How can we promote health in the workplace? The Spanish region of Andalusia has been trialling a workplace health promotion model first developed in Lombardy, Italy with great success. The development of the programme was a result of international collaboration on tackling chronic disease, and understanding how to transfer good practices between contexts.
The development of a model for workplace health promotion
The Lombardy region of Italy is home to an innovative effective system for workplace health promotion. The approach is a public-private network collaborating with the main workplace stakeholders. This includes associations of enterprises, trade unions, and the regional health system. The region has developed a clear step by step implementation model to become a health-promoting organisation which includes:
- assessments to ensure organisations´ compliance with laws, policies, and regulations related to health promotion, and workplace- and environmental safety
- scheduled questionnaires issued at different times of the interventions
- the possibility of accreditation as a Health Promoting Company.
This model was adapted and transferred to Andalusia, Spain by the Andalusian Regional Ministry of Health and Families (CSJA) as part of the Joint Action CHRODIS PLUS, which brought together European public health actors to address Chronic Diseases.
Because the vast majority of companies in Andalusia are small or medium size, they do not have the human resources to implement health-promoting interventions on their own. The Andalusian Health Administration wanted to step in and provide the best support possible. The Lombardy model had already proved to be successful in effectively engaging managers and the workforce, providing a useful comprehensive continuity system, periodic evaluation, and an accreditation system. The clear step-by-step guide coupled with the CHRODIS+ collaboration provided a good opportunity to test the model in Andalusia.
Implementing a new workplace health promotion model
The new model is being piloted over three years in two organisations: a medium-sized public/private venture, EMASAGRA, and a small trade union, CSIF. Actions cover six workplace health promotion areas
- healthy eating
- smoking cessation
- increased physical activity
- alcohol reduction
- safe commuting
- work-life balance
During the first year, EMASAGRA decided to focus on physical exercise for their workplace health promotion measures. It set up facilities with exercise equipment accessible for all workers, an in-house information campaign encouraging the use of stairs, and a corporate walking group called ‘PUMP – For a Million Steps’. They also decided to make organisational changes to promote work-life balance & wellbeing, such as flexi-time, smart working, and time-saving facilities.
CSIF employees chose to focus on healthy diets. This involved:
- an inhouse information campaign
- practical workshops in small groups
- fresh fruits and/or seasonal vegetables available for employees at least two days per week
-all provided by the organisation. They also implemented a ‘PUMP – For a Million Steps’ company walking group to promote physical activity. This turned out to be a highly useful tool for group cohesion and support.
Qualified professionals from CSJA advised, supported, and provided guidance to each organisation throughout the implementation process. This process saw the creation of an internal steering group, and the provision of in-depth practical training sessions.
After nine months of the pilot implementations, the results showed that the interventions had ‘taken root’ in their new contexts. Despite the onset of the COVID-19 crisis in the second year of the pilot, most activities continued as planned. Only the corporate group walk was stopped due to COVID-19. The smart-working measures that were introduced for all employees by EMASAGRA before the pandemic proved to be useful, as they could be extended to most employees for several months in a row. In the first stages of the implementation, the steering group members gained experience in anticipating and resolving potential challenges. This proved useful in managing the unexpected difficulties to come, such as the inability to participate in face-to-face activities
The lead implementers attribute the initial success of the pilot interventions to the application of the CHRODIS+ implementation strategy  because it called for them to
- bring together, from the outset, a team comprised of a variety of profiles, sectors, and experience levels
- carry out situation and SWOT analyses
- develop an action plan and operationalising the actions through measurable indicators
- collect data to test and analyse the intervention.
According to the Andalusian implementers, co-creating a clear action plan ensured a shared vision and common goal. It served as a source of inspiration and motivation to all the members of the implementation teams.
The next steps
The participating companies will be accredited as health-promoting organisations in a public event on 4 November 2021. The CSJA hopes that the event will attract media attention and publicity. The aim is to trigger more interest among organisations and to strengthen the profile of the participating organisations as ‘socially responsible’.
The CSJA will probably upgrade its current workplace health promotion programme after the three-year pilot ends. Several firms (with different profiles, new sectors, and different sizes) are already expressing interest on the basis of information that has already been incorporated on CSJA´s workplace health promotion website. This renewal will mean that all organisations in Andalusia will have access to new enhanced features, new activities, systemic follow-up, and an evaluation and reward system.
-  Guidelines CHRODIS Implementation Strategy Module I: Pre-Implementation phase and Guidelines CHRODIS Implementation Strategy Module II: Implementation phase and impact
- CSJA´s workplace health promotion website