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Worksite Assessment    

The purpose of this assessment is to assist employers with assessing your worksite wellness programs, identify gaps and evaluate the overall health culture at your worksite. This assessment will highlight areas that you are doing well and identify areas for improvement. The questions included are not a comprehensive list and are designed to initiate action and ideas to help you build and sustain a wellness program that will make an impact on your employees.   



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* 1. Name of Worksite

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* 2. City

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* 3. How many employees work at your worksite? This includes full-time and part-time employees.

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* 4. In the past 12 months did your worksite:
Provide an exercise facility or exercise space on-site?

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* 5. In the past 12 months did your worksite:
Subsidize or discount the cost of on-site or offsite exercise facilities?

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* 6. In the past 12 months did your worksite:
Provide environmental supports for recreation or physical activity (e.g. provides trails or a track for walking/jogging, maps of walking routes, bicycle racks, opens space for recreation or exercise)? 

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* 7. In the past 12 months did your worksite:
Post signs at elevators, stairwell entrances or exits and other key locations that encourage employees to use the stairs? Answer "no" if your worksite does not have stairs.

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* 8. In the past 12 months did your worksite:
Provide organized individual or group physical activity programs for employees? (other than the use of an exercise facility)

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* 9. In the past 12 months did your worksite:
Provide brochures, videos, posters, pamphlets, newsletters, or other written or online information that address the benefits of physical activity?

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* 10. In the past 12 months did your worksite:
Provide a series of educational seminars, workshops, or classes on physical activity?

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* 11. In the past 12 months did your worksite:
Provide or subsidize physical fitness assessments, follow-up counseling, and physical activity recommendations either on-site or through a community exercise facility? 

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* 12. In the past 12 months did your worksite:
Provide free or subsidized self-management programs for physical activity? (e.g. programs are provided in-person or online; on-site or off-site; in group or individual settings; through vendors, on-site staff, health insurance plans or programs, community groups, or other practitioners.)

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* 13. In the past 12 months did your worksite:
Implement any new strategies to increase physical activity among your employees in the last 12 months? This may include any of the above strategies or additional ones not listed.

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* 14. Does your organization currently have an established written policy or formal communication that increases opportunities for physical activity (e.g. paid or unpaid release time for employees to exercise)?

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* 15. During the past 12 months, did your worksite:
Provide places to purchase/obtain food and beverage?

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* 16. During the past 12 months, did your worksite:
Have a written policy or formal communication in place that makes healthier food and beverage choices available in cafeterias, or snack bars?

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* 17. During the past 12 months, did your worksite:
Have a written policy or formal communication in place that makes healthier food and beverage choices available in vending machines?

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* 18. During the past 12 months, did your worksite:
Make most (more than 50%) of the food and beverage choices available in vending machines, cafeterias, snack bars, or other purchase points be healthier food items?

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* 19. During the past 12 months, did your worksite:
Provide nutritional information (beyond standard nutrition information on labels) on sodium, calories, trans fats, or saturated fats for foods and beverages sold in worksite cafeterias, snack bars, or other purchase points?

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* 20. During the past 12 months, did your worksite:
Identify healthier vending machines or other food and beverage choices with signs or symbols?

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* 21. During the past 12 months, did your worksite:
Subsidize or provide discounts on healthier foods and beverages offered in vending machines, cafeterias, snack bars, or other purchase points?

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* 22. During the past 12 months, did your worksite:
Have a written policy or formal communication which makes healthier food and beverage choices available during meetings when food is served?

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* 23. During the past 12 months, did your worksite:
Provide educational seminars, workshops, mentoring/coaching or classes on nutrition?

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* 24. During the past 12 months, did your worksite:
Offer or promote an on-site or nearby farmer’s market where fresh fruits and vegetables are sold?

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* 25. During the past 12 months, did your worksite:
Provide brochures, videos, posters, pamphlets, newsletters, or other written or online information that address the benefits of healthy eating?

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* 26. During the past 12 months, did your worksite:
Provide free or subsidized self-management programs for healthy eating?

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* 27. During the past 12 months, did your worksite:
Provide free or subsidized pre-diabetes and diabetes risk factor assessment (beyond self-report) and feedback, followed by blood glucose screening and/or clinical referral when appropriate?

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* 28. During the past 12 months, did your worksite:
Provide access to any level of payment or reimbursement for participation in a diabetes prevention program for employees and/or family members with pre-diabetes or diabetes?

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* 29. During the past 12 months, did your worksite:
Provide a series of educational seminars, workshops, or classes on preventing and controlling diabetes?

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* 30. During the past 12 months, did your worksite:
Have a written policy prohibiting tobacco use at worksite?

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* 31. During the past 12 months, did your worksite:
Inform employees about health insurance coverage or programs that include tobacco cessation medication and counseling?

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* 32. During the past 12 months, did your worksite:
Refer tobacco users to tobacco- cessation programs? (e.g. PEHP – 1-855-366-7500, pehp.quitlogix.org)

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* 33. During the past 12 months, did your worksite:
Have a written policy or formal communication on breastfeeding/lactation support for employees?

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* 34. During the past 12 months, did your worksite:
Provide a private space (other than a restroom)  that may be used by an employee to express breast milk?

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* 35. During the past 12 months, did your worksite:
Provide flexible paid or unpaid break times to allow mothers to pump breast milk?

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* 36. During the past 12 months, did your worksite:
Provide free or subsidized breastfeeding support  groups or educational classes?

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* 37. During the past 12 months, did your worksite:
Provide an on-site refrigerated space for breastmilk  to be stored?

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* 38. During the past 12 months, did your worksite:
Provide stress management programs?

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* 39. During the past 12 months, did your worksite:
Provide training for employees on identifying and reducing workplace stress-related issues?

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* 40. During the past 12 months, did your worksite:
Sponsor or organize social events throughout the year? (e.g. team building events, company picnics, holiday parties, etc.)

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* 41. During the past 12 months, did your worksite:
Provide dedicated space that is quiet where employees can engage in relaxation activities, such as deep breathing exercises?

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* 42. During the past 12 months, did your worksite:
Provide free or subsidized clinical screening for depression (beyond self-report) followed-by directed feedback and clinical referral when appropriate?

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* 43. During the past 12 months, did your worksite:
Provide a series of educational seminars, workshops, or classes on preventing and treating depression?

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* 44. During the past 12 months, did your worksite:
Provide brochures, videos, posters, pamphlets, newsletters, or other written or online information that address depression?

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* 45. During the past 12 months, did your worksite:
Have a written policy or formal communication which allows employees work leave for preventive exams?

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* 46. During the past 12 months, did your worksite:
Conduct ongoing evaluations of health promotion programming that use multiple data sources? (e.g. employee health risks, medical claims, employee satisfaction, etc.)

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