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The phenomenon, called health education, health promotion, fitness, and, most recently, wellness, has been occurring in the workplace and has been hailed as a boon to industry as well as to society in general. The movement, as it expands in leaps and bounds, has brought together many talented professionals who have the basic goal of bringing primary health care to business and industry.

Industry with its watchful eye has incorporated health programs into its environment for both humanitarian and economic reasons. Corporations increasingly realize that such programs are beneficial to the health and well-being of its employees. Smoking cessation programs are regarded as a vehicle to reduce the risk of various pulmonary and cardiovascular problems. Fitness programs are recognized as a method to augment physical and emotional well-being. Back injury control programs are seen as an approach to reduce serious injuries and to improve safety records. Stress management programs are viewed as a tool to control stress-related disorders.

Corporations increasingly recognize that a healthier and happier workforce has better morale, is more innovative, is more efficient, and is more productive. It also is less absent, is less ill, and experiences fewer accidents. The "bottom line" is that it saves businesses considerable insurance dollars and replacement costs. Government and health officials clearly appreciate that proactive corporations who establish their own health programs in an attempt to create a healthier work force are assisting to ease the burden on the health care system and are helping ultimately to save health care dollars.

Because this field is relatively new and growing rapidly, striving for clarity, definition of purpose, direction, and evaluation becomes especially important. This text, which is truly a unique North American effort presents the essential components of health education and fitness programs in the workplace and addresses the above issues and other issues through the contributions of influential and prominent health care experts, virtually a "Who's Who" of North American health education and fitness programs.

Health education has had a very interesting history. It has been influenced by a number of key individuals and a number of significant trends. In order to appreciate fully the health education movement and its effect in the workplace, it is important to examine its roots.

Klarreich in her chapter points out that the 1980s have witnessed a dramatic increase in health promotion programs in the workplace. They have evolved primarily as a remedy for growing health care costs. It is also widely recognized that modern diseases, often termed "diseases of choice," are, to a great extent, preventable if health lifestyles are adopted. She steps back in time to point out that health lifestyles were of concern even to Hippocrates and his medical students.

She indicates that the wellness movement has evolved as a result of the efforts of a number of significant individuals who are regarded as the grandfathers and the fathers of the movement. Their concepts and theories are amply chronicled. They all believed that one should strive to become "more well" even in the absence of disease. She further specifies that this notion has filtered into the workplace, where today it is hoped that wellness programs will lower health care costs, increase staff productivity, and encourage employees to adopt healthier lifestyles.

Vojtecky extensively reviews and illustrates the application of psychological principles that lead to the acquisition of knowledge, attitudes, and behaviors for developing and improving worksite health and safety conditions. Behavioral norms, learning objectives, curriculum, specificity of instruction, practice and transfer of learning, and reinforcement principles are discussed and their roles elucidated. He examines worker education and training as practiced in the United States. Finally, he discusses the developing interest in education and training for job health and safety and its implication for the future.

In the last decade and particularly in the 1980s, there has been a growing trend for companies to offer health promotion programs at the worksite. Between 1979 and 1982 the numbers of such programs have increased by 100-fold (Saxl 1984). "Employee wellness programs," "health enhancement programs," "health promotion programs," or "disease prevention programs," as they are commonly referred to, describe a series of activities that advocate adopting healthier lifestyles. Examples might include programs directed toward smoking cessation, physical fitness, stress management, nutrition education, weight management, cardiopulmonary resuscitation, alcohol and drug abuse counseling, employee assistance programs, and others.

The underlying explanation of the movement toward wellness is that corporate health care has become increasingly proactive (Brennan 1983) because corporate health care costs have been increasing at a staggering rate. Companies that sponsor health promotion programs thus operate under two assumptions. First, they recognize that it is far less costly to prevent illness than to cure it and, second, that optimal health can be approached through improved personal lifestyles (Saxl 1984). The benefits for the company include lower health care costs and increased staff productivity while employees learn to change health-threatening behavior patterns and thus avoid becoming ill. . .

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