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Recognizing that the production metaphor best fits the stages of normal culture production, Heirich shows how scientific, artistic, and religious modes of inquiry build upon societal roots to produce cultural breakthroughs of revolutionary character.

Background. Worksite wellness programs vary considerably in their design. This study tested four models to compare effectiveness at controlling high blood pressure, obesity, and cigarette smoking. Methods. Baseline screening was conducted in four manufacturing plants. Site 1 offered screening only, with referral recommendations for those found to have CVD risks. Site 2 also provided health education information and classes. Site 3 added routine follow-up counseling and a menu of intervention types, and Site 4 added social organization within the plant. Random samples of 400 to 500 employees were rescreened at the end of three years. Results. Major improvements in risk levels were found with the addition of routine follow-up counseling and a menu of interventions (Sites 3 and 4, compared with Sites 1 and 2). More hypertensives entered treatment and showed greater reductions in blood pressure. Participation in worksite weight loss and smoking cessation programs was significantly increased, and those who participated showed significantly better maintenance of improvements where follow-up was provided. Discussion. The program models that offered short-term interventions promoted through local media suffered in comparison with models that included personal outreach to people at risk, a variety of health improvement intervention modalities, and ongoing follow-up counseling to help people make decisions and sustain health improvements.

Findings are presented from a study to compare four types of worksite wellness programs to reduce cardiovascular risks. Using a quasi-experimental design, the study was implemented in four large manufacturing plants, similar in demographic characteristics. At the end of the three-year study period, the two sites that included individual outreach and counseling had engaged about 46 percent of identified smokers and 54 percent of the overweight into smoking cessation and weight loss activities, respectively. This compares with fewer than 10 percent at the site offering health education classes only, and less than one percent at the control site. In order to achieve these results, the outreach and follow-up counseling was coupled with a menu of interventions for smoking cessation and weight loss, to accommodate the needs of people who cannot or will not participate in classes. The menu includes guided self-help, one-to-one counseling, mini-groups, and full classes.

Health educators, medical personnel, and managers interested in worksite efforts to change health behaviors often face problems in communicating effectively with rank and file members of the workforce. This article describes an effective strategy for getting health information flowing among an industrial workforce and changing health behaviors. Identifying effective communication routes at a worksite and creating new ones, establishing relationships with key information carriers, and making health information salient to potential communicators are keys to successful information flow. Wellness Committees can provide access to formal communication routes, which may or may not work for health information. One-to-one counseling and development of buddy systems, however, create short-link, health-oriented communication networks. If people whom large numbers of employees contact for plant business get recruited into these health networks, information spreads rapidly. Poster posting can generate interaction with people so that they read and talk about health messages. Unusual motion, sound, and messages can call attention to special events. Using these methods has increased participation in specific health activities from a handful to between fifty and one hundred people at a time.