Winston Salem WellnessWinston Salem Wellness – Winston Salem Health Promotion

Five reasons to have a wellness program

1.   The U.S. spends more dollars on medical than any other country yet we are not the world’s healthiest
   • Largely sedentary
   • Tobacco use is still popular
   • Stress is at epidemic levels (WHO)
   • Alcohol continues to take its toll on American citizens

2.   Much of the illness in The U.S. is avoidable
   • Tobacco and alcohol are leading causes of death
   • As much as 70% of the cost of health care is driven by avoidable illness

3.   Healthcare costs continue to rise
   • Health Care premiums continue to rise and to be passed on to the employee
   • Medical Care costs are usually the number one benefit cost to most employers

4.   The worksite is an ideal setting to address health and well being
   • Most Americans work
   • Poor health habits take a toll on American Organizations
   • Employers have a vested interest in health related problems.

5.   Research validates that Company Health Promotion Programs can better health, save money, and even produce a ROI.
   • Aldana,S.G. (1998). Financial impact of Corporate Health Promotion Programs and methodological quality of the evidence. The Art of Health Promotion. Vol 2, Number 1.
   • Wilson, M.G. (1996). A accross the board review of the effects of Workplace Health Promotion Programs on health related outcomes: An update. The American Journal of health promotion. Vol 10, Number 6.
   • Wilson, M.G. (1996). A comprehensive review of the effects of Corporate Health Promotion Programs on health related outcomes: An update. The American Journal of health promotion. Vol 11, Number 2.
   • Chapman, L.S. Proof Positive: An analysis of the cost-effectiveness of workplace wellness. 3rd ed. Seattle: Summex Corporation, 1996.
   • Pelletier, K.R. A review of the health and cost-effective outcomes studies of inclusive health promotion and disease prevention programs at the worksite: 1993-1995 Update. The American Journal of Health and Promotion. Vol. 10, Number 5.

   
Key Components of a Company Health Promotion Program

Physical Wellness – Focuses on the development, maintenance, or improvement of one’s physical fitness

Sample Physical Employee Health Promotion Programs / Workshops
• Annual health assessment
• Regular physical exercise
• Good safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

Sample Emotional Workplace Health Promotion Programs / Workshops
• Stress management workshops
• Dealing with aging
• Addictive behaviors
• Parenting

Financial Wellness – Focuses on improving the quality of life of workers by assisting families and people in becoming monetarily stable

Sample Financial Workplace Health Promotion Programs / Workshops
• Financial management
• Savings and Investing
• Credit and Purchasing
• Insurance and Estate Planning

Spiritual Wellness – Focuses on promoting a healthy inner self

Sample Spiritual Workplace Health Promotion Programs / Workshops
• Promote daily devotional readings
• Give regular service opportunities
• Provide a daily/weekly/monthly chapel (meditation) time during work hours

Nutritional Wellness – Will meet the needs of the workers through group and individual nutritional services

Sample Nutritional Worksite Health Promotion Programs / Workshops
• Individual nutritional Assessment
• Individual and group counseling
• Instructional classes
• Weight loss programs

Many employers, as part of their efforts to contain rising health care expenditures, are launching worksite programs variously described as Employee Wellness Programs, lifestyle programs, health and productivity management, population health management and, simply, wellness programs.

The purpose of this article is to consider whether such programs better health. If so, do they in turn cut utilization of healthcare services and cut healthcare expenditures?

The popular media have done much to reward the concept of business wellness. Last year, In Business: Madison magazine printed a story accompanied by a table reporting an impressive range of returns on investment (ROI):

Return on Investment (Per dollar ROI for lifestyle programs)
• Coors $6.15
• Kennecott $5.78
• Equitable Life $5.52
• Citibank $4.56
• General Mills $3.90
• Travelers $3.40
• Motorola $3.15
• PepsiCo $3.00
• Unum Life $1.81
Source: 2004 T.E. Brennan Employer, as published

Would these ROIs stand up to rigorous empirical analysis of the data? What factors produce such disparate returns among these programs? And does the published literature, subject to peer review of scientific methods, support the ROIs published here?

Health and Productivity Leadership

Illness and injury associated with an unhealthy lifestyle or potentially-modifiable risk factors is stated to account for at least 25 percent of employee healthcare expenditures. The most significant of these risk factors are stress, tobacco use, overweight or obesity, physical inactivity, excessive alcohol use, and poor nutritional habits. Over the past two decades, a variety of groups at the local, state, and national levels have promoted the concept that health risk reduction and care management programs are able to improve employee health, and that worksite health education, health risk management, and benefit counseling ought to complement standard healthcare insurance benefits.

The intensity of Company Health Promotion Programs range from bulletin board, pamphlet or newsletter information to workplace fitness facilities, health risk reduction classes, and personal lifestyle change coaching.3 Company Health Promotion Programs today frequently include a health risk assessment (HRA) to evaluate each employee’s modifiable risk factors of disease. Program coordinators then target interventions to those that are at increased risk through personal discussions and individual follow-up.

Complete Workplace Wellness Programs may include classes on health risk reduction and job safety, fitness and exercise activities, health club memberships, and reductions in co-payments or premiums for staff members who adhere to recommended healthcare screening standard procedures.

Along with this, some employers are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing medical care.5 These changes are intended to reduce employees’ need for and utilization of medical care, provideing reduced group medical care expenditures. Demonstrated reductions in medical care expenditures must then support employers with a powerful bargaining chip in negotiating lower health insurance premiums during future terms.

Evidence basis: A range of return on investment estimates

The empirical research has produced results as varied as the popular media on ROI. Nonetheless, evidence continues to grow that well-designed and well-resourced Employee Wellness Program and disease prevention programs support multi-faceted payback on cost. Peer-reviewed evaluations and meta analyses show that ROI is achieved through improved worker health, reduced benefit expense, and enhanced work rate.

• Goetzel and colleagues, in their meta-analysis of two dozen articles summarizing economic evaluations of health and productivity management programs, saw an average return of $3.14 per $1 invested in traditional Employee Wellness Programs. The ROI estimates for the individual programs ranged from $1.49 to $13.7,8
• Aldana reviewed 72 articles and concluded that Company Wellness Programs achieve an average return on investment of $3.48 when thinking of healthcare costs alone, $5.82 per $1 when examining absenteeism, and $4.30 when both outcomes are considered.
• Ozminkowski and collagues conducted a 38 month case study of 23,000 participants in Citibank, N.A.’s health management program and published that within a 2 year period, Citibank realized a return on investment between $4.56 and $4.73.10  Follow-up studies saw improvements in the risk profiles of participants, with the elevated-risk group improving more than the “usual care” group11 as a result of more intensive programming.
• Chapman’s 2004 meta-evaluation of 42 different studies, ranking central validity of the different studies, reports cost-benefit ratios from $2.05-$4.64.

In addition to immediately quantifiable expense reductions, researchers have stated a variety of spin-off benefits: greater productivity, intellectual capacity, and reductions in disability12 and absenteeism.9,13,14,15 Such programs may also have positive effects on employee perceptions of the company14 and worker morale, even among nonparticipants. 13 These outcomes go beyond savings in direct health care costs to support non-health related ROI.

Tailoring program to maximize return on investment Worksite Health Promotion Programs aim to reduce the health risks of staff members at high risk while maintaining the health status of those at low risk. A variety of disease management interventions are available to fit the specific risk profiles of various worksites. Insurers and businesses now seek to calibrate their interventions in order to achieve optimal risk reduction and costeffectiveness.

In 2001, University of Michigan researchers reported on stable trends in health care costs for over 2 million current and former workers in an 18 year data set. The mean cost increase per risk factor gained ($350) was found to be more than double the mean cost decrease per eliminated risk factor ($150). In other words, increases in costs when groups of workers moved from low risk to high risk were much greater than the decreases in costs when groups moved from high risk to low risk. Their conclusion: Programs designed to keep healthy people healthy will likely offer the greatest return on investment.

On the other hand, Pelletier’s meta-analysis16 and other program evaluations18 suggest that individualized risks reduction for high-risk workers within the context of inclusive programming is the vital element in achieving positive clinical and expense outcomes in worksite interventions.

Dose-Response?

Several factors might affect the effect of various programs and the ultimate ROI, including cultural and environmental factors, workforce demographics, level of participation and longevity of the program.

Most cost-benefit research studies have been conducted in large companies with more than fifty employees. But researchers have established that similar results have the potential to be obtained by small companies with as few as five employees actively involved in a well-managed program.

Various studies also suggest that even relatively modest levels of participation can achieve substantial program influence. Contrary to reports by the popular media that such programs require more than 70 percent participation, published reports of at least one case showed positive return on investment with 51 percent participation.

Length of intervention appears to be a more salient variable: an effect on health care expenditures generally requires three-to five years of programming.

Future developments

Despite the abundance of beneficial program evaluations, several caveats remain. Negative results are less likely to be reported or published, thus biasing the return on investment upward.

Uncertainty persists regarding the specific impact of the various program components. But as these programs take hold, further research and evaluation will enable fine-tuning of program investments.

Meanwhile, the preponderance of data and the strength of the published research stand in favor of a beneficial return on investment for Company Wellness Programs. Indeed, the company case for such programs is now well enough defined that some insurance brokers offer discounted rates to employers that institute or subscribe to wellness programs.

Future questions will focus on how best to combine comprehensive and focused interventions, the intensity of components, and how to calibrate the dose-response model to achieve a target ROI. Here, employers, workers, and researchers will need to collaborate to define mutual objectives in terms of both clinical and expense outcomes.

As companies today continue to compete in the global economy, expenditure containment strategies will be increasingly valuable. Controlling the rising expenditure of employee ill health is becoming a priority for corporate leaders. The emerging corporate culture in the U.S. is one which has an employee population centered in health, safety and wellness.

Creating a corporate plan for Employee Health Promotion Programs and disability management makes good business sense. The following eight-step process ensures a strategic, integrated, needs-driven and results-oriented approach.

The following process works best in companies with strong leadership and a long-term commitment to employee health.

1. Identify Your Employee Health Promotion Program Champion

This person ought to be a leader in your organization and a strong advocate of health. Usually this is an individual who actively pursues his or her own personal quest for good health.

The program champion must have the resources and authority to drive the program forward. The program champion’s key role is to ensure the strategic plan for health is in line with with the organization’s objectives, strategic focus and organization values. For example if the organization promotes that “our strength is our people” the wellness program must show how drives will nurture and protect that valuable resource.

2. Form Your Worksite Wellness Program Strategy Team

The Workplace Health Promotion Program Strategy Team ought to include decision makers and stakeholders from sections of the business that can impact health and the company’s bottom line. These areas may include; finance, human resources, training and development, health services, compensation and benefits, employee assistance services (EAP), marketing, facilities, health and safety, rehabilitation, cafeteria or diet services and the union. A team of six to eight representatives is recommended.

The role of the Strategy Team is to cultivate and implement the strategic plan, look for opportunities to encourage health, be sure the program is integrated into key areas of the organization, streamline efforts, maximize business resources and program evaluation.

3. Complete an Employer Health Audit

The purpose of an Organization Health Audit is to evaluate your existing programs and services, physical environment and policies & procedures that support health. It is also important to look at your employer culture or “how things are done” around the employer.

Participants of the Strategy Team complete the Audit independently and then meet to discuss their assessment. During the assessment process, health problems and opportunities are discussed in preparation for the development of the strategic plan.

4. Analyze Your Organization’s Cost Pressures

Cost pressures are identified by analyzing a number of areas including; benefit costs, Workplace Safety Insurance Board (WSIB) claims, drug usage, type of paramedic claims, absenteeism data and EAP utilization. This process helps to target areas that have the potential to be positively impacted by a Worksite Wellness Program and to offer a baseline for evaluating change.

5. Conduct a Health Risk Appraisal or Employee Needs & Interest Survey

The next step is to determine your employee’s health risks, interests and readiness to change. A confidential health risk appraisal can accomplish a myriad of objectives and goals. It supports a baseline from which to measure personal lifestyle changes, supports staff members with relevant health information, motivates staff members to take charge of their health and assists in program planning. Most health risk appraisals offer individual reports and a corporate report identifying high-risk areas in the corporation.

Many employers choose to administer customized needs and interest survey to evaluate employee needs. The benefit of this approach is that the company is able to gather information on the employees’ perceived wellness needs and program interests. This information can be incorporated into the strategic plan. Administering a survey also has the added benefit of fostering a sense of employee ownership to the program.

6. Develop Your Strategic Plan for Wellness

The strategic plan should incorporate information gathered from the Business Health Audit, your organization’s expense pressures, and health risk appraisal data or employee survey results. The strategic plan should include your program mission, three or four objectives and several initiatives under each objective. The strategic plan supports a framework to encourage, reinforcement and evaluate “best health practices.”

It is also important that the plan align itself with the vision, goals and objectives of the organization.

The sample strategic plan that follows was developed for blue jeans maker Levi Strauss & Co. (Canada) Inc. Levi Strauss & Co.’s mission statement and aspirations (how staff members interact with each other in a organization environment) guided the development of the plan.

Levi Strauss & Co.’s aspirations include the following statement: Above all, we want satisfaction from accomplishments and friendships, balanced personal and professional lives, and to enjoy our endeavors. The wellness program plan included a number of components to make sure that it embraced this statement including the following:

1. A vision statement, which tied in with the company’s aspirations.
2. An incentive system to encourage and reward the accomplishment of healthy milestones.
3. A recognition system to applaud success.
4. Friendly competitions between Levi Strauss & Co. locations to ensure a fun environment.
5. Opportunities to participate in small group educational programs to develop group support.
6. Initiation of support groups for workers completing wellness programs (i.e. smoking control support group).
7. Programs concerning work and family balance.

Other information that was analyzed and used to develop the plan included:

1. Company demographics
2. Focus groups
3. Cultural audit
4. Top prescription drug report
5. EAP utilization
6. Employee benefit services report
7. Health and dental claims
8. Operational success summaries
9. Health risk appraisals
7. Prepare a Employer Case to Support Your Plan

Your corporation case for wellness supplies the necessary details for approval at the upper management level. The corporation case includes:

1. The Strategic Plan for Health
2. A proposed program budget
3. Marketing strategies
4. Program leadership options
5. An implementation plan
6. Evaluation methodology.

In presenting the strategic plan it is important to highlight how the plan aligns itself with the strategic direction of the organization.

The program budget should include educational resources, marketing expenditures, rewards and incentives, leadership expenditures and supplies.

Marketing strategies should address how the program will be promoted and rolled out to various groups within the organization i.e. decentralized locations, high risk staff members, older staff members.

Program leadership should address how volunteers will be used, internal resources  and whether consultants have been proposed. All play an equally valuable role in the implementation of your wellness program.

The program implementation plan ought to incorporate the following types of programs that help foster awareness of beneficial health practices, assist  staff members in making lifestyle changes and pushes, which support long-term change.

Awareness programs create an awareness of the effect of healthy lifestyle practices and innervate staff members to take the next step. Examples of awareness programs include posting educational posters, newsletter articles and lunch and learn seminars.

Lifestyle change programs are more all-inclusive and longer in duration. They are designed to assist  workers in changing behavior. Examples of lifestyle change programs are diet education programs, stress management programs, back care classes and smoking control programs.

A supportive corporate environment encompasses everything from corporate policies & procedures, the physical environment and creating a corporate culture that supports good health practices. Follow-up sessions and support groups for workers who have completed 6-10 week wellness programs also provide a supportive environment for long-term change.

Reviewing the effectiveness of a Corporate Wellness Program is ongoing. A formal assessment should be conducted annually and may include; re-administering steps three to five, program participation statistics and a year end survey to revisit “soft” issues such as morale, program satisfaction and future program direction.

8. Solicit Input and Communicate Your Plan

Employee input is critical to the long-term performance of your program. An Employee Advisory Committee must be formed to roll out the plan. Another key responsibility of this group is to solicit feedback from all levels of the organization to ensure buy-in. Front line Manager’s Information Sessions and focus groups are also valuable. This group needs to buy-in to the notion that they play a key role in supporting positive health practices. Regular gatherings are advised with front line managers to receive ongoing input, address issues and orient new managers.

Conclusions

The World Health Organization’s definition of health is “a state of complete physical, mental and social wellness and not merely the absence of disease and infirmity.” In order for us to establish healthy workplaces, wellness initiatives must have a program champion, have employee ownership, be management supported, results driven and strategically aligned with the overall corporation objectives of the organization.

Wellness program that embrace these qualities will have a beneficial impact on an organization’s bottom line. Canadian research points to a myriad of case studies where worksite programs have resulted in lowered absenteeism, cut claims and increased productivity.

Corporations who have embraced wellness as part of “how they do business” have one thing in common. They confirm a commitment to their most valuable resource – their people. They understand the increased pressures associated with downsized corporations, a rapidly changing workplace, an aging work force and the challenge of balancing work and family obligations. And they share a common belief that healthy workers are happier, absent less and more beneficial.

References:
Design of Workplace Wellness Programs by Michael P. O’Donnell. 1995. Published by the American Journal of Health Promotion.
Pro Fit-ability by Veronica Marsden. Group Healthcare Management. May 1997.
Meeting Expectations by Laura Mensch. Employee Health and Productivity. August 1999
7 Steps to Health Promotion by Daphne Woolf and Veronica Marsden. Group Healthcare Management. February 1996.
Published in The Journal of Health Promotion for Northern Ireland, Issue 9, March 2000

Want some wellness program ideas and wellness policy ideas to get you started? Or maybe you want to jump start or better upon your current wellness program? The list below provides ‘best practices’ that can help meet any wellness program budget! The Workplace Health Promotion Program ideas are divided into topic areas.

General Wellness Progam Ideas

• Conduct an Employee Needs & Interest Survey
• Develop a Company Wellness Program Committee
• Identify medical plans that cover costs for weight management and smoking cessation
• Remove co-pay or reimburse for preventive healthcare visits
• Put up pamphlets on a variety of wellness subject matters for workers to take
• Develop a wellness resource center or library with videos, books, magazines, DVD’s on a variety of topics of interest to staff members
• Identify staff members who are mentors or champions for healthy activities and ask them to present or to list as a contact for other staff members
• Develop and reward periodic or regular educational sessions.
• Create monthly educational sessions on the national health observance topic
• Post a Wellness Bulletin Board & update it monthly
• Post messages from national health observances during the month
• Publish healthy tips in newsletters, paycheck stuffers, bulletin boards, etc.
• Develop a benefits fair
• Organize company fitness and healthy eating challenges
• Sponsor corporation health and wellbeing fairs or other on-Site events

Nutrition Programs

• Provide free, healthy snacks for staff members (fruit, nuts, popcorn)
• Offer healthy meal choices in cafeterias and at organization activities
• Provide information to employees about the nutritional content of food served in the cafeteria
• Develop a fresh fruit “snack basket” in the breakroom or cafeteria
• Stock snack machines with healthier options
• Partially fund healthy foods in the cafeteria or snack machines (10¡ apples may be more appealing than $1.00 candy bars)
• Start a weekly or monthly healthy lunch club
• Provide brochures available on a variety of healthy eating issues
• Include nutrition articles in organization newsletters
• Have a healthy meal tasting contest Free
• Provide educational sessions at lunchtime-time on a variety of nutrition subject matters of interest
• Develop an employee healthy meal cookbook. Either sell the cookbook and use profits for programs, or purchase a cookbook for all workers

Weight Loss Programs / Weight Management Programs

• Consider offering flexible work schedules so that staff members can participate in weight-loss programs
• Subsidize registration costs for weight-management programs
• Provide a support group to help staff members who are trying to lose weight
• Arrange for registered dieticians near your worksite as a resource for employees who want information on healthy eating, meal planning or weight management
• Offer individual counseling for employees trying to lose weight
• Provide workplace fitness and weight-management programs through your local hospital, Weight Watchers, TOPS or local, registered dietician
• Provide an educational session on diet myths and healthy eating

Physical Activity Programs

• Provide flexible work schedules to encourage exercise
• Design a fitness space with aerobic equipment, and weights
• Design accessible walking paths, trails, and/or bike routes
• Encourage staff members to walk more by parking farther away from the entrance
• Design a fitness center with aerobic equipment, weights, aerobic classes, fitness professionals
• Hold walking meetings
• Make the stairwells more appealing (carpet, fresh paint, artwork, posters)
• Provide reduced fitness center membership fees to all staff members
• Give facilities for staff members to secure bikes
• Provide 5 – ten minute stretch breaks during the day
• Partially fund fitness center membership for workers who take part a minimal number of days per week (ex., 3 days per week)
• Support lunchtime walking/running clubs or company sports team
• Urge stairwell use and incentives and rewards
• Install a basketball hoop outside
• Urge & support neighborhood walks or fitness events
• Urge walking during breaks and other off-time periods
• Offer periodic fitness incentive programs to encourage physical activity
• Schedule educational sessions on fitness activities

Smoking Cessation Programs / Tobacco Cessation Programs

• Organize a smoke-free grounds
• Create a tobacco-free workplace
• Encourage the use of 1-800-QUIT-NOW, North Carolina’s no cost Tobacco Use Quitline. Or check www.QuitlineNC.com
• Reimburse staff members for tobacco replacement products
• Subsidize the cost of smoking cessation classes
• Give handouts and information on health effects from tobacco use and tobacco cessation
• Provide awareness sessions to excite workers to try to quit tobacco use
• Have workplace tobacco cessation seminars

Employee Health Screening

• Discount health insurance premiums or lower co-payments for employees who take part in screenings and who take part in managing their risk factors
• Install Blood Pressure monitoring equipment
• Offer flu shots for workers and family members
• Provide Health Risk Assessments to all workers, including counseling and follow-up
• Provide periodic Blood Pressure (BP) screenings and follow-up
• Provide periodic screenings for blood lipids, blood glucose, body composition, etc.

Stress Management Programs / Work Life Balance Programs

• Provide flexible schedules for family/work life balance
• Provide and encourage an Employee Assistance Program
• Offer information on substance abuse prevention
• Offer handouts and information on stress management and mental health
• Offer handouts and information on work life balance, such as monetary planning, childcare, parenting, elder care, etc.
• Offer supervisor and manager training on communication, relationship building, organization stressors, etc.
• Assess company policies and work schedules to identify company stressors
• Review the EAP to make sure it is meeting the needs of the workers and company
• Schedule educational sessions on stress management and work life balance
• Provide courses on relaxation, stress management, and work life balance subject matters

Health screenings are significant programs to identify chronic disease in their early stages. Once identified, wellness behavior modification programs can help prevent a disease from progressing. Working with local hospitals and other businesses, you can obtain information on offering evaluation and behavior modification programs that could improve your employees’ health and save your organization money in absenteeism, treatment for disease complications, and reduced productiveness. Below are some ideas to assist you in getting started.

Based on your Employee Needs & Interest Survey and the demographics of your workplace, consider offering periodic screenings to find specific health risks such as:

• Blood Pressure Checks to identify staff members with pre-hypertension or hypertension (high blood pressure),
• Cholesterol Screenings for total, HDL (good cholesterol), LDL (bad cholesterol) and/or Triglycerides
• Blood Sugar Screenings fasting or non-fasting to screen for possible diabetes,
• Body composition, such as body mass index (BMI) or body fat measures
• Bone density for potential risk of osteoporosis,
• Cancer screenings such as, skin examinations, mammograms, or PSA screenings,
• Vision checks for glaucoma, or visual acuity
• Other health screenings depending on your worker population and needs

Your local hospital, company physician practice, or health department may support assistance. However, if you have workers you may want to concentrate on programs that will keep them healthy rather than screening for early identification of chronic conditions. The focus of your wellness program might be healthy lifestyle practices to lower risk and prevent disease.

In addition to the wellness screenings, consider offering a Health Risk Appraisal / Health Risk Assessment to all staff members. The Health Risk Appraisal / Health Risk Assessment will help to identify factors that may lead to additional risks, such as smoking history, stress levels, perception of health, family history, job satisfaction, support systems, and mental health. Often the screening results are included on the Health Risk Appraisal / Health Risk Assessment, which supports a more accross the board snap shot of health risks. The summary results support the valuable information to plan appropriate interventions.

Worksite Wellness Program Interventions

The key to the effectiveness of screenings and Health Risk Appraisals / Health Risk Assessments (HRA’s) is the interventions or follow-up programs. The information from the screenings increases awareness and often motivates workers to consider making healthier changes. It’s the follow up interventions that provide the important backing and assistance needed for workers to actually make and maintain those changes. The interventions can include individual follow-up and ongoing counseling, individual or group health coaching on the risk factors, behavior modification programs, and/or organization backing. Examples include:

• Strategies to lower Blood Pressure (BP)
• Managing diabetes
• Taking care of your heart
• Healthy eating
• Weight loss strategies
• Improving physical activity
• Smoking Cessation

Of course, this is for individual information only. Any follow-up interventions planned by the organization would be based on interest expressed by the employee.

Based on the results and your Worksite Wellness Program Committee goals and objectives you have the potential to plan the best strategies for your company and workers. Consider the area resources available to provide services, such as health associations, hospitals, healthcare providers, and/or public health agencies.

Health Risk Appraisals / Health Risk Assessments, are an assessment tool or questionnaire scientifically designed to identify health risks and outline information to assist  Americans in making healthy changes that impact their health and prevent chronic conditions.

Health Risk Appraisals / Health Risk Assessments have four standard components in worksite settings:
• A Questionnaire
• A Computer Program to Review Health Risk Factors
• Confidential Individual Reports
• Group Summary Report

Staff Members complete a lifestyle questionnaire that includes for example nutrition practices, height and weight, exercise habits, family history, stress perceptions, smoking history, and work satisfaction. Another significant feature to consider is readiness to change questions to determine participation interest. Including health screenings such as cholesterol and Blood Pressure (BP) results increases the benefits of an Health Risk Appraisal / Health Risk Assessment by offering a more accurate health assessment and therefore improving lifestyle choice decisions and program options. However, it is significant to determine if the Health Risk Appraisal / Health Risk Assessment can be used without including this information.

The health risk questionnaire information is entered into a computer program and an individual confidential report is generated that summarizes health risks as well as information on how to reduce risk factors. Individual reports are totally confidential. Depending on the reason for implementing the Health Risk Appraisal / Health Risk Assessment, it’s significant to consider the type of report the business will receive as well. A group report summarizing major risk factors and recommendations for programs to implement in order to reduce employee and business risks supports significant information for your wellness program.

The Health Risk Appraisals / Health Risk Assessments (HRA’s) have the potential to be used to:
• Raise awareness to individual employee’s health status
• Encourage employees to make healthier lifestyle changes
• Coach elevated-risk staff members
• Develop Workplace Health Promotion Programs based on the identified needs
• Assess program effectiveness by comparing Health Risk Appraisals / Health Risk Assessments (HRA’s) completed at set intervals such as yearly.

There are many advantages to considering a part-time or full-time occupational and environmental health nurse (OHN). Occupational health nursing is the specialty practice that supplies for and delivers health and safety programs and services to employees, and worker populations. The practice focuses on promotion and restoration of health, prevention of illness and injury, treatment of work and non-work related injuries and illnesses, and protection from work related  and environmental hazards.

Onsite Heath Professional roles can include: Case management, Counseling, Workplace Wellness Program, Legal and regulatory compliance, Clinical services, and Hazard detection and controls. The American Association of Occupational and Environmental Health Nurses is the national association, www.AAOHN.org. The State Chapter also has a website with information including local chapter information to help you find a contact near you, www.NCAOHN.org.

Health educators can design, conduct and evaluate activities that help better the health of all your staff members. They are subject matter experts who may be a significant asset regardless your program needs and goals. They can help form a Corporate Health Promotion Program Committee and implement countless of its programs and services, for example or depending on the structure and time commitments of your Corporate Health Promotion Program Committee, they can also coordinate the entire program as well. Integrating the activities of the Committee and/or Corporate Health Promotion Program consultant services within your operations, including within your safety and occupational health program will offer additional benefits!

We are organizing Worksite Health Promotion Programs to help you feel better and maintain your health. In order to plan programs that best meet your needs and interests we would like your suggestions! Please take a few minutes to answer some questions about your interests. Your answers will be combined with those of others’ and reviewed to help plan programs for you. Do not sign your name.

Please complete the survey today and return it to__________. Thank you for your significant input! Your help is significant for planning efficacious programs. Return the completed form by _____________.

Rate your interest on a scale of 1 – 3 with one (1) being of little or no interest; two (2) being of some interest and three (3) indicating that you are very interested. Indicate your response by circling or ‘Xing’ the number.

I am interested in:

Participating in wellness programs before work 1 2 3
Participating in wellness programs after work 1 2 3
Participating in wellness programs during my lunch break 1 2 3
Adopting healthy eating options to lose weight 1 2 3
Sports nutrition 1 2 3
Healthier cooking 1 2 3
Helping my children eat healthier 1 2 3
Quick, healthy meals for hectic lifestyles 1 2 3
Healthy snack options 1 2 3
Learning how to quit smoking 1 2 3
Attending classes to help me quit smoking cigarettes 1 2 3
Stress Mangement skills 1 2 3
Balancing work, family, and personal life 1 2 3
Time management skills 1 2 3
Participating in a beginning fitness program 1 2 3
Planning time to exercise for busy people 1 2 3
Getting health information that I can read or watch at home 1 2 3
Learning about cancer prevention 1 2 3
Heart health options 1 2 3
CPR and First Aid 1 2 3
Team sports activities at work 1 2 3
Learning how to stretch 1 2 3
Learning how to increase intake of fruits and vegetables 1 2 3
Parenting Topics (age of children: ) 1 2 3
Onsite exercise classes: walking Yoga aerobic other: 1 2 3
Health assessment such as Blood Pressure, cholesterol, blood glucose 1 2 3

Program evaluation may be The last step, but it should be planned at the onset of your efforts!  Evaluation helps you identify what parts of the program are working well and what parts need improvement.  Then, based on the evaluation data, adjustments can be made to fine-tune your wellness program.   Adjusting the program based on evaluation data is critical to its continued success.  

Analyzing your program need not be complicated.  However, it is valuable to plan how you will monitor your wellness efforts and determine success during the planning phase or Step 5.  Also keep in mind to evaluate the program based on the goals you already identified during your planning process.  

In order to evaluate your program you must have a system to document specifics as you progress.  This can be as simple as maintaining file folders on programs that are offered, or a computer document with a table or spreadsheet summarizing information collecting.  Consider:

• Program topic and numbers of workers who participated
• The numbers of pamphlets taken by workers or distributed and on what subject matters
• The number of participants in a behavior modification program and how many met their objectives and goals as well as how many attended all of the sessions
• Numbers of staff members who continued the healthy behavior change following the program?
• Overall employee satisfaction with the program or each topic.  

Depending on your goals and objectives, gather desired data and compare it to previous data collected during the initial assessment to determine if the goals and objectives were met.  Such data might include

• Absentee rates
• Injury rates
• Health risk factors Insurance expenditures  

Summarize and Report Employee Health Promotion Program Results

Once you have collected all of the evaluation information it needs to be reviewed with the Workplace Wellness Program Committee and summarized.  You will probably have positive results and some areas where a change is needed or additional focus needed for continuous improvement.  This not-so positive information can be used to make any needed adjustments as well as to plan for next year and is important to include in your report.  

It is important to communicate the wellness program results to both senior staff and workers.  Consider how senior staff usually receives reports on operations and productiveness problems and include the annual wellness program report in the same format.  At some employers the reports are made during senior staff meetings using presentation styles such as power point slides.  At other employers, graphs and bar charts are the norm or a list of the objectives and the summary outcomes published.  

No matter the format, it’s significant to convey the outcomes and successes achieved, including any anecdotal stories, as well as areas for improvement.  Be sure to link the outcomes to the company mission and bottom line whenever possible.

Staff Members want to receive the same information!  Consider using the same communication channels used when informing staff members of the wellness program:

• Employer newsletters,
• Bulletin boards,
• E-mails  

Also consider celebrating successes and recognizing achievements by:

• Posting pictures from events
• Highlighting success stories
• Posting pictures of successes
• Scheduling a celebration
• Recognizing champions  

Armed with data, Company Wellness Program topic preferences and goals and objectives – and a Company Wellness Program Committee eager to get things done – it is now time to decide how best to take action.  This website supplies tools to help you!  You can read about the different types of wellness programs offered by other corporations to get an idea of what might work for your corporation.  There are Statewide Resources listed along with national non-profit groups offering resources, and particular examples of resources available on various wellness issues.  In addition, keep looking under Steps to an Effective Program for ideas to get you started!

If your planning phase was well executed, you should simply have to follow through with the plans you have already made.  

Important Company Wellness Program considerations include:

1. Formally Introduce the Worksite Wellness Program and consider policy statements that state the effect of the wellness program.  Examples include a general policy concerning the responsibility to employee health and safety as well as specific policies such as No Smoking, Healthy Eating and Physical Activity.
2. Communicate Your Program: The best planned program with great wellness programs will not be productive if your workers don’t know about it or do not be aware of the options or how to participate.  Communicate your wellness program using a variety of methods to ensure the message and “how-to’s” are heard!

   Company Wellness Program Communication Strategies might include:

   • Newsletter articles
   • Postings on the company’s intranet or internet
   • A designated Champion of the program
   • Formal or informal meeting to announce program, “the kick-off”
   • Flyers / pamphlets / brochures / table tents,
   • Bulletin boards / kiosk where all material is promoted or found,
   • Email / phone messages,
   • Mailings or distributions  

3. Use Workplace Wellness Program Incentives:  You’ll be amazed to discover what most of us will do for a no cost T-shirt.  Incentives are able to both support and innervate participation among employees.  Consider both formal or company incentives and rewards and informal or program rewards/prizes from local resources to reinforce participation in Workplace Wellness Programs. Either way, it’s valuable to offer incentives and rewards that are enticing and meaningful to your employees.

   Formal Company Health Promotion Program Incentives:

   • Savings on employee healthcare insurance premiums or co-pays, or contributions to 401K programs, employee stock options, or other mechanisms.  
   
   Click here for more information on health plan incentive ideas
   
   • gym/Fitness Center discounts or enrollment fee coverage
   • Public transportation vouchers
   • Flexible work time options
   • “Wellness Days” off work  

   Prizes or Informal Company Health Promotion Program Incentives:

   • Cash – a most effective incentive!
   • Prize incentives and rewards such as gift certificates to healthy restaurants; media player to use while working out, emergency kits, or any other prizes that would excite your employees.
   • T-Shirts, water bottles, or other inexpensive rewards

4. Assess neighborhood resources available to provide some of the wellness services.  The local health department or your organization medical care provider may be able to help  you with this information.  There are also vendors throughout the State providing excellent wellness services for companies.  They are available to assist you when strategizing and find the best options available.

5. Implement your program as planned documenting information and outcomes as you go such as numbers of participants, dates of activities, and any other special details you are tracking.