Effective Wellness Programs.

Corporate America is increasingly investing in worker wellness because it’s good corporation.  In order to meet productivity demands, organizations must rely on a healthful, productive workforce to succeed in the highly competitive global marketplace.

Over a hundred studies in both corporate and governmental settings have documented the economic advantages of worker wellness programs, including decreased absenteeism, decreased injuries and workman’s compensation costs, decreased health care costs, decreased worker turnover, as well as increased productivity, greater worker satisfaction, and improved morale.1-10

The more recent literature reflects improvements in wellness programming along with greater return on investment.  In general, the more focused and intensive the wellness program, the greater benefit realized.

To enhance their effectiveness federal government employee health promotion programs could  be able to incorporate some of the features described. Worker health promotion programs shown to have positive returns on investment often include the following features -

1   Health and productivity management model

Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors like smoking, lack of exercise, excess weight, unhealthy diet, high cholesterol, high blood pressure, stress, depression, and so on.

High-risk staff are in particular targeted for intervention, although the most successful health promotion programs also direct efforts towards healthy staff to maintain their low-risk status.  This model emphasizes outcomes as opposed to simply offering wellness activities for their own sake.

2   Health risk appraisal

Use of a computerized health risk assessment  instrument with individualized feedback and recommendations is nearly universal in successful health promotion programs. Employees take the questionnaire annually in many cases.

The Health Risk Appraisal (HRA) serves to increase awareness, provide direction, and motivate individuals to improve specific behaviors.  In some cases, the personalized report is directly linked to appropriate resources related to identified risks.

Research indicates that the use of an HRA is effective if it is followed by some kind of educational or therapeutic intervention for identified risks.  It often serves as the entry point into health promotion programs.

3   Biometric analysis

Many health promotion programs combine the results of the health risk appraisal with measurement of each employee’s biometrics, including weight and Body Mass Index (BMI) , blood pressure, cholesterol, fasting glucose, and assorted other metrics.

Combining the results of the Health Risk Appraisal (HRA) with biological measures results in a more precise risk profile.   Computerized health risk assessments often incorporate biometric data in their risk analysis.

4   Wellness Program Incentives

Workers are frequently given monetary or other significant rewards for completing an HRA, participation in a health promotion program or class, specific accomplishments like stopping tobacco use, losing weight, or exercising, and for maintaining healthy status and/or behaviors.

In many cases the monetary incentives are associated with reductions in health insurance premiums.  Some wellness programs use disincentives as well as incentives, such as charging staff who smoke higher rates for their health insurance contribution.

5   High wellness program participation rates

Successful wellness programs use incentives to drive participation rates up.  They also market their wellness programs extensively, and may use contest or challenge strategies to heighten enthusiasm and encourage participation.

6   Wellness coaching

Employees with identified risks or desire to improve their health habits might  be periodically coached via telephone by trained health Coaches.

Coaching helps workforce set and achieve realistic lifestyle-related objectives including those addressing stress, work life balance, smoking, weight, physical activity, and various behavior modifications.

Three or more sessions are usually offered.  In some intensive wellness programs, the coaching extends to actual disease management (DM) intervention for staff with identified high-risk diseases.

7   Multiple formats

Programs might offer wellness content in online, paper, and seminar formats to provide stimulating variety and alternatives to accommodate the needs of all workforce.

In addition to on-site exercise and healthful consuming events, on-line health promotion programs, e-mail reminders and notices, printed newsletters and materials, and workplace classes and workshops are common dissemination strategies.

8   Senior level management support

Enthusiastic and frequent endorsement by upper-level management is crucial to achieving high rates of participation.  When senior executives are wellness role models themselves the effects of endorsement are enhanced.

9   Frequent contact

Successful health promotion programs have frequent contact of some sort with every worker.  This may  be through marketing efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, staff meeting presentations, discussion in new worker orientation, supervisory sessions, etc.

The key is to enhance employee awareness of wellness opportunities and reinforce the corporate emphasis on wellness through frequent and multiple “touches”.

10   Open enrollment

To encourage high participation rates workers must have easy access to the wellness programs and activities.  Open and uncomplicated enrollment processes achieve this.

Many organizations automatically enroll all staff and then allow those who do not wish to participate to “opt-out”.  This practice has been shown to improve enrollment rates in some establishings.

11   Family involvement

A lot of health promotion programs encourage spouses and other family members to take part in the organization wellness activities and to adopt a healthy lifestyle along with the designated employee. It is far easier for the employee to have a healthy lifestyle when his/her family does so as well.

12   Smoking cessation

Because tobacco use and other tobacco use is the number one threat to health it is crucial to offer staff members effective and convenient assistance with quitting.

Access to smoking cessation pharmaceuticals is usually part of such health promotion programs.  In-house health promotion programs provide the most convenient access to these services, although on-line or telephone-based health promotion programs might  be available as well.

13   Physical Activity

Regular physical activity is a core component of every wellness program. Workers must be strongly encouraged to engage in regular physical activity.

Most wellness programs provide either periodic or continuous on-site opportunities, and some locations have on-site health and fitness centers, swimming pools, walking trails, etc.  Discounted or paid memberships to community exercise facilities is a common alternative to on-site facilities.

14   Weight management

Because obesity is a major threat to health it is critical that programs offer effective assistance with weight control. Comprehensive encouragement from senior management to shed excess weight is important.

Online wellness programs, workplace programs, or discounted access to weight control programs in the community may all be available.  Long-term follow-up is crucial for maintenance of weight loss.

15   Stress management

Workplace stress is perhaps the most common complaint among personnel and a major contributor to absenteeism, presenteeism (reduced productivity), and low morale.

   

Nearly all successful health promotion programs offer assistance with personal and worksite stress.  Some programs refer staff members to outside resources for additional serious conditions like depression and anxiety disorders, but most offer web-based or frequent onsite general stress reduction programs.

   

A lot of businesses endeavor to structure the work environment to minimize stress, both physically and operationally.

16   Health testings/immunizations

Employees are actively encouraged to complete advised medical screenings for blood pressure, cholesterol, Body Mass Index (BMI), colorectal and breast cancer, and others.

Annual influenza immunizations are also encouraged.  Some sites provide these services at the workplace.  Incentives are often awarded for completion of these screenings/immunizations.

17   Onsite health care

Actual provision of on-site primary care medical services is a growing trend.  The rapidly escalating costs of medical care insurance for personnel has stimulated this trend.

Many corporations have found that it’s less costly to provide primary care services themselves than to fund those services through health insurance.

On-Site care also reduces the amount of time workers would otherwise spend away from the worksite getting such services.

References

1   Aldana, Steven G.  (2001)   Financial Impact of Health Promotion Programs –   A Robust Review of the Literature.   Am J Health Promotion 15(5) – 296-320.

2   Chapman, Larry.  (1998)   the Role of Incentives in Wellness.  The Art of Wellness  2(3) – 1-8.

3   Chapman, Larry.   (2003)   Biometric Screening in Health Promotion –   is it Really as Important as We Think?  the Art of Health Promotion  7(2) – 1-12.

4   Chapman, Larry.  (2005)   Meta-Evaluation of Employee Wellness Economic Return Studies –  2005 Update.  The Art of Wellness, July/August, 1-15.

5   Chapman, Larry.   (2006)  Worker Participation in Employee Health Promotion and Health Promotion Programs –  Just how Important are Incentives, and Which Ones work Best?   North Carolina Medical Journal   67(6) –   431-432.

6   Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth.   (2007)   the Role of Health Promotion Coaching in Company Health Promotion.   the Art of Wellness, July/August, 1-12.

7   Chapman, Larry.  (2007)   Proof Positive –   an Analysis of the cost-Effectiveness of Company Health Promotion.  Northwest Health Management Publishing, Seattle, WA.

8   Chapman, Larry.  (2007)   an In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change.   Workshop presentation at the World Research Group “Rewarding Healthful Behaviors for Health Plans and Companys” Conference, Orlando, FL, January 23-24.

9   Edington, Dee.   (2001)   Emerging Research –   A View from One Research Center.  American Journal of Health Promotion 15(5) –  341-349.

10   Edington, Dee W.  (2007)   Health Management as a Serious Company Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.

11   Pelletier, Barbara, Boles, Myde, and Lunch, Wendy.  (2004)  Changes in Health Risks and Be sure to work Productivity.   Journal of Occupational and Environmental Medicine, 46(7) –  746-754.

12   Pelletier, Kenneth R.  (2005)   A Review and Analysis of the Clinical and Cost-Effectiveness Studies of extensive Health and Disease ManagementPrograms at the Workplace –  Update VI 2000-2004.  JOEM 47(10)1051-1058.

13   DeVol, Ross, Bedroussian, Armen, et.  Al.  (2007)  an Unhealthy America –   the Economic Burden of Chronic Condition.  Report released by the Milken Institute.   www.milkeninstitute.org.

14   Partnership for Prevention.  (2008) Investing in Health –   Proven Health Promotion Practices for Workplaces.   http – //www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.