When you think of worksite wellness, does your mind conjure images of an elaborate fitness center in a large company? If so, you may need to rethink what makes an effective worksite wellness program, experts say.

Employer-sponsored wellness programs come in all shapes and sizes.

Companies do not have to have elaborate fitness centers to provide an effective worksite wellness program, and small as well as large businesses can develop successful wellness programs without large expenditures, experts say.

Worksite wellness programs can improve employee health and morale, according to the University Extension Center at Charleston. Over a period of time, the programs will reduce health-care costs. They combine an educational, organizational and environmental approach.

A conscious effort to make the program an integral part of the corporate mission, philosophy and culture does more to ensure success than large dollar expenditures, say experts.

Custom Design Interiors (CDI) of Cape Girardeau, a small business that employs 22 people, has selected the American Heart Association's "Heart At Work" program.

Judy Below, manager at CDI, initiated the program.

"I went to an American Heart Association board meeting and became interested," Below said. "We decided to offer the program at CDI."

Often the responsibility of implementing a wellness program falls into the hands of supervisors and managers, but Below has found a way to ease the burden. She is working with Jacqueline Hooper, associate professor in the department of health and leisure at Southeast Missouri State University. Hooper instructs students in the university's health management degree program, in which they specialize in either health promotion or sports management.

"We are their project," Below said. "They are implementing the program."

Heart At Work covers five broad areas, including high blood pressure, smoking, nutrition, exercise and survival skills. A committee of three CDI employees helps decide which specific topics will be covered. Critical to the success of most employer-sponsored wellness programs is employee involvement in the planning.

A primary goal of the Heart at Work program is to reduce absenteeism through prevention and that is what Below hopes will happen.

"If the employees are healthier, of course, they're not going to miss as much work," she said.

Absenteeism at CDI has a drastic effect on production just as it does at many other work sites.

"It just stands to reason if your workforce is there everyday, your productivity is going to be where it needs to be," Below said. "It's going to show up on the bottom line."

CDI's wellness program is voluntary. Employees who choose to participate do so on work time. Their only cost is the blood analysis, approximately $20. CDI purchases the Heart at Work kit from the American Heart Association. The cost is $50, a price within the means of most businesses on a tight budget.

Hooper, who oversees the implementation of CDI's program, describes it in five main components:

Organizational study of the company.

Organization of employee committee.

Participant input personal family history, blood analysis, interest survey.

Educational component (four to six 30-minute sessions).

Evaluation.

Some employers target their wellness goals. For example, Tom Hedrick of Hedrick Concrete Products in Sikeston aims to entice his workers to quit smoking. Recognizing the health risks of smoker's smoke, Hedrick's company offices have operated under a smoke-free policy since 1978.

In addition to smoke-free offices, Hedrick encourages employees to stop smoking altogether. In fact, he puts his money where his mouth is. Employees who quit smoking receive a cash award of $400. Seven awards have been made since the program began about six years ago. Of those who are still employed there, none have started smoking again.

Why does Hedrick go to such lengths to encourage his employees to stop smoking?

"It's simple. The bottom line is that healthy employees are more productive," Hedrick said. "Smokers are very costly on the average."

Hedrick cites the absenteeism of smokers and the actual time it takes to light up and puff as costly to him.

"The smoker, healthwise, is simply not here as often and when he's sick, he gets sicker than the people who do not smoke," he said.

Hedrick Concrete employs from 70 to 150 people, depending on the season. Most of his employees are men.

While Hedrick's wellness program is focused, Gates Rubber Co. in Charleston takes a multi-faceted approach.

Gates philosophy of wellness includes family involvement. The company strives to provide opportunities for its employees and their families to "have fun together."

The company slogan even has a "family feel" to it. "We're one company, one goal," said Ron Gardner, industrial relations manager. The company encourages employees to be open about their ideas and suggestions for the good of the company.

About a year ago, Gates became involved in a cholesterol screening program through the Missouri Department of Health.

Employees who volunteer to participate in the pilot program are screened for cholesterol levels. Those with high cholesterol are given information and attend diet and nutrition classes at the worksite. Employees are re-tested after several months to evaluate the success of the program.

In addition to cholesterol screening, Gates participates in the Great American Smokeout every year, offers employees the opportunity to walk or jog in the company's warehouse after their shift, organizes CPR training at no cost to the employee and sponsors a Little League baseball team.

According to Janet Stevens, industrial relations assistant/secretary, the annual family picnic, Easter egg hunt, and Christmas party for the children are all great hits with the employees and their families.

The Christmas party for the children of Gates employees includes entertainment, treats and a gift for each child.

"It's usually a real nice gift," Stevens said. In fact, the Gates Corporation in Denver has a department that works year-round purchasing and wrapping gifts for each plant's Christmas party.

"Gates really puts a lot of emphasis on the family," Stevens said.

Gates Rubber Co. in Charleston employs 104 people.

On a larger scale, Noranda Aluminum Inc.'s plant in Marston also sees the benefit of worksite wellness.

The Noranda plant operates around-the-clock, employing about 1,200 people.

Because of the nature of the work and potential for injury, Noranda boasts a 24-hour, on-site medical clinic staffed with registered nurses. Noranda employees suggest topics for their four health education seminars each year.

Kay Keen, supervisor of Nursing Services, is very matter-of-fact about the importance of wellness at the worksite.

"Your best money is spent keeping that person healthy," she said.

In addition to health education, safety is an ongoing issue at Noranda. A full-time position is devoted to the prevention and monitoring of existing environmental hazards.

The lobby of Noranda's industrial relations building is equipped with a blood pressure machine, weight machine that evaluates your current weight in relation to your ideal weight and a new pharmacy information center (PIC) for employees and visitors to use.

Keen made the suggestion to purchase the PIC and says it has been very well received. Though costly (approximately $7,800), the PIC provides a wealth of information about prescription drugs, adult and child health issues, and diet and nutrition. After the user chooses a topic of interest, the PIC will print out a copy of the information. Its computer database is consistently updated to assure correct information.