - to be a tool that a workplace could implement completely
on its own.

Time Involved
1. Time to complete tool
No information available.

2. Time from distribution to presentation of results

No information available.

3. Recommended implementation cycle

No information available.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: No

The analysis would be completed by an individual at the workplace. Typically this individual has been one of the
following: a Health and Safety manager, Practice Team manager, Human Resources manager, Employee Care
Advisor, or a Policy and Information officer.

2. Process to analyze
Electronic: Yes

Manual: Yes

The tool is analyzed using a tool that can be downloaded off of the Work Positive website. “Scores” must be
manually entered in, however.

3. Time to analyze
Analysis of the data is automatically provided and integrated when using the online tool. No information avail-
able on time to analyze print copies.

4. Outcome of analysis
Workplaces end up with an Excel spread sheet from which a report could be written by someone with experi-
ence.

168 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: $0
Cost per unit/respondent: $0
Workplace Resources Used
Printing of survey when administered on paper and time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
Supporting materials are available online. The Work Positive pack comes with: benchmarking tool, risk assess-
ment questionnaire, analysis tool (CD). As well, there are additional resources on stress on the Work Positive
website.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

To implement the tool, the following skills are required:

• Familiarity with workplace health promotion

To analyze and report, the following skills are required:

• Familiarity with Excel

• Experience analyzing data
• Report writing skills

Languages: English
Tested for Cultural Appropriateness: No information available.
Tested for literacy level: No information available.

Recommended and Promising Practices For Situational Assessment Tools 169



Work Positive Risk Assessment Questionnaire cont'd

D. Access
Packaged, ready-to-use: Yes
How to access
The health risk assessment questionnaire itself, a benchmarking tool, case studies, and an analysis tool are all
available for free access online at www.hebs.org/workpositive. The tool can also be accessed through the online
Resource Listing. You can also order a hard copy of the pack for a small price: (outside of Scotland) 3.50 (British
pounds) + minimum 1.95 (British pounds) postage and package. The order form is available online at www.hebs.
org/workpositive/request.cfm.

Restrictions or conditions of access or use

If the tool is used or adapted, please credit NHS Health Scotland.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No information available.

Reliability: No information available.

Note that the tool was built upon established stress audit tools.

Formative Testing
Pilot testing: Yes

Initial Pilot testing: Fourteen organizations were involved in pilot testing. Within the organizations, the risk
assessment questionnaire was distributed to all employees. These employees completed the questionnaire and
returned them directly to Entec UK for analysis. Interviews within the organizations were conducted with a
random sample of employees using the original organizational stress health audit (OSHA) interview. As well, the
employees and the coordinators within the organizations were asked to complete evaluation questionnaires.

Follow-up pilot testing: After the risk assessment had been designed and validated, Health Scotland put it together
with the rest of the items intended for the Work Positive Pack and created a draft pack that was distributed to
ten organizations throughout a range of different sectors. In depth interviews and feedback followed regarding
the implementation and process of using the Work Positive questionnaire. Case studies were developed from
this process evaluation.

Consultations: Yes

170 Comprehensive Workplace Health Promotion

 In the beginning, Health Scotland commissioned the IOM (Institute of Occupational Medicine) to develop a
risk management approach for workplace stress. Later, Health Scotland commissioned ENTEC (UK) to conduct
a further piece of research. The key elements of this project were to develop a self-administered risk manage-
ment process in order to prevent the need for external consultants.

Focus Groups: No information available.

Process Evaluation
No information available.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Principles of effective health and safety management (developed by the British Health and Safety Authority,
1997).

SELECTED REVIEW PANEL COMMENTS

Strengths
The process and the questions in the tool are good.

Limitations
The tool does not allow for any coding to gather data from different employee groups and different level of
managers so that you can simply see how managers impact on their direct reports.

The tool is set up as a “one-off ” so that the organization doing their survey will have to develop and add a
coding system to distinguish between the various employee groups, union and non-union and different
levels of management. This will need to be done in order to provide data that is meaningful.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 171

Wellness Checkpoint
InfoTech Inc.

RECOMMENDED

Description
Current Practices
Wellness Checkpoint helps simplify the process of
identifying at-risk employees and provides organiza-
Health Risk Assessment
tions with the aggregate data to make better deci-
sions on how to create a healthier work environment
that leads to better health, wellness and performance Validity/Reliability Evaluation Conducted
of employees.

Tool Construction Cost

See InfoTech’s Sources Reference Summary for a

Proprietary
detailed description of tool construction. This addi-
tional resource can be accessed through the online
Resource Listing. Made in Canada

Online Access

Additional Resources Language + (other than English and French)

Sources Reference Summary French

Wellness Checkpoint Risk Score Rating
Wellness Checkpoint Standards
Lifestyle Practices

Employee Completion
Contact Information
Long Completion Time
InfoTech Inc.
485 Madison Street
Winnipeg, Manitoba Internal Implementation
R3J 1J2 Canada

Phone: 204-788-1500
Toll-free: 1-800-363-WELL
Fax: 204-788-1600
sales@wellnesscheckpoint.com
www.wellnesscheckpoint.com

172 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1991

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not necessarily size or sector specific, but Wellness Checkpoint has historically been sold to multi-national
organizations that have a diverse, multi-lingual, geographically spread out profile.

Intended Users
All employees are encouraged to complete the survey.

Known Users
DuPont, PPG Industries, Proctor & Gamble, CIBC, Bell Canada, BP, Nestlé, Nova, VanCity.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace implements the tool with InfoTech’s help and support.

2. Workplace staff involvement

In general, it is the staff within either HR or the benefits department that implements the tool. Often, the
Chief Medical Advisor is intimately involved. Successful program launches often involve an assigned project
‘champion’ who co-ordinates the set-up, marketing, launch, incentives, etc.

3. Workplace leader involvement

Workplace leaders often take the HRA themselves before the commitment to the program launch and are
involved in the due diligence process.

Recommended and Promising Practices For Situational Assessment Tools 173



Wellness Checkpoint cont'd

4. Collaborative aspects
There is no collaboration during implementation outside of collaboration between the workplace and InfoTech.

Time Involved
1. Time to complete tool
Approximately 40 minutes per employee.

2. Time from distribution to presentation of results

Information is immediate at completion of assessment (both at individual and corporate level).

3. Recommended implementation cycle

Recommended implementation cycle is annually. Licenses run for one full year. Users can access the HRA at
anytime during that year. Administrators can access the back-end at any point in time as well. Once a license
expires, InfoTech can do a data dump for a client. Otherwise, information remains on the server in an encrypted
format. It is then considered an archive.

Analysis Involved
1. Analysis completed by
In-house: Yes

(InfoTech gives administrator rights to clients).

External: Yes

In 80% of cases, InfoTech’s clients analyze their own data using the online Wellness Checkpoint DataBanker
LIVE. The DataBanker LIVE provides an organizational view of the risk profile of a workplace’s population.
Training administrators at the client end is part of the sales/maintenance package. In special cases, InfoTech
runs the reports and completes the analyses on behalf of the client.

2. Process to analyze
Electronic: Yes

Manual: No

3. Time to analyze
No information available.

4. Outcome of analysis
The reports are created using the online Wellness Checkpoint DataBanker LIVE. Wellness Checkpoint provides
multiple options for outcome reports. Wellness Checkpoint provides three key areas of aggregate reporting: a
Corporate Summary Report; a Key Indicator Report (provides a graphic view of participant data by risk, readiness
to change and key modifiable behaviours and health indicators); and Comparative Index Reports. These results
provide comprehensive data to organizations. In addition to these reports, there are also individual reports that
are available for each respondent. The employee reports inform respondents of areas where they may be at risk.

174 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: $2500.00 CDN for the annual set-up and maintenance.
Cost per unit/respondent: Companies charged on a per capita basis. This is volume based, and can be
anywhere from $9.00 per user down to $2.50 per user.

Workplace Resources Used

Time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
InfoTech does not provide any kind of user guides, but instructions appear in the web portal when users log in.
As well, there are on-line training tools and InfoTech will also train clients’ project leads and administrators.
InfoTech trains 2-3 designated administrators on how to run reports and make minor customizations. This is
typically done via phone and web. Typical training time requirements are 3-4 hours.

Customization
The tool can be slightly modified to reflect the nuances of the workplace.

Questions can be added or omitted.

Skills required to implement, and to analyze and report

To implement the tool, the following skills are required:

• Human resources, benefits and program management skills.

Languages: English, French, Queen’s English, Chinese, German, Italian, Polish, Portuguese, and Spanish.
Tested for Cultural Appropriateness: Yes
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
Contact InfoTech, Inc. (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted. Licenses only last for one year and then must be repurchased. The tool is only available
online.

Recommended and Promising Practices For Situational Assessment Tools 175



Wellness Checkpoint cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: For more information on the standards/norms used, see Wellness Checkpoint®’s Risk Score Ratings
and Standards documents. This additional resource can be accessed through the online Resource Listing.

Reliability: For more information on the standards/norms used, see Wellness Checkpoint®’s Risk Score Ratings
and Standards documents. This additional resource can be accessed through the online Resource Listing.

Formative Testing
Pilot testing: Yes

A medical panel was used to verify algorithms and the logic. InfoTech used an independent IT group to test the
software for efficiency.

Consultations: Yes

The development of the tool involved a group of Chief Medical Officers. They provided consultation throughout
the development of the tool, the weighting of the scales and the scoring algorithms.

Focus Groups: No information available.

Process Evaluation
InfoTech has used and continues to use what they call “user groups.” These groups are made up of users from
Europe and North America who go through the tool and explore new areas. They go over the reporting capabili-
ties, problem areas, and potential modifications. This typically happens once a year.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Readiness to Change (based on James Prochaska’s Stages of Change). Additional information on theoretical
underpinnings can be found in InfoTech’s Wellness Checkpoint® Standards document. This additional resource
can be accessed through the online Resource Listing.

176 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
Questions are easy to follow, organized and have simple language.

The support materials are very comprehensive (ROI, sample communications, analyzing results).

A medical panel was used to verify algorithms and the logic.

Limitations
Not available in hard copy - may be a challenge for those that are IT challenged.

The company aims for a 40% response rate - this is considered low.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 177

Heart Check
New York State Department of Public Health

RECOMMENDED

Description
Needs Assessment
Heart Check is a 226-item inventory designed to
measure such features in the worksite as organi-
Organizational Culture
zational foundations, administrative supports,
tobacco control, nutrition support, physical activity
support, stress management, screening services, Workplace Audit
and company demographics. Additional side studies
used professional judgments and behavioral surveys.
Validity/Reliability Evaluation Conducted
When applied during interventions, positive changes
in organizational support levels can result.
Cost
Tool Construction
9 sections, which include the following topics: Pre- Public Domain
liminary Information; Organizational Demograph-
ics; Smoking; Nutrition; Physical Activity; Stress;
Electronic Access
Screening; Administrative Support; and Organiza-
tional Foundations.
Organizational Culture /#

Employer/Committee Completion

Lond Completion Time

Contact Information Internal Implementation

Source:
New York State Department of Public Health
Healthy Heart Program

Contact:
Thomas Golaszewski (Developer of tool)
Department of Health Sciences
SUNY at Brockport
17D Hartwell Hall
Brockport NY
14420

178 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1993

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
The instrument is implemented as an interview directed at key individuals with the requisite knowledge of the
organization. These individuals have included human resource managers, occupational health nurses, safety
managers, health educators, or other professionals having responsibility for employee health. Often teams of
these individuals have been surveyed.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Either someone from the workplace, or by an impartial individual from outside the workplace.

2. Workplace staff involvement

Key individuals from the workplace act as subjects of the interviews. These individuals have included human
resource managers, occupational health nurses, safety managers, health educators, or other professionals having
responsibility for employee health. Often teams of these individuals have been surveyed.

3. Workplace leader involvement

Workplace leaders may be the individuals from the workplace who are being interviewed.

Recommended and Promising Practices For Situational Assessment Tools 179



HeartCheck cont'd

4. Collaborative aspects
No information available.

Time Involved
1. Time to complete tool
Approximately 40 minutes per interview. The number of interviews conducted is determined by the workplace.

2. Time from distribution to presentation of results

No information available.

3. Recommended implementation cycle

No information available.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

A workplace could have someone in the wellness committee conduct the interviews and analyze the data and
then create the outcome of analysis.

2. Process to analyze
Electronic: No

Manual: Yes

Using a checklist approach, Heart Check tallies the number of ways a worksite has promoted healthy living for
employees over the last 2 years through policies, opportunities and administrative means. There are a total of
226 possible points. The score for a worksite is recorded as the percent (%) of total points tallied out of the total
possible points. Scoring is based on a dichotomous system. Points can be totaled to create a composite score or
be grouped by content areas to form subscales.

3. Time to analyze
No information available.

4. Outcome of analysis
Taken in total and summarized as a numeric score, the characteristics uncovered by the survey are intended
to define a company’s internal support related to employee heart health. This stands as the initial “outcome
of analysis”, but a formal report can be written up by the individual(s) holding the interviews if the workplace
prefers.

180 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: The tool is available in an article in The American Journal of Health Promotion (see below under
Access for more info), which is downloadable and also available in hardcopy. The cost is
pproximately $13 US.

Cost per unit/respondent: $0

Workplace Resources Used
Printing of survey when administered on paper and time given to complete the interviews.

C. Other Considerations
Supports for Implementation (materials and training)
None.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

No information available.

Languages: English
Tested for Cultural Appropriateness: No information available.
Tested for literacy level: No information available.

D. Access
Packaged, ready-to-use: Yes
How to access
The survey can be found accompanying an article on its development: Golaszewski, Thomas & Brian Fisher.
“Heart Check: The Development and Evolution of an Organizational Heart Health Assessment.” American
Journal of Health Promotion. 2002, 17 (2): 132-153. This article can be accessed online at www.ajhp.com at a
cost of $13 US (price is subject to change) in PDF or hardcopy format.

Restrictions or conditions of access or use

No.

Recommended and Promising Practices For Situational Assessment Tools 181



HeartCheck cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Construct validity proven through the Composite Study and the Behavioral Study. Criterion validity proven
through the Student Study and the Johnson & Johnson Study. Construct validity proven through Composite
Study. Construct validity proven through Behavioral Study.

Reliability: Yes

During the Student Study the following was observed: interrater reliability and internal consistency reliability.
During the Johnson & Johnson Study the following was observed: interrater reliability and intrascale reliabil-
ity.

Formative Testing
Pilot testing: Yes

The instrument was field tested in four cooperating worksites using a group of 14 advanced health promotion
undergraduate students serving as independent raters (the Student Study). On-site group interviews conducted
by the students were held at each location. Students rotated interviewing duties, with all having the option of
probing for more details when a response was given. Scores were independently tabulated on a worksheet and
later entered in to a statistical software package for analysis.

Consultations: Yes

The instrument was reviewed by an external group of national health promotion experts. Since this early activity,
numerous health professional have subsequently used Heart Check with periodic editorial suggestions provided
to its authors.

Focus Groups: No information available.

Process Evaluation
Since formative testing, numerous health professionals have subsequently used Heart Check with periodic edi-
torial suggestions provided to its authors.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The Social-Ecological Model.

182 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
It appears to be a good research tool for policy development.

Limitations
No comments provided.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 183

HeartWorks Survey
Regional Niagara Public Health Department

RECOMMENDED

Description
Current Practices
To identify the health status of employees – what
kind of health behaviours they have, their self-per-
Health Risk Assessment
ceived health, their intent to change, and their rela-
tive job satisfaction.
Organizational Culture
Tool Construction
52 questions. Sections include: Food choices; BMI; Cost
Physical Activity; Smoking; Stress; Alcohol, Medica-
tion and Other Drugs; and questions specific to Data Public Domain
Analysis.
Made in Canada

Paper Access

Additional Resources
Organizational Culture /#

Sample PowerPoint Presentation

HeartWorks Survey (tool itself) Lifestyle Practices

Employee Completion

Medium Completion Time

Contact Information Internal Implementation

Corinne Smith
Public Health Nurse
Regional Niagara Public Health Department
573 Glenridge Avenue
St. Catharines, Ontario
L2T 4C2 Canada

www.regional.niagara.on.ca/government/health/
default.aspx

184 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1998. Revised in 2004.

Adapted From/Built On:

Modeled after Health Canada’s tool – the “Workplace Health Needs and Risks Survey”, and the National Quality
Institute’s healthy workplace criteria. Questions on alcohol and substance abuse are from the Centre for Addic-
tion and Mental Health.

USERS
Intended Sectors/Sizes of Workplaces
Medium to large workplaces. Could also be used by smaller workplaces.

Intended Users
All employees are encouraged to complete the survey.

Known Users
General Motors Canada Plants, Family and Children Services, West Lincoln Memorial Hospital. Niagara College
of Applied Arts, GDX Corporation, Daytimers of Canada, Niagara Credit Union, Region of Niagara, Brain Injury
Community Re-entry (Niagara inc), Loyalist Nursing Home, CNIB.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with the help and support of the Regional Niagara Public Health Department.

2. Workplace staff involvement

It is very important with the implementation of the HeartWorks survey that the workplace itself and the wellness
committee takes ownership, and makes final decisions. The Wellness Committee is in charge of distributing the
survey, setting up programming afterwards, communicating information to workers, and following the stages of
health promotion. The wellness committee works in consultation with Niagara, and does ongoing programming.
The committee meets every month with union representatives, management and front line representatives to
ensure that there is cross representation from all staff.

Recommended and Promising Practices For Situational Assessment Tools 185



HeartWorks Survey cont'd

3. Workplace leader involvement

Workplace leaders are invited to participate from the beginning. Niagara Public Health feels strongly that the
HeartWorks survey cannot be talked about without senior management at the table. When the final Report is
presented, it is important that Senior Management is there as well.

4. Collaborative aspects
Collaboration involved Brock University at the beginning of the HeartWorks survey implementation in work-
places. Niagara has been asked by many other public health departments for collaboration and they provide the
tool to others for adaptation.

Time Involved
1. Time to complete tool
Approximately 20 minutes per employee.

2. Time from distribution to presentation of results

2 to 3 months depending on the workplace and how long it takes surveys to come back. Time constraints might
occur in the analyzing process.

3. Recommended implementation cycle

Every 2-3 years.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Niagara Public Health analyzes the data.

2. Process to analyze
Electronic: Yes

Manual: No

The surveys are scanned through a machine that the Niagara Public Health Prep Planning Research Evaluation
Program (PREP unit) has purchased (scanning equipment SPSS format).

3. Time to analyze
Approximately 1-2 weeks to analyze, one month for the report (per 1500 surveys).

4. Outcome of analysis
An aggregate report and a summary report in PPT presentation are presented to the wellness committee and
senior management. In the report, there is information beyond just the data that was collected. For instance,
there are provincial benchmarking comparisons.

186 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: No information available.
Cost per unit/respondent: $1
Workplace Resources Used
Printing of survey when administered on paper and time given to complete the survey; workplace wellness
committee member time to manage the process.

C. Other Considerations
Supports for Implementation (materials and training)
No supporting materials are provided, but consultation is needed from Niagara Public Health to set up the
survey, write communications to employees regarding the survey process, decide what kind of timeline to use
and whether or not to use incentives, etc.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

For implementation, Regional Niagara Public Health Department assists the workplace in implementing the
survey and through a consultant from Regional Niagara, offers the following skills:

• Good background in Workplace Health

• An understanding of workplace health principles, health promotion theory, and workplace
dynamics
• High language skills and good communication skills

For analysis and reporting, not applicable. Regional Niagara Public Health Department completes these steps.

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: No

Recommended and Promising Practices For Situational Assessment Tools 187



HeartWorks Survey cont'd

D. Access
Packaged, ready-to-use: Yes
How to access
Contact the Regional Niagara Public Health Department (See contact information above). The tool can also be
accessed through the online Resource Listing.

Restrictions or conditions of access or use

If the tool is used or adapted, please credit the Regional Niagara Public Health Department.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

Formative Testing
Pilot testing: Yes

The HeartWorks survey was piloted at Niagara Regional Public Health Department and the Canadian Tire
Corporation in 1999 as well.

Consultations: No

Focus Groups: No

Process Evaluation
There were revisions in 2004 and multiple sources were used for wording of questions. Centre for Addiction and
Mental Health was used for questions related to alcohol and substance abuse, and then those questions were
taken to an epidemiologist to confirm reliability. Informally, through their own team, Niagara has found that
they seem to know what works best for the HeartWorks Survey.

188 Comprehensive Workplace Health Promotion

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Healthy Eating Practices from the Registered Dietitians Association, and James Prochaska’s Stages of Change.
Questions on alcohol and substance abuse are from Centre for Addiction and Mental Health; satisfaction ques-
tions are based on what NQI constitutes as a healthy workplace, and other concepts are based on general health
promotion principles.

SELECTED REVIEW PANEL COMMENTS

Strengths
Informal follow-up with workplaces who implemented the study found positive results & good changes following the
survey.

Lowest participation rate cited was 60%. Others 80% and higher. This is very good.

Limitations
If used in workplaces without high English language comprehension, it might be problematic.

Not formally tested for validity and reliability.

Some answers/questions were slightly complex and required re-reading of the questions. Especially questions which
asked about behavior AND the length of time in the behavior.

The full range of “supports” (i.e., consultations and follow-up) might not be available to workplaces outside of the
Niagara Region.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 189

Workplace Health Promotion Quality
Assessment Questionnaire
National Centre for Workplace Health Promotion
The Nofer Institute of Occupational Medicine

PROMISING
Description
Workplace Audit
The tool is aimed at general assessment of the quality
of Workplace Health Promotion programmes. It
No Cost
also serves as a guideline and a marketing tool. It is
a questionnaire consisting of 6 parts concerning the
policy, structures, objectives, planning, implementa- Public Domain
tion and evaluation of Workplace Health Promotion
in the company. In each part several crucial issues
are tackled. The respondent/organization has to Paper Access
establish whether the criteria indicated in each part
are met. It is process oriented, allows an insight into
Online Access
structures, management of the healthy workplaces
projects, and covers all key areas in integrated health
management in the organization. Language + (other than English and French)
Tool Construction
Organizational Culture /#
6 sections, which cover the following topics: Health
Promotion Policy; Health Promotion Structures;
Health Promotion Planning; Health Promotion Occupational Health and Safety
Objectives; Health Promotion Implementation; and
Health Promotion Evaluation.
Lifestyle Practices

Additional Resources Employer/Committee Completion

Workplace Health Promotion Quality Assessment Ques-

Long Completion Time
tionnaire (tool itself)

Internal Implementation
Contact Information

Elzbieta Korzeniowska
The National Centre for Workplace Health Promotion
The Nofer Institute of Occupational Medicine
Ul. Sw. Teresy 8, 90-950 Lodz, Poland

Phone: +48 42 63 14 686 Fax: +48 42 63 14 685

whpp@imp.lodz.plhttp://www.imp.lodz.pl/

190 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2001

Adapted From/Built On:

The tool has been developed on the basis of a literature review of existing Workplace Health Promotion evalua-
tion tools and practical experience from work with enterprises.

USERS
Intended Sectors/Sizes of Workplaces
Medium to large workplaces (>50+ employees), all sectors.

Intended Users
A person or a group of people in charge of workplace health promotion initiatives in a company.

Known Users
The tool has been used by local occupational medicine stations and workplace health promotion leaders active
in those stations for the evaluation of activities in regional workplace health promotion strategies.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace implements the tool on its own.

2. Workplace staff involvement

A Healthy Workplace Committee (or a person with a similar role in the company) is involved in gathering the
information. It usually requires a consultation with the management of the company to receive all the detailed
information.

3. Workplace leader involvement

Workplace leaders can be consulted about issues regarding the data collection. The tool also provides the respon-
dents with the knowledge of what the essential elements of good practice in workplace health are. In that respect,
it could be used as a guidebook in the process of developing a healthy workplace policy.

Recommended and Promising Practices For Situational Assessment Tools 191



Workplace Health Promotion Quality Assessment Questionnaire cont'd

4. Collaborative aspects
Collaboration is not necessary, but if the workplace is interested in guidance while planning new programming,
it might try to obtain the assistance of some workplace health promotion professionals.

Time Involved
1. Time to complete tool
Approximately 60 minutes by the Workplace Committee or person completing the survey.

2. Time from distribution to presentation of results

The results can be presented immediately, so it only takes a few hours.

3. Recommended implementation cycle

Annually. It is also helpful to implement the tool before or after the realization of major workplace health pro-
motion developments.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: No

The data is analyzed by the Workplace Committee or the individual that completes the tool.

2. Process to analyze
Electronic: No

Manual: Yes

Points are tabulated and then measured against a set ‘benchmark’ number. If the workplace’s score matches or
exceeds that number, its workplace health promotion programs are considered a ‘model of good practice’.

3. Time to analyze
Only as long as it takes to tabulate the data. As little as a few minutes.

4. Outcome of analysis
The completed tool stands as the outcome of analysis – it provides workplaces with a score to measure their
workplace health promotion programs by. If the employee(s) completing the tool decides to put the information
into a formal report for the workplace, that is up to them.

192 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: $0
Cost per unit/respondent: $0
Workplace Resources Used
Time given to employees to complete the survey.

C. Other Considerations
Supports for Implementation (materials and training)
None.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

For implementation, the following skills are required:

• A general knowledge of workplace health promotion.

• A general knowledge of either the workplace’s policies and programming, or knowledge of who
to speak with to obtain such information.

For analysis and reporting, the following skills are required:

• A general knowledge of workplace health promotion.

Languages: English, Polish (this has not been checked from a translation perspective).
Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
In Poland it has been published in Medycyna Pracy (Nr 2002/5Elzbieta Korzeniowska, Krzysztof Puchalski,
Kwestionariusz Oceny Jakosci Programu Promocji zdrowia w miejscu pracy) and is available online on the
National Centre for Workplace Health Promotion Web site. (Medycyna Pracy can be purchased from NIOM
Publishing Office at http://www.imp.lodz.pl/oficyna/oficyna.htm. It is also available on the National Centre Web
site.) The tool can also be accessed through the online Resource Listing.

Recommended and Promising Practices For Situational Assessment Tools 193



Workplace Health Promotion Quality Assessment Questionnaire cont'd

Restrictions or conditions of access or use

There are no formal restrictions. However, to use the tool properly a general knowledge of workplace health
promotion is vital.

If the tool is used or adapted, please credit the National Centre for Workplace Health Promotion, The Nofer
Institute of Occupational Medicine.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

Formative Testing
Pilot testing: No

No customary, formal pilot testing of the Polish version of the tool. (The English version has had no testing.)

Consultations: Yes

A draft of the tool was presented to the workplace health promotion leaders that cooperate with the Nofer
Institute (people trained to perform workplace health promotion programs) and used their responses to prepare
the final version of the tool. This consultancy, though, has not been carried out in a systematic way.

Focus Groups: No

Process Evaluation
No information available.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The tool has been developed using the elements of theories on self-learning organization, quality management
and setting approach; the key theory would be model of system socio-organizational change (Grossmann, Scala),
the questionnaire was prepared according to RUMBA standards on quality (as presented in Parish R., Quality of
Health Promotion in the Workplace).

194 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
This tool is elegant in its simplicity.

Although it is process oriented, it provides workplaces with excellent insight into the structures and management of
healthy workplace projects. This is a very promising tool.

The tool has very well organized sections with clear headings and relevant questions and very well composed format.
It is easy & clear to understand how to use the tool.

Tool can be re-used to assess progress.

Limitations
Language improvement (i.e. translation) would improve the plausibility rating further. Some questions need refinement
in translation into English. They were “in the right direction,” but left a little too much latitude/room for interpretation.
Some examples may help the survey respondent to more easily identify initiatives that fit within each category.

Would be improved with a planning support manual for “now what” after audit is conducted. This would not be neces-
sary if committee had knowledge of CWHP.

In the introduction to the tool the explanation needs to be bulleted rather than in paragraph format when explaining
point structure. Also, the explanation that a workplace needed at least 4 points in each of the 6 categories needs to be
further refined.

General Comments
Most appropriate for larger workplaces (greater than 40 employees).

Recommended and Promising Practices For Situational Assessment Tools 195

NQI Employee Healthy Workplace Survey
National Quality Institute (NQI)

RECOMMENDED

Description
Needs Assessment
The NQI Employee Healthy Workplace Survey is an
online (and/or paper-based) survey tool that organiza-
tions can use to reliably track employee perceptions and Organizational Culture
attitudes about their workplace and provide them with
timely feedback on organizational strengths and oppor-
tunities for improvement. It was constructed with four
major goals in mind. Cost

• To be based on sound and empirically

tested theories of employee satisfaction. Proprietary
• To be designed in such a way as to
balance the needs of scientific rigour Made in Canada
(including high reliability and validity
of the scales), with the practical aspects
of being used in organizations. Electronic Access
• To be a generic measure that could be
used with a wide variety of industries,
across job levels and job functions. Online Access
• To capture a wide range of employee
satisfaction facets and provide atti- French
tudinal scales to measure employee
attitudes related to the practice of
Healthy Workplace and Quality and in Organizational Culture /#
the workplace.

Tool Construction Occupational Health and Safety

8 sections with 5-10 questions in each. Sections include:

Physical Environment; Health Practices; Culture and Lifestyle Practices
Supportive Environment; Leadership; Planning; People
Focus; Processes; and Other Questions.
Employee Completion
Contact Information
Medium Completion Time
Adam Stoehr
Director, Educational Services
National Quality Institute External Implementation
2275 Lake Shore Blvd. West, Suite 307
Toronto ON
M8V 3Y3 Canada

www.nqi.ca

196 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2003

Adapted From/Built On:

It is based on the Canadian Healthy Workplace Criteria, which was developed by NQI with the help of Health
Canada health and wellness professionals.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
It is good for a cross section of the employee population to complete the tool. There needs to be a statistically
significant portion based on sample size.

Known Users
Hospitals and private and public sector companies.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
NQI, with the help and support of the workplace.

2. Workplace staff involvement

Workplace HR or workplace health staff people are involved in implementation. A staff person is also selected to
be the “lead” on the project and to work closely with NQI.

3. Workplace leader involvement

The invitation letter typically comes from the CEO and managers. CEOs and managers are involved as respon-
dents as well.

Recommended and Promising Practices For Situational Assessment Tools 197



NQI Employee Healthy Workplace Survey cont'd

4. Collaborative aspects
Collaboration typically takes place between NQI and the organizations HR department or workplace health
staff.

Time Involved
1. Time to complete tool
Approximately 15 minutes per employee.

2. Time from distribution to presentation of results

Typically takes 2-6 weeks.

3. Recommended implementation cycle

Annually. The survey is designed to be administered periodically (annually) to provide a workplace with infor-
mation over time. Cumulative reports can be generated to show how an organization is doing compared to
previous administrations.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: Yes

See below.

2. Process to analyze
Electronic: Yes

Manual: Yes

See below.

3. Time to analyze
Approximately two weeks.

4. Outcome of analysis
There are two reports available. The first is electronically created in real time by the NQI database. This is free,
but it is a score-based report that only gives a workplace figures to work with. The second report is available for
a fee and it is manually created by NQI staff that analyzes trends, does benchmarking, etc. This report involves
actual analysis of the scores, whereas the first only provides numbers. It is possible for a workplace to create its
own report, however, if there is an individual who is capable.

198 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Printing of survey when administered on paper and time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
The “lead” at the workplace is emailed instructions on how to access the administrative side of the online web
application. These instructions are quite detailed and straightforward. Also, the invitation email sent out to
employees has some instructions about how to access the tool online and each question in the online survey has
a help button that can be clicked on if a respondent wants more background on the question.

Customization
Tool can be slightly modified to reflect the nuances of the workplace.

Questions can be added or omitted.

Skills required to implement, and to analyze and report

This is only applicable when a workplace decides to create its own report.

The individual responsible for that task must be familiar with:

• Workplace health promotion

• Writing reports
• Analyzing data

Other than that, all steps are typically completed by employees of NQI.

Languages: English, French

Tested for Cultural Appropriateness: No
Tested for literacy level: Yes

Recommended and Promising Practices For Situational Assessment Tools 199



NQI Employee Healthy Workplace Survey cont'd

D. Access
Packaged, ready-to-use: Yes
How to access
Contact NQI (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

Formative Testing
Pilot testing: Yes

Pilot testing was conducted by NQI in a client organization. Employees completed the electronic version of the
survey (online) alongside focus groups who were asked similar questions.

Consultations: No

Focus Groups: Yes

Focus groups with employees of a client organization were asked similar questions to those on the survey to
prove or disprove the survey’s ability to retrieve the information it was intended to.

Process Evaluation
NQI regularly receives feedback from clients. This typically happens in either follow-up face to face meetings or
over the phone and usually involves the person at the workplace who acted as “lead” during the implementation
of the survey.

200 Comprehensive Workplace Health Promotion

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
NQI’s Canadian Framework for Excellence and Canadian Healthy Workplace Criteria* were used as a guideline
for developing the survey, consistent with internationally recognized Principles of Quality.

*The Canadian Healthy Workplace Criteria were developed by the National Quality Institute and in partnership
with Health Canada, in association with professionals from the health and wellness sector.

SELECTED REVIEW PANEL COMMENTS

Strengths
Covers all three aspects of CWHP including: physical environment, health practices and cultural and supportive envi-
ronment. Framework promotes a comprehensive approach to managing a healthy workplace.

Easy to follow and understand.

Relevant to all business types.

NQI provides many support services, including onsite consultation regarding implementation.

Limitations
Workplaces with a high percentage of employees with low literacy levels may have difficulty with some questions.

General Comments
Survey is used as part of the NQI Healthy Workplace Criteria process, used to identify strengths and challenges. NQI
emphasizes organizational commitment to implement change based on survey results.

Recommended and Promising Practices For Situational Assessment Tools 201

Improving Your Workplace Employee Survey
NRC + Picker Canada

RECOMMENDED

Description
Current Practices
The tool is intended to help workplaces understand
the important factors in a positive health workplace, Needs Assessment
to identify strengths and areas for improvement.
Organizational Culture
Tool Construction
33 Questions. Sections include: How do you rate your Validity/Reliability Evaluation Conducted
workplace?; How can your organization improve?;
Quality of Care; Perspectives on Patient Care; Orga- Cost
nizational Commitment and Career Plans; Overall
Impressions; Safety, Training and Health; Specific Proprietary
Work Life Issues; and Information About You.
Made in Canada
Electronic Access

Paper Access

Online Access

French

Organizational Culture /#

Occupational Health and Safety

Contact Information
Lifestyle Practices
Mary Fraser
Account Director Employee Completion
NRC + Picker Canada
7100 Woodbine Avenue Long Completion Time
Suite 411
Markham, Ontario
L3R 5J2 Canada
External Implementation

www.nrcpicker.com

202 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2002 (Enhanced)

Adapted From/Built On:

The tool was revised from an original survey developed by Hays et al. Additional scales/questions were taken
from recommendations by the National Quality Institute and the Institute for Work and Health. In collabora-
tion with St. Michael’s Hospital, NRC + Picker Canada adapted the questionnaire to reflect what was important
to employees. NRC + Picker asked a sample of employees what was important to measure, then designed the
questionnaire and tested it with employees across a facility through focus groups and written feedback.

USERS
Intended Sectors/Sizes of Workplaces
Small, medium, and large workplaces (workplaces with a minimum of 20+ employees).

Intended Users
All employees are encouraged to complete the survey.

Known Users
Numerous Ontario Hospital Association facilities and other health-related organizations in Ontario, Western
Provinces and Nova Scotia.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with the help and support of NRC + Picker.

2. Workplace staff involvement

Usually the Head of Human Resources, or a Quality Director, or Director of Nursing are involved in the process.
They are also typically the ones who make initial contact with NRC + Picker, help customize tool, do promotion,
and act as primary contact throughout the process.

Recommended and Promising Practices For Situational Assessment Tools 203



Improving Your Workplace Employee Survey cont'd

3. Workplace leader involvement

Workplace leaders are responsible for signing contracts with NRC + Picker, helping in promotion, and answering
the survey themselves.

4. Collaborative aspects
Other than the collaboration that takes place between NRC + Picker and the workplace, there is no other col-
laboration.

Time Involved
1. Time to complete tool
Approximately 30 minutes per employee.

2. Time from distribution to presentation of results

Approximately 4 months.

3. Recommended implementation cycle

Every 12-18 months.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

The data is analyzed by the analysts at NRC + Picker Canada.

2. Process to analyze
Electronic: Yes

Manual: No

NRC + Picker’s computer system is designed to analyze the results automatically. Data from paper copies is
entered in as it comes in.

3. Time to analyze
No information available.

4. Outcome of analysis
An Action Plan Report is created for the workplace, and also for any sub-units that they identify (example:
Hospital Corporate level, department level, unit level, union group, floor etc). Interactive data (data that are
loaded online so the workplace can look at progress as it is coming in 5 days after surveys are received) are also
available to drill down to get results at a deeper level. Aggregate results are placed on the client’s Web site. NRC
+ Picker will set this Web site up for the workplace and subsequently train the workplace to access the results.

204 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: Depends on volume and Data Collection Method.
Cost per unit/respondent: Depends on volume and Data Collection Method.
Workplace Resources Used
Provide employee information for inviting participation and criteria for reporting data. Success also depends on
workplace promoting survey to employees and sharing results.

C. Other Considerations
Supports for Implementation (materials and training)
An implementation manual is provided to the primary contact. Ongoing support throughout implementation
is provided via email and phone.

Customization
Tool can be slightly modified to reflect the nuances of the workplace.

Questions can be added or omitted.

Skills required to implement, and to analyze and report

No information available for skills required for implementation.

For analysis and reporting, not applicable. NRC + Picker’s Project Team complete all steps.

Languages: English, French

Tested for Cultural Appropriateness: No
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
Contact NRC + Picker Canada (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted.

Recommended and Promising Practices For Situational Assessment Tools 205



Improving Your Workplace Employee Survey cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Reliability: Yes

Formative Testing
Pilot testing: Yes

Consultations: Yes

Focus Groups: Yes

In collaboration with St. Michael’s Hospital, NRC + Picker adapted the questionnaire to reflect what was impor-
tant to employees. Employees were asked what they felt was important to measure. The tool was then designed
and tested with employees across a facility through focus groups and written feedback.

Process Evaluation
Process evaluation has come in the form of the satisfaction of respondents with the survey process, and client
evaluations of NRC + Picker.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
No information available.

206 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
It is a flexible tool that can be modified.

Strong participative approach.

Good theoretical underpinnings.

The questions are grouped logically and the structure is consistent.

Limitations
Client may need assistance in how to use the information to create a CWHP.

The sentences seem to be fragmented and not always clear (reviewers had to refer back to the heading to obtain
the context of the question).

Seems to be written at about a grade 12 level. This could be an issue in some workplaces.

General Comments
Would be appropriate for health care based organizations looking to address organizational culture issues.

Recommended and Promising Practices For Situational Assessment Tools 207

OHA Healthy Hospital Employee Survey
(©HHES)
Ontario Hospital Association, in partnership with
Brock University

RECOMMENDED
Description
Organizational Culture
The ©HHES addresses the following purposes:
1) Identify the key drivers of employee satisfaction and
productivity in health care organizations Health Risk Assessment
2) Identify gaps between the respondents’ satisfaction
with, and perceived importance of, key quality of work Proprietary
life factors
3) Clearly identify organization’s greatest areas of Validity/Reliability Evaluation Conducted
strength - and pinpoint the greatest opportunities for
improvement
Cost
4) Identify respondents’ key health behaviours and risk,
current health status and readiness to change
5) Compare the findings across departments and levels Organizational Culture /#
in participating organizations
6) Systematically evaluate comments and suggestions of Occupational Health and Safety
respondents
7) Allows for the review and action on provincial/ Lifestyle Practices
national employee health/quality of work life issues
8) Benchmarking capabilities Online Access

Contact Information Paper Access

Andrea Parent, Wellness Consultant Made in Canada

Organizational Health Management Services
Ontario Hospital Association Long Completion Time
200 Front Street, Suite 2800. Toronto, ON M5V 3L1
Phone: 416.205.1414, Fax: 416.205.1390 Employee Completion
www.oha.com

John Yardley, Director Internal Implementation

Workplace Health Research Unit
Brock University, 43 Church St., Suite 401
St. Catharines, Ontario L2R 7E1
Phone: (905) 641-7578 or 1-800-726-4082
Fax: (905) 641-7538
http://www.whru.ca

208 Comprehensive Workplace Health Promotion

Tool Construction
4 sections with multiple questions in each, which cover the following topics. Section 1: Organization Health
Leadership and Supervision; Employment Relationships; Quality of Work life; Overall; and Job Activities.
Section 2: Individual Health and Well-being Personal Information; Physical Activity; Tobacco Use; Nutrition;
Alcohol; Medication; Stress and Well-being; Sleep; Overall Health; Medical History. Section 3: Your Feedback.
Section 4: Work and Research Categories.

HISTORY
Current Status: Active
Developed: 2002

Adapted From/Built On:

The OHA ©HHES was compiled from the Employee Feedback System (©EFS) developed by WHRU - Brock
University, and the Health Risk Appraisal developed by Global Medic (a subsidiary of the Canadian Medical
Association). The Ontario Hospital Association and Brock University also wrote and added healthcare specific
questions. The survey and report templates and algorithms developed for the ©EFS and the Global Medic Health
Risk Appraisal (HRAA) were customized and are used by WHRU to implement the ©HHES in healthcare orga-
nizations.

USERS
Intended Sectors/Sizes of Workplaces
This tool was designed and is used in the Canadian health care sector (largely hospitals, health care systems).

Intended Users
All employees are encouraged to complete the survey, but sometimes departments within an organization com-
plete the tool, or random samples are completed in large workplaces.

Known Users
There are approximately 32 known users of the OHA ©HHES (June 2005).

Recommended and Promising Practices For Situational Assessment Tools 209



OHA Healthy Hospital Employee Survey (©HHES)

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with the help and support of the OHA and Brock’s WHRU.

2. Workplace staff involvement

Representative employee committees (such as wellness committees or other cross-functional teams) are encour-
aged to assist in the design and implementation of the survey and the survey process. Further, the OHA in
collaboration with Brock encourages employee groups to be actively engaged in the action planning process with
the findings.

3. Workplace leader involvement

Workplace leaders participate in the design and implementation of the survey. It is often the leaders who set the
parameters and goals for the process. They are largely involved in reviewing and customizing the survey and
report templates to meet their information needs, determining the scope of reporting to be created, identifying
the follow up action planning processes that will be put into place, etc. It is usually the organizational leaders
who ‘receive’ the findings first, via a presentation or a teleconferenced review of their report(s). Ongoing discus-
sions and consultative support are often offered to Senior Leaders as they work to finalize and implement their
action plans. Further, OHA in collaboration with Brock consultants often work directly with Senior Leaders to
incorporate/integrate the EFS findings with other strategic initiatives such as balanced scorecards, organiza-
tional and HR strategic plans, management performance programs, etc.

4. Collaborative aspects
WHRU and Brock’s client workplaces implement the tool in partnership with the Ontario Hospital Associa-
tion.

Time Involved
1. Time to complete tool
Approximately 25-35 minutes per employee.

2. Time from distribution to presentation of results

Usually 1 -2 weeks of distribution and reports are delivered 4 weeks following distribution. However, timelines
are largely affected by the organization’s size (# of employees) and specifications of the project (e.g. delivery
mode, type and level of reports, number of reports, level of customization, etc.). Brock generally encourages at
least a 2-week ‘window’ where employees can complete and return the survey and in standard projects with one
overall organizational report, the presentation of results would occur within 1 month of receipt of the paper
surveys (shorter timelines are possible if the data collection is 100% web based).

3. Recommended implementation cycle

Anywhere from annually to every 3 years.

210 Comprehensive Workplace Health Promotion

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Brock’s internal statisticians and researchers conduct the data analysis.

2. Process to analyze
Electronic: Yes

Manual: Yes

Pen/paper surveys are scanned electronically with some manual qualitative entry. WHRU’s and Global Medic’s
standardized, proprietary analysis and reporting templates are used to analyze and report on data at the orga-
nizational and group level (e.g. department, location, job type, job level, etc.). Various software programs have
been used to develop Brock’s systems (e.g. Autodata, Visual Basic/Excel, SPSS), but all have been fully custom-
ized to meet their analysis/reporting needs. Their web based systems were custom designed and built by WHRU
and are proprietary to Brock University.

3. Time to analyze
Reports delivered within 4 weeks of receiving data. Individual requests can be completed within same day to 3
days following request.

4. Outcome of analysis
Various types and levels of aggregate reports are generated and provided back to the client organization in both
paper and CD Rom. These reports are fully colour coded and consist of a series of graphs/tables demonstrating
the results. There is also often a written interpretation/recommendation section included. Individual reports are
not available.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: Reduced price for OHA members vs. non-members.
Workplace Resources Used
Time given to employees to complete survey. Time required for internal processes.

Recommended and Promising Practices For Situational Assessment Tools 211



OHA Healthy Hospital Employee Survey (©HHES)

C. Other Considerations
Supports for Implementation (materials and training)
The OHA and Brock provide the following materials to workplaces:

• An outline of how to plan for a survey in an organization.

• Public domain documents on how to ensure success.
• Marketing materials and posters.

The OHA provides information to interested organizations addressing the OHA Healthy Hospital Initiative
which is a broad initiative focused on improving organizational health within the healthcare sector.

Also available is access to the OHA Wellness Consultant whose expertise focuses on the OHA ©HHES via
telephone and e-mail, counseling clients in the process. Brock account managers are also available via phone and
e-mail to counsel organizations throughout the process. Brock often provides orientation/training to internal
groups regarding employee survey best practices, data interpretation, action planning, etc.

Customization
Items can be slightly modified to reflect the nuances of the workplace.

Items and scales can be added or omitted.

Skills required to implement, and to analyze and report

For implementation, the project leads need to fully understand their organization and how to best get the highest
response rate possible.

For analysis and reporting, not applicable. WHRU completes all steps.

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact the OHA Wellness Consultant who then connects interested organizations with the Workplace Health
Research Unit at Brock University (See contact information above).

Restrictions or conditions of access or use

Users must agree to the terms and conditions as established by OHA and WHRU.

212 Comprehensive Workplace Health Promotion

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Reliability: Yes

Formative Testing
Pilot testing: Yes
The ©HHES was originally pilot tested with 19 Ontario based hospitals/health care systems.

Consultations: No information available.

Focus Groups: No information available.

Process Evaluation
The Ontario Hospital Association (OHA) conducted an evaluation of the tool and the ©HHES project immedi-
ately after the initial pilot of 19 hospitals. The OHA had a series of formal discussions with the ‘sponsor’ of the
©HHES project at each of the participating pilot health care institutions to determine:

1) Key challenges and success factors of the ©HHES projects;

2) Recommended changes/improvements to the ©HHES survey and reports;
3) Planned actions based on the survey findings.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Much of the ©HHES was based on the ©Employee Feedback System developed by Brock University. The OHA
in partnership with Brock University wanted to create a survey that not only reflected the work-life aspect of
employees, but also took into account individual responses. Therefore, an HRA (from Global Medic) was incor-
porated into the survey, and the single item scales were used instead of the multi-scale items from the ©EFS.
The ©HHES was theoretically derived from the ©EFS, but was elaborated and expanded upon to capture extra
elements for use in health care organizations. The ©EFS has been extensively validated.

Recommended and Promising Practices For Situational Assessment Tools 213



OHA Healthy Hospital Employee Survey (©HHES)

SELECTED REVIEW PANEL COMMENTS

Strengths
Well thought out questions and some that were interesting to ask.

The tool seems fairly clear and easy to follow. Questions are grouped according to purpose of the question. Nice to
see some open-ended questions.

The tool is fairly comprehensive in scope.

Limitations
Perhaps a little on the lengthy side - 40 minutes. Although, in looking at the survey, it doesn’t seem like it would take
quite that long. It may be a deterrent for respondents though.

The tool has not been reviewed for literacy level or cultural appropriateness. Only available in English. Terminology
may be higher than a grade 5 level.

General Comments
Test developers collaborate directly with workplace leaders to design and implement survey.

214 Comprehensive Workplace Health Promotion

Recommended and Promising Practices For Situational Assessment Tools 215
SF-36v.2
QualityMetric Incorporated

PROMISING

Description
Current Practices
To measure the health and well being (quality of life)
of individuals and populations for the purposes of mea-
Needs Assessment
suring disease burden and treatment effectiveness, pre-
dicting risk, as well as to engage the consumer/patient/
employee meaningfully in his or her own health status Validity/Reliability Evaluation Conducted
measurement for compliance, wellness, and health pro-
motion initiatives.
Cost
Tool Construction
Proprietary
36 Questions. Sections include 8 scales on: Physical
Functioning; Role Physical; Bodily Pain; General Health;
Vitality; Social Functioning; Role Emotional; Mental Electronic Access
Health. There is also a Reported Health transition ques-
tion. The above scales may be used to calculate the MCS
(Mental Component Summary) and the PCS (Physical Paper Access
Component Summary).
Online Access

Language + (other than English and French)

French

Lifestyle Practices

Employee Completion
Contact Information
Short Completion Time
QualityMetric Incorporated
640 George Washington Hwy.
Ste. 201
Internal Implementation
Lincoln, RI
02865 USA

www.qualitymetric.com

216 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1988

Adapted From/Built On:

The SF-36v2 is an adaptation of the original SF-36*. After 10 years of use it was apparent that there were areas
that could be improved. The SF-36v2 is the result of the improvements. Changes made include:

1. Improved instructions and item wording

2. Improved layout for questions and answers
3. Increased comparability in relation to translations and cultural adaptation and minimized
ambiguity and bias in wording
4. Adopted five-level response choices in place of dichotomous choices for seven items in the two
role functioning scales.
* Interest in short-form (SF) health surveys became a necessity during the Health Insurance Experiment (HIE) in
1980 when study participants refused to complete a lengthy health survey. With colleagues, Dr. Ware reviewed
the content of various source instruments for measuring limitations in physical, social, and role functioning;
general mental health; and general perceptions. It is the accumulation of experience with these full-length scales
that made it feasible to construct useful short-form health scales. Dr. Ware’s objective in developing the SF-36
was two-fold: 1) to standardize the content and scoring of an improved form, and 2) the accumulation and
evaluation of information that would be useful in interpreting results. The most difficult task in developing the
SF-36 was the selection of a subset of 8 health concepts from the more than 40 concepts and scales studies in
the Medical Outcomes Study. The 8 health concepts were chosen because they were most frequently represented
in similar surveys. They are: physical functioning, role limitations due to physical health problems, bodily pain,
general health, vitality (energy/fatigue), social functioning, role limitations due to emotional problems, and
mental health (psychological distress and psychological well-being).

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
More than 40 pharmaceutical, biotechnology, and medical device enterprises globally; Over 70 leading health
plans, large employers, Pharmacy Benefit Managers, insurance companies, DM companies etc.; over 1,000 hos-
pitals/health systems; and thousands of clinicians, researchers and academics.

Recommended and Promising Practices For Situational Assessment Tools 217



SF-36v2 cont'd

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace implements the tool.

2. Workplace staff involvement

Typically implemented by an individual from human resources. The IT department may be needed if the tool is
to be implemented online.

3. Workplace leader involvement

Managerial involvement is based on the commitment to include the employees’ voice in the measurement of
their health. It is an engagement strategy that is progressively employed by management and human resources
professionals.

4. Collaborative aspects
QualityMetric can analyze the data for workplaces, but at an additional cost. However, collaboration is not
necessary.

Time Involved
1. Time to complete tool
Approximately 10 minutes per employee.

2. Time from distribution to presentation of results

No information available.

3. Recommended implementation cycle

It is only recommended that the tool be used sometime after programs or initiatives have been put in place to
determine if they have had any effect.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: Yes

The workplace can analyze the data themselves using the QualityMetric “How to Score Version 2 of the SF-
36 Health Survey” manual. Or, QualityMetric’s Consulting Division offers services for analysis and reporting.
However, this comes at an additional cost.

218 Comprehensive Workplace Health Promotion

2. Process to analyze
Electronic: Yes

Manual: Yes

Analysis must always be completed manually, but workplaces can purchase QualityMetric’s “SF Health Out-
comes Scoring Software,” which will complete initial scoring of surveys electronically.

3. Time to analyze
No information available.

4. Outcome of analysis
Aggregate reports can be compiled from the data. If QualityMetric completes analysis, they work with custom-
ers to practically integrate the data and results into meaningful action that manages costs and improves care
delivery.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Printing and time given to employees to complete the survey.

C. Other Considerations
Supports for Implementation (materials and training)
QualityMetric has a CD-ROM Education series that is accredited through Tufts University, which explains
health outcomes. Additionally, they have manuals which provide scoring algorithms and administration and
interpretation guidelines. They also have consulting services available. Support materials available include: The
Manual and Interpretation Guide, the How to Score manual, and the SF Health Outcomes Scoring Software
(optional). Each is available at a cost.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

No information available on skills required for implementation.

For analysis and reporting, the following skills are helpful:

• Basic math skills for calculating the algorithms.

• Computer skills if the individual wants to program the algorithms rather than compute the
scores by hand, or if they would like to use the software, which is a Windows based application
• Familiarity with data analysis.

Recommended and Promising Practices For Situational Assessment Tools 219



SF-36v2 cont'd

Languages:
Available in 60 languages, including English and French.

Tested for Cultural Appropriateness: Yes

Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact QualityMetric (See contact information above).

Restrictions or conditions of access or use

Since the surveys are Intellectual Property and are copyrighted, organizations and individuals must be licensed
to use the surveys. Typically the licenses are for a specific number of administrations for each our survey tools,
and are typically issued on per study, per survey, and per language basis. QualityMetric does, however, have
master license agreements available as well.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Two kinds of strategies were used to evaluate the validity of the SF-36 and to accumulate information for inter-
preting scale scores. First, content validity was judged by comparing it with other widely used survey forms.
Second, empirical approaches including factor analytic tests of construct validity, criterion-based approaches,
and numerous correlation studies were used. Some of the other surveys the SF-36 was compared with include
The Health Insurance Experiment (HIE), the Nottignham Health Profile (NHP), the Sickness Impact Profile
(SIP), and the McMaster Health Index Questionnaire (MHIQ).

Reliability: Yes

Estimates of the score reliability for the SF-36 have been reported in 14 studies, with a full list provided in the
SF-36 Manual and Interpretation Guide. Reliability estimates for the SF-36 were also done from the Medical
Outcomes Study (MOS), for the general US population, and for the US and UK studies published by others. All
estimates exceeded acceptable standards for measures used in group comparisons. For each scale, the median
of the reliability coefficients across equal studies equals or exceeds .80, with the exception of the Social Func-
tioning scale (the median for this two-item scale is 0.76). These results support the use of the SF-36 scales in

220 Comprehensive Workplace Health Promotion

 studies of health status that are based on group-level analyses. Only the Physical Functioning scale consistently
exceeded the 9.0 standard of reliability, which some consider a minimum standard for comparisons of scores for
individual patients.

Formative Testing
Pilot testing: Yes

Consultations: Yes

Focus Groups: Yes

Process Evaluation
Due to the breadth and depth of applications involving the SF-36, process evaluation has been addressed over
time as it relates to content, administration (data collection), scoring, interpretation and analysis of data. Addi-
tionally, customers such as Kaiser Permanente have addressed process evaluation by studying the differences in
modes of administration.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The conceptual framework for the SF-36v2 rests in the development of minimum standards of comprehensive-
ness (i.e., content validity in relation to accepted definitions of health) for representation of both physical and
mental health concepts and multiple manifestations of functioning and well-being for each concept. From these
standards and empirical work, multiple categories of operational definitions were chosen to measure each health
concept: (a) behavioral functioning, (b) perceived well-being, (c) social and role disability, and (d) personal evalu-
ation perceptions (perceptions) of health in general.

Recommended and Promising Practices For Situational Assessment Tools 221



SF-36v2 cont'd

SELECTED REVIEW PANEL COMMENTS

Strengths
Developed for research purposes, so has a very high standard of testing done.

The validity and reliability of the SF-36 have been tested extensively. Extensive testing of both validation and reli-
ability in international settings with many languages.

Tool is straightforward and easy to complete.

Has been used world-wide for more than 15 years.

Limitations
Major drawbacks are lack of individual feedback and very generic questions. The tool is fairly limited in scope as it
applies to comprehensive workplace initiatives.

Just knowing that your workforce scored low on “general health”, does not give any direction to wellness initia-
tives.

Tool focuses exclusively on personal health status info and is, therefore, not comprehensive.

General Comments
This was strictly developed as a current practice tool that could be administered over time. The data is in a summary
form and has use in needs assessment for organizations.

222 Comprehensive Workplace Health Promotion

Recommended and Promising Practices For Situational Assessment Tools 223
Employee Health Survey
Simcoe Muskoka Health Unit

PROMISING

Description
Current Practices
The Employee Health Survey was designed to
determine the health needs, stages of change, and
Interest Survey
the type of programming desired by employees for a
comprehensive workplace health program.
Needs Assessment
Tool Construction
59 questions. Sections include: general health; physi- Organizational Culture
cal activity; nutrition; smoking; alcohol, medication
and other drugs; sleep; stress; job stress and job sat-
No Cost
isfaction; physical environment; and environmental
supports.
Public Domain

Made in Canada
Additional Resources
Electronic Access
Employee Health Survey (tool itself)
Wellness Works Guide Paper Access

Organizational Culture /#

Occupational Health and Safety

Contact Information
Lifestyle Practices
Brenda Marshall
Project Officer
Employee Completion
Simcoe Muskoka Health Unit
5 Pineridge Gate
Gravenhurst, Ontario Medium Completion Time
P1P 1Z3

TEL: (705) 684-9090 Internal Implementation

FAX: (705) 684-9959
www.simcoemuskokahealth.org

224 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2004

Adapted From/Built On:

The Employee Health Survey was adapted from the following surveys:

• Haldimand Norfolk Health Unit – “Health at Work” Survey

• Halton Region Health Department Survey - (no name)
• Brant County Health Unit -The Wellness Works Meter, The Engaging Employee Health Survey
• Grey Bruce Public Health - Workplace Wellness Needs Assessment
• Sudbury and District Health Unit - Employee Questionnaire
• Health Canada - Workplace Health Needs and Risks Survey: Long Survey Form.

USERS
Intended Sectors/Sizes of Workplaces
Medium to large workplaces (> 51+ employees).

Intended Users
All employees are encouraged to complete the survey.

Known Users
Ministry of Natural Resources (adapted it and used a consultant to analyze it); Algonquin Automotive (used
parts of it and analyzed it themselves); Muskoka Parry Sound Health unit.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with help and support of the public health unit.

Recommended and Promising Practices For Situational Assessment Tools 225



Employee Health Survey cont'd

2. Workplace staff involvement

The wellness committee at the workplace would work closely with health unit’s staff (workplace coordinator
and/or health promotion consultant).

3. Workplace leader involvement

The wellness committee would have as many major stakeholders involved (management, union, department
representatives, etc.) as possible.

4. Collaborative aspects
There is collaboration between the workplace, the Health Unit Workplace Wellness coordinator, and an external
consultant (typically hired to analyze the results).

Time Involved
1. Time to complete tool
Approximately 30 minutes per employee.

2. Time from distribution to presentation of results

It takes approximately 4-6 months to work through all the steps of the Wellness Works Guide (a guide to imple-
menting a comprehensive workplace wellness program). Once the tool is completed it takes about 1 month for
the consultant to supply the report containing the analysis and recommendations for action.

3. Recommended implementation cycle

The intended implementation cycle is approximately every 4-5 years. A follow-up survey and focus group ques-
tions should be used as they relate to the results and are specific to the areas of need of the initial employee
wellness survey. They are also needed to evaluate the programs that have been implemented following the initial
survey.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

The survey is typically analyzed by an independent consultant with expertise in research, data analysis, and
epidemiology for data entry and report writing. The workplace must contract this service.

2. Process to analyze
Electronic: Yes

Manual: No

The consultant typically uses EPI-Info to analyze the data.

3. Time to analyze
It takes about 1 month for the consultant to analyze the data and supply the report.

226 Comprehensive Workplace Health Promotion

4. Outcome of analysis
The outcome of the analysis is one overall workplace report that reflects the overall picture of health in the
workplace. There are no individual employee reports.

B. Economics
Total Cost: $0 – not including cost for external analysis and production of report.
Cost per unit/respondent: $0 – no direct cost, however, employees usually complete the survey on work
time.

Workplace Resources Used

Printing of survey when administered on paper and time given to employees to complete survey; workplace
wellness committee member time to manage the process.

C. Other Considerations
Supports for Implementation (materials and training)
The Wellness Works Guide outlines a seven step process to implementing a comprehensive workplace wellness
program. It includes topics such as organizing a wellness committee, implementing a needs assessment, follow-
ing-up on the action plan, and evaluating a program. This additional resource can be accessed through the online
Resource Listing. The workplace also has the support of Simcoe Muskoka’s Workplace Wellness coordinator if
the tool is being implemented in that region.

Customization
The tool can be slightly modified to reflect the nuances of the workplace.

The tool can be modified with the help of a consultant. The external consultant would be needed to create the
template for the EPI-Info analysis that would later take place.

Skills required to implement, and to analyze and report

No information available on the skills required for implementation.

For analysis and production of a report, the following skills are required:

• Familiarity with EPI-Info is helpful.

• Familiarity with Comprehensive Workplace Health Promotion.
• Report writing skills, research skills.
• Background in data entry and analysis.
• Epidemiology background is helpful.

Recommended and Promising Practices For Situational Assessment Tools 227



Employee Health Survey cont'd

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Simcoe Muskoka Health Unit (See contact information above). The survey can also be accessed through
the online Resource Listing.

Restrictions or conditions of access or use

It is recommended that workplaces use the tool with the assistance and guidance of a local health unit’s workplace
health promotion specialist where available. If the tool is used or adapted, please credit the Simcoe Muskoka
Health Unit.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

Formative Testing
Pilot testing: Yes

Conducted at the Muskoka-Parry Sound Health Unit. Formative testing was put on hold because of the amalga-
mation of the Muskoka-Parry Sound Health Unit.

Consultations: No

Focus Groups: No

Process Evaluation
Has not been completed to date.

228 Comprehensive Workplace Health Promotion

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
James Prochaska’s Stages of Change and general principles of health promotion practice.

SELECTED REVIEW PANEL COMMENTS

Strengths
This is a helpful tool that could become a recommended practice tool with enhancements to some of the criteria
and further formal evaluation.

Questions include important issues that need to be considered for development of a comprehensive approach.

Sub-headings and specific questions are relevant to the elements of a healthy workplace.

Instructions are clear. Similar questions are grouped together under sub-headings and skip patterns are clear. Mul-
tiple choice questions are quick and easy to complete.

Limitations
It would be better if demographic questions were moved to the end of the survey.

General Comments
The tool addresses the elements of a comprehensive approach i.e. lifestyle practices, occupational health & safety,
and organizational culture. It also uses stages of change theory and health promotion theory.

Analysis done by external consultant, usually an epidemiologist, using EPI-Info software. Could be done in-house if
workplace has expertise, otherwise will cost the workplace to contract out.

Workplace Wellness Guide available as a support. Assistance should be available to workplaces from workplace
program staff in Ontario health units.

Tool should work for both large and small businesses. The cover letter could be adapted to fit the workplace.

Supporting documents indicate a 60-90% response rate. A draw for prizes offered as an incentive for participants
to complete the surveys.

Recommended and Promising Practices For Situational Assessment Tools 229

HEALTH MONITOR™
Summex Health Management

RECOMMENDED

Description
Current Practices
The purpose of the HEALTH MONITOR™ is to help
individuals identify the areas of their health that may
Health Risk Assessment
be at risk and provide suggestions for improvement.
Follow-up interventions that counsel individuals
based on their HEALTH MONITOR™ results are Validity/Reliability Evaluation Conducted
also available. If taken during successive years, the
HEALTH MONITOR™ can also provide a means
for employers to measure the success of wellness
Cost
programs.
Proprietary
Tool Construction
65 questions. Sections include: Medical History; Pre- Paper Access
ventative Screening; Overall Health; Men’s Health;
Women’s Health; Men and Women; Overall Health;
Exercise; Tobacco Use; Nutrition Habits; Alcohol Online Access
Use; Safety; Mental Health; Lifestyle Choices;
Medical Care; Evaluation; and Clinical Information
(for professional use only). Language + (other than English and French)

Lifestyle Practices

Employee Completion

Medium Completion Time

External Implementation
Contact Information
Summex Health Management
7602 Woodland Drive
Suite 100
Indianapolis, IN
46278 USA

www.summex.com

230 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1996

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Medium to large workplaces (> 50+ employees).

Intended Users
All employees are encouraged to complete the survey, but sometimes departments or certain members of specific
health plans or programs within an organization complete the tool. It has also been made available to spouses
of employees.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Summex Health Management, with the help and support of the workplace.

2. Workplace staff involvement

This is designated by each organization; it can be a benefits manager, a team of wellness staff members, human
resources professionals, etc.

3. Workplace leader involvement

No information available on specific kinds of workplace leader involvement. It varies from workplace to work-
place.

Recommended and Promising Practices For Situational Assessment Tools 231



Health Monitor cont'd

4. Collaborative aspects
Outside of the collaboration between the workplace and Summex, there is no other collaboration that takes
place.

Time Involved
1. Time to complete tool
Approximately 15 minutes per employee.

2. Time from distribution to presentation of results

No information available on typical time from distribution to presentation of results.

3. Recommended implementation cycle

Annually. Annual use allows for time over time measurement. For this reason, once a person has taken HEALTH
MONITOR™ online, their data (via their pin number and password) is forever maintained and housed in Sum-
mex’s online application.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

All analysis is performed by Summex.

2. Process to analyze
Electronic: Yes

Manual: No

All analysis is completed electronically.

3. Time to analyze
No information available.

4. Outcome of analysis
Individual reports, aggregate management reports, specialized reports based on risk factors, and interven-
tion reports are available. Summex may also provide more in-depth explanations/presentations of findings,
as requested by the organization. Online HRAs automatically generate an online personal report that can be
viewed and printed using Adobe Acrobat. Participants who complete a paper HRA will be mailed a personal
report within ten business days following the receipt of the HRA.

232 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Time given to employees to complete survey. When an online survey is taken, an Adobe Acrobat report is avail-
able, which some employees may choose to print at the workplace or at home.

C. Other Considerations
Supports for Implementation (materials and training)
Summex does not provide supporting materials, but personal support. A Summex account manager/consultant
works closely with the workplace he/she is assigned to. As well, there is a 1-800 number that all respondents can
call for assistance. They have access to both administrators and health educators.

Customization
Tool can be slightly modified to reflect the nuances of the workplace.

Questions can be added or omitted.

Skills required to implement, and to analyze and report

For implementation, not applicable. Summex implements all steps.

For analysis and reporting, not applicable. Summex completes all steps.

Languages: English, Spanish.

Tested for Cultural Appropriateness: Yes
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Summex Health Management (See contact information above).

Restrictions or conditions of access or use

The tool and the analyzing algorithms are copyrighted.

Recommended and Promising Practices For Situational Assessment Tools 233



Health Monitor cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Summex ensures the validity of the HEALTH MONITOR™ in several ways. First, the modifiable risk factors
assessed by the HEALTH MONITOR™ are based on statistics and benchmarks from a number of reputable
research institutions: Center for Disease Control (CDC), Carter Center (Healthy People 2000), ACSM, American
Heart Association, National Cancer Society, American Diabetes, and others. Additionally, Summex continuously
reviews the literature and adjusts the HEALTH MONITOR™ risk factor algorithms to reflect the most current
research findings. HEALTH MONITOR™ clients also have the option of increasing or decreasing the sensitivity
of risk factor analysis to meet their population’s specific needs. Furthermore, the language of many HEALTH
MONITOR ™ questions has been based on questions within Healthy People 2000, Rand SF36, HEDIS and other
previously validated public domain question sets.

Reliability: Yes

Summex’s development staff conducted the reliability testing. This is done each time the HEALTH MONITOR™
is updated. Updates occur every time there are changes in national (US) health regulations. Changes to HEALTH
MONITOR™ are meant to reflect the changes in regulations, but Summex tries to keep the changes as minimal
as possible so that the question set can remain stable. This is necessary for maintaining a database that will
provide accurate time over time data.

Formative Testing
Pilot testing: No information available.

Consultations: No information available.

Focus Groups: No information available.

Process Evaluation
Formative evaluation is a part of Summex’s daily processes, due to the fact that all of its departments are centrally
located. Therefore, they have the ability to evaluate their products continuously using various methods. Summex
has a satisfaction survey distribution process. This is a paper survey distributed to a representative sampling of
participants in order to get their feedback on the tool. As well, each HEALTH MONITOR ™ as a short evaluation
section at the end. Respondents are encouraged to fill that out along with the rest of the tool. In addition to that,
Summex has a customer service tracking system, which enables them to track issues that repeatedly come up
and respond accordingly to them.

234 Comprehensive Workplace Health Promotion

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
The main theoretical basis for Summex’s tools and interventions is James Prochaska’s Transtheoretical Model
(Stages of Change).

SELECTED REVIEW PANEL COMMENTS

Strengths
The tool appears to have undergone rigorous testing for validity and reliability, including efforts to minimize and
control some of the key threats to validity (history, maturation, etc.)

Questionnaire is very clear, thoughtfully laid out and easy to follow.

Description indicates tool is written at Grade 6 reading level, tested for cultural appropriateness and available in
Spanish.

Limitations
The testing relies heavily on respondents remembering their laboratory results for cardiac and diabetic tests. This is
of concern, as most people cannot remember this.

The tool is a good example of its kind, but definitely not a sufficient tool for a comprehensive workplace health
promotion initiative. It’s not an appropriate tool (at least as a stand-alone) for comprehensive workplace health
promotion efforts.

Issues of confidentiality/anonymity are addressed in the sample cover letter. However, the reviewers could see how
concerns about confidentiality would arise, given the amount of clear ‘identifier’ information sought by the tool.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 235

Employee Feedback System (©EFS)
Brock University, Workplace Health Research Unit

RECOMMENDED

Description
Current Practices
The ©EFS can address several purposes. Individual
clients identify their own goals for the ©EFS project,
Organizational Culture
but they generally are along the following lines:

1) Identify the key drivers of employee satisfaction Validity/Reliability Evaluation Conducted

and productivity in organizations

2) Identify gaps between the respondents’ satisfac- Proprietary

tion with, and perceived importance of, key quality
of work life factors Cost
3) Clearly identify organization’s greatest areas of
Made in Canada
strength -- and pinpoint the greatest opportunities
for improvement in employee quality of work life
Paper Access
4) Compare the findings across departments and
levels in their organization
Online Access
5) Systematically evaluate comments and sugges-
tions of respondents French
6) Create action plans for organizational change
Organizational Culture /#
7) Evaluate progress in organizational quality of
work life change programs.
Employee Completion

Long Completion Time

Internal Implementation
Contact Information
John Yardley, Director
Workplace Health Research Unit, Brock University
43 Church Street, Suite 401
St. Catharines, Ontario, L2R 7E1

Phone: (905) 641-7578 1-800-726-4082

Fax: (905) 641-7538
http://www.whru.ca

236 Comprehensive Workplace Health Promotion

Tool Construction
23 core sections, which cover the following topics: Organizational Satisfaction; Job Satisfaction; Satisfaction
with Supervisor; Pay Satisfaction; Benefits Satisfaction; Satisfaction with Physical Work Environment; Work-
place Stress (Workload, Personal, Job Control, Job Clarity, Employee Involvement); Communication; Co-worker
Cohesion; Internal Organizational Quality (Resources and Supplies and Inter-Unit Cooperation); Continuous
Quality Improvement (Organizational Level and Individual Level); Training Satisfaction; Strategic Leadership;
Recognition and Reward of Quality (Team Level and Individual Level); Intentions to Remain; and Organizational
Commitment (Personal Involvement and Loyalty). Additional scales are available for review.

HISTORY
Current Status: Active
Developed: 1998

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey, but sometimes departments within an organization com-
plete the tool, or random samples are completed in large workplaces.

Known Users
As of June 2005, over 80 organizations have used the EFS. No specific information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with the help and support of Brock’s Workplace Health Research Unit (WHRU).

Recommended and Promising Practices For Situational Assessment Tools 237



Employee Feedback System cont'd

2. Workplace staff involvement

Representative employee committees (such as wellness committees or other cross-functional teams) are encour-
aged to assist in the design and implementation of the survey and the survey process. Further, Brock encourages
employee groups to be actively engaged in the action planning process with the findings.

3. Workplace leader involvement

Workplace leaders participate in the design and implementation of the survey. It is often the leaders who set the
parameters and goals for the process. They are largely involved in reviewing and customizing the survey and
report templates to meet their information needs, determining the scope of reporting to be created, identifying
the follow up action planning processes that will be put into place, etc. It is usually the organizational leaders
who ‘receive’ the findings first, via a presentation or a teleconferenced review of their report(s). Ongoing discus-
sions and consultative support are often offered to Senior Leaders as they work to finalize and implement their
action plans. Further, Brock consultants often work directly with Senior Leaders to incorporate/integrate the
EFS findings with other strategic initiatives such as balanced scorecards, organizational and HR strategic plans,
management performance programs, etc.

4. Collaborative aspects
WHRU and Brock’s client workplaces implement the tool in partnership. No other parties are generally
involved.

Time Involved
1. Time to complete tool
15 to 40 minutes per employee.

2. Time from distribution to presentation of results

Usually distribution is no longer than 2 weeks (has been as short as 2-3 days) and results are available within 4
weeks of the last data being collected. Specific requests for results can sometimes be delivered same day to 2-3
days depending on the quantity and form.

3. Recommended implementation cycle

Ranges from every 3 months (in a pulse format), to 2-3 years.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Brock’s internal statisticians and researchers conduct the data analysis.

2. Process to analyze
Electronic: Yes

Manual: Yes

238 Comprehensive Workplace Health Promotion

 Pen/paper surveys are scanned electronically with some manual qualitative entry. WHRU’s standardized, pro-
prietary analysis and reporting templates are used to analyze and report on data at the organizational and
group level (e.g. department, location, job type, job level, etc.). Various software programs have been used to
develop Brock’s systems (e.g. Autodata, Visual Basic/Excel, SPSS), but all have been fully customized to meet
their analysis/reporting needs. Their web based systems were custom designed and built by WHRU and are
proprietary to Brock University.

3. Time to analyze
The time required varies greatly based on the specifications of the project.

4. Outcome of analysis
Various types and levels of aggregate reports are generated and provided back to the client organization in both
paper and CD Rom. These reports are fully colour coded and consist of a series of graphs/tables demonstrating
the results. There is also often a written interpretation/recommendation section included.

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
In-house time for development and carrying out of internal distribution and collection processes (if applicable).
Printing and time given to employees to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
The Workplace Health Research Unit works with each of Brock’s client organizations to design and implement a
survey process that ensures success. This generally includes committee or management training/orientation to
the tool and the process, design of the communications and implementation strategies and plans, and ongoing
support throughout the implementation and follow phases of the employee survey.

Customization
Tool, scales or items can be slightly modified to reflect the nuances of the workplace.

Items and Scales can be added or omitted.

Skills required to implement, and to analyze and report

For implementation, experience with marketing support is helpful.

For analysis and reporting, not applicable. Brock University completes all other steps.

Recommended and Promising Practices For Situational Assessment Tools 239



Employee Feedback System cont'd

Languages: English and French (reporting only available in English).

Tested for Cultural Appropriateness: No
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
Contact the Workplace Health Research Unit at Brock University (See contact information above).

Restrictions or conditions of access or use

The tool and the analyzing algorithms are copyrighted.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Results of initial testing: both concurrent and content validity was established. Results of ongoing testing: valid-
ity has been established in all cases.

Reliability: Yes

Results of initial testing: The scales all recorded internal consistencies of greater than 0.80. Results of ongoing
testing: Stability reliability has been shown, internal consistency results show that the Alpha coefficients for all
23 core EFS Survey scales range from 0.87 to a high of 0.95. In terms of across form consistency, they have found
that at the aggregated organizational level the ratings were very similar, which they present as an approximation
of across form consistency.

Formative Testing
Pilot testing: No information available.

Consultations: No information available.

Focus Groups: No information available.

Process Evaluation
Validity and Reliability are continually being monitored.

240 Comprehensive Workplace Health Promotion

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
Quality Principles from Dr. W.E. Deming, Canadian Quality Criteria from the National Quality Institute, some
original scales were validated against the Job Descriptive Index (JDI).

SELECTED REVIEW PANEL COMMENTS

Strengths
This tool is extremely practical for organizations from a variety of sectors and size. The tool promotes the involvement,
commitment, planning and implementation of everybody in the workplace (from top to bottom). It encourages the
union participation in a collaborative manner. It is highly recommended for small to medium sized businesses.

Lay out is user friendly and easy to follow with clear headings. The questions are batched and there is consistent sen-
tence structure.

Overall, this tool has been successfully used in both the not for profit and private sectors with workplaces having
anywhere between 250-10,000 employees.

Limitations
No comments provided.

General Comments
This tool was developed by a multi-disciplinary team representing a variety of sectors, researchers, and different pro-
fessionals. This tool effectively assesses employee needs and organizational culture, as it presents a number of relevant
questions in a logical manner.

Recommended and Promising Practices For Situational Assessment Tools 241

TRALE Explorer (Online) & TRALE Backpack (Paper)
TRALE, Inc.

RECOMMENDED

Description
Current Practices
TRALE provides the first step tools (TRALE Back-
pack and TRALE Explorer) necessary to start health
Health Risk Assessment
promotion and disease management programs.
The TRALE Backpack is a portable stand-alone
health risk assessment tool designed to offer fully Needs Assessment
integrated health risk assessments, individual well-
ness reports, and full aggregate/executive reports.
Organizational Culture
TRALE Explorer is an online self-scored health risk
appraisal with immediate feedback via a private and
secure Web link. Health Coaching is also included Validity/Reliability Evaluation Conducted
with the TRALE Backpack (Paper).

Tool Construction Cost

13 sections. 42 questions with multiple choice

Proprietary
answers. The answer are on a weighted point scale
and the dynamic results are characterized as “ideal”,
“borderline”, or “at risk”. Paper Access

Online Access

Language + (other than English and French)

Organizational Culture /#

Contact Information
Lifestyle Practices
Dan O’Flaherty
Vice President of Sales Employee Completion
TRALE, Inc.
196 SE Spokane Street Short Completion Time
Suite # 107
Portland, Oregon
97202 USA External Implementation

www.trale.com

242 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 2002

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
Amerigroup Inc., Ceridian, Daimler Chrysler, O’Neal Steel, City of Portland, State of Florida Department of
Health, Wellness Institute of America, World Hope Organization.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The tool is implemented by the workplace, with the help and support of TRALE.

2. Workplace staff involvement

The Wellness manager, occupational health, marketing, or human resources implements the tool.

3. Workplace leader involvement

CEO and managers are involved in the promotion of the tool. They might send out mass emails which are signed
by them, add promotional stuffers to pay checks, or put up promotional posters.

4. Collaborative aspects
There is collaboration with WellCall, a health management company. After reports have been provided to the
workplace, WellCall provides personal coaching to respondents.

Recommended and Promising Practices For Situational Assessment Tools 243



Trale Explorer & Trale Backpack cont'd

Time Involved
1. Time to complete tool
Approximately 10 minutes.

2. Time from distribution to presentation of results

The software allows for each step of the implementation process to happen immediately. 2 weeks are given as the
time for employees to complete the assessment. The Backpack (paper-pencil) can be implemented upon delivery
and it provides immediate results/reports.

3. Recommended implementation cycle

Recommended implementation cycle is bi-annually (twice every year). Each license for both TRALE Explorer
and TRALE Backpack expire after one year.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: Yes

Either the workplace analyzes the data or TRALE’s Intervention Partner, WellCall (www.wellcall.com ). WellCall
is a provider of personalized health management services. Often the workplace doesn’t purchase the Backpack
themselves, but hires an outside party who has it and can implement it. With an outside party, confidentiality is
better maintained while providing individual reports. If the online Explorer is used, then TRALE’s Intervention
Partner, WellCall, creates the outcome of analysis.

2. Process to analyze
Electronic: Yes

Manual: No

If the workplace uses the online TRALE Explorer, then TRALE’s Intervention Partner, WellCall, processes the
data using TRALE’s custom query analyzer (software). This software comes with the Explorer license. If the
workplace uses the TRALE Backpack, then they process the data using the scanner and software that comes
included with the Backpack.

3. Time to analyze
No information available.

4. Outcome of analysis
There are several kinds of reports that comprise the outcome of analysis: individual respondent report (online
& paper); executive summary report (online & paper); aggregate report (online & paper); and branded reports
(available online). When workplaces are using the Backpack, they create the reports using TRALE’s software.
After a respondent’s initial assessment, follow-up assessments receive progressive reports which detail changes
from the prior report.

244 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: For current pricing or a quote, please contact Dano@trale.com.
Cost per unit/respondent:
No information available.

Workplace Resources Used

Time given to complete the survey.

C. Other Considerations
Supports for Implementation (materials and training)
TRALE Backpack comes with an owner’s manual and a demo link to software. As well, 1-888-94-TRALE Tech-
nical support and training staff are available.

Customization
The tool can be slightly modified to reflect the nuances of the workplace.

Skills required to implement, and to analyze and report

The phone training by TRALE provides the workplace with the required skills to operate Backpack software.

Languages: English (Canadian/Australian), Spanish

Tested for Cultural Appropriateness: Yes
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact TRALE, Inc. (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted. Licenses only last for one year and then must be repurchased.

Recommended and Promising Practices For Situational Assessment Tools 245



Trale Explorer & Trale Backpack cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Face validity: Established through review and integration of information in health care and health promotion
industry literature, utilizing experts in the field, focus groups and a sample of potential users. The HRA is
determined to sufficiently measure and report a broad spectrum of relevant health-related information.

Construct Validity: Health-related information assessed and reported in the HRA is determined to be reflective
of norms, health status, and scores (which shifts according to age, gender and health-affecting behaviors), as
confirmed through research and analysis of health industry literature.

Content Validity: The HRA is designed to adequately assess and report individual and population data regard-
ing self-reported medical history, family history, preventive care status, health habits and life experiences, and
general information (demographics), as confirmed through research and analysis of health industry literature.

Criterion Validity: TRALE, Inc., is currently (2005) engaged in several projects to establish criterion validity,
including: Research and assessing various risk algorithms and health concepts; Correlating, and assessing the
significance of, data reported on the HRA with independently measured biometric data; Developing Standards
for HRA scores (e.g. a given score in on risk category is equivalent to the same score in another category).

Reliability: Yes

A matched analysis of biometric and self-reported HRA data (including aerobic, exercise, blood pressure, body
mass index, cholesterol, diabetes, family history, height, smoking status, and weight) was performed.

Formative Testing
Pilot testing: Yes

TRALE, Inc. assessed adults and seniors for ability to understand and interpret HRA questions, and completion
time.

Consultations: Yes

There was an expert review completed by academic, managed care, research, hospital, and marketing profes-
sionals. They assessed content and applicability to the practice setting and critiqued report types for relevance
as clinical and educational tools in the clinical setting.

Focus Groups: Yes

TRALE, Inc. assessed groups consisting of a representative mix of age, gender, and ethnicity for ability to under-
stand and interpret HRA questions, and completion time. TRALE also assessed whether the HRA would provide
a fair overview of health/medical background to personal health care provider.

246 Comprehensive Workplace Health Promotion

Process Evaluation
HRA questions, scoring, and risk algorithms (regarding normative standards, clinical, health-related behavior
and epidemiology HRA areas) are continually updated using standard operating procedures, including routine
monitoring of the HRA industry and review by an advisory board, an academic collaborative panel, and health-
care, academic, and marketing consultants.

PLAUSIBILITY ELEMENTS
Theoretical Underpinnings
James Prochaska’s Stages of Change Theory.

SELECTED REVIEW PANEL COMMENTS

Strengths
This tool seems very well thought out and researched.

It seems to be a good tool to assess health risks in individuals.

Limitations
The reports can be very general and can be manipulated with less than honest answers.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 247

Organizational Health Audit
Tri Fit Inc.

PROMISING

Description
Organizational Culture
The Organizational Health Audit was developed
to assist organizations in developing strategic and
Workplace Audit
targeted health promotion initiatives that meet
organizational goals.
No Cost
Tool Construction
4 sections, which cover the following topics: Physical Proprietary
Environment; Programs and Services; Policies and
Procedures; and Corporate Culture. Made in Canada

Electronic Access

Paper Access

Organizational Culture /#

Occupational Health and Safety

Lifestyle Practices

Employer/Committee Completion

Long Completion Time

Contact Information Internal Implementation

Tri Fit Inc.

1307 Devon Road
Oakville, Ontario
L6J 2L7 Canada

www.trifit.com

248 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1997

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
To be completed by a group of 3- 5 people with responsibility for Health, Safety, Wellness and the Environment
of the workplace.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Implemented by the workplace.

2. Workplace staff involvement

Depending on the workplace, an employer or the appointed head of a health promotion or workplace wellness
program committee would complete the tool.

3. Workplace leader involvement

Workplace leaders might be a part a potential team of people completing the tool.

4. Collaborative aspects
No collaboration involved in implementing the tool.

Recommended and Promising Practices For Situational Assessment Tools 249



Organizational Health Audit cont'd

Time Involved
1. Time to complete tool
Approximately 60 minutes to complete the tool (as a group or per person).

2. Time from distribution to presentation of results

Total implementation time (up to presentation of results) can take up to 2 working days.

3. Recommended implementation cycle

Recommended implementation cycle is every 1-2 years.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: Yes

Data is analyzed either internally or externally by a consultant.

2. Process to analyze
Electronic: No

Manual: Yes

Numerical scores are given to each question on the audit, which can be added up by the Wellness Committee to
form a total number of points. There are three ranges of totaled points that the workplace can achieve - a bronze
wellness level, a silver wellness level, or a gold wellness level.

3. Time to analyze
No information available.

4. Outcome of analysis
A report is compiled either internally or externally by a consultant, depending on the workplace’s preference,
resources, and experience. If analyzed internally, the project lead would create the report (normally someone
with responsibility for healthy workplace initiatives, human resources, or occupational healthy and safety).

B. Economics
Total Cost: $ 0 – not including cost for external analysis and reporting if used (estimated at $1500.00 CDN).
Cost per unit/respondent: $0
Workplace Resources Used
Time given to employees to complete survey; workplace wellness committee member time to manage the
process.

250 Comprehensive Workplace Health Promotion

C. Other Considerations
Supports for Implementation (materials and training)
No supports are offered.

Customization
No customizations are offered.

Skills required to implement, and to analyze and report

Organizational interest in employee health and well-being.

If analyzing and writing report internally, a background in report writing is recommended.

Languages: English
Tested for Cultural Appropriateness: No
Tested for literacy level: No

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Tri Fit Inc. (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted and cannot be modified without permission from Tri Fit Inc.

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: No

Reliability: No

Formative Testing
Pilot testing: No

Recommended and Promising Practices For Situational Assessment Tools 251



Organizational Health Audit cont'd

Consultations: No

Focus Groups: No

Process Evaluation
No formal process evaluation has been done. Tri Fit Inc. receives client feedback and this has shown the tool to
be effective in its purpose.

PLAUSIBILITY ELEMENTS
No information available.

SELECTED REVIEW PANEL COMMENTS

Strengths
It seems to be a good tool to use to gauge overall organizational wellness levels.

Excellent category headers and good probing lists.

Overall set-up is good.

Categories (Bronze, Silver, and Gold) are easily determined.

It seems as if the tool could be used as a guide for the Wellness Committee of a workplace. Their goal would be to strive
to include in their strategic plan as many aspects of a healthy workplace as possible. They could readily revisit the lists
in the future.

Limitations
Both reliability and validity of the questions have not been assessed.

Not all workplaces may have the capacity to act upon the weaker areas of their workplace. (e.g., building structure,
etc.)

Some questions could be grouped together better. For example, “cafeteria that provides healthy food choices” should
be followed by “vending machines with healthy food choices.” However, they seem to have grouped them according
to the number of points available for each statement.

Feedback reports are not generated.

Might be a bit lofty for some companies’ budgets if they expect to implement the entire list of things.

Smaller workplaces may score much lower, though, because they don’t have the physical space or capital to improve
upon their current situation.

General Comments
No comments provided.

252 Comprehensive Workplace Health Promotion

Recommended and Promising Practices For Situational Assessment Tools 253
Personal Wellness Profile™
Wellsource, Inc.

RECOMMENDED

Description
Current Practices
The tool is designed to assess a workplace’s employee
population and promote a healthy workplace. Health Risk Assessment
Tool Construction Interest Survey
39-75 questions. Sections include: Health Informa-
tion; Physical Activity; Eating Habits; Alcohol, Drugs Needs Assessment
and Smoking; Stress and Coping; Social Health;
Safety; Medical Care; and Health View. Validity/Reliability Evaluation Conducted

Cost

Proprietary

Electronic Access

Paper Access

Online Access

Language + (other than English and French)

French

Occupational Health and Safety

Contact Information
Rod Birdsell Lifestyle Practices
Toronto Regional Business Development Manager
Wellsource, Inc. Employee Completion
15431 SE 82nd Drive
Clackamas, Oregon Employer/Committee Completion
97015 USA
Medium Completion Time
TEL: (800) 533-9355
www.wellsource.com
Internal Implementation

254 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1989

Adapted From/Built On:

None.

USERS
Intended Sectors/Sizes of Workplaces
Not size or sector specific.

Intended Users
All employees are encouraged to complete the survey.

Known Users
There are currently approximately 10 users, which includes healthcare providers and corporations.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
The workplace, with Wellsource’s help and support.

2. Workplace staff involvement

This can vary by organization. Some references are Human Resource Mangers, Personnel Managers, Safety
Managers or Health Managers. They often serve as the primary contact(s) for Wellsource.

3. Workplace leader involvement

Executives and Managers are needed to promote participation and the healthy workplace philosophy.

4. Collaborative aspects
If a workplace chooses to incorporate biometrics into its assessment, a medical-type institution would be
engaged.

Recommended and Promising Practices For Situational Assessment Tools 255



Personal Wellness Profile cont'd

Time Involved
1. Time to complete tool
Approximately 20 minutes per employee.

2. Time from distribution to presentation of results

No information available.

3. Recommended implementation cycle

Annually.

Analysis Involved
1. Analysis completed by
In-house: Yes

External: Yes

Wellsource can analyze the data or provide the workplace with a scanning device that will allow it to complete
analysis without support.

2. Process to analyze
Electronic: Yes

Manual: Yes

For the online version, the data is analyzed by the program. Paper versions are scanned by OpScan® in-house
and then placed into the PWP Software System (which is licensed by the workplace) for data mining and report
generation.

3. Time to analyze
Typically takes 2-5 days to complete analysis (per 500 surveys).

4. Outcome of analysis
The reports available are: individual, trend, executive summary, physician summary, and group summary. There
is training made available to workplaces by Wellsource to help learn how to implement the tools and analyze the
data using the software.

B. Economics
Total Cost: Depends on edition selected – contact Wellsource for pricing.
Cost per unit/respondent: No information available.
Workplace Resources Used
Time given to employees to complete survey.

256 Comprehensive Workplace Health Promotion

C. Other Considerations
Supports for Implementation (materials and training)
A workplace typically licenses the PWP Software System. This software completes the analysis and reporting
end of implementation. The purchase of that software license includes: Basic System module; Group Statisti-
cal Report module; Progress Report module; Executive Summary Report module; Physician Summary Report
module; Counselor Report Module; Personal Trend Report Module; Support Pacs for 200 participants (Support
Pac includes: questionnaires, learning guides, report covers and report paper); Guide to Operations manual;
1-year Software Maintenance Agreement entitling user to free updates of the software, access to Wellsource
Technical Support including software development staff and health professionals; Hands-on training at Well-
source.

Customization
Tool can be slightly modified to reflect nuances of the workplace.

Skills required to implement, and to analyze and report

Training is provided by Wellsource, but the following is recommended:

• Program administrator
• Participants with 6-8th grade reading competency
• Online participants require desktop access (it is recommended that a workplace’s IT depart-
ment be involved in this process).

Languages: English, French Canadian, Spanish

Tested for Cultural Appropriateness: Yes
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Wellsource, Inc. (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted and the name protected under trademark law.

Recommended and Promising Practices For Situational Assessment Tools 257



Personal Wellness Profile cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

The questions included in the Personal Wellness Profile™ assessment are based on research that has proven
to have significant relationships to health risk. The reported outcomes are evidence-based on scientifically
valid research studies and nationally published research by leading health organizations. Wellsource does not
conduct their own research studies. The Fitness section is based on national guidelines published by the Ameri-
can College of Sports Medicine. Similarly, each section is based on other national guidelines established by the
United States’ best recognized scientific authority in each area of health. These also include, but are not limited
to, the National Academy of Sciences, Institute of Medicine, National Institutes of Health, and US Department
of Health and Human Services. As well, the University of South Florida conducted a content validity evaluation
of the PWP program. They used 5 experts in the clinical field to evaluate each question. The experts consisted
of a registered dietician, an exercise physiologist, an advanced registered nurse practitioner, a health educator,
and a physician. The overall Content Validity Index for the entire instrument was rated 0.90 (0= no validity, 1.0
= perfect validity). Their evaluation concluded, “The (PWP) instrument has strong validity characteristics.”

Reliability: Yes

Formative Testing
Pilot testing: Yes

Consultations: Yes

Focus Groups: Yes

BETA testing was conducted with clients and users. The testing was conducted by Wellsource’s Product Devel-
opment and Engineering Teams.

Process Evaluation
Recommendations, comments, etc. are gathered and considered at regular meetings by the development teams
at Wellsource. Decisions are then made as to whether any changes need to be made to address these concerns.
These issues are generally related to the software and not so much to the tool’s content, however.

PLAUSIBILITY ELEMENTS
General principles of health promotion and behaviour change.

258 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
Overall, there are some really good features in this tool. It does talk about how to implement the tool - gain senior
maximum commitment, do a situational assessment, develop a health plan, develop program and evaluation
report.

Background materials discuss the link between healthy employees and the overall health of the company. For
example, healthier employees are more productive, less costly.

The tool measures abdominal girth and that is a key indicator for heart disease and diabetes. This is progressive!

It is comprehensive and based on latest research. It is always being updated to respond to changes in research
knowledge.

Overall the tool is straightforward and easy to answer, with clear instructions.

This tool has very sophisticated software to assist in consolidating and tabulating the results. It also presents the
findings in useful (simple or comprehensive) formats that enable the employee to plan their interventions and
monitor progress.

Wellsource Inc. provides 1 1/2 day train the trainer program, thereby giving the organization the skills and knowl-
edge to implement the tool within the organization.

The participation rates are between 80-90%, if there are incentives for participants.

Limitations
The actual tool only focuses on lifestyle practices. Few questions on the environment, occupational health & safety,
or organizational factors are considered.

The same standards of practice do not apply in Canada (e.g., fruit and vegetable consumption - they are similar but
not identical) so this may be a limitation.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 259

STORM Index(Strategic Organizational Management Index)
Workplace Consultants Inc.

RECOMMENDED
Description
Current Practices
The STORM Index was initially intended to be
a comprehensive cultural, organizational health
Organizational Culture
assessment, but it has expanded to also become a
productivity, performance and quality assessment.
The results of the survey are intended to help work- Validity/Reliability Evaluation Conducted
places assess their current organizational culture
and to be able to work towards improving areas
where organizational culture needs improvement. Cost

Tool Construction Proprietary

2 sections: Section I includes 10 core stimulus
word response items, plus additional custom items. Paper Access
Section II utilizes traditional survey items related to
demographics, job satisfaction, stress, health, work-
life balance, product/service quality, productivity, Online Access
employee recommendations. Section II is optional
and customizable depending on needs of the client,
averaging 60-70 questions.
French

Organizational Culture /#

Additional Resources
Employee Completion
STORM Index: Why it Works: Validity and Reliability
Information
Employer/Committee Completion

Contact Information Medium Completion Time

Michael Peterson External Implementation

President
Workplace Consultants Inc.
114 Ridgewood Dr.
Landenberg, PA
19350 USA

www.stormindex.com

260 Comprehensive Workplace Health Promotion

HISTORY
Current Status: Active
Developed: 1998

Adapted From/Built On:

STORM Index was built on/adapted from the Associative Group Analysis process of psychosocial/cultural
evaluation.

USERS
Intended Sectors/Sizes of Workplaces
Medium to large workplaces (> 51+ employees).

Intended Users
All employees are encouraged to complete the survey.

Known Users
No information available.

PRACTICALITY ELEMENTS
A. Process
Who is Involved
1. Implemented by
Workplace Consultants Inc., with the help and support of the workplace.

2. Workplace staff involvement

Typically there is one person that is designated by the workplace to act as the coordinator/contact. Preferably
this is an individual who can communicate with the company and has sufficient credibility with employees. This
person may be someone in management, HR, or even a CEO.

3. Workplace leader involvement

As many as the company deems necessary are involved. CEOs and Managers report that the findings are very
rich and profound, providing them with a clear understanding of the cultural and environmental factors that
impact their business.

Recommended and Promising Practices For Situational Assessment Tools 261



STORM Index cont'd

4. Collaborative aspects
No information available.

Time Involved
1. Time to complete tool
Approximately 20 minutes.

2. Time from distribution to presentation of results

Approximately 4 weeks. Time depends on the corporate client (how long it takes to make decisions, etc).

3. Recommended implementation cycle

Every two years.

Analysis Involved
1. Analysis completed by
In-house: No

External: Yes

Analysis is conducted by Workplace Consultants Inc.

2. Process to analyze
Electronic: Yes

Manual: Yes

The process of analysis is a combination of electronic and manual work that is completed by Workplace Con-
sultants Inc.

3. Time to analyze
No information available.

4. Outcome of analysis
A comprehensive report is generated that covers 10 vital aspects of the organization, including a thorough iden-
tification of the culture. Results are presented in written form, and a follow-up meeting (via phone or in-person)
is provided. There is the option of also expanding report results based on customizations of the survey itself
and/or any tiered or stratified results the workplace might request.

262 Comprehensive Workplace Health Promotion

B. Economics
Total Cost: No information available.
Cost per unit/respondent: No information available.
Workplace Resources Used
Printing and time given to complete survey.

C. Other Considerations
Supports for Implementation (materials and training)
There are the instructions and an explanation of the tool that precede the questions themselves online. As well,
the workplace receives instructions on how to read the results. Other than that, no supports are needed since
Workplace Consultants Inc. implements the steps.

Customization
Tool can be slightly modified to reflect nuances of the workplace.

Questions can be added or omitted.

Skills required to implement, and to analyze and report

For implementation, not applicable. Workplace Consultants Inc. implements all steps.

For analysis and reporting, not applicable. Workplace Consultants Inc. implements all steps.

Languages: English, French Canadian

Tested for Cultural Appropriateness: No
Tested for literacy level: Yes

D. Access
Packaged, ready-to-use: Yes
How to access
Contact Workplace Consultants Inc. (See contact information above).

Restrictions or conditions of access or use

The tool is copyrighted.

Recommended and Promising Practices For Situational Assessment Tools 263



STORM Index cont'd

EFFECTIVENESS ELEMENTS
Evaluation
Reliability and Validity
Validity: Yes

Various assessments of the construct and content validity indicate that it is a viable measure of meaning and
evaluation. It has also been reviewed by a panel of independent researchers and found to be a valid instrument
in the assessment of organizational factors, especially culture and proclivity for performance.

Reliability: Yes

The STORM Index method of measurement has been assessed for reliability through content analysis of meaning
components by specific assessment of interjudge reliability; the dominance hierarchy measure by a test-retest
assessment and the evaluative attitude index by the interjudge method. More information on reliability and
validity can be found in the document, STORM Index: Why it Works: Validity and Reliability Information. This
additional resource can be accessed through the online Resource Listing.

Formative Testing
Pilot testing: Yes

It was pilot tested by Angus Reid Group on the company itself, and then used in a National Canadian Study. This
pilot testing was conducted by Workplace Consultants Inc. and the Angus Reid Group (1998-9).

Consultations: Yes

Dr. M. Peterson has been involved with Edgar Schein – a management expert out of MIT.

Focus Groups: No

Process Evaluation
National Study solicited respondent feedback. Each implementation is followed by a feedback mechanism for
corporate client responses. Conducted by the Angus Reid Group in 1999 and Workplace Consultants Inc. from
1999 to present.

PLAUSIBILITY ELEMENTS
STORM Index is based on the Culture-Work-Health Model, which has been published twice in the American
Journal of Health Behavior.

264 Comprehensive Workplace Health Promotion

 SELECTED REVIEW PANEL COMMENTS
Strengths
Information provided reveals that the validity and reliability of this tool have been tested and are shown to be
high.

Tool uses word association which gives the respondent flexibility in answering questions. Because the purpose is to
evaluate organizational factors, questions seem appropriate for this outcome.

Nice that a company can adapt for their own goals and purposes.

On-line access makes distribution effective and efficient.

Reports are discussed with management and they are taught how to interpret the results. Website gives evidence
of the effective use of charts for results.

Limitations
The reviewers felt that a one-word response is not always explicit enough. Why don’t they allow phrases for the
stimulus items?

May not be useful for factories and their workers as they don’t have individual computers.

General Comments
No comments provided.

Recommended and Promising Practices For Situational Assessment Tools 265