Environmental Approaches for Environmental Approaches for Obesity ManagementObesity Management

at Dow Chemical Company: at Dow Chemical Company: Year 1 Results and Lessons Year 1 Results and Lessons

LearnedLearnedRZ Goetzel, DM DeJoy. MG Wilson, RZ Goetzel, DM DeJoy. MG Wilson,

RJ Ozminkowski, TL McPherson, RJ Ozminkowski, TL McPherson, DC Stapleton, KJ Tully, JM White DC Stapleton, KJ Tully, JM White

ObjectiveObjective

Assess the feasibility and effectiveness Assess the feasibility and effectiveness of complementing individual risk of complementing individual risk reduction programs with moderate and reduction programs with moderate and intensive environmental interventions intensive environmental interventions directed at overweight and obesity directed at overweight and obesity prevention at Dow worksites.prevention at Dow worksites.

Overall HypothesisOverall Hypothesis

Relative to the individual intervention, Relative to the individual intervention, environmental interventions a) reduce environmental interventions a) reduce the prevalence of obesity, overweight, the prevalence of obesity, overweight, and other weight-related risk factors, b) and other weight-related risk factors, b) improve overall health and well-being, c) improve overall health and well-being, c) reduce healthcare utilization and reduce healthcare utilization and expenditures, d) improve indices of expenditures, d) improve indices of employee productivity, and e) achieve a employee productivity, and e) achieve a positive return on investment.positive return on investment.

Project TeamProject Team

Cornell University Institute for Health and Cornell University Institute for Health and Productivity Studies – Washington, DCProductivity Studies – Washington, DCThe Medstat Group – Ann Arbor, MIThe Medstat Group – Ann Arbor, MIUniversity of Georgia – Athens, GAUniversity of Georgia – Athens, GANational Business Group on Health – National Business Group on Health – Washington, DCWashington, DCThe Dow Chemical Company – Midland, The Dow Chemical Company – Midland, MIMI

Study DesignStudy DesignQuasi-experimental – treatment vs. control/pre Quasi-experimental – treatment vs. control/pre vs. post (3 data points – baseline, year 1, year 2)vs. post (3 data points – baseline, year 1, year 2)12 participating sites 12 participating sites Intervention sites – matched/randomly assigned Intervention sites – matched/randomly assigned to moderate and intensiveto moderate and intensive#employees; HP participation; leadership support; #employees; HP participation; leadership support;

effectiveness C-D team, etc.effectiveness C-D team, etc.

Other Dow sites in US providing Other Dow sites in US providing benchmark/comparison databenchmark/comparison data

Treatment Group Assignments: Treatment Group Assignments: Moderate & IntenseModerate & Intense

SiteSite # Employees# Employees ConditionConditionHalterman, TXHalterman, TX 146146 IIClear Lake, TXClear Lake, TX 9898 MMHouston Dow Center, TXHouston Dow Center, TX 566566 IIFreeport, TXFreeport, TX 4,2024,202 IILaporte, TXLaporte, TX 216216 MMOyster Creek, TXOyster Creek, TX 323323 IISeadrift, TXSeadrift, TX 659659 MMTexas City, TXTexas City, TX 467467 MMPlaquemine, LAPlaquemine, LA 1,5211,521 II

TotalsTotals 8,1988,198 I = 5/M = 4I = 5/M = 4

Control SitesControl Sites

SiteSite # Employees# Employees

St. Charles, LASt. Charles, LA 1,1121,112

Bound Brook – Weston Bound Brook – Weston Canal, NJCanal, NJ

252252

South Charleston, WVSouth Charleston, WV 1,0561,056

TotalTotal 2,4202,420

GRAND TOTAL = 10,618

Formative Research ActivitiesFormative Research ActivitiesMeetings with Corporate ManagementMeetings with Corporate ManagementSurveys of key informants (at each site)Surveys of key informants (at each site)– Leading by Example Questionnaire (LBE)Leading by Example Questionnaire (LBE)– Open-ended surveyOpen-ended surveyFocus Groups (at each site)Focus Groups (at each site)Interviews with Site-level Leadership (Management)Interviews with Site-level Leadership (Management)Environmental Assessments (EAT) Environmental Assessments (EAT) (at each site)(at each site)Analysis of Dow Archival DataAnalysis of Dow Archival Data

Meetings with Corporate ManagementMeetings with Corporate Management

Summary Observations:Summary Observations:Senior management support evidentSenior management support evidentProject aligned with new corporate health Project aligned with new corporate health strategystrategyStrong emphasis on goals and metricsStrong emphasis on goals and metricsLimited tolerance for deviation from business Limited tolerance for deviation from business prioritiesprioritiesCompetitive Culture; Global Market Competitive Culture; Global Market Continual emphasis on improving efficienciesContinual emphasis on improving efficiencies

Surveys with key informantsSurveys with key informants

Questionnaires were administered to health Questionnaires were administered to health services staff, cross-disciplinary teams services staff, cross-disciplinary teams and site leadership and site leadership Leading by Example QuestionnaireLeading by Example QuestionnaireOpen-ended questionsOpen-ended questions

Leading By Example Leading By Example (Adapted from Partnership for Prevention, 2005)(Adapted from Partnership for Prevention, 2005)

15 Item Questionnaire; 5-point rating scales SA-SD 15 Item Questionnaire; 5-point rating scales SA-SD

Sample Items: Sample Items:

Q1. Site leadership is committed to health promotion as Q1. Site leadership is committed to health promotion as an important investment in human capital an important investment in human capital

Q3. Site health promotion programs are aligned with our Q3. Site health promotion programs are aligned with our business goalsbusiness goals

Q9. Site provides support for participation in health Q9. Site provides support for participation in health programs programs

Q12. Health benefits and insurance programs support Q12. Health benefits and insurance programs support prevention/health promotion prevention/health promotion

Q15. Overall, site promotes a culture of health and well Q15. Overall, site promotes a culture of health and well beingbeing

LBE: Exploratory Factor AnalysisLBE: Exploratory Factor Analysis

PCA with varimax rotation (n = 135) - Three PCA with varimax rotation (n = 135) - Three main factors extractedmain factors extracted

The 3 factors explained 62% of variation in the The 3 factors explained 62% of variation in the datadata

internal consistency coefficientsinternal consistency coefficientsFactor 1: Factor 1: αα = .739 = .739Factor 2: Factor 2: αα = .811 = .811Factor 3: Factor 3: αα = .783 = .783

Exploratory Factor Analysis: Exploratory Factor Analysis: Factor LoadingsFactor Loadings

Factor 1: Perceived Worksite Support for Factor 1: Perceived Worksite Support for Health Promotion Health Promotion ((αα = .739) = .739)

Q10. Our work teams provide support for Q10. Our work teams provide support for participation in health promotion programs participation in health promotion programs .738.738

Q13. This site offers incentives for employees to stay Q13. This site offers incentives for employees to stay healthy, reduce their high risk behaviors, and/or healthy, reduce their high risk behaviors, and/or practice healthy lifestyles practice healthy lifestyles

.718.718

Q9. Our site provides support for participation in Q9. Our site provides support for participation in health promotion programs health promotion programs .658.658

Q12. Our health benefits and insurance programs Q12. Our health benefits and insurance programs support prevention and health promotion support prevention and health promotion .627.627

Exploratory Factor Analysis: Exploratory Factor Analysis: Factor LoadingsFactor Loadings

Factor 2: Perceived Business Alignment Factor 2: Perceived Business Alignment with Health Objectives with Health Objectives ((αα = .811) = .811)

Q6. Our site goals and plans advocate for the Q6. Our site goals and plans advocate for the improvement of employee health improvement of employee health .863.863

Q7. Site objectives for health improvement are Q7. Site objectives for health improvement are set annually set annually .832.832

Q3. Our site health promotion programs are Q3. Our site health promotion programs are aligned with our business goalsaligned with our business goals .645.645

Exploratory Factor Analysis: Exploratory Factor Analysis: Factor LoadingsFactor Loadings

Factor 3: Perceived Leadership Support for Factor 3: Perceived Leadership Support for Health Promotion Health Promotion ((αα = .783) = .783)

Q11. Dow provides our site leadership training Q11. Dow provides our site leadership training on the importance of employee health on the importance of employee health .863.863

Q14. Our leaders view the level of employee Q14. Our leaders view the level of employee health and well-being as one important health and well-being as one important indicator of the site’s business success indicator of the site’s business success

.832.832

Q1. Our site leadership is committed to health Q1. Our site leadership is committed to health promotion as an important investment in promotion as an important investment in human capitalhuman capital

.645.645

Exploratory Factor Analysis: Exploratory Factor Analysis: Descriptive StatisticsDescriptive Statistics

TeamTeamFactor/Total ResponsesFactor/Total Responses

Site Site LeadersLeaders

(70)(70)

Cross Cross Disc.Disc.(32)(32)

Health Health ServicesServices

(33)(33)

Perceived Worksite Support Perceived Worksite Support for Health Promotionfor Health Promotion 3.013.01AA 3.073.07 3.363.36AA

Perceived Business Alignment Perceived Business Alignment with Health Objectiveswith Health Objectives 2.962.96AA 2.962.96BB 3.493.49ABAB

Perceived Leadership Support Perceived Leadership Support for Health Promotionfor Health Promotion 3.253.25 3.093.09 3.233.23

* Ratings based on a scale of 1 – 5, where 1 = “strongly disagree” and 5 = “strongly agree”

* Shaded rows indicate that overall F in ANOVA is significant at .05 level

* Superscript letters indicate significant group differences at the =.05 level using LSD post-hoc contrasts in a one-way ANOVA assessed for each factor.

Surveys with key informants (cont.)Surveys with key informants (cont.)

Open-ended questions asking about Open-ended questions asking about previous and proposed health promotion-previous and proposed health promotion-related programs and activitiesrelated programs and activities

1.1. Factors influencing successFactors influencing success2.2. Challenges/barriersChallenges/barriers3.3. Participation Participation 4.4. Communication Communication

Surveys of Key Informants – Surveys of Key Informants – Responses toResponses to open-ended questionsopen-ended questions

SuccessSuccessLeadership supportLeadership supportIncentives Incentives Access Access PromotionPromotionIntegrate with existing Integrate with existing processes / networksprocesses / networks

ChallengesChallengesTime constraintsTime constraintsWorkloadWorkloadPerception of benefitsPerception of benefitsAccess Access

ParticipationParticipationIncentivesIncentivesLeadership supportLeadership supportEasy participation/accessEasy participation/accessPromotion Promotion

CommunicationCommunicationMultiple sources and Multiple sources and coordinatedcoordinatedPresentations Presentations EmailEmailwebsitewebsite

Focus GroupsFocus Groups

PurposePurpose: : refine the interventions and the refine the interventions and the implementation strategies for this projectimplementation strategies for this project

Groups conducted with: Groups conducted with: health services staffhealth services staffcross-disciplinary teamscross-disciplinary teams

Focus Group Findings - Physical Activity Focus Group Findings - Physical Activity

OptionsOptions Competitions (e.g., pedometers)Competitions (e.g., pedometers)General physical activity education General physical activity education Create a safe walking area on-siteCreate a safe walking area on-siteDesignate company time to exercise (e.g., flex-time)Designate company time to exercise (e.g., flex-time)Start or increase off-site fitness center reimbursement Start or increase off-site fitness center reimbursement Have health promotion personnel conduct stretching Have health promotion personnel conduct stretching sessions in control roomssessions in control roomsInstall cardio equipment in control rooms (e.g., Install cardio equipment in control rooms (e.g., treadmills, stationary bikes, stair climbers)treadmills, stationary bikes, stair climbers)Encourage more bike usage on-siteEncourage more bike usage on-site

Focus Group Findings - Nutrition and Weight Focus Group Findings - Nutrition and Weight ManagementManagement Options Options

Education about how to cook healthy meals Education about how to cook healthy meals (demonstrations in control rooms – tasting!)(demonstrations in control rooms – tasting!)Label vending, cafeteria, and/or control room take-out Label vending, cafeteria, and/or control room take-out menus with nutrition informationmenus with nutrition informationChange vending and/or cafeteria to healthier optionsChange vending and/or cafeteria to healthier optionsPolicy change – require Dow sponsored events to serve Policy change – require Dow sponsored events to serve healthy foodhealthy foodHave a healthy mobile food cart (on-site or at gate)Have a healthy mobile food cart (on-site or at gate)Prepared healthy meals to take home at night after shiftPrepared healthy meals to take home at night after shiftDifferential pricing for vending/café Differential pricing for vending/café

Environmental AssessmentEnvironmental AssessmentPurposePurpose: Assess site’s organizational and : Assess site’s organizational and physical environments, and resources available physical environments, and resources available in the surrounding community. in the surrounding community. Reviewed existing assessment instrumentsReviewed existing assessment instruments– Heart Check Heart Check (Golaszewski & Fisher, AJHP, 2002)(Golaszewski & Fisher, AJHP, 2002)– Checklist of Health Promotion Environments at Checklist of Health Promotion Environments at

Worksites (CHEW) Worksites (CHEW) (Oldenberg, etal., AJHP, 2002)(Oldenberg, etal., AJHP, 2002)– CDC Walkability Tool CDC Walkability Tool (CDC, 2002)(CDC, 2002)– CA Dept. of Health Services CA Dept. of Health Services (2004)(2004)Created the EAT – Environmental Created the EAT – Environmental Assessment ToolAssessment ToolCreated database for the 12 sitesCreated database for the 12 sites

Environmental Assessment Tool Environmental Assessment Tool (EAT): Categories(EAT): Categories

Size of WorkforceSize of WorkforceEmployee CharacteristicsEmployee CharacteristicsSite CharacteristicsSite CharacteristicsWork RulesWork RulesCurrent Health Promotion Current Health Promotion ProgramsProgramsCurrent Health Promotion Current Health Promotion PoliciesPoliciesPhysical Activity FacilitiesPhysical Activity Facilities

Signs & Bulletin BoardsSigns & Bulletin BoardsParking/Bike AssessmentParking/Bike AssessmentPhysical Activity/Fitness Physical Activity/Fitness FacilitiesFacilitiesStair/Elevator Stair/Elevator assessmentassessmentVending Machine Vending Machine AssessmentAssessmentChanging FacilitiesChanging FacilitiesCafeteria/Food Service Cafeteria/Food Service AssessmentAssessment

EAT ResultsEAT ResultsWorkforceWorkforce – Range 98 to >4,000 employees; 85% – Range 98 to >4,000 employees; 85% male/40’s/low turnover; 12-hr rotating shifts male/40’s/low turnover; 12-hr rotating shifts (production workers); other mostly standard 8-hr(production workers); other mostly standard 8-hrSite CharacteristicsSite Characteristics – Size range 57 to >5,000 – Size range 57 to >5,000 acres; multiple buildings; often rural settings; orderly acres; multiple buildings; often rural settings; orderly layouts; high safety consciousness; access controlled layouts; high safety consciousness; access controlled Current HP ProgsCurrent HP Progs – standard options; Access varies – standard options; Access varies across sites and employment classifications; overall across sites and employment classifications; overall participation limitedparticipation limitedCurrent HP PoliciesCurrent HP Policies – few official policies; – few official policies; participation often not permitted or possible on participation often not permitted or possible on company time; site leadership support variescompany time; site leadership support varies

EAT ResultsEAT ResultsParking/BikesParking/Bikes – parking very close to work – parking very close to work units; auto predominant mode; some bike use at units; auto predominant mode; some bike use at some sitessome sitesStairs/ElevatorsStairs/Elevators – majority of buildings are 1-2 – majority of buildings are 1-2 storiesstoriesChanging FacilitiesChanging Facilities – access varies but usually – access varies but usually available to production workersavailable to production workersPhysical Activity/Fitness FacilitiesPhysical Activity/Fitness Facilities – quite – quite variable; some sites have well-equipped variable; some sites have well-equipped facilities; access also varies across sites; facilities; access also varies across sites; general site characteristics frequently not general site characteristics frequently not conducive to outside activityconducive to outside activity

EAT ResultsEAT ResultsSigns & Bulletin BoardsSigns & Bulletin Boards – few if any – few if any

environmental prompts; HP messages quite environmental prompts; HP messages quite limited overalllimited overall

VendingVending – most employees have access; choices – most employees have access; choices typical and not healthy; no incentives to buy typical and not healthy; no incentives to buy healthyhealthy

Cafeterias/Food ServicesCafeterias/Food Services – some sites have – some sites have cafeterias – available choices “fast, familiar, and cafeterias – available choices “fast, familiar, and filling” (fried/high fat); most production units have filling” (fried/high fat); most production units have full kitchens; Outside food sources (“beyond the full kitchens; Outside food sources (“beyond the fence”) vary across sites with some innovative fence”) vary across sites with some innovative arrangementsarrangements

Production Unit Control RoomProduction Unit Control Room

Production Unit KitchenProduction Unit Kitchen

EAT DatabaseEAT Database

Vending AreaVending Area

Location Building ItemsHealthy Foods

Unhealthy Foods

% Healthy

Healthy Slots

Unhealthy Slots

% Healthy

Clear LakeControl Room Chips/Snacks 3 16 16 3 17 15

Candy 0 8 0 0 11 0Beverages 1 5 17 2 5 29

Maintenance Chips/Snacks 2 22 8 2 23 8

Candy 1 11 8 1 13 7Beverages 1 4 20 1 6 14

Vending Machine Data

Compilation of Vending DataCompilation of Vending Data

Analysis Archival DataAnalysis Archival Data

Health care expenditure and HRA for 2003 Health care expenditure and HRA for 2003 and 2004and 2004These data comprise a baseline for future These data comprise a baseline for future comparisonscomparisonsExpenditure data from PPO plansExpenditure data from PPO plans

VariableVariable Treatment Treatment SitesSites

Control SitesControl Sites

Ave. # employees in PPOs Ave. # employees in PPOs (2004)(2004)

6,3826,382 1,6111,611

Ave. # employees in PPOs Ave. # employees in PPOs (2003)(2003)

6,6366,636 1,9061,906

PER EMPLOYEE COSTS:PER EMPLOYEE COSTS:Total Medical + Absenteeism Total Medical + Absenteeism 20042004

$3,474.63$3,474.63 $3,655.12$3,655.12

Total Medical + Absenteeism Total Medical + Absenteeism 20032003

$3,460.42$3,460.42 $3,729.04$3,729.04

DifferenceDifference $14.21$14.21 ($73.92)($73.92)

Percent of Dow employees who completed a Percent of Dow employees who completed a Health Risk Appraisal who were at high risk at Health Risk Appraisal who were at high risk at

(2004)(2004)

Risk Factors All Treatment Sites

All Control Sites

All Other Dow Sites Not Involved in the

Study

Overweight or Obese* 85% 81% 75% High LDL 36% 31% 27% Low HDL (<46) 46% 43% 42% High Total Cholesterol (>199) 48% 49% 44% High Blood Glucose (>99) 27% 23% 16% High Blood Pressure 24% 25% 14% Current Smoker 21% 18% 12% Poor Exercise Habits** 63% 59% 59%

*Overweight or Obese = BMI > 24**Poor Exercise Habits = Less than 3 times a week

Percent of Dow employees who completed Percent of Dow employees who completed Health Risk Appraisals by BMI category at Health Risk Appraisals by BMI category at

(2003 and 2004)(2003 and 2004) All Other Dow Sites

BMI Category All Treatment Sites All Control Sites Not Involved in the Study ___________________________________________________________________________________ Normal weight 15.1% 19.5% 25.0% Overweight 40.0% 40.4% 41.6% Obese 44.9% 40.1% 33.4% ___________________________________________________________________________________

Moderate Intervention PackageModerate Intervention PackageMark walking paths inside and outside buildings – offer a pedometer Mark walking paths inside and outside buildings – offer a pedometer program;program;Bring education/programs/cooking classes to employees at their Bring education/programs/cooking classes to employees at their workstations;workstations;Provide fitness equipment at workstations;Provide fitness equipment at workstations;Open up restricted fitness facilities to all employees;Open up restricted fitness facilities to all employees;Provide additional healthy choices in vending machines – provide Provide additional healthy choices in vending machines – provide preferential pricing for healthy food;preferential pricing for healthy food;Work with cafeteria vendors/on-site “meals on wheels” vendors to Work with cafeteria vendors/on-site “meals on wheels” vendors to offer healthy food choices;offer healthy food choices; Invite “farmers’ market” catering trucks to the sites;Invite “farmers’ market” catering trucks to the sites;Provide better labeling of healthy food choices in vending Provide better labeling of healthy food choices in vending machines/cafeterias/food carts;machines/cafeterias/food carts;““Saturate” the workplace with physical activity/healthy eating Saturate” the workplace with physical activity/healthy eating messages, communication, signs/posters;messages, communication, signs/posters;Offer discounts at local gyms/fitness centers;Offer discounts at local gyms/fitness centers;

Moderate Package (cont.)Moderate Package (cont.)Provide “healthy cupboard” space for healthy eating choices;Provide “healthy cupboard” space for healthy eating choices;Offer “intensive” weight management programs – specifically Offer “intensive” weight management programs – specifically targeting male workers;targeting male workers;Provide scales in control rooms or bathrooms;Provide scales in control rooms or bathrooms;In buildings with staircases, create more inviting stairwells;In buildings with staircases, create more inviting stairwells;Offer healthy snack stations throughout the workplace; Offer healthy snack stations throughout the workplace; Require healthy food choices at company sponsored Require healthy food choices at company sponsored meetings, events and training programs; meetings, events and training programs; Place water coolers and/or filtration systems near vending Place water coolers and/or filtration systems near vending machines; machines; Promote area restaurants that offer health eating choices; Promote area restaurants that offer health eating choices; and and Make it inconvenient to bring cars on grounds.Make it inconvenient to bring cars on grounds.

Intensive InterventionsIntensive InterventionsSet site/workgroup health goals; Set site/workgroup health goals; Provide rewards/recognition to site leaders who Provide rewards/recognition to site leaders who achieve site goals; achieve site goals; Train site leaders to be health leaders;Train site leaders to be health leaders;Encourage site leaders to provide employees Encourage site leaders to provide employees with time off during the workday to participate in with time off during the workday to participate in physical activity and health promotion programs; physical activity and health promotion programs; and and Provide regular feedback and monitoring reports Provide regular feedback and monitoring reports to site leaders on their site’s performance against to site leaders on their site’s performance against overall company health performance measures. overall company health performance measures.

Current StatusCurrent Status

Interventions and measures have been Interventions and measures have been finalizedfinalizedCommunication/recruitment plans have Communication/recruitment plans have been developedbeen developedFinalizing logistics of implementationFinalizing logistics of implementationSetting up process evaluationSetting up process evaluationThen, there is KatrinaThen, there is Katrina

Thank YouThank You

Project DesignProject Design

Year 1:Year 1: Formative Research, Project Planning Formative Research, Project Planning and Baseline Measuresand Baseline Measures

Year 2 & 3:Year 2 & 3: Intervention Program Intervention Program ImplementationImplementation

Year 4:Year 4: Measurement and EvaluationMeasurement and Evaluation

Exploratory Factor Analysis: Exploratory Factor Analysis: Descriptive StatisticsDescriptive Statistics

FactorFactor MeanMean (n =135)(n =135)

Std. Dev.Std. Dev.

Perceived Worksite Support for Perceived Worksite Support for Health PromotionHealth Promotion 3.123.12 .70.70

Perceived Business Alignment with Perceived Business Alignment with Health ObjectivesHealth Objectives 3.093.09 .82.82

Perceived Leadership Support for Perceived Leadership Support for Health PromotionHealth Promotion 3.213.21 .72.72

* Ratings based on a scale of 1 – 5, where 1 = “strongly disagree” and 5 = “strongly agree”

* No significant differences were found between factor means across the three groups

Intensive InterventionsIntensive InterventionsSet site/workgroup health goals; Set site/workgroup health goals; Provide rewards/recognition to site leaders who achieve Provide rewards/recognition to site leaders who achieve site goals; site goals; Train site leaders to be health leaders;Train site leaders to be health leaders;Encourage site leaders to provide employees with time Encourage site leaders to provide employees with time off during the workday to participate in physical activity off during the workday to participate in physical activity and health promotion programs; and and health promotion programs; and Provide regular feedback and monitoring reports to site Provide regular feedback and monitoring reports to site leaders on their site’s performance against overall leaders on their site’s performance against overall company health performance measures. company health performance measures.

Intervention - IntenseIntervention - Intense

Site goals with work group alignmentSite goals with work group alignmentRecognition and rewardsRecognition and rewardsLeadership trainingLeadership trainingReporting goals and progress to top Reporting goals and progress to top managementmanagement

Dow’s CultureDow’s Culture

DataDataSafetySafetySecurity Security CompetitionCompetitionAccountabilityAccountabilityGoal oriented Goal oriented Permission Permission Empowerment Empowerment

Section ISection I Work RulesWork Rules

Size of WorkforceSize of Workforce Current Health Promotion Current Health Promotion ProgramsPrograms

EmployeeEmployeeCharacteristicsCharacteristics

Current Health Promotion Current Health Promotion PoliciesPolicies

Site CharacteristicsSite Characteristics Physical Activity FacilitiesPhysical Activity Facilities

Environmental Assessment Tool Environmental Assessment Tool (EAT)(EAT)

Administrative/Office AreaAdministrative/Office Area

Implementation/Process EvaluationImplementation/Process Evaluation

InterventionsInterventions MeasuresMeasures CommunicationCommunication

WhatWhat

HowHow

WhenWhen

Environmental Assessment Tool Environmental Assessment Tool (EAT)(EAT)

Section IISection II Signs & Bulletin BoardsSigns & Bulletin Boards

Parking/Bike Parking/Bike AssessmentAssessment

Physical Physical Activity/Fitness Activity/Fitness FacilitiesFacilities

Stair/Elevator Stair/Elevator AssessmentAssessment

Vending Machine Vending Machine AssessmentAssessment

Changing FacilitiesChanging Facilities Cafeteria/Food Service Cafeteria/Food Service AssessmentAssessment

Participating Dow Chemical SitesParticipating Dow Chemical Sites

1.1. Clear Lake, TX Clear Lake, TX 2.2. Freeport, TXFreeport, TX3.3. Haltermann, TX Haltermann, TX 4.4. Houston Dow Houston Dow

Center, TX Center, TX 5.5. LaPorte, TX LaPorte, TX 6.6. Oyster Creek, TX Oyster Creek, TX

7.7. Seadrift, TXSeadrift, TX8.8. Texas City, TX Texas City, TX 9.9. Plaquemine, LA Plaquemine, LA 10.10. St. Charles, LASt. Charles, LA11.11. South Charleston, South Charleston,

WVWV12.12. Bound Brook -Bound Brook -

Weston Canal, NJWeston Canal, NJ