CSWW Wellness Signage

CSWW Wellness Signage

To support any organization’s successful completion of the Healthy Workplace Award’s criterion regarding posted wellness signage (Criterion 9), the CSWW Wellness Signage sheet is designed to:

      • Summarize the types of wellness signage
      • Cite any available research that supports the intervention
      • Provide inspirational examples
      • Provide usable/adaptable examples for your organization

We hope you find the following information interesting and useful! The organization(s) that provide your employee benefits may already have signage/graphics for you to use- It may be prudent to check with them.

Before we discuss the various types of wellness signage, we think it would be helpful to explain the broad category of Point-of-Decision Prompts.

Point-of-Decision Prompts

How point of decision prompts work

Point-of-decision (POD) prompts act to influence individuals’ decisions when they are at a crucial location to make them. They are most often used as motivational signs placed on or near stairwells, elevators, and escalators to encourage individuals to use stairs. Point-of-decision prompts can be implemented in workplaces or in public venues such as train, subway, and bus stations, airports, shopping malls, banks, and libraries. These can be implemented alone or in combination with stairwell enhancements such as music, art, signs, carpet, paint, or lighting upgrades. Point-of-decision prompts can also be motivational messages such as signs, posters, front of package labels or shelf labels placed near fruits, vegetables, and other items to encourage individuals to purchase these healthier food options. These would be considered Point-of-Purchase prompts and are a subtype of point-of-decision. They often provide specific nutrition information, use symbols to rate or indicate healthy items, or promote selection of specific types of healthy foods. When examining the best type of point-of-decision prompt to use in your work setting, consider your workplace’s environmental factors.

 Available research to support this intervention

There is strong evidence that point-of-decision prompts increase stair use and physical activity levels (CG-Physical activityBrownson, 2006*Soler, 2010Sax-Bellew, 2008Nocon, 2010*), especially when implemented in public venues (Bellicha, 2015*). Point-of-decision prompts are effective in a range of settings among a variety of population subgroups (CG-Physical activity); the largest effects have been shown for individuals who are obese (Brownson 2006*). Point-of-decision prompts have greater effects on stair climbing in worksites when motivational signs are supplemented with directional signs (Bellicha, 2015*).

The research on signs/labeling creating behavioral nudges to improve health expands beyond just prompts to use of stairs. A pooled analysis of 60 interventional field and laboratory studies revealed that healthy food labels reduced consumer intake of calories by 6.6%, total fat by 10.6%, and other unhealthy food options by 13% (Shangguan et al., 2019). RWFJ’s evidenced-based intervention webpage lists restaurant nutrition labeling in the second highest category of scientific support. Point-of-purchase prompts (POP) for healthy food choices can be implemented in cafeterias, vending machines, grocery stores, or retail locations in worksites, hospitals, schools, or other community venues. Point-of-purchase prompts are often implemented as part of a multi-component approach to improving food environments (US FDA-POP labeling). There is dearth of evidence that point-of-purchase prompts can increase the purchase and consumption of fruits and vegetables and other healthy foods (Freedman, 2010*Buscher, 2001*Reed 2011*Story, 2008*Sonnenburg, 2013*) especially when implemented with other food environment improvements (Seymour, 2004*AHA-Mozaffarian, 2012). Used in conjunction with advertising and general promotion of healthy foods, point-of-purchase prompts have been shown to increase healthy food selection (Escaron, 2013).

Wellness Signage Type 1:

Point-of-Decision Prompt-
Encouraging observers to take the stairs

As mentioned in the previous section, POD prompts encouraging the use of stairs are the most common form of them. This is one of our personal favorites due to the ease of implementation and the measurably positive impact they tend to have.

Examples for inspiration – Let other ideas inspire you! The CDC StairWELL examples are simple and free for you to use, but do not hesitate to design your own if you think you can enhance it for your unique work environment/culture!

The CDC StairWELL to Better Health program in Atlanta, Georgia (CDC-StairWELL) is an example of a point-of-decision prompt and stairwell enhancement initiative; it has been the basis for many similar initiatives to increase stair use across the country, as in Maine (MMC-5210 StairWELL) and Texas (ASTHO-Texas POD prompts 2013). The Indiana Healthy Weight Initiative and Indiana’s Communities Putting Prevention to Work grant projects also use point-of-decision prompts to increase stair use in worksites (NBCH-CPPW IndianaIHWI-Worksites).

Example from Community Strong

(Feel free to use or adapt the Community Strong examples for your workplace.  This template was created on Canva.com)(This example courtesy of Dr Amy Estlund’s Health Communication course students, Lindenwood University)

Wellness Signage Type 2:

Point-of-Purchase Prompts –
Encouraging observers to choose healthy, nutritious snacks/meals.

As cited previously, there are a number of evidence-based outcomes tied to the use of point-of-purchase (POP) subtype as well. There are a multitude of ways that an employer could act in alignment with the research. To develop a POP, first examine the food-choice points available in your workplace.

Do you have vending machines, or a cafeteria where you could possibly have an immediate and direct influence? Perhaps your leadership could develop and post an attention-grabbing nutritional FAQ sheet of which option each vendor offers. You could also include mention of the health benefits of each item’s specific nutritional emphasis.

Do many of your employees eat at nearby lunch spots? Your wellness leadership committee could plot out the nutrition value of items at nearby eateries on a FAQ sheet.

Creativity and consideration of where you are most likely to nudge employees towards healthy nutrition is key. There are federal guidelines on what “healthy nutrition” means. These can assist you in outlining nutrition and recommending it (via signage and beyond) to employees,. Check the tools available at:

        • https://www.nutrition.gov/
          Federally backed resource page for eating nutritious foods (Includes databases to look up the nutritional value of common food items)

Keep in mind that the research on the use of symbolic colors, pictures, and text coding that indicate the overall rating of a product’s nutrition content can influence employee’s selection of healthy food items. (County Health Rankings and Roadmaps)

Consider these examples!

This could be as simple as printing out a word document with the information you want to convey; The information is the most important part. But consider adding some vibrance. Can you create a logo/icon to indicate a healthy food or several variations of the icon to indicate degrees/categories of nutrition? A color-based sticker system could provide simplified suggestions for your employees!

**These are proprietary 3rd party examples, but adapting the colors, context, composition/structure, and rhetoric could be very handy.  Borrowed from Tennessee.edu

Example from Community Strong

(Feel free to use or adapt the Community Strong examples for your workplace.  This template was created on Canva.com)

Wellness Signage Type 3:

Wayfinding in Walkable Places

According to the CDC, Wayfinding signs should be placed at strategic points at or near walkable places to direct people to nearby destinations- including: parks, recreation facilities, and other attractions. These signs not only act to promote physical activity, but also increase familiarity with a surrounding environment and reduce stress/mental barriers to getting out and moving.

Consider: Are there any interesting landmarks near your workplace? Any walkable lunch spots or healthy lunch spots? Any other locations that employees would frequent? Can you gamify walking (on or off your work setting) into a type of scavenger hunt?

These are questions that are important to answer when developing a Wayfinding sign.

Example from Community Strong 

(Feel free to use or adapt the Community Strong examples for your workplace.  This design was created on Canva.com)

An Example Template!

This could be as simple as taking a above-view map of the area surrounding your workplace from google, apple, etc., or any workplace floorplans you have available- and then placing dots or colored lines to walkable destinations. This could also be as simple as designing an appealing graphic with typed directions to walkable destinations. Perhaps include the benefits of adding realistic number of steps everyday- much like in the…

An Example Map!

This is a quick an easy way if you are limited in graphic design resources. The map includes directions to a Legacy Park trail from Community Strong Headquarters at the Economic Development Center. This could go a step further and indicate walkable lunch spots/restaurants- even recommend a specific healthy menu item.

Creating this was as easy as taking a snapshot from google maps and using Microsoft Paint to indicate directions.

Wellness Signage Type 4: 

Point-of-Decision Prompt- Encouraging observers to try a 60 second stretch

 Work-related musculoskeletal disorders (WMSDs) account for more than 30 percent (OSHA) of all nonfatal occupational injury and illness cases each year. In addition to this, WMSD costs employers roughly $20 Billion in direct workers’ compensation costs per year (OSHA)- not to mention, the other costs associated with it (absenteeism, lost productivity, increased health care, disability).

For organizations with office settings and a large amount of sedentary work, you still want to promote periodic breaks for physical movement; Sitting for lengthy periods is terrible for your health. Among the long list of poor health outcomes and much like research on strenuous physical activity- WMSD risk factors also include “sustained postures such as prolonged sitting” (Da Costa & Viera, 2010).

According to the CDC:

“work conditions that may lead to WMSD include routine lifting of heavy objects, daily exposure to whole body vibration, routine overhead work, work with the neck in chronic flexion position, or performing repetitive forceful tasks.”

If your workplace involves a degree of the above the above conditions, you may want to strongly consider posting signs that promote regular stretch periods. You may even want to take it a step further and implement a full stretching program for your employees and help facilitate their use of functional fitness trainings and exercises.  The CSWW Provisions Guide includes access to free, 2-week+ memberships to several fitness programs that could address this directly based on individual needs.

Relevantly, signs that prompt observers to take time for stretching activities would be a helpful addition to address sedentary ills. This could become a fun and quirky part of your work culture as well!

Consider this Example!

These signs would ideally encourage the stretch and offer visual illustration/instructions for it. Including more than one instruction/stretch for those with physical disabilities/difficulties is highly recommended.

You could include one or several types of stretches on your wellness sign. There are free and usable stretch graphics online that you could easily adapt into a design. If your organization is limited in its ability to create graphics, CANVA.com is a Community Strong favorite for cost-free, quick, and easy designs.  Some organizations promote stretching: before work begins, after having sit in an office chair for an extended duration, or when they reach certain locations in the workplace.

 

**From SafetySigns.com      [left]

From GraphicSafety.com [right]

These are proprietary 3rd party examples, but adapting the colors, context, composition/structure, and rhetoric could be very handy

Wellness Signage Type 5:

Prompts to encourage employees to utilize their benefits, EAP, and other resources.

Employers could take an evidence-informed approach by promoting the use and availability of employee health amenities. Research is strongly in favor of positive outcomes form the promotion of EAPs specifically. These concepts could presumably expand to promotions of other available employee resources.

While only 3.5% of employees utilize EAP services (Granberry et al. 2013), nearly 1 in 5 adults live with mental illness. EAP usage has apparently increased to 5.5% in 2018 according to the National Business Group on Health, but there is still a glaring disparity between the incidence of mental health illness and the utilization of EAPs. According to the National Alliance on Mental Illness (NAMI), untreated mental health illness is projected to cost as much as $200 billion for employers in the US. According to the National Business Group on Health, the number of days of work lost for mental illness outweigh many chronic conditions like heart disease, diabetes, arthritis (etc.). Despite its’ cost and prevalence, “8 of 10 workers with a mental health condition report that shame and stigma prevent them from seeking treatment” (NAMI).

With this in mind, proper promotion of EAP services is suggested to significantly increase its’ utilization according to a pooled analysis from Azzone et al (2009). Additionally, EAP is widely regarded as having a stigmatic barrier for its use (Milot, 2019) and interventions that would reduce self-stigma of using mental health resources are a popular area of research.  To be in alignment with current research, your signage could promote the resources and/or campaign to reduce any stigma surrounding the utilization of its contents.

Community Strong advocates for staunch positivity and leveraging strengths rather than highlighting and ruminating on weaknesses. With that in mind, we recommend anti-stigma campaigns efforts focusing on messages that inspire thought processes of “staying healthy and personal growth” rather than through processes of “fixing what is wrong with you”. We have created a separate section, Stigma-Free Signage, to help address stigma with wellness signage at the end of this document.

If your worksite wellness assessment indicates that your employees perceive a lack of awareness of the health and wellness resources available to them (or a strong interest in them), consider placing signage in an employee common area (or other high-traffic points) that incisively summarizing the resources available to them and where/how to access them. Part of one of the Healthy Workplace Award’s key application requirements (Criterion 2) encourages employers to promote available resources & tools to employees through “effective communication channels”. This signage would act in great supplement to campaigns that are geared to accomplish this, and the work to summarize the resources would need to be done regardless! The resources and tools you promote could be EAP, benefits, inputs from the CSWW Provisions Guide among other resources and resource pages.

When you’re developing a summary of the programs, resources, and services available- make sure you demonstrate the ease of use by providing simplified instructions for each input. As we mentioned before, try including positive language that would reduce stigma-related thinking. This signage would ideally be colorful and appealing, we recommend CANVA.com for free and easy signage designing if you have limited graphic design resources available!

NOTE:  Because this could include a wide array of intimate information about your organization’s EAP and/or benefits, Community Strong would not be able to provide a template to match as universally as we intend our examples to be.

Wellness Signage Type 6:

Health Event Promotions

Another category of signage would include any general promotion of a health event. Whether you want to promote each quarterly wellness challenge, healthy activities, a company-wide or public health fair, or health/wellness classes and learning opportunities- having signage with the details out in common areas would offer a lot to increase consistent employee engagement.

Providing a template for the wide array of types of “Health Events” and approaches to promoting events- would be next to impossible. But to hopefully act as some inspiration, we have provided several Community Strong examples below.

Consider these examples!

Wellness Signage Type 7:

Encouraging observers to utilize walking meetings

Walking meetings are fantastic way to get out and move while maintain productivity if the meeting is more discussion oriented. Research suggests big benefits to small behavioral changes- especially when they add up. Even adding a realistic, extra 2,000 steps has big benefits, and taking walking meetings is an easy way to reach that figure.

Identify specific meetings or meeting types that are “walkable.” Design Point-of-Decision signage to encourage brainstorming project ideas with a co-worker while walking, walking during the first 15 minutes of one-on-one meetings, or walking during business calls when employees don’t need access to their workstations.

Consider These 3rd Party Examples!

These are proprietary 3rd party examples, but adapting the colors, context, composition/structure, and rhetoric could be very handy. Perhaps you want a very simple reminder that ______ day is a walking meeting day. Maybe you want to add a motivating factor by providing more information on ease and health benefits. This signage could also be synthesized to include wayfinding (Signage Type 3). This is all best decided by the wellness leaders familiar with your organization’s environment and culture…

Wellness Signage Type 8:

General/targeted Motivational

It can never hurt to provide general motivation and express confidence in your employees’ ability to get and stay healthy.. Perhaps you create a focused campaign on positivity and mindfulness, or you might have reason to believe that a series of inspirational quotes about the importance and enjoyment of cooking/eating healthy. Providing messages of hope and positivity can come in a variety of forms and can only be best decided by the wellness leaders at your organizations.

Consider these examples!

**Courtesy of Dr. Amy Estlund’s (Lindenwood) Health Communication course students

You are free to use the following graphics. The QR code leads directly to the Community Strong website, which features health resources & tools, events calendar, news and more! You can make your own graphics using websites like CANVA.com, and your own QR codes at no cost with the various available QR Code Generators by searching google for the generator of your choice.

Stigma-free workplace

Because of the prevalence of stigma surrounding mental health and seeking support, we find it important enough to mention this specific subcategory for motivational signage. Individuals should not shy away from seeking support- they should feel confident and encouraged to do so. As mentioned in the section for signage type 5, mental health stigma could be very costly for individuals and employers, and a growing body of research suggests that effective policy communication strategies can garner more supportive environments for those with mental health illness and substance use disorder (McGinty et al., 2018). Effective communication would promote compassion and empowerment as opposed to a coping model when dealing with stigma- as empowerment is strongly associated with success in overcoming stigma (Shih, 2004) (Corrigan et al. 2013). A strength-based tactic to combatting stigma would “embrace an asset-based approach where the goal is to promote the positive” where people are the experts of their own lives and the supports they receive for mental health are just another tool at their disposal (Pattoni, 2012). In a Literature review of the effectiveness of strengths-based models, Huiting (2013) notes that the research on strengths-based models is positive, but still emerging.

When developing Stigma-free signage, consider messages that are goal-oriented and emphasize hope, the availability of resources, thoughtful compassion, strength, and empowerment…

      • Presumes a desire for the possibility of positive outcomes
      • Reframes deficits as opportunities for growth, problems as “challenges”
      • Introspection is a key step in personal growth
      • Focuses on what is strong, not just what is wrong.
      • Promotes the acknowledgement of personal successes
      • Encourages mindfulness as a development of skills, and increasing self-awareness
      • Encourage seeking support as a strength- building connections
      • “It’s ok not to be ok.”
      • “reaching out for support is a sign of strength”
      • “we care about your wellbeing and that most definitely includes your mental health”
      • “you are not alone”

Taking a stigma-free stance could go a step further and offer employees to take Strengths Assessments like the VIA Assessment– the widely regarded and free, scientific survey of character strengths.

Consider this Example!

This is a Community Strong creation using CANVA.com. It is intended to promote mental health through the lens of strength and adaptation, and forwards users directly to the free and widely regarded VIA Character Strengths Survey. Please feel free to use it as wellness signage.


 References

    1.  Bellicha A, Kieusseian A, Fontvieille AM, et al. Stair-use interventions in worksites and public settings: A systematic review of effectiveness and external validity. Preventive Medicine. 2015;70:3-13.
    2. Brownson RC, Haire-Joshu D, Luke DA. Shaping the context of health: A review of environmental and policy approaches in the prevention of chronic diseases. Annual Review of Public Health. 2006;27:341–70.
    3. Soler RE, Leeks KD, Buchanan LR, Brownson RC, Heath GW, Hopkins DH. Point-of-decision prompts to increase stair use: A systematic review update. American Journal of Preventive Medicine. 2010; 38(2 Suppl):S292-300.
    4. Nocon M, Muller-Riemenschneider F, Nitzschke K, Willich SN. Increasing physical activity with point-of-choice prompts: A systematic review. Scandinavian Journal of Public Health. 2010;38(6):633-8.
    5. Siyi Shangguan, MD, MPH, Ashkan Afshin, MD, ScD, Masha Shulkin, BS, Fumiaki Imamura, PhD, Dariush Mozaffarian, MD, DrPH. A Meta-Analysis of Food Labeling Effects on Consumer Diet Behaviors and Industry Practices. VOLUME 56, ISSUE 2, P300-314, FEBRUARY 01, 2019
    6. OSHA’s Prevention of Musculoskeletal Disorders in the Workplace, https://www.osha.gov/SLTC/ergonomics/
    7. OSHA’s Prevention of Work-Related Musculoskeletal Disorders https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=UNIFIED_AGENDA&p_id=4481
    8. CDC- Work-Related Musculoskeletal Disorders & Ergonomics https://www.cdc.gov/workplacehealthpromotion/health-strategies/musculoskeletal-disorders/index.html#:~:text=Examples%20of%20work%20conditions%20that,or%20performing%20repetitive%20forceful%20tasks.
    9. New York Times- Stand Up While You Read This! https://opinionator.blogs.nytimes.com/2010/02/23/stand-up-while-you-read-this/?hp
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    11. Robert Woods Johnson Foundation’s County Health Rankings and Roadmaps https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/strategies/point-of-purchase-prompts-for-healthy-foods
    12. Stanford W. Granberry, PhD, Mark Attridge, PhD, MA, Terry Cahill, MSW, LCSW, CSADC, Patricia Herlihy, PhD, RN. NATIONAL BEHAVIORAL CONSORTIUM INDUSTRY PROFILE OF EXTERNAL EAP VENDORS. 2013.
    13. Azzone V, McCann B, Merrick EL, Hiatt D, Hodgkin D, Horgan C. Workplace Stress, Organizational Factors and EAP Utilization. J Workplace Behav Health. 2009;24(3):344-356. doi:10.1080/15555240903188380
    14. McGinty E, Pescosolido B, Kennedy-Hendricks A, Barry CL. Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy. Psychiatr Serv. 2018;69(2):136-146. doi:10.1176/appi.ps.201700076
    15. Corrigan PW, Kosyluk KA, Rüsch N. Reducing self-stigma by coming out proud. American Journal of Public Health. 2013;103(5):794–800.
    16. Shih, Margaret. (2004). Positive Stigma: Examining Resilience and Empowerment in Overcoming Stigma. Annals of The American Academy of Political and Social Science – ANN AMER ACAD POLIT SOC SCI. 591. 175-185. 10.1177/0002716203260099.
    17. Xie H. Strengths-based approach for mental health recovery. Iran J Psychiatry Behav Sci. 2013;7(2):5-10.
    18. National Alliance on Mental Illness (NAMI)- StigmaFree Company https://www.nami.org/Get-Involved/Pledge-to-Be-StigmaFree/StigmaFree-Company
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