Health Circles
Author(s): Birgit Aust & Antje Ducki Country: Germany
Is the intervention sector specific?	No
Is the intervention usable with different enterprise sizes?	Yes
Is the intervention equally applicable to both genders?	Yes
Is the intervention based on theory?	Yes
Can the intervention approach be adapted/ tailored?	Yes
Does the intervention promote CSR and how?	Yes, the approach promotes responsible business practices. Health circles utilise both a bottom up and top down approach and requires impetus from management to be successful.
Does the intervention promote social dialogue and how?	An integral element of health circles is the active dialogue between key stakeholders within the organisation in developing strategies and solutions to identified problems, followed by, the implementation of identified solutions.
Overview (including risk assessment and law – legal requirements etc.): Health circles were designed in Germany to facilitate health promotion in the workplace with an emphasis on organisational and psychosocial factors. Health circles are structured discussion groups were employees identify the major health-related problems in the workplace and develop and implement appropriate solutions to address these issues. The areas that are assessed include: lifestyle changes, and changes to the work environment and organisation. The overall aim of the health circles is to improve the working conditions, and thereby improve and promote the health and wellbeing of employees. The Health Circle approach is a flexible approach that can be tailored for various different companies and situations. Assessed outcomes vary according to the requirements of the organisation, in a tailored approach. Typical outcomes include reducing absenteeism, increasing job satisfaction, reducing turnover rates, reducing early retirement, and higher motivation. This approach was developed as a result of changes in OSH legalisation in Germany during the 1980’s, which placed greater emphasis on prevention activities. This approach was designed using a participative problem solving approach; which is underpinned by the assumption that the employee/ worker are the experts on their work and the management of that work environment. Health circles use this ‘employee expertise’ to develop suggestions to improve the situation at the workplace, and, in turn, promote their health and wellbeing.
Implementation: Health circles are generally implemented in departments which have specific problems related to absenteeism or dissatisfaction. Health circles are based on structured group discussions of employees, where employees evaluate psychosocial risk factors and define solutions to address the identified solutions. These meetings are conducted under the guidance of a specially trained facilitator, whose primary role is to act as a moderator. Meetings are generally conducted during paid working hours lasting a total of 90 minutes. In most cases, the process includes between 6 to 10 meetings. The process has 6 steps: • Commitment & Infrastructure: A contract is signed between management and employees; thus, ensuring commitment of all parties throughout the intervention process and with the project goals. • Needs Assessment: A health surveillance report is produced from company or insurance data; identifying absenteeism rates, length and causes of sick leave, ‘high risk’ departments of absenteeism and the identification of possible psychosocial hazards. Following the health report, an employee survey assessing hazards (both physical and psychosocial), employee health and wellbeing is conducted. • Health Circles: A steering group is formed by those responsible for health and safety in the company; with the overall intention of overseeing the process. Approximately, 10-15 participants are invited to each health circle (these include representatives from the employees, company and the union, and the facilitators). Results of the needs assessment provides structure to the discussion; where participants discuss the identified problems, as perceived by a larger number of employees, and develop proposed solutions to the identified issues. These meetings are formally recorded and disseminated to all employees in the affected department. • Feedback to the management team: The management team is informed of the progress and suggestions developed by the health circle. The management team makes the decision on which suggestions will be implemented, and in which order. • Implementation of solutions: Proposed solutions are implemented throughout the process. These provide the basis for health improvements. • Review and transfer: In the last health circle meeting, all participants are asked to evaluate what has been achieved. Additionally, it is commonplace to conduct a follow up meeting with the participants to complete the evaluation of the process. In some cases, the employee survey is repeated in the department were changes were implemented; thus allowing an assessment of the change in outcomes.
Practical applications: Health circles have been applied in hundreds of companies since its inception. Overall, participants report a high degree of satisfaction with health circles. The approach has been demonstrated to be an effective tool for improving the psychosocial and physical work environment and in reducing sickness absence.
Innovative aspects: Health circles follow a systematic and structured participatory process that uses the expertise of the employee and is actively supported by additional key stakeholders. Health circles utilise both a bottom up and top down approach, and integrating these two methods through the use of social dialogue.
Evaluation (including process issues, outcomes and sustainability): In the last stage (meeting) of the appraoch, the evaluation stage, all participants are asked to evaluate what has been achieved. The objectives of the evaluation stage are to determine: whether the proposed solutions were implemented effectively, and whether the solutions had any impact on the problems identified. Additionally, it is commonplace to conduct a follow up meeting with the participants to complete the evaluation of the process. In some cases, the employee survey is repeated in the department were changes were implemented; thus allowing an assessment of the changes in the outcomes.
Benefits (including cost effectiveness): Health circles have been found to be an effective tool for the improvement of physical and psychosocial working conditions in many organisations and industrial sectors. Health circles have also been demonstrated to have a positive effect on outcomes; including, enhanced employee health and wellbeing and reduced sickness absence.
References: Aust, B. & Ducki, A. (2004). Comprehensive health promotion interventions at the workplace: experiences with health circles in Germany. Journal of Occupational Health Psychology. 9(3), 258-270. Schröer, A., & Sochert, M. (2000). Health promotion circles at the workplace. Essen, Germany: Federal Association of Company Health Insurance Funds Beermann, B., Kuhn, K., Kompier, M. (1999). Germany: Reduction of stress by health circles. In M. Kompier & C. Cooper (Eds.), Preventing stress, improving productivity: European case studies in the workplace (pp. 222-241). London: Routledge.
Comments: The Health Circle approach is a flexible approach that can be tailored for various different companies and situations. However, as the intervention requires a specially trained facilitator to moderate group meetings, smaller organisations may not always find this approach viable to implement.