Attachment_C-1_NHWP_Program_Objective_Survey_Instrument_Crosswalk_Overview_and_DetailSheets

Program Objective - Survey Instrument Cross Walk (Overview)
Respondent Type

Interested
Program Participating Employer
Employer
D-2
E-1 E-2 E-3 E-4 E-5/E-6 E-7

Program Objectives /
Survey Instrument
1. Establish the National Healthy Worksite Program
a. Recruit and select NHWP
participants.
b. Assess interest in NHWP
training and networking among
community employers.
c. Conduct needs assessments
and describe program
implementation for NHWP
participants.

Community
Participant
E-8 E-9 E-10

Employee
F-1

F-2

F-3

F-4

F-5

F-6

Program
Provider
G-1 H-1 H-2

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2. Evaluate Program Implementation, Impact, and Sustainability
d. Collect process outcomes
relating to changes in
programs, policies, and
environmental supports.
e. Describe NHWP integration
into organizational structure.
f. Quantify changes to
aggregate employee level
health risk and health status.
g. Characterize changes to
organizational culture/norms
w/r/t program sustainability.

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3. Establish Best Practices for Future Employers who want to Establish a National Healthy Worksite Program
h. Assess the usefulness of
worksite health training.
i. Determine factors that affect
program sustainability.
j. Characterize experiences of
workplace health programs
that do not receive intensive
NHWP support.
k. Assess employer interest in
NHWP expansion and factors
related to non-participation.

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Program Objective - Survey Instrument Cross Walk – Interested Employers (Detail)
Respondent Type
Interested Employer
Program Objectives / Survey Instrument
NHWP Employer Phone Interview Guide
1. Establish the National Healthy Worksite Program
a. To recruit and select employers for participation in the NHWP.
All Questions
b. To understand employer intentions to participate in community-based training and peer-topeer networking provided by the NHWP.
c. To describe the process of implementing tailored, customized comprehensive workplace
programs, including employer and employee assessment, planning, program implementation,
including challenges encountered and means to overcome them, such as people or practices that
have facilitated implementation and lessons learned along the way.
Respondent Type
Interested Employer
Program Objectives / Survey Instrument
NHWP Employer Phone Interview Guide
2. Evaluate the Impact of the National Healthy Worksite Program
d. To evaluate outcomes and the ways in which participating employers have achieved the desired
program, policy, and environmental support changes.
e. To understand how participating employers have leveraged and sustained existing health
promotion and health protection programs and practices and integrated the NHWP into their
organizational structure.
f. To quantify changes to aggregate employee level health risk and health status.
g. To describe changes to organizational culture and social norms and how they may relate to
workplace health program sustainability.
3. Establish Best Practices for Future Employers who want to Establish a National Healthy Worksite Program
Respondent Type
Interested Employer
NHWP Employer Phone Interview Guide
h. To describe the usefulness of worksite health training for participating employers and
community participants and the impact of training on overcoming barriers to implementing a
comprehensive workplace health program.
i. To understand factors that affect the sustainability of the workplace health program.
j. Characteristics, including sustainability, of workplace health programs that do not receive the
All Questions
intensive support provided by the NHWP.
k. To describe the type and number of qualified employers who are willing, motivated, and
interested in becoming NHWP participants, or the barriers -based on employer size or industry
All Questions
sector- that factored into employer decision-making not to participate in the NHWP.

(D-2)

(D-2)

(D-2)

Program Objective - Survey Instrument Cross Walk – Program Participating Employer (Detail)
Respondent Type
Program Objectives / Survey Instrument

1. Establish the National Healthy Worksite
Program
a. To recruit and
select employers
for participation in
the NHWP.
b. To understand
employer
intentions to
participate in
community-based
training and peerto-peer networking
provided by the
NHWP.
c. To describe the
process of
implementing
tailored,
customized
comprehensive
workplace
programs, including
employer and
employee
assessment,
planning, program
implementation,
including
challenges
encountered and
means to overcome
them, such as
people or practices

Organizational
Assessment
(E-1)

Program Participating Employer
Employee
Employer
NHWP Health
Eligibility File
Information Screening Site
(E-2)
Form (E-3) Interview Form
(E-4)

Employer
Discussion
Guides
(E-5 / E-6)

Employer
Follow-Up
Survey
(E-7)

that have
facilitated
implementation
and lessons learned
along the way.
i. The implementation of
comprehensive workplace
program elements including
employer and employee
assessment, planning, program
implementation, and evaluation
and the ways in which
participating employers have
achieved the desired program,
policy, and environmental support
changes.
ii. How participating employers
have implemented their program
elements and strategies
documenting challenges
encountered and means to
overcome them, people or
practices that have facilitated
implementation, and lessons
learned along the way.

All Questions

All Questions

All Questions

Q6

Reg Mgrs
Section:
Q3-18
Health
Coaches:
Q2-3, 5-10
Steering
Comm Mbr:
Q3-14
Wellness
Comm Mbr:
Q3-14

Q5, 7-8, 10

Respondent Type
Program Objectives / Survey Instrument

Organizational
Assessment
(E-1)

Program Participating Employer
Employee
Employer
NHWP Health
Eligibility File
Information Screening Site
(E-2)
Form (E-3) Interview Form
(E-4)

All Questions

All Questions

Employer
Discussion
Guides
(E-5 / E-6)

Employer
Follow-Up
Survey
(E-7)

2. Evaluate the Impact of the National Healthy
Worksite Program
d. To evaluate
outcomes and the
ways in which
participating
employers have
achieved the
desired program,
policy, and
environmental
support changes.
i. The implementation of
comprehensive workplace
program elements including
employer and employee
assessment, planning, program
implementation, and evaluation
and the ways in which
participating employers have
achieved the desired program,
policy, and environmental support
changes.
ii. How participating employers
have implemented their program
elements and strategies
documenting challenges
encountered and means to
overcome them, people or
practices that have facilitated
implementation, and lessons
learned along the way.

All Questions

Q6

Reg Mgrs
Section:
Q3-18
Health
Coaches:
Q2-3, 5-10
Steering
Comm Mbr:
Q3-14
Wellness
Comm Mbr:
Q3-14

Q5, 7-8, 10

e. To understand
how participating
employers have
leveraged and
sustained existing
health promotion
and health
protection
programs and
practices and
integrated the
NHWP into their
organizational
structure.
f. To quantify
changes to
aggregate
employee level
health risk and
health status.
g. To describe
changes to
organizational
culture and social
norms and how
they may relate to
workplace health
program
sustainability.

All Questions

Q10-14 (E-5)
Q3-10 (E-6)

Q:4 - 16

Regional
Mgrs
Section:
Q7-9
Steering
Comm/HR:
Q10-13
Wellness
Comm Mbr:
Q6-9

Q4, 9, 10,
12-14

All Questions

All Questions

Respondent Type
Program Objectives / Survey Instrument

Organizational
Assessment
(E-1)

Program Participating Employer
Employee
Employer
NHWP Health
Eligibility File
Information Screening Site
(E-2)
Form (E-3) Interview Form
(E-4)

Employer
Discussion
Guides
(E-5 / E-6)

Employer
Follow-Up
Survey
(E-7)

3. Establish Best Practices for Future Employers
who want to Establish a National Healthy Worksite
Program
h. To describe the
usefulness of
worksite health
training for
participating
employers and
community
participants and
the impact of
training on
overcoming
barriers to
implementing a
comprehensive
workplace health
program.
i. To understand
factors that affect
the sustainability of
the workplace
health program.

Stress Q5
Depression Q6
Community
Resources Q2

Q15-17 (E-5)
Q11-14 (E-6)

All Questions

Regional
Mgrs
Section:
Q7-9
Steering
Comm/HR:
Q10-13
Wellness
Comm Mbr:
Q6-9

Q4, 9, 10,
12-14

Respondent Type
Program Objectives / Survey Instrument

j. Characteristics,
including
sustainability, of
workplace health
programs that do
not receive the
intensive support
provided by the
NHWP.
k. To describe the
type and number
of qualified
employers who are
willing, motivated,
and interested in
becoming NHWP
participants, or the
barriers -based on
employer size or
industry sectorthat factored into
employer decisionmaking not to
participate in the
NHWP.

Organizati
onal
Assessment
(E-1)

Employee
Eligibility
File
(E-2)

Program Participating Employer
Employer
NHWP Health
Employer
Information
Screening Site
Discussion
Form (E-3)
Interview Form
Guides
(E-4)
(E-5 / E-6)

Employer Follow-Up
Survey
(E-7)

Program Objective - Survey Instrument Cross Walk – Community Participant (Detail)
Respondent Type
Program Objectives / Survey Instrument

1. Establish the National Healthy Worksite Program
a. To recruit and select employers for
participation in the NHWP.
b. To understand employer intentions
to participate in community-based
training and peer-to-peer networking
provided by the NHWP.
c. To describe the process of
implementing tailored, customized
comprehensive workplace programs,
including employer and employee
assessment, planning, program
implementation, including challenges
encountered and means to overcome
them, such as people or practices that
have facilitated implementation and
lessons learned along the way.
i. The implementation of comprehensive workplace
program elements including employer and employee
assessment, planning, program implementation, and
evaluation and the ways in which participating
employers have achieved the desired program, policy,
and environmental support changes.
ii. How participating employers have implemented
their program elements and strategies documenting
challenges encountered and means to overcome
them, people or practices that have facilitated
implementation, and lessons learned along the way.

Community Participant
Worksite Health
Worksite
101 Training
Health 101
Survey: Parts I-III
Training
(E-8)
Survey: Part
IV
(E-9)

Community
Participant
Engagement
Feedback
Survey (E-10)

All Questions

Q2-10

Q2-11

Q1-11

Respondent Type
Program Objectives / Survey Instrument

2. Evaluate the Impact of the National Healthy Worksite Program
d. To evaluate outcomes and the ways
in which participating employers have
achieved the desired program, policy,
and environmental support changes.
i. The implementation of comprehensive workplace
program elements including employer and employee
assessment, planning, program implementation, and
evaluation and the ways in which participating
employers have achieved the desired program, policy,
and environmental support changes.
ii. How participating employers have implemented
their program elements and strategies documenting
challenges encountered and means to overcome
them, people or practices that have facilitated
implementation, and lessons learned along the way.
e. To understand how participating
employers have leveraged and
sustained existing health promotion
and health protection programs and
practices and integrated the NHWP into
their organizational structure.
f. To quantify changes to aggregate
employee level health risk and health
status.
g. To describe changes to organizational
culture and social norms and how they
may relate to workplace health
program sustainability.

Community Participant
Worksite Health
Worksite
101 Training
Health 101
Survey: Parts I-III
Training
(E-8)
Survey: Part
IV
(E-9)

Q2-10

Community
Participant
Engagement
Feedback
Survey (E-10)

Q2-11

Q1-11

Q5-6, 8-9

Q6-7,9-10

Q4, 9, 10, 1214

Respondent Type
Program Objectives / Survey Instrument

3. Establish Best Practices for Future Employers who want to Establish a National Healthy
Worksite Program
h. To describe the usefulness of
worksite health training for
participating employers and community
participants and the impact of training
on overcoming barriers to
implementing a comprehensive
workplace health program.
i. To understand factors that affect the
sustainability of the workplace health
program.
j. Characteristics, including
sustainability, of workplace health
programs that do not receive the
intensive support provided by the
NHWP.
k. To describe the type and number of
qualified employers who are willing,
motivated, and interested in becoming
NHWP participants, or the barriers based on employer size or industry
sector- that factored into employer
decision-making not to participate in
the NHWP.

Community Participant
Worksite Health
Worksite
101 Training
Health 101
Survey: Parts I-III
Training
(E-8)
Survey: Part
IV
(E-9)

Community
Participant
Engagement
Feedback
Survey (E-10)

All Questions

All Questions

Q6

Q5-6, 8-9

Q6-7,9-10

Q4, 9, 10, 1214

All Questions

All Questions

All Questions

Q1-2, 5a-h, 9

Program Objective - Survey Instrument Cross Walk – Employee (Detail)
Employee

Respondent Type
Program Objectives / Survey Instrument
All
Employee
Survey
(F-1)

Employee
Health
Assessment
(F-2)

Success
Story
Consent
Form
(F-3)

NHWP
Satisfaction
Survey
(F-4)

Wellness
Challenge
Logs (F-5)

Nutrition
Tracking
Log (F-6)

Program
Consent
Form
(G-1)

1. Establish the National Healthy Worksite Program
a. To recruit and select
employers for
participation in the
NHWP.
b. To understand
employer intentions to
participate in communitybased training and peerto-peer networking
provided by the NHWP.
c. To describe the process
of implementing tailored,
customized
comprehensive workplace
programs, including
employer and employee
assessment, planning,
program implementation,
including challenges
encountered and means
to overcome them, such
as people or practices
that have facilitated
implementation and
lessons learned along the
way.
i. The implementation of
comprehensive workplace program
elements including employer and
employee assessment, planning,
program implementation, and
evaluation and the ways in which

All
Questions

All Questions

All
Questions

participating employers have
achieved the desired program, policy,
and environmental support changes.
ii. How participating employers have
implemented their program elements
and strategies documenting
challenges encountered and means to
overcome them, people or practices
that have facilitated implementation,
and lessons learned along the way.

Employee

Respondent Type
Program Objectives / Survey Instrument
All
Employee
Survey
(F-1)

Employee
Health
Assessment
(F-2)

Success
Story
Consent
Form
(F-3)

NHWP
Satisfaction
Survey
(F-4)

Wellness
Challenge
Logs (F-5)

Nutrition
Tracking
Log (F-6)

Program
Consent
Form
(G-1)

2. Evaluate the Impact of the National Healthy Worksite
Program
d. To evaluate outcomes
and the ways in which
participating employers
have achieved the desired
program, policy, and
environmental support
changes.
i. The implementation of
comprehensive workplace program
elements including employer and
employee assessment, planning,
program implementation, and
evaluation and the ways in which
participating employers have
achieved the desired program, policy,
and environmental support changes.
ii. How participating employers have
implemented their program elements
and strategies documenting
challenges encountered and means to
overcome them, people or practices
that have facilitated implementation,
and lessons learned along the way.

All
Questions

All Questions

All
Questions

e. To understand how
participating employers
have leveraged and
sustained existing health
promotion and health
protection programs and
practices and integrated
the NHWP into their
organizational structure.
f. To quantify changes to
aggregate employee level
health risk and health
status.
g. To describe changes to
organizational culture and
social norms and how
they may relate to
workplace health
program sustainability.

Q: 12-16

Q: 1-12;
14-15, 1622

All Questions

All
Questions

All Questions

All
Questions

All
Questions

All
Questions

Employee

Respondent Type
Program Objectives / Survey Instrument
All
Employee
Survey
(F-1)
3. Establish Best Practices for Future Employers who want
to Establish a National Healthy Worksite Program
h. To describe the
usefulness of worksite
health training for
participating employers
and community
participants and the
impact of training on
overcoming barriers to
implementing a
comprehensive workplace
health program.
i. To understand factors
that affect the
sustainability of the
workplace health program.
j. Characteristics, including
sustainability, of workplace
health programs that do
not receive the intensive
support provided by the
NHWP.
k. To describe the type and
number of qualified
employers who are willing,
motivated, and interested
in becoming NHWP
participants, or the barriers
-based on employer size or
industry sector- that
factored into employer
decision-making not to
participate in the NHWP.

Q: 1-12; 14-15,
16-23

Employe
e Health
Assessm
ent (F-2)

Success
Story
Consent
Form
(F-3)

NHWP
Satisfaction
Survey
(F-4)

Wellness
Challenge
Logs (F-5)

Nutrition
Tracking
Log (F-6)

Program
Consent
Form
(G-1)

Program Objective - Survey Instrument Cross Walk – Program Provider (Detail)
Respondent Type
Program Objectives / Survey Instrument

Program Provider
Community
Director
Discussion
Guide (H-1)*

1. Establish the National Healthy Worksite Program
a. To recruit and select employers for participation in the NHWP.
b. To understand employer intentions to participate in community-based
training and peer-to-peer networking provided by the NHWP.
c. To describe the process of implementing tailored, customized
comprehensive workplace programs, including employer and employee
assessment, planning, program implementation, including challenges
encountered and means to overcome them, such as people or practices
that have facilitated implementation and lessons learned along the way.

Health Coach
Discussion
Guide (H-2)*

Q18-21

i. The implementation of
comprehensive workplace program
elements including employer and
employee assessment, planning,
program implementation, and
evaluation and the ways in which
participating employers have achieved
the desired program, policy, and
environmental support changes.
ii. How participating employers have
implemented their program elements
and strategies documenting challenges
encountered and means to overcome
them, people or practices that have
facilitated implementation, and
lessons learned along the way.

All Questions

Q10-12, 18

All Questions

Q6-7

* Information will be collected from the NHWP program staff. These Program Providers -Community Directors and Health Coaches - will supplement and
corroborate the input provided by Participating Employers and Employees

Respondent Type
Program Objectives / Survey Instrument

Program Provider
Community
Director
Discussion
Guide (H-1)*

Health Coach
Discussion
Guide (H-2)*

2. Evaluate the Impact of the National Healthy Worksite Program
d. To evaluate outcomes and the ways in which participating employers
have achieved the desired program, policy, and environmental support
changes.
i. The implementation of
comprehensive workplace program
elements including employer and
employee assessment, planning,
program implementation, and
evaluation and the ways in which
participating employers have achieved
the desired program, policy, and
environmental support changes.
ii. How participating employers have
implemented their program elements
and strategies documenting challenges
encountered and means to overcome
them, people or practices that have
facilitated implementation, and
lessons learned along the way.
e. To understand how participating employers have leveraged and
sustained existing health promotion and health protection programs and
practices and integrated the NHWP into their organizational structure.
f. To quantify changes to aggregate employee level health risk and health
status.
g. To describe changes to organizational culture and social norms and how
they may relate to workplace health program sustainability.

All Questions

Q10-12, 18

All Questions

Q6-7

Q7-9, 18-21

Q2-3, 6-9

Q2

Q2-7, 10-11

Q7-9, 13-14

Q8-9

* Information will be collected from the NHWP program staff. These Program Providers -Community Directors and Health Coaches - will supplement and
corroborate the input provided by Participating Employers and Employees

Respondent Type
Program Objectives / Survey Instrument

3. Establish Best Practices for Future Employers who want to Establish a
National Healthy Worksite Program
h. To describe the usefulness of worksite health training for participating
employers and community participants and the impact of training on
overcoming barriers to implementing a comprehensive workplace health
program.
i. To understand factors that affect the sustainability of the workplace
health program.
j. Characteristics, including sustainability, of workplace health programs
that do not receive the intensive support provided by the NHWP.
k. To describe the type and number of qualified employers who are willing,
motivated, and interested in becoming NHWP participants, or the barriers
-based on employer size or industry sector- that factored into employer
decision-making not to participate in the NHWP.

Program Provider
Community
Director
Discussion
Guide (H-1)*

Q7-9, 13-14

Health Coach
Discussion
Guide (H-2)*

Q8-9