Wellness Protocol: Multiple CVD and Alcohol Risk Factors

DESCRIPTION:   A comprehensive program designed to engage clients as active participants in their own health improvement. Each client chooses which risk factor to work on at a particular time. The program develops motivation and provides both information and support for health behavior changes. (The strategy for selecting a targeted risk factor involves negotiation between the wellness counselor and the client, and remains flexible and negotiable.)

PHILOSOPHY:   Encourage and utilize client's commitment/decision to make positive behavior or health changes. Counsel the client to comply with any treatment and/or specific directions his/her physician has given.

PROCEDURE:   One-to-one counseling, allows the client to change which risk factor is targeted over time.

SESSION I. Initial Visit

1. Based on screening data obtained, review with the client his/her health status. Assess with the client:



• Fixed and modifiable risk factors (including blood pressure and cholesterol assessed through direct measurement, weight, smoking, exercise, and alcohol consumption)



• The client's current level of medical supervision/interaction.



• The client's understanding of physician's directions.



• The client's desire to follow physician's directions.



• Any external support systems available to the client (wife/husband, co-worker, housemate, etc)



2. Encourage the client to select which health risk he/she would like to improve, establishing awareness that one behavior change can impact multiple risk factors.
   
   *If the client has either high BP or high cholesterol, the counselor should encourage the client to see a physician for a medical evaluation as the first goal. If client is at a high risk level for alcohol consumption, assess with the client if outside referral would be appropriate. Assist with referral if necessary. Plans and goals for reducing other risks may be pursued concurrently.



3. Assist the client in developing a plan of action, utilizing relevant materials from the specific guided self-help program for addressing the health risk the client has selected. Have the client commit to a date when he/she will begin this plan. If the client is under the care of a physician, the plan should include assistance with following the physician's orders. Give the client a Multiple CVD wallet card and explain its use.



4. In developing the plan, provide for some immediate tasks with which the client can be successful without much effort (phone physician to set up an appointment, park further from the door when shopping or running errands, skip the pop at break and have a glass of water, skip the vending machines and have a piece of fruit, cut down one drink per day/week or any behavior that encourages or supports positive health changes.) It is important to find some client specific task that engages the client actively in this process, that will demonstrate the client's ability to be successful.



5. Schedule follow-up session, to monitor progress and support the behavior or health change. (one week if client is willing to work on a risk factor, one month if not)

SESSION II. Review Progress

1. Review the progress that has been made since the client's last session, and support any positive level of behavior or health change that the client has made.



2. Review the significant outcomes of continued success, both with the targeted risk factor and other risk factors that the client exhibits.



3. If alcohol is a risk factor for this client, matter-of-factly remind the client of how level of alcohol consumption affects the various risk factors this client now has.



4. Complete the follow-up form. Determine when follow-up is needed for each risk factor, to enable the counselor to monitor progress and offer support for efforts at health behavior change.



5. Modify the time frame for the targeted risk factors as needed, keeping in mind that this client may need more frequent visits, being at a higher level of risk for CVD and alcohol risk factors.



6. Schedule the next visit. (one to two weeks if client is working on a behavior change, one month if client is not ready to take action)

• Multiple CVD Wallet Card (developed by the University of Michigan Worker Health Program).
• Follow-up form (developed by the University of Michigan Worker Health Program).
• Wellness Protocols utilized in targeting specific risk factors such as smoking, weight management, alcohol reduction, etc. (developed by the University of Michigan Worker Health Program).