Assessing and Addressing Extension Employees' Wellness Needs

This research study was supported in part by a University of Vermont Graduate College Summer Research Fellowship.

Wellness is more than the absence of illness. Health has been defined as a position on a continuum, from illness and premature death on one end to wellness, or optimal health, on the other (O'Donnell, 1986). Wellness is multi-dimensional and involves a person's entire lifestyle.

Research has shown that lifestyle choices affect the quality of health and well-being and, thus, where one is on the health continuum (Girdano, 1986; Selleck, Sirles, & Newman, 1989; and Sloan, Gruman, & Allegrante, 1987). Wellness programs focus on positive health behaviors that enable people to move from their current state of health to a higher level of well-being. Recognizing the relationship between health and productivity, many employers in the U.S. now provide wellness programs for their employees. A 1992 national survey of worksites with 50 or more employees found that 81% offer one or more health promotion activities (U.S. Department of Health and Human Services, 1993). Employers view these programs as a means of taking a more active role in health cost containment and the health status of their employees.

The purpose of this study was to assess the wellness needs and interests of University of Vermont (UVM) Extension System employees. By identifying areas of perceived need, this study could assist leaders within Extension and the university as a whole in the planning and development of employee health promotion activities designed to improve the health and well-being of Extension faculty and staff, as well as to boost morale and enhance performance.

Specific objectives of the study were to: (a) assess the perceived health-related needs, interests, and practices of UVM Extension System employees; (b) investigate the attitudes of Extension faculty and staff regarding the prospect of an employee health promotion program; (c) determine if UVM Extension System employees perceive organizational and co-worker support for the practice of positive health behaviors; and (d) identify major goals plus desired topics, programs and activities for a wellness program for Extension employees.

A mail questionnaire developed by the researchers was used to gather data for the quantitative part of the investigation. For the qualitative portion of the study, four focus group interviews were held.

During the time this study was conducted, the UVM Extension System was undergoing a significant reduction in workforce affecting the total number of employees who would be active as of July 1, 1992. That projected number of employees was 135, with 57 employees located on the university campus and 78 located off campus at field offices. This total included 86 females and 49 males; 72 were faculty members and 63 were program and clerical staff. Since this population was relatively small, all were included in the survey sample.

The 27-question survey was developed based on a review of other existing health information surveys and related literature (Aday, 1989; Babbie, 1973; and Nickens, Purga III, & Noriega, 1980). As this was a new instrument, a pre-test was conducted with five university employees who were not included in the sample for the final survey. The instrument was also critiqued by three UVM faculty with expertise in survey research methods. The questionnaire contained four sections. The first section included demographic data, such as gender, age, position (faculty, program staff or clerical), location (on or off campus), length of employment, Extension FTE, hours worked for Extension per week, and hours at another paying job per week. Questions in the second section assessed interest in an employee wellness promotion program. This section included questions relating to the components of a wellness promotion program, specific programs and activities which should be offered, intent to participate, cost sharing, and when programs should be offered. The third section concerned health and lifestyle. Respondents were asked about their smoking, weight, seat belt use, blood pressure, cholesterol, stress, back pain and daily dietary habits. The fourth section addressed workplace culture with questions about support by co-workers and the organization for positive health practices. At the end of the survey, an open-ended question was included asking the respondent to provide his/her own definition of wellness.

Pre-notification about the mail questionnaire was given to all UVM Extension employees through an electronic mail message from the Extension associate director in late April. The questionnaire, a cover letter, incentive prize drawing information and an addressed, stamped return envelope were sent to the survey sample in early May. A follow-up mailing to those who did not respond to the first request was done three weeks later. This mailing included a new cover letter, a second copy of the questionnaire, and an addressed return envelope. The final cut-off date for receipt of completed questionnaires was June 10. Completed questionnaires were reviewed and coded, and the data was entered into the UVM VAX computer for statistical analysis procedures using SPSS software. Statistics used include frequencies, percentages, and cross tabulations (Orlich, 1978; Alreck & Settle, 1985; Aday, 1989).

Thirty-one Extension employees, nearly a quarter of the total population, participated in the focus group interviews (each group consisted of 7-9 employees). Participants represented variations in position, geographic location, age, length of service, and gender. Participation was voluntary and it was made clear that the ideas and opinions shared by individual participants would be kept confidential. During the initial recruitment, the purpose and format of the interviews were explained via phone or in person. Follow-up letters were sent, to confirm dates and locations and provide additional background information. About a week before each scheduled focus group session, recruits were again contacted through electronic mail to help ensure participation. All participants voluntarily signed a consent form prior to the beginning of each session.

The 1 1/2-hour focus group interviews were conducted during the last week in May and the first week in June 1992. Three were held at Extension field offices with the fourth held on the university campus. The Extension educator who designed the study moderated all sessions using the nominal group process and other recommended focus group interview techniques (Stewart & Shamdasani, 1990; Kirk & Miller, 1986; and Krueger, 1985). The same set of five questions was used with each focus group. All sessions were tape recorded and detailed written notes were also taken by an assisting faculty member.

A 79% response rate was received for the survey. The majority of faculty and staff who completed the questionnaire had positive feelings about the prospect of an employee wellness program being offered, with 93% indicating that they were at least moderately interested; 40% of the total indicated they were excited about the prospect. No respondents were opposed to the prospect, and only eight were not interested. In addition, a large number of respondents (91%) said they would expect to participate in wellness program offerings. This level of interest was supported by the findings of the focus group research.

On the questionnaire, the components selected most often for inclusion in an Extension employee wellness program were: (a) exercise and fitness activities, (b) a component on mental and emotional health, and (c) lifestyle enhancement workshops /seminars. Wellness educational programs of most interest to survey respondents included balancing work and leisure, stress management techniques, and relaxation training. Respondents also indicated the greatest interest in the following fitness/sports activities: (a) walking/running, (b) hiking, and (c) canoeing/boating.

All but one of the 32 invited Extension employees took part in the focus groups. Participants identified major goals for an employee wellness program and provided input on kinds of topics, programs and activities they would like to see included. They also identified potential benefits and drawbacks associated with having such a program, and suggested ideas on how to move forward with an employee wellness program.

Based on a combined analysis of the questionnaire and focus group findings, the following recommendations were made to the University of Vermont Extension administration:

1. An employee health promotion (wellness) program should be made available to all UVM Extension System faculty and staff.

2. Major program goals identified during the research investigation should be made central to the planning and development of an Extension employee wellness program.

3. Such a program should include a variety of components, with many different offerings provided that address employees' needs and interests. Program offerings should be made easily available for all Extension faculty and staff who wish to participate.

4. An employee wellness program should support, enhance and be integrated into all other UVM Extension programs and activities. There should be a special emphasis on role modeling for wellness.

5. An Extension employee wellness program should be an integral part of the planned wellness program for all University of Vermont employees, and the needs and interests of Extension faculty and staff should be fully considered and addressed as the UVM employee wellness program is developed and implemented.

A complete report of the research findings, including an in-depth discussion of the recommendations, was shared with state and regional Extension administrators and with key personnel involved with the new university employee wellness program.

During the year following this needs assessment study, a six-member Extension wellness team provided leadership for a number of activities designed to increase awareness about wellness and promote healthier lifestyles among UVM Extension employees. Using the findings from this research, they carried out specific actions that targeted one of their action plan goals: "to improve the health and well-being of all Extension employees in order to strengthen and enhance both the individual and the organization" (Campbell, 1992).

Wellness orientation sessions for Extension faculty and staff were led by team members at regional office conferences and on-campus meetings. Wellness action groups, comprised of interested faculty and staff, were formed to promote wellness among all Extension employees at various times during the year. "Wellness: Focus on You" was the theme of the 1993 UVM Extension Spring Conference, where nearly 100 faculty and staff participated in a day filled with wellness workshops, lifestyle awareness opportunities, and recreational activities. The conference topics and activities were based on the research data from this study. Wellness concepts have been integrated into Extension activities at little or no cost. Activities based on these concepts include stretch breaks at meetings, fitness activities at conferences, healthy refreshments, walking programs, stress management workshops, and humor in the workplace.

Furthermore, as the University of Vermont's employee wellness program is being developed, the findings from this study continue to serve as a guide for the design and implementation of programming that addresses specific needs and interests of Extension employees. Recognizing the lead Extension took in identifying and addressing its employees' wellness needs, the university has included an Extension liaison on a new UVM employee wellness committee, which serves as an advisory group to the wellness program coordinator.

Historically, Extension has provided education for healthy living. One of the goals of Extension's national Decisions for Health agenda focuses on people adopting healthy lifestyles (National Extension Health Agenda Task Force, 1992). The adoption of healthy lifestyle practices by Extension employees is important for many reasons, not the least of which is that, to be most effective, educators must be positive role models for what they teach.

In addition, organizations are only as healthy and productive as their employees. In times of tight budgets and spiraling health care costs, employee wellness programs offer cost-effective opportunities for promoting positive health behaviors that lead to increased productivity, improved morale and reductions in health care costs (Gebhardt & Crump, 1990; Selleck et al., 1989; Marcotte & Price, 1983; O'Donnell & Ainsworth, 1984; and Sloan et al., 1987). Using needs assessment data, a team approach and, in many cases, existing resources, Extension organizations in other states can follow Vermont's example by providing wellness activities that improve their employees' health and well-being, and at the same time, increase their ability to address health-related issues of the 90's. Such programming can ultimately strengthen and enhance both the individual and the organization.

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