MPH INTERNSHIP

PROPOSAL

MPH Internship Proposal

Lindsey Arthur
Cone Health: Employee Health and Wellness Division
Site Preceptor: Megan Norriss

The Health Problem.

Obesity is a worldwide epidemic. As of 2014, 1.9 billion adults (18 years and older) are
overweight and 600 million of those are obese (World Health Organization, 2015). There are
numerous risk factors that are associated with being overweight or obese. A risk factor is any
variable that increases the likelihood of an individual developing a disease or injury (WHO,
2015). Among nurses, obesity is linked with the following risk factors: musculoskeletal diseases,
hypertension and other cardiovascular diseases, type II diabetes, and sleep disorders (Fronteira &
Ferrinho, 2011). Overall, when compared to persons of normal weight, obese persons experience
a 12-fold increase in mortality (Miller et al., 2008). While numerous factors contribute to
overweight and obesity, the vast majority of circumstances are predominantly associated with
modifiable behaviors, such as poor eating habits and sedentary lifestyle (Miller et al., 2008).
In the U.S., almost 54% of nurses, advanced practice nurses, and nurse educators were
found to be overweight or obese. Fifty-three percent attributed this to a lack of motivation for

MPH INTERNSHIP
PROPOSAL

adopting lifestyle changes (Miller, Alpert, & Cross, 2008). Research has shown that although
nurses promote a healthy lifestyle and healthful practices to patients, they, themselves, often
demonstrate poor lifestyle behaviors. This has been attributed to work-related stressors and shiftwork that result in nurses neglecting their own health (Blake, Sumaria, & Mo, 2011). The way in
which nurses perceive their own health statuses, as well as their capability and confidence to
participate in health promotion activities, often directly affects the level of care they provide to
patients (Fronteira & Ferrinho, 2011).
Over 75% of nurses do not consume the recommended five servings of fruits and
vegetables daily. More than 50% disclosed they consumed foods high in fat and sugar at least
once daily (Blake et al., 2011). Participants indicated low levels of self-efficacy and social
support, in regards to family and friends, for healthy dietary practices (Blake et al., 2011). Only
approximately 17% of nurses were reported to consuming a mostly healthy diet, indicating
barriers of cafeteria opening times, lack of selection of healthy food items, and lack of breaks
(Albert, Butler, & Sorrell, 2014).
Despite knowing the benefits of physical activity and an understanding of their role as
health-promoters, health-care staff often fail to meet the recommended guidelines for physical
activity (Mo et al., 2011). Nearly 50% of Registered Nurses (RNs) reported not being physically
active for 30 minutes on most days due to lack of time, lack of motivation, fatigue, and cost
(Bakhshi, Sun, & Murrells, 2015). Lack of social support and self-efficacy were noted as barriers
found to discourage healthcare staff from participating in physical activity as well (Mo, Blake, &
Batt, 2011). Research has indicated that RNs self-efficacy, in regards to health behaviors,
directly and positively predicts their weight-management practices (Bakhshi et al., 2015).
The search strategy used included utilizing the library database located at the University
of North Carolina Greensboro (e.g., EBSCO, PUBMED) using keywords and phrases in regards

to the clinical population and health behaviors. In addition, an expert interview conducted with a
public health doctoral student.
The Non-Health Problem.
The Employee Health and Wellness Division of Cone Health provides online
programming and resources to its employees, to address the following four areas of focus:
building health, fitness, diet, and stress management skills (Cone Health: LiveLifeWell, 2015).
The health issues that are present in the literature, among the nursing workforce, can be
addressed through an on-site weight management program. Research shows that individuals are
more likely to achieve goals when peer support is present (Speroni, 2014). However, at present
time there are challenges related to providing onsite, face-to-face programing. The division
serves over 12,000 employees across three counties (Forsyth, Guilford, and parts of Alamance).
It is staffed by five people: a wellness manager, two wellness coordinators, and two fitness
coordinators. The current employee wellness program, LiveLifeWell, consists of mostly online
tracking and accountability (Norriss & Athas, 2015).
Through the internship, a program that focuses on increasing physical activity to achieve
the recommended guidelines, as well as improving poor dietary habits will be designed. Along
with these outcomes, the risk factors associated with obesity and sedentary lifestyle will decrease
for participants. Research shows that education alone does not necessarily always lead to
behavior change (Mo et al., 2011). Therefore, the program will also address the socio-ecological
factors that may be impeding the employees from reaching and maintaining healthy lifestyles.
SWOT Analysis and Potential Ethical Dilemmas
The mission of the Employee Health and Wellness Division of Cone Health is: To
improve the health and well-being of Cone Health employees and their families through
education, programs and a culture that supports positive lifestyle choices. (Norriss & Athas,
2015).

MPH INTERNSHIP
PROPOSAL

A SWOT analysis is used to identify the internal strengths and weaknesses of an

organization, as well as the external opportunities and threats. The process allows for
organizations to develop strategies to avoid or minimize threats and advance or maximize
opportunities (CDCynergy, 2010).
Factors/
Variables

Positive

Internal

External

Strengths

Opportunities

Online portal to serve large amount of

employees
Staff commitment and loyalty to
employees
Free/discounted services to employees
Weaknesses

Negative

Small staff size for division

Resources
Marketing techniques
Amount of time given to employees for
breaks

Health coaching
Dietician
Fitness classes
Interns
Threats
Employee engagement/participation
Infrastructure
Size of area being served
Funding

After meeting with the wellness manager and the two wellness coordinators, the need for an
on-site, face-to-face program that focused on weight management and incorporated health
coaching strategies was expressed. The team indicated that due to the large amount of employees
that cover the three counties they serve, as well as the lack of staffing, that the online portal
approach for their employee wellness program, LiveLifeWell, has been the most efficient
outreach technique thus far. They also stated that due to the limited amount of break time for
employees, that it is easier for the Cone Health staff to complete activities through the portal due.
However, they believe that offering a face-to-face workshop series, which could address all four
of their focus areas, would be the most beneficial for improving their workforces overall health
and well-being. The staff are allotted a 30 minute break for lunch. The representatives I spoke

with explained that each session of the program designed needed to be around 20 minutes to
allow for travel time for the employees (Norriss & Athas, 2015).
A possible ethical dilemma that may be present with the division and/or internship activities
might be the issues surrounding the interventions messages and the persuasive appeals being
used. The messages of the current and developing interventions must avoid: stigmatizing
employees and their behaviors, placing blame and full responsibility on the staff for their current
medical situations, and conveying a sense of those who do not pursue good health are then
worthless or have vices (CDCynergy, 2010).
A second potential ethical dilemma might be the respect for personal autonomy and
privacy. The employees should be able to make their own decisions based upon what they think
would be best for themselves. The current employee wellness program is online and is said to
protect the confidentiality of participants. Facilitators of the programs must avoid harm through
the actions of trying to help participants and paternalism. The Employee Health and Wellness
Division staff must also adhere to strict protocol with participants disclosed information to
adequately maintain confidentiality and trust (CDCynergy, 2010).
A third dilemma could be the adherence to the equity and fairness of the distribution of
the onsite, face-to-face weight management program. The on-site, face-to-face weight
management program, to be developed during the internship, will have to identify the best tactics
to serve 12,000 employees across all three counties. The current programs through the online
employee wellness program, LiveLifeWell, needs to analyze if the program is serving the
employee population adequately; particularly those who are of the most need (CDCynergy,
2010).
Problem Analysis

MPH INTERNSHIP
PROPOSAL

In order to better understand overweight and obesity in the clinical employee population,
the Social Ecological Model for Health Promotion was used as a framework to identify various
factors, at multiple levels, that contribute to an obesogenic environment (McLeroy, Bibeau,
Steckler, & Glanz, 1988). An obesogenic environment refers to the sum of the impact that the
surroundings, opportunities, or circumstances of life have on promoting obesity among

individuals or populations (Washington State Department of Health, 2008). The SEMHP

examines five levels of influence: intrapersonal, interpersonal, organizational, community, and
public policy. Guided by the SEMHP, a conceptual model was developed to identify contributors
to both the health and non-health problems, as well as to illustrate how the factors impact one
another and contribute to the overall health problem of overweight/obesity among nurses. The
conceptual model addresses the following levels of influence: intrapersonal (individual
characteristics), interpersonal (formal and informal social networks and support systems), and
organizational (employer/worksite) (McLeroy, et al., 1988).

Referring to the conceptual model above, the contributing factors to the health problem of
overweight and obesity and the non-health problem of the lack of on-site, face-to-face
programming have been identified. While numerous factors contribute to overweight and obesity,
not all factors can be addressed for the internship process. From the review of the literature, the
vast majority of contributing factors are predominantly associated with modifiable behaviors,
such as poor eating habits and sedentary lifestyle (Miller, Alpert, & Cross, 2008). By targeting
poor eating habits through a weight management program, theoretically, consumption of high fat
and sugary foods daily will decrease; consumption of fruits and vegetables will increase; chronic
diseases such as: type II diabetes, cardiovascular diseases, and hypertension will decrease; and
social support will increase. By targeting sedentary lifestyle through a weight management
program, hypothetically, the amount of time spent being physically active will increase;
musculoskeletal diseases will decrease; chronic diseases such as: type II diabetes, cardiovascular
diseases, and hypertension will decrease; support in exercising will increase; and self-efficacy in
completing physical activity will increase. Research has indicated that RNs self-efficacy, in
regards to health behaviors, directly and positively predicts their weight-management practices
(Bakhshi, Sun, & Murrells, 2015).
The non-health problem that has been identified for the Cone Health Employee Wellness
Division is the lack of an on-site, face-to-face weight management program (Norriss & Athas,
2015). The most commonly reported barrier to making healthy lifestyle choices was lack of time
(Blake, Zhou, & Batt, 2013). Nurses often neglect their own health as a result of work-related
stressors and shift-work (Blake, Sumaria, & Mo, 2011). At Cone Health, nurses are allotted a 30
minute lunch break, including travel time from the facility (Norriss & Athas, 2015). Addressing
the time barrier through designing and offering a weight management program,that is facilitated

MPH INTERNSHIP
PROPOSAL

in person; to occur within the employees break-times for lunch can help to improve modifiable
behavioral determinants of healthy living (Blake et al., 2013). Providing the program during this
timeframe can decrease work stressors. Offering this type of program, in theory, will increase
motivation; increase social support; increase self-efficacy in completing physical activity and
eating healthy; and decrease work stressors. Research shows that individuals are more likely to
achieve goals when peer support is present (Speroni, 2014). When social support exists, it is
suggested that it may have a direct effect on physical activity by influencing the individuals
engagement; it is also suggested to also have an indirect effect on physical activity through
strengthening the individuals self-efficacy(Mo, Blake, & Batt, 2011).
Previous Attempts
It is important to review the literature on previous interventions that are similar to the one
that will be designed during the internship to understand the successes and failures of the
previous attempts. One study found an increase in the proportion of employees who reported that
they met the recommended guidelines for physical activity, along with an increase in engagement
of incidental physical activities and reduced sedentary behavior. The more active employees
were found to have a lower BMI, improved mood, better general health, higher satisfaction level
with their jobs, more sleep, and were less likely to smoke in comparison to the employees who
were less active. The findings from the study support the approach of wellness programs that
target multiple unhealthy behaviors or lifestyle risk factors (Blake et al., 2013).
Another study that offered weekly exercise, yoga, and nutrition programs found that
frequency and timing, location, and content and activities were where issues lied. The programs
were offered one to two times a week for an hour over a period of 12 weeks. The nurses
perceived barriers to attending the sessions included not being able to leave work for the whole

hour of the program and committing to a series of tightly scheduled programs due to shift-work.
The sessions that focused on cardiovascular training, strength training, stretching, injury
prevention, core strength, portion distortion, and the balance between calories in and out were
deemed most beneficial and applicable by nurses (Speroni, 2014).
A third study found that although nurses are required to learn about nutrition while
completing their coursework, they struggle with translating that knowledge to everyday lifestyle
habits. Providing nurses with nutrition basics has been seen to have a positive impact on
dietary habits of the nurses, as well as the dissemination of the knowledge and practices to their
patients. The sessions were suggested to focus on the important nutrition principles of:
consistency, portion size, and variety of foods to ensure nurses adopted healthier food choices.
The study also addressed the common pitfalls of planning meals, commitment, and occupational
stressors (Reed, 2014).
Impact/Outcome Objectives of Internship Based On Conceptual Model

Interviews with nurses

Interview with preceptor
Outline of the health needs of Cone Health nurses
Development of weight management program curriculum
Workplace health promotion interventions have been found to increase spirituality,

interpersonal relations, physical activity levels, and improve nutrition among nurses (Tucker,
Weymiller, Cutshall, Rhudy, & Lohse, 2012). The Employee Health and Wellness Division of
Cone Healths four areas of focus are: building health, fitness, diet, and stress management skills
(Cone Health: LiveLifeWell, 2015). The internship will work to address the issue of overweight
and obesity among the employees of Cone Health, through an on-site facilitated weight

MPH INTERNSHIP
PROPOSAL

10

management program. It will be challenging to directly measure changes in overweight and

obesity during the internship, therefore the program will target lifestyle risk factors related to the
condition. The objectives of the program will be focused on: increasing the amount of time being
spent physically active; increasing fruit and vegetable consumption while decreasing high-fat
and sugary food consumption; increase social support and self-efficacy through providing an
onsite facilitated option and attending the program with fellow employees; and provide an
opportunity to engage in physical activity and healthy eating habits during the workday to
decrease work related stressors. According to the observation that health behaviors typically
cluster together in individuals, addressing these factors can lead to overall improved health
(Blake et al., 2013).
Internship Activities Plan/Methods
Below is a logic model that describes the important activities, outputs, and outcomes of
the proposed internship (Figure 1). The logic model is intended to read from left to right
(Knowlton & Phillips, 2009). To illustrate the time-frame allotted for activities to be completed,
a Gantt chart is also provided below (Figure 2) (Gantt.com, 2015).
*P.A.= Physical Activity
Inputs
Staff
Time
Equipment/Technolog
y
Materials
Online Employee
Wellness Program
Facility

Activities
Develop script for
interviews
Identify
contributing
factors to
overweight/obesit
y in nurses

Outputs
Completed
semistructured
interviews
with
preceptor
and
employees
Outline of
the needs of
Cone Health
employees
Literature

Short-term Outcomes
Increased awareness of Cone Health
employees health statuses

review

Develop sessions
about dietary
guidelines
Develop sessions
that target
applicable
strategies with
using nutritional
information

Develop sessions
about P.A.
guidelines
Develop sessions
about P.A. types
Develop sessions
about
incorporating P.A.
into lifestyle

Develop sessions
about stressors in
nursing
Develop sessions
about negative
effects of stress
on nurses
performance
levels
Develop sessions
about stress
management
strategies

Fig. 1

Gantt Chart (Project Timeline)

Completed
dietary
habits
portion of
weight
management
program
curriculum

Increased knowledge about dietary

guidelines
Increased self-efficacy in meeting dietary
guidelines
Improved skill set in practicing applying
nutritional information to make healthier
decisions
Increased motivation in eating healthier

Completed
P.A.
portion of
weight
management
program
curriculum
Created an
opportunity
for
participants
to
incorporate
P.A. into life
Completed
stress
management
portion of
weight
management
program
curriculum

Improved attitudes toward healthy food

items
Increased knowledge about P.A. guidelines
Increased self-efficacy in meeting P.A.
guidelines
Increased knowledge about P.A. types
Improved skill set in adding P.A. into
lifestyle
Increased motivation to exercise
Improved attitudes toward P.A.

Increased awareness of common stressors

nurses face
Increased knowledge of how stress
negatively affects the body and
performance at work
Improved skill set in adopting and
practicing stress management strategies
Increased self-efficacy in reducing
perceived overall stress

Increased
social
support

MPH INTERNSHIP
PROPOSAL

Activity
Semi-structured
interviews (preceptor)
Semi-structured
interviews(employees)
Identify contributing
factors
Develop sessions for
dietary habits
portion of curriculum
Develop sessions for
P.A. portion of
curriculum
Develop sessions for
stress management
portion of curriculum
Loose Ends

Fig. 2

12

Weeks
8

10

11

12

13

MPH INTERNSHIP
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14

The internship will be focused on developing a weight management program for implementation.
Before the development of the program begins, a protocol for the semi-structured interviews will
be created. The interviews will occur with both the internship preceptor and the employees of
Cone Health to determine what the perceived health needs of the organization are. The
interviews with the preceptor are anticipated to occur the first week of the internship. To recruit
employees for the interviews, the internship preceptor will be asked to send out a mass e-mail
asking the available employees to meet for interviews. The employee interviews are predicted to
occur during weeks one and two (Figure 2). Not all employees will be reached, but as many as
possible during the first two weeks will be met with to obtain as much of a representative
population response as possible. A literature review to identify the contributing factors to
overweight/obesity among the nursing population, will also take place before the development of
the program curriculum. This is expected to occur within weeks four and five (Figure 2). The
combination of these activities will lead to an increased awareness of the employee population's
health status among The Employee Health and Wellness Division, Cone Health employees, and
myself (Figure 1).
There is intended to be three main areas of focus for the program: healthy dietary habits,
physical activity, and stress management. These areas of focus align with The Employee Health
and Wellness Division of Cone Healths areas of focus, which are: building health, fitness, diet,
and stress management skills (Cone Health: LiveLifeWell, 2015). The development of the
sessions for the weight management program curriculum is where the majority of the internship
time will be spent. Creating the sessions is estimated to transpire across weeks six through
fourteen (Figure 2).

Development of the dietary habits portion of the weight management program

curriculum will involve designing sessions around the recommended dietary guidelines put in
place by the U.S. Department of Agriculture (USDA), as well as applying the knowledge about
nutrition (United States Department of Agriculture, 2015). The result of this section of the
curriculum will lead to: increased knowledge about the USDA recommended dietary guidelines;
increased self-efficacy in meeting those guidelines; improved skill set in applying knowledge
towards buying food items out and preparing foods; increased motivation in eating healthier; and
improved attitudes toward healthy food items (i.e. fruits, vegetables, whole grains, low-fat dairy
products, lean meats, etc.) (Figure 1). This segment is expected to occur between weeks six
through eight. (Figure 2).
Development of the physical activity (P.A.) portion of the weight management program
curriculum will involve designing sessions around the recommended physical activity guidelines
for adults and the different types, published by the U.S. Department of Health and Human
Services (HHS) (Office of Disease Prevention and Health Promotion, 2015). Sessions in this
focus area will also educate participants on ways to incorporate physical activity into daily life,
as well as create an opportunity for them to engage in physical activity. These particular sessions
will transition from education to skill building by providing the participants with the chance to
try different forms of exercise. The result of this section of the curriculum will lead to: increased
knowledge about HHS physical activity guidelines; increased self-efficacy in meeting those
guidelines; increased knowledge about the types of physical activity; improved skill set in adding
physical activity into lifestyle through the opportunity of trying various types of physical
activity; increased motivation to exercise; and improved attitudes toward physical activity
(Figure 1). This segment is anticipated to occur between weeks eight through ten (Figure 2).

MPH INTERNSHIP
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16

Development of the stress management portion of the weight management program

curriculum will involve designing sessions around stressors that are specific to nurses and
clinical staff, how those stressors negatively impact the body and performance levels at work,
and stress management strategies. The result of this section will lead to: increased awareness of
common stressors the employees face daily; increased knowledge of the negative effects stress
has on the body, as well as job performance; improved skill set in adopting and practicing stress
management strategies; and increased self-efficacy in reducing perceived overall stress (Figure
1). This segment is estimated to occur between weeks ten through twelve (Figure 2).
All three areas of focus for the weight management program curriculum is anticipated to
increase social support through participants attending the program, in a supportive environment,
with fellow co-workers who are facing the same obstacles and struggles (Figure 1). Lastly, any
loose ends that need to be addressed for developing the program for implementation are
predicted to occur between weeks thirteen and fourteen (Figure 2).

References
Albert, N., Butler, R., & Sorrell, J. (2014). Factors related to healthy diet and physical activity in
hospital-based clinical nurses. Online Journal of Issues in Nursing, 19(3), 32-48.
Bakhshi, S., Sun, F., & Murrells, T. (2015). Nurses' health behaviours and physical activityrelated health-promotion practices. British Journal of Community Nursing, 26(6), 289296.
Blake, H., Sumaria, M., & Mo, P. e. (2011). Do as I say, but not as I do: Are next generation
nurses role models for health? Perspectives in Public Health, 131(5), 231-239. Retrieved
from http://rsh.sagepub.com.libproxy.uncg.edu/content/131/5/231.full.pdf+html
Blake, H., Zhou, D., & Batt, M. (2013). Five-year workplace wellness intervention in the NHS.
Perspectives in Public Health, 133(5), 262-271.
Centers for Disease Control and Prevention. (2015, October). Workplace Health Site Visit

Interview Quetions. Retrieved from Workplace Health Promotion:

http://www.cdc.gov/workplacehealthpromotion/pdfs/WorkplaceHealthInterviewQuestion
s.pdf
CDCynergy. (2010). Assess factors and variables that can affect the project's direction.
Retrieved from CDCynergy Process Steps Phase 1: Describe Problem:
http://www.orau.gov/cdcynergy/web/ba/Content/phase1/phase1mainframeset.htm
CDCynergy. (2010). Consider SWOT and ethics of intervention options. Retrieved from
CDCynergy Process Steps Phase 2: Analyze Problem:
http://www.orau.gov/cdcynergy/web/ba/Content/phase2/phase2mainframeset.htm
Cone Health: LiveLifeWell. (2015). LiveLifeWell Employee Wellness: Caring for ourselves.
Retrieved from Cone Health: https://livelifewell.conehealth.com/default.aspx
Fronteira, I., & Ferrinho, P. (2011). Do nurses have a different physical health profile? A
systematic review of experimental and observational studies on nurses physical health.
Journal of Clinical Nursing, 20(17-18), 2404-2424. Retrieved from
http://onlinelibrary.wiley.com.libproxy.uncg.edu/doi/10.1111/j.13652702.2011.03721.x/full
Gantt.com. (2015). Creating Gantt Charts. Retrieved from Gantt.com:
http://www.gantt.com/creating-gantt-charts.htm
Han, K., & Trinkoff, A. M. (2011). Job stress and work schedules in relation to nurse obesity.
The Journal of Nursing Administration, 41(11), 488-495.
Knowlton, L., & Phillips, C. (2009). The logic model guidebook: better strategies for great
results. Thousand Oaks: SAGE Publications, Inc.
McLeroy, K., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health
promotion programs. Health Education & Behavior, 15(4), 351-377.
Miller, S., Alpert, P., & Cross, C. (2008). Overweight and obesity in nurses, advanced practice
nurses, and nurse educators. Journal of the American Academy of Nurse Practitioners,
20, 259-265.
Mo, P. K., Blake, H., & Batt, M. (2011). Getting healthcare staff more active: The mediating role
of self-efficacy. British Journal of Health Psychology, 16, 609-706.
Norriss, M., & Athas, J. (2015). Internship Discussion. (L. Arthur, Interviewer).
Office of Disease Prevention and Health Promotion. (2015). Physical Activity Guidelines for
Americans. Retrieved from health.gov: http://health.gov/paguidelines/guidelines/
Reed, D. (2014). Healthy eating for healthy nurses: nutrition basics to promote health for nurses
and patients. The Online Journal of Issues in Nursing, 19(3), Manuscript 7.

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18

Speroni, K. (2014). Designing exercise and nutrition programs to promote normal weight
maintenance for nurses. The Online Journal of Issues in Nursing, 19(3), Manuscript 6.
Tucker, S., Weymiller, A., Cutshall, S., Rhudy, L., & Lohse, C. (2012). Stress ratings and health
promotion practices among RNs. The Journal of Nursing Administration, 42(5), 282-292.
United States Department of Agriculture. (2015). MyPlate. Retrieved from ChooseMyPlate.gov:
http://www.choosemyplate.gov/
Washington State Department of Health. (2008). Models, Factors and Theories of Change.
Retrieved from Partners in Action: Good Nutrition, Active Living & Healthy
Communities: http://depts.washington.edu/waaction/plan/append/a.htmL
World Health Organization. (2015). Obesity and overweight. Retrieved from Media centre:
http://www.who.int/mediacentre/factsheets/fs311/en/
World Health Organization. (2015). Risk factors. Retrieved from Health topics:
http://www.who.int/topics/risk_factors/en/

Appendix A
Script for Interview (Employees)
Interviewer: Introduction
Hi, my name is Lindsey Arthur and I am an intern working for Cone Healths Employee
Wellness Division. Thank you for taking the time to meet with me today. I will be asking you
various questions to determine what your needs are at Cone Health. I will be using this
information to help with the development of an onsite, face-to-face facilitated weight
management program for the Employee Health and Wellness Division to offer for employees. To
make sure that health-related information and programs are tailored to address your health issues
and concerns, I will be talking with different groups of individuals over the next couple of
weeks. There are no right or wrong answers, and it is okay to say I dont know or I rather
would not answer. Please know that your name will not be used in any reports and I will not
quote you directly without your consent to do so. Your permission is completely voluntary, you
may end the interview at any time, and if I ask a question that you would prefer not to answer,
just let me know, and I will skip over it.

Questions
1.
2.
3.
4.
5.

Could you begin by telling me what your job title is?

Are you currently participating in the LiveLifeWell employee wellness program?
If yes, what do you see as the benefits of the online program?
What do you see as the barriers to the program?
Would you be interested in a weight management program that is offered during your
lunch break?
6. Does a 20 minute session seem like a reasonable length of time for each session?
7. What would your ideal timeframe (weeks, amount of sessions) be for the program?
8. What health risks are present? What do you perceive as a health risk?
9. What health issues would you like to see addressed (i.e. dietary habits, physical activity,
stress management, etc.)?
10. Do you believe you would benefit more in reaching your goals through a program offered
on-site versus online?
11. Is there anything else you would like to add about current or future programs offered for
employees?
Thank you for your time and your input. You have provided me with very helpful and useful
information! If you have any questions following the interview please contact me at
lnarthur@uncg.edu.

Appendix B
Script for Interview (Preceptor)
Interviewer: Introduction
Today, I will be asking you various questions to determine what you perceive the health needs
are at Cone Health. I will be using this information to help with the development of an onsite,
face-to-face facilitated weight management program for the Employee Health and Wellness
Division to offer for employees. To make sure that health-related information and programs are
tailored to address the appropriate health issues and concerns, I will be talking with different you,
as well as employees over the next couple of weeks. There are no right or wrong answers, and it
is okay to say I dont know or I rather would not answer. Please know that your name will
not be used in any reports and I will not quote you directly without your consent to do so. Your
permission is completely voluntary, you may end the interview at any time, and if I ask a
question that you would prefer not to answer, just let me know, and I will skip over it.
Questions
1. Could you tell me about the types of program activities that are currently offered?
2. Could you tell me about the types of program acitivities you would be interested in
seeing implemented as part of the Employee Health and Wellness Division?

MPH INTERNSHIP
PROPOSAL

20

3. How do you foresee the structure of an on-site program option (i.e. length of time,
amount of weeks)?
4. What types of sessions do you foresee being covered (i.e. dietary habits, physical activity,
stress management, etc.)?
5. How would such a program be implemented and facilitated (i.e. staffing, budget)?
6. Who is likely to be eligible to participate in the program? Are there specific employee
groups that you would like to reach? Why?
7. Which of the following avenues are used within your organization to communicate
information to employees (internet/website, e-mail, newsletter, bulletin board, mail, etc.)?
8. Is there anything else you would like to add about current or future programs offered for
employees?
Thank you for your time and your input. You have provided me with very helpful and useful
information! If you have any questions following the interview please contact me at
lnarthur@uncg.edu.

Appendix C
Consent Form for Participants
Today, I will be conducting interviews as part of my internship activities to design an on-site,
face-to-face facilitated weight management program for the Employee Wellness Division to offer
to employees. The interviews will allow me and the division to gather opinions and insights into
worksite health. The interviews will help us understand the factors that support and/or hinder the
health of employees at Cone Health and identify opportunities to improve or address them.
The interview is designed to take about an hour for employees. There are no right or wrong
answers, and it is okay to say I dont know or I rather would not answer. Please know that
your name will not be used in any reports and I will not quote you directly without your consent
to do so. Your permission is completely voluntary, you may end the interview at any time, and if
I ask a question that you would prefer not to answer, just let me know, and I will skip over it.
For the Interview Participant
I am aware that my participation in this interview is voluntary. I understand the intent and
purpose of this interview. If, for any reason, at any time, I wish to stop the interview, I may do so
without having to give an explanation. I have the right to decline having the interview recorded.

If I have any questions about the interview, I am free to contact Lindsey Arthur by e-mail at
lnarthur@uncg.edu. I have read the above form and with the understanding that I can withdraw
at any time and for whatever reason, I consent to participate in todays interview.

__________________________________
Signature of Participant
__________________________________
Signature of Interviewer

(Centers for Disease Control and Prevention, 2015)

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Date
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Date