THE WELLNESSCLINIC APP 1

Introducing The WellnessClinic App

Prepared for
Union General Hospital; Director of Employees; Director of the Nursing Department;
Supervisor of the Nursing Department

Prepared by
Jay Parayno,
Digital Health and Wellness Coordinator
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Date: February 26, 2021

To: Union General Hospital; Director of Employees; Executive Director of the Nursing
Department; Supervisor of the Nursing Department
From: Jay Parayno
Subject: Maintaining and Improving Smoking Habits for Nurses

This report will present a proposal of a solution on maintaining and improving smoking habits for the
nurses that work in the Union General Hospital. As a Digital Health and Wellness Coordinator, I believe
This program can benefit your employees and their overall health within the workplace.

Throughout my experiences in my career, I have developed skills and knowledge that are suitable to
maintain and improve employees’s health and wellness within various healthcare companies. This
responsibility is my top priority and I make sure that both employees and employers are satisfied with the
outcome for each problem or situation.

In order to have the best possible outcome for this program, I excel on developing responsibilities such as:

1. Monitoring the employees well being.

2. Analyzing behavior techniques.
3. Communicating with both employees and employers
4. Capturing data and results.
5. Exploring other opportunities that can help and solve a problem.

Taking the time to read this report can potentially benefit the health and wellness for your employees and
make your workplace environment improve. To the Director of Union General Hospital, Executive
Director of the nursing department, and Supervisor of the nursing department, I appreciate the time and
effort of implementing this program into your workplace.
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Table of Contents

Cover Page………………………………………………………………………………………………….1

Cover Letter………………………………………………………………………………………………...2

Executive Summary………………………………………………………………………………………...4

Proposal Introduction……………………………………………………………………………………….5

The WellnessClinic App……………………………………………………………………………………6

Behavior Change Technique/Strategy……………………………………………………………………...7

Rewards…………………………………………………………………………………………………….8

Peer-Vetting Conclusion…………………………………………………………………………………....8

References………………………………………………………………………………………………….9
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Executive Summary
The purpose of this report is to maintain and improve employee smoking habits, specifically nurses
working in your company, the Union General Hospital. It’s important to know that nurses are one of the
most important healthcare professionals because they are the first to serve professional medical care when
a patient enters a hospital.

In 2012, National Health Interview Survey for adults that are age 18 years old or more that work in health
care facilities smoke cigarettes (Syamlal et al, 2015). 16 percent of 18.9 million healthcare and social
assistance workers were reported cigarette smokers (Syamlal et al, 2015). Evidently, it has been found
that 26.9 percent of nurses are smoking cigarettes (Syamlal et al, 2015). That is basically ¼ of nursing
smokers. I believe that this isn’t relatively new because the nursing job comes with a lot of
responsibilities and stress.

There are three main reasons that may explain why nurses smoke: (Perdikaris et al, 2010).
1. stress caused by the working environment,
2. peer and social influence,
3. socioeconomic status and education.

In order to solve nurses' smoking habits, behavior change techniques or intervention strategies has to be
implemented. With the advanced digital technology, we have the advantage and higher potential for the
employees to participate in this program. Additionally, a reward will be given for those who participate in
the program and it will benefit the employer due to its increased productivity from the nursing employees.
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Proposal Introduction
To identify how many nurses smoke cigarettes, a survey that consists one one question to all nurses
whether they smoke or not. After collecting the data, the ones that said yes would receive an invitation
from their mail or email regarding joining the program of participating in quitting smoking cigarettes. Of
course, in order to gain its interest in participating, a reward is the price of participating in the program.

Also, with the help of technology, it would be easy for all to participate. The WellnessClinic makes its
impact, it is a health app used as a smoking log and monitors how much a person smokes cigarettes on a
daily basis. This consists of a 30 day program/intervention, after this process, we can evaluate whether
this program benefits the employees which results in making the hospital environment better.

It’s important to make sure that nurses are mentally healthy because it affects their productivity within
their workplace. When they are off duty, they search for something that they can relieve their stress from
their work, and smoking cigarettes is one of stress relievers. One of the main reasons why nurses smoke
cigarettes is their worry about their socioeconomic status which can develop anxiety (Perdikaris et al,
2010). Research has found that smoking lowers anxiety and tension because cigarettes contain nicotine
and it creates an immediate sense of relaxation so people smoke in the belief that it reduces stress and
anxiety, this feeling of relaxation is temporary and soon gives way to withdrawal symptoms and increased
cravings (Mental Health Foundation, 2021).

Although smoking cigarettes is a stress reliever it negatively affects the overall body. According to the
CDC, “smoking causes cancer (which can result to death), heart disease, stroke, lung diseases, diabetes,
and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis,
also it increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including
rheumatoid arthritis (Centers for Disease Control and Prevention, 2020).
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The WellnessClinic App

This app can create a group for the nurses and it helps monitor their smoking habits and have the ability to
analyze their behavior. The outcome from this 30 day program is to be smoke-free or decrease the number
of smoking cigarettes. This application comes with an integrated health journal which can make it easier
for the employees to quit smoking. Also, they have the ability to express their feelings of each recorded
data into the application. It will help them to remember how they felt on a certain day, time or event when
they decided to stop smoking. There will be an option or circumstances where they are tempted to smoke
in a certain event and able to rate on a scale on how much they crave cigarettes, and it helps understand
their addiction and potential triggers.

Employees have the time to describe their feelings or general mood when they are engaged with smoking
cigarettes, they can share their feeling of stress, anxiety, and depression. Everyone in the application can
view other nurses' journals or log, similar to the twitter platform. The difference is that it is only viewed
for the people in the group. This can help cope negative emotion from smoking because they will realize
that they aren’t alone with this problem.

The WellnessClinic is available both apple and android which is suitable for everyone, since everyone has
a phone. They can keep tabs with the application with notifications on who is updating their status and
reminding them if they are monitoring their behavior.
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Behavior Change Technique/Strategy

The transtheoretical model aka stages of change is the behavior strategy to use for this intervention. I
believe this is the best method to quit smoking cigarettes due to various reasons. Smoking cessation
treatment is effective and it proves it in the past. Evidently, it has been found that behavioral support can
increase to quit rate to 35 percent (Mallin, 2002). With the support from a healthcare professional, there
will be a high possible chance that a patient will quit smoking cigarettes.

There are 6 stages of the Transtheoretical Model (stages of change) which are:
1. Precontemplation - In this stage, people do not intend to take action in the foreseeable future
People are often unaware that their behavior is problematic or produces negative consequences.
People in this stage often underestimate the pros of changing behavior and place too much
emphasis on the cons of changing behavior (LaMorte, 2019).
2. Contemplation - In this stage, people are intending to start healthy behavior in the foreseeable
future. People recognize that their behavior may be problematic, and a more thoughtful and
practical consideration of the pros and cons of changing the behavior takes place, with equal
emphasis placed on both. Even with this recognition, people may still feel ambivalent toward
changing their behavior (LaMorte, 2019).
3. Preparation (Determination) - In this stage, people are ready to take action. People start to take
small steps toward the behavior change, and they believe changing their behavior can lead to a
healthier life (LaMorte, 2019).
4. Action - In this stage, people have recently changed their behavior and intend to keep moving
forward with that behavior change. People may exhibit this by modifying their problem behavior
or acquiring new healthy behaviors (LaMorte, 2019).
5. Maintenance - In this stage, people have sustained their behavior change for a while and intend
to maintain the behavior change going forward. People in this stage work to prevent relapse to
earlier stages (LaMorte, 2019).
6. Termination - In this stage, people have no desire to return to their unhealthy behaviors and are
sure they will not relapse. Since this is rarely reached, and people tend to stay in the maintenance
stage, this stage is often not considered in health promotion programs (LaMorte, 2019).
*Important to note that the patient has the possibility to relapse in any stage*
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Rewards
After completing and participating in this 30 day program of behavior change. There will be a winner
with its price of a 50 dollar gift card. This can motivate employees to participate because they have the
mind that they will be rewarded from this program. Also, this will boost their motivation and it’s
important for them to have this trait because it develops them to be able to quit smoking cigarettes. In
order to stay consistent with their motivation for participating on the program, I make sure to keep tabs
with them personally by email, conversate with their mental being and how they are feeling about work.

Rewarding them is important because it makes them feel good about themselves, especially having the
ability to quit smoking cigarettes. The process and journey of changing this behavior can be difficult to
various people, specifically the people working in a stressful environment such as the nurses. There are
two types of rewards when one achieves a goal whether its a big or small which are:
1. Extrinsic - coming from the outside, such as buying a CD, going to a spa, getting praise from
others (Fried, 2006).
2. Intrinsic - the reward is in how the action makes us feel: proud, content, victorious (Fried,
2006).

Peer-Vetting Conclusion
The Peer-Vetting classroom session was great to be involved in because it gave me more knowledge on
what I needed to do to improve my proposal. One question that stood out to me was “is there any cost for
this intervention or program?”. Although the app is free, the only expense that is included for this
proposal is the printing supplies materials because of its invitation and having to update with the program.
Before encountering this question, I didn’t realize that realistically there will be cost included and I’m
glad I had that thought in mind for this proposal.

The final question that was asked was if my proposal has a reward. Entering this session, I didn’t prepare
a solution for the reward section for my proposal. And it gave me the idea to reward the participants a 50
dollar gift card award. Also, expanding the reward, it gave me the thought on how to make sure that the
participants stay motivated and engaged with the program. The ability to analyze the part of the
WellnessClinic application where they share their information with their co-workers gives them a sense of
motivation because they are involved with people that has the same behavior change goal.
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References
Centers for Disease Control and Prevention. (2020). Health Effects. Retrieved from
https://www.cdc.gov/tobacco/basic_information/health_effects/index.htm#:~:text=Smoking%20c
auses%20cancer%2C%20heart%20disease,immune%20system%2C%20including%20rheumatoid
%20arthritis.
Fries, A. (2006). Reward Yourself: Celebrating Behavior Change. ValueOptions. Retrieved from
http://www.valueoptions.com/spotlight_heart/html/pdfs/Articles/English/change_management/ma
naging_change_reward_yourself_celebrating_behavioral_change.pdf
LaMorte, W. W. (2019). The Transtheoretical Model (Stages of Change). Retrieved from
https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/behavioralchangethe
ories6.html
Mallin, R. (2002). Smoking Cessation: Integration of Behavioral and Drug Therapies. American Family
Physician. Retrieved from https://www.aafp.org/afp/2002/0315/p1107.html
Mental Health Foundation. (2021). Smoking and mental health. Retrieved from
https://www.mentalhealth.org.uk/a-to-z/s/smoking-and-mental-health#:~:text=Smoking%20and%
20anxiety,it%20reduces%20stress%20and%20anxiety.
Perdikaris, P., Kletsiou, E., Gymnopoulou, E., & Matziou, V. (2010). The relationship between workplace,
job stress and nurses' tobacco use: a review of the literature. International journal of
environmental research and public health, 7(5), 2362–2375.
https://doi.org/10.3390/ijerph7052362
Syamlal, G., Mazurek, J. M., Storey, E., & Dube, S. R. (2015). Cigarette Smoking Prevalence Among
Adults Working in the Health Care and Social Assistance Sector, 2008 to 2012. Journal of
occupational and environmental medicine, 57(10), 1107–1112.
https://doi.org/10.1097/JOM.0000000000000529