Ring the changes

programme of preventative health launched for the benefit of employees was
regarded as dynamic when it was launched. An analysis of Lucas Care nine years
later asks how many participants have altered their lifestyle.  By Caroline Mobley

perceptions of a health screening programme offered to them at work resulted in
questions been raised about its success at encouraging individuals to alter
their lifestyles.

the mid-1980s the employees share fund at Cheltenham-based firm Lucas Bryce was
terminated and the assets transferred to the Lucas Employees Benefit Fund,
which were held in trust for the benefit of Lucas employees. One of the
benefits it funded was a programme known as Lucas Care. When it was launched in
1990, Lucas Care was a new and dynamic approach to preventative health at work.
Its principal aim was to help achieve positive health through education,
promotion and screening. The service was preventative in nature, based on self
help and professional support. The programme was designed to help employees to
improve their chances of a long and healthy life, by introducing the
"Staying Healthy Programme", well women screening, and an independent
confidential counselling service.

Staying Healthy Programme identified health risks from diet, alcohol intake,
measurement of blood pressure, weight, cholesterol, exercise and stress levels.
Individual health programmes, designed to help employees understand the health
issues involved, encouraged lifestyle changes in an easy to follow, step by
step way to improve their state of health and reduce the risk of heart disease,
stroke and cancer. Participation in the programme is entirely voluntary.

years on and the success of the Staying Healthy Programme has been
considerable. The uptake rate is at least 75 per cent of the total workforce.
Data collected is analysed so that we can understand the risks facing
employees, their attitude to these risks and the short and long benefits
gained, by compliance with the programmes.

has shown that one in two employees had a cholesterol level above the desired
range and of these, two in three are on the cholesterol intervention programme.
One in three employees were not taking enough exercise and of these, one in
three are trying to increase their weekly level of exercise. One in four
employees smoked and of these, one in two are on the smoking intervention

per cent of employees who were considered overweight are now on the weight loss

1997, an in-depth analysis of the 15,000 employees who had gone through the
screening programme was undertaken by the University of Birmingham. Results
showed that in the short term, employees who had followed the relevant
intervention programmes, had shown an improvement.

improvements, however, were only sustained in four categories. These were a
reduction in stress levels, an increase in exercise and a slight drop in the
measurement of systolic blood pressure and of the number of cigarettes smoked.
There was evidence that other intervention programmes or the advice from the
occupational health nurse, could also have a significant effect on the short
and long term benefits.

we approached the millennium, plans were made for new software to update the
Staying Healthy Programme to become year 2000 compliant. To help improve the
screening service to employees, it was necessary to research employees’
perceptions of the service in its current format, to review the effectiveness
of the service and invite suggestions for improvement.

of the employees who had undergone health screening during 1998 were selected
to participate in the survey. The most effective way to gather information was
to distribute a questionnaire. This focused on lifestyle screening and the
specific identified risks, blood pressure, weight, cholesterol, alcohol intake,
smoking, stress and exercise levels. It also asked for feedback on the leaflets
and health education given to them by the nurse, their impression of the print
out of results, and following the screening if they had been encouraged to make
positive changes to their lifestyle, or had an increased understanding of their

were requested about whether, by offering the service the company had shown an
interest in their health, and if they would recommend the service to fellow
employees. Finally they were asked to give a reason for what prompted them to
have the screening.

response rate was excellent – 71 per cent. Over 60 per cent of respondents
strongly agreed that the lifestyle screening was very important. The individual
results, leaflets and health education given by the nurse were perceived as
valuable. Most people were satisfied with the service and would recommend
it.  Most were prompted into having the
screening, either due to the time elapsed from the previous one, or because of
the literature displayed in the workplace.

some respondents – 52 per cent did not feel encouraged to eat a healthier diet,
exercise more, or make positive changes to their lifestyle. This may have been
because they did not need to make any changes or, that the information given to
them was insufficient, too complicated or too time consuming. However, this
particular result did raise the question of the programmes success at
encouraging individuals to alter their lifestyle to maintain or improve their

may feel that as long as no abnormality is found and most of their results are
within normal limits, they then do not have to do anything. Occupational health
expertise and better use of the intervention programmes should be utilised, to
help individuals plan and co-ordinate changes to their lifestyle. Increased
promotion of the service, improved access to examples of best practice from the
Health Education Authority, the Health Promotion Unit, or from other companies
or organisations could be incorporated into the programme.

the greatest threat to Lucas Care is its success. The programme is now firmly
established and employees are actively encouraged to participate.  Expectations often exceed what the programme
can achieve in relation to the avoidance of lifestyle risks.

of choice is likely to maximise participation in the screening programme,
although we must continue to do more to raise the level of awareness of staying

new initiatives, targeting and developing imaginative programmes, running
support groups, holding awareness sessions and increasing the amount of
information available should help employees to take control of their own
health, with Lucas Care continuing to support them.

Mobley RGN OHNC is occupational health adviser at Lucas Bryce in Cheltenham.

writer wishes to acknowledge Jan Calvert from the University of Birmingham and
Dr Jerry Beach, group occupational health physician at Lucas Varity, for their
statistical analyses


K, Occupational Health Nursing, Chapter 6, part two: Research Guidelines,
(1997), Jan Maw, pp124-138

Healthier Nation Green Paper 1998 (HMSO)

C, Lucas Care progress report (1996)

the programme has helped

It is available on a voluntary basis to all employees

The service is free

It is available on site, saving the time it would take to visit a GP

Employees have the opportunity to be better informed about their health

It encourages employees to undertake regular health screening and checks

Employees have the opportunity to reduce the risks of coronary heart disease, cancer
and stroke

It has resulted in upgraded occupational health facilities and more highly
trained OH staff

There have been improvements in performance, efficiency, quality and morale

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