Health education quality assessment for public health clinics: responding to staff resistance.

The South Carolina Department of Health and Environmental Control has developed and tested several quality assessment tools over the last 7 years to assess both the administration and direct delivery of patient education services. The most recent system covers three aspects of patient education: environment, materials and personal interaction. Practical assessment tools, methods of introducing them into clinic settings, and areas of possible resistance are discussed.

School worksite wellness programs: a strategy for achieving the 1990 goals for a healthier America.

Employee health promotion programs, first developed for private business and industry, are being extended to governmental employees. South Carolina established a pilot health promotion program in 1982 for 20,000 state employees in the area surrounding Columbia, the state capital. In 1985, the Carolina Healthstyle program was institutionalized as an employee benefit, extended statewide, and was broadened to include all school district employees and state retirees. This article describes the Carolina Healthstyle program in school worksites as it is being implemented by one pilot school district, with a briefer description of the organization, funding, and evaluation of the overall state employee wellness program. The article describes contributions that schoolsite wellness programs can make to increase positive health behaviors of staff, parents, and community as part of the movement to achieve the health goals of the nation.

Evaluating health promotion: a longitudinal quasi-experimental design.

A quasi-experimental research design is used to evaluate Carolina Healthstyle, a health promotion project for South Carolina state employees. A 10% stratified random sample of employees was surveyed in the Spring of 1983 and again in 1984. Eighteen agencies were intervention agencies and the rest comparison that year. This article reports changes with simple before-after comparisons in the intervention agencies and matched pair analysis and randomized block designs to compare intervention and comparison agencies. Results are reported for smoking, exercise safety, nutrition, stress, and alcohol. Significant increases in exercise were found in both intervention and comparison agencies. The number of smokers decreased in intervention from 30%-26% with no change in comparison agencies. Safety practices changed at similar rates in both intervention and comparison groups. Consumption of chicken increased significantly only in the intervention agencies. Few other diet or stress changes were found. There were changes in alcohol consumption in intervention agencies only. The presence of the comparison group helps to separate the program effects from secular trends.

A public sector health promotion program.

The use of a volunteer model in the provision of health promotion programs in the public sector is described based on the experiences of the Carolina Healthstyle Project, originally a health promotion project for state employees in the Columbia, South Carolina metropolitan area and now expanding to all state employees, public school district employees, and, in a more limited fashion, to state government retirees. The revised models for this project may be particularly helpful to other modestly-funded health promotion efforts.