Posts Tagged ‘Total Health Assessment’

Healthy lifestyles: tough to achieve, worth the effort

posted on May 31, 2013

By Ginny McPartland, Heritage writer

Kaiser Permanente’s Northwest Region initiated its Freedom from Fat program in 1989. Exercise was an integral part of the healthy living program. This photo of Donna Dean, a Health Plan member, William Cooper, associate regional manager of the Northwest Region, and Chris Overton, health education staff member, appeared on the cover of the Spring 1989 Spectrum, a magazine for Kaiser Permanente employees.

Kaiser Permanente founding physician Sidney Garfield caught on early that changing people’s habits would have positive results for their health. Urging his patients to avoid accidents by following safety guidelines and eating right to avoid health problems was a no-brainer for Garfield. Everyone would be happier and healthier, and the need for costly medical care could be minimized.

Voila! Prepaid care with an emphasis on prevention. Garfield adopted this theme in 1933, and Kaiser Permanente leaders have held this as a predominant tenet ever since.

Garfield’s interest in nutrition and exercise programs for shipyard workers in the 1940s, multiphasic examinations (annual physicals) in the 1950s, data processing of patient records in the 1960s, health education centers in the 1970s and the Total Health Project in the 1980s all fed into the push to promote healthy lifestyles and prevent illness.

Newsletters in the World War II Kaiser shipyards constantly reminded workers to eat three square meals a day and avoid too much fat and sugar. “Are you starving?” one article asked. “You can be starved without being hungry. . . Are you aware: 24 million man-hours per month (nationally) are lost through minor illnesses preventable by better nutrition?”

‘Are You Starving’ article in the Oct. 6, 1944, issue of the Kaiser Richmond Shipyard newsletter Fore ‘N Aft. The message: Eat healthy food and stay fit.

The Kaiser child care centers served healthy meals, and parents could buy nutritious family dinners to take home when they collected their offspring at the end of the day. Shipyard management sponsored intramural sports teams to help workers blow off steam and stay fit.

Screening workers for unhealthy habits

In 1950 Dr. Garfield responded to labor leader Harry Bridges’ request for a preventive care screening program for the members of his longshoremen’s and warehousemen’s union. The examinations, union-mandated for all workers, highlighted lifestyle problems and educated the men on how to avoid heart disease and other chronic illness.

In the 1960s, the first computer technology recorded the examination results so physicians could track their patients’ progress electronically and identify trends that could aid in the care and treatment of other patients, even in subsequent decades.

The 1970s saw the debut of the health education centers in which patients could seek disease prevention information and partake in groundbreaking programs to help them maintain healthy lifestyles and a healthy weight. (This was the beginning of Kaiser Permanente’s Healthy Living centers that offer a myriad of programs designed to preserve good physical and mental health and help patients manage chronic conditions.)

Health appraisal gains momentum

Health appraisal programs were established in a number of Kaiser Permanente locations, and healthy members were encouraged to visit the clinic when they were well, not just when illness struck. They filled out questionnaires and discussed their health status with practitioners who tracked their lifestyles and gave advice on staying well.

The transparent woman was a prominent exhibit in the first Oakland Health Education Center. Instructors could light up various parts of the body and describe the functions for visitors to the center. This photo appeared on the cover of the Kaiser Permanente’s 1967 annual report.

In the 1980s, Dr. Garfield conducted the Total Health research project in which he expanded the health assessment theme and had new well members diverted to a Total Health Center in which the emphasis was on promoting healthy lifestyles.

In the 1990s, Kaiser Permanente researchers participated in studies to test the success of a dietary regimen meant to reduce blood pressure and help prevent heart attacks and strokes. The Dietary Approaches to Stop Hypertension approach called for a healthy diet rich in fruits, vegetables, whole grains, low-fat dairy, fish, poultry and nuts.

The participants who followed DASH experienced a significant reduction in 24-hour blood pressure. The others, who continued to eat red meat, sweets and sugary soda, saw no improvement in blood pressure. Following the study, the DASH approach became the basis of Kaiser Permanente’s teaching about the prevention of hypertension and related conditions.

Also in the 1990s, Kaiser Permanente physician Vincent Felitti discovered while running a health appraisal clinic in the San Diego area that some patients needed help overcoming childhood trauma before they could change unhealthy behavior. Felitti conducted the Adverse Childhood Experience study and urged the consideration of psychological as well as physical issues in assessing a patient’s ability to adopt a healthy lifestyle.

Thriving in the 21st century

Kaiser Permanente offers a wide variety of healthy living classes at its facilities in all regions. Here, students enjoy an exercise class in Oakland, Calif.

In 2004 Kaiser Permanente launched its Thrive advertising campaign, which spotlighted the health plan’s continuing emphasis on healthy living to help patients stay well. In the 20-Teens, the organization gave birth to other behavior change modalities, including online healthy lifestyle programs, Healthy Eating and Active Living community programs and free classes open to the public.

In 2012, Kaiser Permanente launched “Every Body Walk!” a campaign to get literally everyone up on their feet to take the first small steps that can lead to success in achieving a healthy lifestyle.

Today, patients who choose to alter their habits to achieve better health can get help in Kaiser Permanente’s Healthy Living classes, by enrolling in online Healthy Lifestyle programs, and by accessing the bonanza of health information on kaiserpermanente.org.

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Permanente traditions advance with total health assessment campaign

posted on December 29, 2010

By Ginny McPartland 

Longshoremen line up for their health assessment or "physical" in 1961

I recently took an online total health assessment (THA) through the healthy lifestyles program on Kaiser Permanente’s members Web site, kp.org. This was my second time (in three years) so I knew the drill: answer quite a few questions about my health and lifestyle habits and find out where I stand health-wise. I did it for me, but I had another motive. By taking the assessment, I earned $50 for charity.

When I first heard Kaiser Permanente was offering its employees a $50-to-charity incentive to take the THA, I wasn’t that impressed. I didn’t think the donation would convince people to participate in KP’s initiative to build a healthier workforce. I also didn’t think $50 would go that far. I have to admit I was WRONG!

By mid-December, more than 22,000 (14.5%) KP employees nationwide had taken the THA and by that small action collectively raised an impressive $1.1 million. Now that will go a long way. How far? For starters, each $50 could buy 700 pounds of fruits and vegetables or 77 dozen eggs for the hungry. Or it could provide 10 pediatric flu shots for needy kids. Multiply those items by 22,000 donors and you get the picture. 

The money raised by the 2010 THA incentive program will go to community healthy eating initiatives and to support health care for disadvantaged people and families, especially the homeless, the disabled and those living with HIV/AIDS.  The KP region whose employees raise the most money will receive an extra $50,000 for charities in their communities. The winner will be announced in January; the money will be awarded in March.* 

1951 brochure announcing Longshoremen assessment program. Image courtesy of the ILWU.

I think it says something about the KP culture that so many employees were motivated to raise money for others less fortunate than themselves. If they hadn’t felt compelled to take the assessment for their own sake, they were motivated to help others. Of course, Kaiser Permanente has given millions to good causes over the years through its Community Benefit programs.†

Total health assessment by any other name

Given our history as a preventive care organization, it shouldn’t come as a big surprise that Kaiser Permanente has been a champion of the total health assessment for over 60 years. In 1950, such an assessment was called the “multiphasic examination,” and it was initiated when labor leader Harry Bridges of the International Longshore and Warehouse Union (ILWU) demanded it for all members of the union. 

The ILWU members lined up at the waterfront for preventive clinics that included blood and urine screening tests, chest X-ray, electrocardiogram, and other tests to search for chronic disease. Each member also completed a health questionnaire similar to today’s THA. The recording and archiving of test results became the impetus for Kaiser Permanente to acquire its first computers in 1960. 

These records, still accessible today, have supported long-term health research related to heart disease and other chronic diseases. One such study, “Characteristics of Longshoremen Related to Fatal Coronary Heart Disease and Stroke” by Paffenbarger et al., was published in the “American Journal of Public Health,” in 1971. 

Robert Feldman, MD, and Sidney Garfield, MD, confer on the health assessment program launched in the late 1960s.

In the late 1960s, Permanente founding physician Sidney Garfield launched a program called “The Total Health Care Project” to expand the multiphasic programs in Oakland and San Francisco. Garfield and Robert Feldman, MD, hired and trained KP’s first nurse practitioners to run the program that included the use of computerized lab machines that yielded results while the patient was still at the clinic. Their goal was to collect baseline health data that could be used to identify health risks and to prevent disease. 

Today’s iteration of the multiphasic exam is a system of chronic disease screening programs designed to detect symptoms early and identify risk factors. The total health assessment questionnaire challenges participants to scrutinize their lifestyles and work with their doctors to figure ways to head off diseases such as diabetes, heart disease and cancer. 

For me, the THA results are a reminder of what I need to do to stay healthy. I’m also hoping I can improve my sleep by following through with the online insomnia program. But most of all, I feel glad that my co-workers saw fit to get involved for themselves and to raise money to improve the health of others less fortunate. 

*Benefit-eligible Kaiser Permanente employees and physicians may earn the $50 charitable donation by taking the THA by Dec. 31.  Go to the Healthy Workforce site to participate. 

†Click here for more information about Kaiser Permanente’s Community Benefit Program

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