Employee Wellness Newsletter : Corporate Health Promotion Programs: Effective Components

Company America is increasingly investing in employee wellness because it is good business.  In order to meet productivity demands, employers must rely on a healthy, productive workforce to succeed in the highly competitive global marketplace.  Over a hundred research studies in both corporate and governmental settings have documented the economic advantages of Company Wellness Programs, including reduced absenteeism, reduced injuries and workman’s compensation expenditures, reduced health care expenditures, reduced employee 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 program, the greater benefit realized.  To enhance their performance federal government Workplace Wellness Programs may be able to incorporate some of the features described.  Employee wellness programs determined to have beneficial returns on investment frequently include the following features:

1.   Health and productiveness management model
Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors such as smoking, lack of physical exercise, excess weight, unhealthy diet, high cholesterol, high Blood Pressure, stress, depression, and so on.  High-risk employees are specifically targeted for intervention, even though the most efficacious programs also direct efforts towards healthy employees in order 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 appraisal (HRA) instrument with individualized feedback and recommendations is almost universal in thriving programs.  Employees take the questionnaire each year in many cases.  The HRA serves to expand awareness, provide direction, and arouse individuals to better specific behaviors.  In some cases, the customized 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 wellness programs.

3.   Biometric Testing
Many 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 (BP), blood lipids, fasting glucose, and assorted other metrics.  Combining the results of the HRA with biological measures results in a more accurate risk profile.   Computer health risk appraisals frequently incorporate biometric data in their risk analysis.

4.   Incentives
workers are generally given monetary or other important rewards for completing an HRA, participation in a program or class, specific accomplishments such as stopping smoking, losing weight, or exercising, and for maintaining healthy status and/or behaviors.  In many cases the monetary incentives are associated with reductions in medical insurance premiums.  Some programs use disincentives as well as incentives, such as charging workers who smoke higher rates for their medical insurance contribution.

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

6.   Wellness coaching
employees with identified risks or desire to improve their health habits may be periodically coached via phone by trained wellness coaches.  Wellness Coaching helps employees set and achieve realistic lifestyle-related objectives and goals including those discussing stress, work life balance, smoking, weight, physical exercise, and various behavior modifications.  Three or more sessions are generally provided.  In some intensive programs, the coaching extends to actual disease management intervention for employees with identified elevated-risk diseases.

7.   Multiple formats
Programs may offer wellness content in online, paper, and seminar formats to support stimulating variety and alternatives in order to accommodate the needs of all workers.  In addition to on-Site physical exercise and healthy eating programs, on-line programs, e-mail reminders and notices, printed newsletters and materials, and employer sessions are common dissemination strategies.

8.   Senior Leadership support
Enthusiastic and persistent endorsement by upper management is critical to achieving high rates of participation.  When senior executives are wellness role models themselves the effects of endorsement are enhanced.

9.   Frequent contact
Effective programs have successive contact of some sort with every employee.  This may be through marketing efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, employee meeting presentations, discussion in new employee orientation, supervisory sessions, etc.   The key is to enhance employee awareness of health and wellness opportunities and reinforce the corporate emphasis on wellness through successive and multiple “touches”.

10.   Open enrollment
To promote high participation rates employees must have easy access to the wellness programs and activities.  Open and uncomplicated enrollment processes achieve this.  Some corporations automatically enroll all employees and then allow those who do not wish to take part to “opt-out”.  This practice has been determined to boost enrollment rates in some settings.

11.   Family involvement
Many programs advocate spouses and other family members to take part in the corporation 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 if his/her family does so as well.

12.   Smoking cessation
Because smoking and other tobacco use is the number one threat to health it is vital to offer staff members effective and convenient assistance with quitting.  Access to smoking cessation pharmaceuticals is frequently part of such programs.  In-house programs offer the most convenient access to these services, although on-line or phone-based programs may be available as well.  

13.   Exercise
Regular physical activity is a core component of every wellness program.  Workers must be strongly encouraged to engage in regular physical activity.  Most programs provide either periodic or continuous onsite opportunities, and some locations have onsite gyms, swimming pools, walking trails, etc.  Discounted or paid memberships to community exercise facilities is a common alternative to onsite facilities.

14.   Weight management
Because obesity is a major threat to health it is imperative that programs offer effective assistance with weight control.  Robust encouragement from management to shed excess weight is valuable.  Web-based programs, workplace programs, or discounted access to weight control programs in the community may all be available.  Long-term follow-up is essential for maintenance of weight loss.

15.   Stress management
Workplace stress is perhaps the most common complaint among staff members and a primary contributor to absenteeism, presenteeism (reduced productivity), and low morale.  Almost all efficacious wellness programs offer assistance with personal and workplace stress.  Some programs refer staff members to outside resources for more weighty conditions like depression and anxiety disorders, but most offer internet based or frequent worksite general stress reduction programs.  Some organizations endeavor to structure the work environment to minimize stress, both physically and operationally.

16.   Wellness screenings/immunizations
employees are actively encouraged to complete recommended medical care screenings for Blood Pressure, blood lipids, BMI, colorectal and breast cancer, and others.  Annual influenza immunizations are also encouraged.  Some sites offer these services at the workplace.  Incentives are often awarded for completion of these screenings/immunizations.

17.   On-Site health care
Actual provision of onsite primary care medical services is a growing trend.  The rapidly escalating costs of medical care insurance for staff members has stimulated this trend.  Some businesses have found that it is less expensive to support primary care services themselves than to fund those services through health insurance.  Onsite care also reduces the amount of time staff members would otherwise spend away from the workplace getting such services.

References

1.   Aldana, Steven G.  (2001)   Financial Impact of Corporate Wellness Programs:  A Comprehensive Review of the Literature.   Am J Health Promotion 15(5):296-320.
2.   Chapman, Larry.  (1998)   The Role of Incentives in Health Promotion.  The Art of Health Promotion  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 Company Health Promotion Programs Economic Return Studies: 2005 Update.  The Art of Health Promotion, July/August, 1-15.
5.   Chapman, Larry.   (2006)   Employee Participation in Company Wellness Programs and Company Wellness Programs:  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 and Wellness Coaching in Company Wellness Programs.   The Art of Health Promotion, July/August, 1-12.
7.   Chapman, Larry.  (2007)   Proof Positive:  An Analysis of the cost-Effectiveness of Job Site Wellness.  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 Healthy Behaviors for Health Plans and Employers” 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 Business 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 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 comprehensive Health and Disease Management Programs at the Worksite: 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 Disease.  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.