Corporate wellness program and employee wellness program information, tips and resources

Begin a Health Promotion Program for Your Employees Today

The benefits to beginning a wellness program are many.

A few employee health promotion tips to get personnel started on the path to a healthier lifestyle

1. Look around, and determine if staff lead a healthy way of life before beginning an worker health promotion program.

o Just how many staff members dash outside at lunch for a smoke break?
o Would a use of tobacco cessation program help?
o Just how often do the junk food-laden vending machines have to be replenished?
o Is whoever exercising or taking advantage of local walking trails as part of their healthful living goals?

The answers to these questions will give corporations a better idea of the worker health promotion program that’s right for them.

2. Survey staff members to determine their healthy lifestyle habits.

o Are they exercising regularly?
o Eat three square meals a day?
Have regular physicals? Really? Then what planet are they on?

Because we’d love to visit! A wellness program benefits most businesses because staff members do not have the time or energy to stay on top of wellness concerns at work or when they leave the office to go home.

3. Give wellness programs a big kick-off with a healthful living “fair.” Give staff free flu shots, blood pressure checks, cholesterol screenings, body/fat ratio assessments, use of tobacco cessation programs and free mammograms- and contact the local hospital, because there’s plenty more where this came from.

Corporations keep their employees hopping during the week. Give employees a chance to amp up their healthful lifestyle on the business dime. A wellness program is an added benefit that employees get for working for the company!

4. Incent to live- offer money for workers to lose weight, commit to a tobacco use cessation program and usually enjoy a healthier lifestyle.

Make certain to encourage humankind’s innate competitive nature by offering prizes for wellness staff member “winners.” And, encourage a healthier way of life by sponsoring personnel who want to enter a local 5K for charity race, run a marathon or play a sport.

Wellness Program Introduction

The last ten years has brought major changes in employer attitudes toward wellness programs. Interest in self-help and self-care programs has increased as growth in healthcare costs have encroached substantially into profits.

Changes in the organizational structures of health care facilities, particularly the growth of the for-profit health care sector, and the need to contain costs are changing the ways in which purchasers of health care plans are viewing their own efforts toward provision of workplace health care programs and facilities.

Projections for the next decade indicate that wellness programs will continue to become important factors in the provision of healthcare, including prevention activities, for both government and private industry.

In corporations with existing health promotion programs, administrative rationale for sponsoring these activities ranged from improving employee health (28%) to improving employee morale (9.7%).

Programs include interventions associated with safety, health risk appraisal, smoking cessation, blood pressure (BP) control, nutrition programs and stress management. Benefits cited range from improved health and productivity to decreasing healthcare costs.

Demographics of the U.S.  Workforce

o 110 million American Citizens were in the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.

o 44 percent of the 1984 labor force was female; 10 percent was Black.

o The median age of the workforce is 32 years and is expected to raise to 32 years by 2030.

o 57.9 percent of all workers work in organizations with between 2 and 500 employees; 45 percent work in organizations with fewer than 100 workers.  An additional 7.5 million American Citizens are self-employed and 3 million are farmers.

o 18% of all wage and salaried employees in 1985 were union members.            

o 45 percent of all workforce are employed in offices.            

Prevalence of Corporate Health Promotion Activities            

Based on a 1985 survey, almost 66% of workplaces with 50 or more staff had company health promotion activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was            

Health Promotion Program Activities            

Use of tobacco Control          35.60%   

Health Risk Assessment (HRA)    29.50%         

Back Care             28.60%

Stress Management       26.60%      

Exercise             22.10%

Off the Job Accidents    19.80%         

Nutrition             16.80%

Blood Pressure (BP) Control    16.50%         

Weight Control          14.70%   

Workplace size is the strongest indicator of wellness program prevalence.            

Most personnel believe the advantages of their employee wellness activities outweigh the costs, even though few formal evaluations exist.            

The most frequently cited cause for starting wellness programs and perceived benefit from programs is improved worker health.

At most workplaces with activities (85.4%), all personnel meet the requirements to participate. 30% of workplaces with activities offer them to company dependents, and an equal% offer them to retirees.

When workplaces seek outside wellness program assistance, they turn to voluntary, not-for-profit corporations (57.1%), private for-profit providers-consultants (50%), local hospitals (44%), and insurance corporations (43%).

Tobacco use Cessation Programs

Use of tobacco related health problems cost United States businesses $26 billion a year in lost productivity and $7 to $8 billion in tobacco-related health care costs.

Workers who smoke are 50% more likely to be hospitalized than nonsmokers, have 2 times as many job-related accidents as nonsmokers and have absenteeism rates approximately 50% higher than nonsmokers.

People  who smoked an typical of one or more packs of cigarettes per day had 118 percent higher medical costs than nonsmokers.

76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that organizations should restrict use of tobacco to certain areas.

In 1985, 65 percent of smokers, 85 percent of nonsmokers and 78 percent of former smokers, felt that smokers should refrain from smoking in the presence of nonsmokers.

In 1986, 17 states had laws regulating use of tobacco in offices or worksites either in government-controlled offices or offices of private employees.

Examples of tobacco use cessation intervention program used by corporations include

o offering nonsmokers a discount of health and life insurance;

o compensating full or partial fees for tobacco use cessation programs;

o providing cessation programs on organization or shared time;

o giving cash payments to quitters after 6 of 12 tobacco-free months;

o participating in national quit tobacco use days; and

o Adopting a smoke free company policy and establishing deadlines for implementing the policy.

Physical Fitness Programs

An active 55-year-old man can lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related activity has been proven to yield a two- to three-fold difference in cardiovascular deaths between active workers and their more sedentary counterparts.

Additionally bettering strength, balance, and flexibility, fitness programs could reduce  the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost each year as the result of back problems.

Research findings support the notion that workplace fitness plans improve fitness and help reduce other health risks, although results related to improved productivity are weak due to insufficient methods for accurately measuring productivity.

A very small proportion of workplaces have on-site physical fitness facilities.

The majority of workers sponsored physical fitness programs involve skills training such as aerobic dance, low impact aerobics, weight training, preand post-natal exercise classes, and walking/jogging groups.

Some organizations subsidize worker participation in community “Ys,” gyms or other community programs when no onsite facilities are available.

Worksite physical fitness programs could reduce costs to companys by lowering worker health care claims and expenditures.

Individuals  whose weekly exercise was equivalent to climbing less than five flights of stairs or walking less than a half mile, spent 114% more on health claims than those who ascended at least 15 flights of stairs or walked 1 1/2 miles weekly.

Health care costs for obese individuals  are roughly 11% higher than those for thin individuals .

Nutrition and Weight Control

One-third of the United States  population is obese to the extent of reducing their life expectancy.

Improvements in consuming habits can reduce  the risk of serious health problems like high blood pressure and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

The worksite offers a few advantages for nutrition education; support and influence of peers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Workplace nutrition programs can be grouped in 6 wide categories

o cafeteria programs;

o multi-component programs;

o weight control programs;

o cholesterol reduction programs;

o programs for pregnant and lactating women; and

o other nutrition education topics.

Men are less likely to participate in weight-loss programs than are female workforce.

Stress Management

Estimates suggest that 50 percent to 80 percent of doctor visits can be attributed to psychosomatic or stress-related origins.

Company compensates many of the costs related to employee stress, both directly in the form of health care costs and in lower productivity.

Job factors which are associated with stress include

o not authorizing employees to take part in decisions about the work process;

o positions which require more or less skill than the worker has;

o changes in work demands;

o insufficient clarity about expectations and standards; and

o conflict with colleagues or supervisors.

Most workplace stress management programs are implemented as a result of requests from personnel.

Stress management programs focus on three types of skills –  relaxation skills, coping skills, and interpersonal skills.

Workplace stress management programs are often delivered in one of three formats

o seminars conducted by trained experts;

o self-learning tools; and

o personal teaching to assist with self-assessment, planning for changes, learning new skills and responding to life crises.

The two major methods used in worksite stress management programs are

o Teaching people  to reduce the negative physical effects of stress; and

o Teaching individuals  to recognize and control sources of stress at work and in personal life.

Seat Belt Usage

Motor car accidents are the largest single cause of lost work time and on-the-job fatalities of United States company.

Motor automobile accidents account for 27% of all work-related deaths and 45 million days of lost work yearly.

More than 36% of the 11,300 accidental work deaths in 1983 involved cars.

Employees who routinely fail to use seat belts may spend up to 54% more days in the hospital.

Traffic accidents caused about 3 times as many days of restricted activity as any other kind of disability.

Motor automobile crashes cost $15.2 billion in lost productivity, 88 percent of which is attributed to losses from workforce activities and future earnings.

In corporate settings where seatbelt policies, requiring use of belts by anybody riding in a corporation automobile or using a private automobile on corporation corporation, have been enforced, 60% to 90% use has been reported.

Incentive programs, accompanied by education and use requirement restrictions have resulted in 40% to 70% initial usage rates.

Factors influencing the sources of worksite seatbelt programs include

o Active commitment on the part of management;

o clearly defined and well enforced policy of required belt use on the job;

o positive incentives; and

o ongoing education and training programs.

Case Research studies of Wellness Programs

Based on an comprehensive investigation of its comprehensive staff member wellness program, LIVE FOR LIFE, Johnson and Johnson stated the break-even point for the program occurs in year 3 and by year 5 they have a net advantage of $316 per staff member. Their year 9 projected benefit is $677 per staff member.

Workers at four Johnson and Johnson organizations who were exposed to the health promotion program increased their daily energy expenditure in vigorous activity by 104% compared to an increase of 33% among workers at organizations that were offered only an annual biometric screen.

Participants in the United Methodist Publishing House’s wellness program submitted more claims (1.14 per participating worker and .82 for the control in 1984, 1.44 and 1.3 respectively in 1985), but the average cost per claim was less for participants ($316 for participants and $567 for control, in 1984, $262 and $602 respectively in 1985, $270 and $566 respectively in the first four months of 1986).

The United Methodist Publishing House attributes some lower than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the health promotion program even though the results are not conclusive.

In 1985, the Adolph Coors Company conducted a telephone interview of a random sample of its 10,000 workers to determine changes in health practices since the introduction of an worker wellness program 4 years earlier.

The sample of 495 workers was stratified to match the organization profile in terms of age, sex and job description.

The survey stated that 65% of respondents started exercising in the last 4 years, 37% had improved their diets, 20% were regular users of the wellness center, 9% had stopped tobacco use as the result of the corporation’s tobacco use cessation program and regular participants of the wellness center miss an average of 1.96 workdays yearly because of disease or injury compared to 3.08 days for non-participating personnel.

The Coors Corporation also achieved a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 personnel were out of work 7.2 months after a heart attack or bypass operation.

In 1984, cardiac patients were out an average 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an average of 2.6 months, saving $125,000 that year.

Corporate Fitness Programs Improve Staff Member Wellness

Instituting a health promotion program improves the health of staff, decreases employee absenteeism and saves the company money, too. Learn more about starting an employee health promotion program in the office.

Advantages of  Wellness Programs

o A business investment of $100-$150 per employee yearly to participate in an employee wellness program can save companies $300 to $450 for each employee every year, according to Ron Goetzel, Director, Cornell Univ. Institute for Health and Productivity Studies.

The savings can take several years to actualize, says Goetzel, and are seen in reduced health expenditures.

o The Health Promotion Councils of America reported a $24 return for every $1 spent on a organization health promotion program for small corporations.

o As reported by a 2005 survey by the Art of Wellness, businesses who instituted worker health promotion programs realized a 30 percent reduction in healthcare and absenteeism costs in less than four years.

A successful health promotion program starts with corporation leaders. Business owners should lead by example, taking part in their corporation’s corporate exercise initiative and working closely with a wellness coach.

Corporation leaders should make sure workforce are well conscious of their wellness efforts, posting weight loss results or tobacco use cessation results on company intranet or bulletin boards for everyone to see.

Employee Health Promotion Programs that Really Work

o Be certain to encourage employees to kick start their own wellness programs by visiting their physician. A complete physical ought to include information about blood sugar, cholesterol levels and overall health.

o Target specific health-related concerns in a employee exercise initiative. Information about how to fight obesity, smoking, alcoholism and drug abuse must be at the forefront of an worker wellness program, along with related conditions.

o Hire a wellness coach to instruct staff members on how to lead a healthy lifestyle.

o Reward employees for participating in business wellness programs. Let employees accrue wellness points that they can redeem for prizes.

Make the prizes healthy, too- a free massage, private training session with the corporation’s wellness coach or health food gift certificate encourages even healthier way of life options.

o Acknowledge worker health promotion leaders in organization newsletters, in posted bulletins and on the organization intranet.

Corporation Health Promotion Programs Yield Big Results

For business owners who want to increase worker participation in a business health promotion program, consider Johnson and Johnson’s approach.

Faced with only 26% of workforce participating in their employee health promotion program, Johnson and Johnson offered workforce a $500 discount on health insurance costs if they completed a health risk profile.

The number of staff participating in the Johnson and Johnson corporate exercise initiative jumped after they offered the incentive — to more than 93%.

Ron Goetzel encourages those looking to pitch a employee fitness program to company leaders to use basic facts about the advantages of worker wellness programs as part of their argument.

Keep it simple, and share results from other corporation’s staff member wellness program success stories.

Five reasons to have a wellness program   

1   The United States spends more dollars on health care than any other nation yet we aren’t the world’s healthiest

o Largely sedentary   

o Tobacco use is still popular   

o Stress is at epidemic levels (WHO)   

o Alcohol continues to take its toll on Americans   

2   Much of the disease in the United States is preventable

o Tobacco and alcohol are leading causes of death   

o As much as 70 percent of the cost of healthcare is driven by avoidable illness   

3   Healthcare costs continue to rise

o Health Care premiums continue to rise and to be passed on to the employee   

o Healthcare cost are usually the number one benefit cost to most employers    

4   The worksite is an ideal setting to address health and well being

o Most Americans work   

o Poor health habits take a toll on American business   

o Businesss have a vested interest in medical issues.   

5   Research validates that health promotion programs can improve health, save money, and even produce a Return On Investment (ROI).

o Aldana,S.G. (1998). Financial impact of company health promotion and methodological quality of the evidence.  The Art of Wellness. Vol 2, Number 1.   

o Wilson, M.G. (1996). A comprehensive review of the effects of corporate health promotion on medical outcomes –  an update.  The American Journal of wellness. Vol 10, Number 6.   

o Wilson, M.G. (1996). A extensive review of the effects of employee health promotion on medical outcomes –  an update.  The American Journal of wellness. Vol 11, Number 2.   

o Chapman, L.S. Proof Positive –  an analysis of the cost-effectiveness of employee health promotion. 3rd ed. Seattle –  Summex Corporation, 1996.   

o Pelletier, K.R. A review of the health and cost-effective outcomes studies of extensive wellness and illness prevention programs at the workplace –  1993-1995 Update.  The American Journal of Health and Promotion. Vol. 10, Number 5.   

Key Components of a Health Promotion Program   

Physical Health Promotion – Focuses on the development, maintenance, or betterment of one’s fitness   

Sample Physical Wellness Programs / Seminars

o Annual health testing

o Regular exercise

o Good safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

Sample Emotional Health Promotion Programs / Seminars

o Stress management workshops

o Dealing with aging

o Addictive behaviors

o Parenting

Financial Health Promotion – Focuses on bettering the quality of life of staff members by assisting families and individuals in becoming financially stable

Sample Financial Wellness Programs / Workshops

o Financial management

o Savings and Investing

o Credit and Purchasing

o Insurance and Estate Planning

Spiritual Wellness – Focuses on promoting a healthy inner self

Sample Spiritual Wellness Programs / Workshops

o Be certain to encourage daily devotional readings

o Give regular service opportunities

o Give a daily/weekly/monthly chapel (meditation) time during work hours

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

Sample Nutritional Health Promotion Programs / Seminars

o Individual nutritional Assessment

o Individual and group counseling

o Educational classes

o Weight loss wellness programs

Many businesss, as part of their efforts to contain rising health care costs, are beginning health promotion programs variously described as wellness, lifestyle programs, health and productivity management, population health management and, simply, health promotion programs.

The purpose of this article is to consider whether such health promotion programs improve health. If so, do they in turn reduce utilization of health care services and reduce health care expenditures?

The well-liked media have done much to promote the concept of company wellness. Last year, In Business –  Madison1 magazine printed a story accompanied by a table reporting an impressive range of Return On Investment (ROI)

Return on Investment (Per dollar Return On Investment for lifestyle programs)

o Coors $6.15

o Kennecott $5.78

o Equitable Life $5.52

o Citibank $4.56

o General Mills $3.90

o Travelers $3.40

o Motorola $3.15

o PepsiCo $3.00

o Unum Life $1.81

Source –  2004 T.E. Brennan Corporation, as reported

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

Health and Productivity Management

Illness and injury associated with an unhealthful way of life or modifiable risk factors is announced to account for at least 25 percent of worker health care expenditures.

The most significant of these risk factors are stress, tobacco use, overweight or obesity, physical inactivity, excessive alcohol use, and poor nutritional habits.

In the last 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 can improve staff member health, and that workplace health education, health risk management, and benefit counseling should complement standard health insurance benefits.

The intensity of wellness programs range from bulletin board, handout or newsletter information to on-site fitness facilities, health risk reduction classes, and personal way of life change coaching.

Health promotion programs today often include a health risk appraisal  to evaluate each worker’s modifiable risk factors of disease. Program coordinators then target interventions to those that are at increased risk through personal communications and individual follow-up.

Robust wellness programs might include classes on health risk reduction and job safety, fitness and exercise activities, gym memberships, and reductions in co-payments or premiums for workers who adhere to advised biometric testing guidelines.

Along with this, some employers are restructuring health benefits and stimulating employees’ cost-sensitivity when accessing health care.5 These changes are intended to reduce employees’ need for and utilization of health care, yielding reduced group health care costs.

Demonstrated reductions in healthcare expenditures should then provide businesss with a powerful bargaining chip in negotiating lower health insurance plan rates 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. Nevertheless, evidence continues to grow that well-designed and well-resourced wellness and illness prevention programs provide multi-faceted payback on investment.

Coworker-reviewed evaluations and meta analyses show that Return On Investment (ROI) is achieved through improved staff member health, lowered benefit expense, and enhanced productivity.

o Goetzel and coworkers, in their meta-analysis of two dozen articles summarizing economic evaluations of health and productivity management programs, found an typical return of $3.14 per $1 invested in traditional wellness programs.  The Return On Investment (ROI) estimates for the individual wellness programs ranged from $1.49 to $13.7,

o Aldana reviewed 72 articles and concluded that wellness programs achieve an typical Return On Investment of $3.48 when considering health care costs alone, $5.82 per $1 when examining absenteeism, and $4.30 when both outcomes are considered.

o Ozminkowski and collagues conducted a 38 month case study of 23,000 participants in Citibank, N.A.’s health promotion program and reported that within a 2 year period, Citibank realized a Return On Investment between $4.56 and $4.73.10  

Follow-up studies found improvements in the risk profiles of participants, with the high-risk group improving more than the “usual care” group1 thus of more intensive wellness programming.

o Chapman’s 2004 meta-evaluation of 42 studies, ranking overall validity of the studies, reports cost-benefit ratios from $2.05-$4.64.

Furthermore immediately quantifiable cost reductions, researchers have stated a selection of spin-off benefits –  greater productivity, intellectual capacity, and reductions in disability12 and absenteeism.9,13,14,15

Such health promotion programs might also have positive effects on employee perceptions of the organization and employee morale, even among nonparticipants.  These outcomes go beyond savings in direct health care costs to provide non-medical ROI.

Tailoring wellness program to maximize ROI Wellness programs aim to reduce the health risks of personnel 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 workplaces. Insurers and organizations now seek to calibrate their interventions to achieve optimal risk reduction and costeffectiveness.

In 2001, Univ. of Michigan scientists stated on stable trends in health care costs for over 2 million current and former workforce 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 staff members moved from low risk to high risk were much greater than the reduces in costs when groups moved from high risk to low risk. Their conclusion –  Programs designed to keep healthful people healthful will likely provide the greatest return on investment.

On the contrary, Pelletier’s meta-analysis and other health promotion program evaluations18 suggest that individualized risks reduction for high-risk personnel within the context of comprehensive health promotion programming is the critical element in achieving positive clinical and cost outcomes in worksite interventions.

Dose-Response?

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

Most cost-benefit studies have been conducted in big businesses with more than fifty staff. But researchers have shown that similar results can be obtained by small businesses with as few as five staff actively involved in a well-managed wellness program.

Various studies also suggest that even relatively modest levels of participation can achieve substantial wellness program impact. Contrary to reports by the popular media that such wellness programs require more than 70% participation, published reports of at least one case showed positive Return On Investment with 51% participation.

Length of intervention appears to be a more salient variable –  an impact on healthcare costs typically requires three-to five years of health promotion programming.

Future developments

Despite the abundance of positive wellness program evaluations, several caveats remain. Negative results are less likely to be reported or published, therefore biasing the ROI upward.

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

Meanwhile, the preponderance of data and the strength of the published research stand in favor of a positive Return On Investment for wellness programs.

Truly, the corporation case for such wellness programs is now well enough defined that some insurance agents offer discounted rates to corporations that institute or subscribe to wellness programs.

Future questions will focus on how to best to combine extensive and focused interventions, the intensity of elements, and how to calibrate the dose-response model to achieve a target ROI.

Here, businesss, staff, and scientists will need to collaborate to define mutual goals respecting both clinical and cost outcomes.

Sources

1. In Business –  Madison. Madison, WI –  September 2004. p. 39.

2. Anderson DR, Whitmer RW, Goetzel RZ, Ozminkowski RJ, Wasserman J, Serxner S. Health Enhancement Research Organization Committee. American Journal of Wellness 2000; 15(1) –  45-52.

3. Manning J. Wellness movement gains ground among businesses, health insurers. Milwaukee Journal Sentinel. August 19, 2004.

4. Chapman LS. Professional opinions on “best practices” in employee health promotion (WHP).  The Art of Health Promotion Newsletter, July/August 2004 – 1-6.

5. Fronstin, P, and Werntz, R. EBRI Issue Brief No. 267, March 2004. Washington, DC – Staff Member Benefits Research Institute (EBRI).

6. Powell C. Professionals urge businesses to promote worker wellness strategies. Akron Beacon Journal. October 25, 2004.

7. Goetzel RZ, Juday TR, Ozminkowski RJ. AWHP’s Workplace Health, Summer, 1999.

8. Goetzel, RZ. Absolute Advantage. Washington DC – Wellness Councils of America. Vol 1(8); 2002.

9. Aldana SG. American Journal of Health Promotion 2001; 15(5) –  296-320.

10. Ozminkowski RJ, Dunn RL, Goetzel RZ, Cantor RI, Murnane J, Harrison M. American Journal of Health Promotion 1999; 14(1) –  31-43.

11. Ozminkowski RJ, Goetzel RZ, Smith MW, Cantor RI, Shaughnessy A, Harrison M.  The impact of the Citibank, N.A. J Occup Environ Med. 2000; 42(5) –  502-511.

12. Serxner S, Gold D, Anderson D, Williams D. J Occup Environ Med. 2001; 43(1) –  25-29.

13. Riedel JE, Lynch W, Baase C, Hymel P, Peterson KW. American Journal of Health Promotion 2001; 15(3) –  167-191.

14. Edington MD, Karjalainen T, Hirschland D, Edington DW. AAOHN J. 2002 Jan; 50(1) –  26-31.

15. Aldana SG, Pronk NP. J Occup Environ Med. 2001 Jan; 43(1) –  36-46.

16. Pelletier KR. American Journal of Wellness. 2001; 16(2) –  107-16.

17. Edington DW. American Journal of Wellness 2001; 15(5) –  341-349.

18. Leatherman S, Berwick D, Iles D, Lewin LS, Davidoff F, Nolan T, Bisognano M. Health Affairs 2003; 22(2) –  17-30.

19. Erfurt JC, Holtyn K. J Occup Med 1991; 33(1) –  66-73.

20. Serxner S, Anderson DR, Gold D. American Journal of Wellness. 18(4) –  1-6, iii, 2004 Mar-Apr.

21. Serxner SA, Gold DB, Grossmeier JJ, Anderson DR.

As companies today continue to compete in the global economy, cost containment strategies will be increasingly important. Controlling the rising cost of employee ill health is becoming a priority for corporate leaders.

The emerging corporate culture in the United States  is one which has an staff member population centered in health, safety and wellness.

Creating a corporate strategy for wellness and disability management makes good company 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 Health Promotion Program Champion

This individuals ought to be a leader in your business and a strong advocate of health. Normally this is an individual who actively pursues his or her own personal quest for optimal health.

The health promotion program champion must’ve the resources and authority to drive the program forward.  The program champion’s key role is to ensure the strategic plan for health is aligned with the company’s business objectives, strategic focus and organizational values.

For example when the company promotes that “our strength is our people ” the health promotion program must demonstrate how programs will nurture and protect that valuable resource.

2. Form Your Wellness Strategy Team

The Wellness Strategy Team should include decision makers and stakeholders from areas of the organization that can influence health and the corporation’s bottom line.

These areas might include; finance, human resources, training and development, health services, compensation and benefits, staff member assistance services (EAP), marketing and advertising, facilities, safety and health, rehabilitation, cafeteria or food services and the union. A team of six to eight representatives is advised.

The role of the Strategy Team is to create and implement the strategic plan, look for opportunities to promote health, ensure the health promotion program is integrated into key areas of the business, streamline efforts, maximize business resources and health promotion program investigation.

3. Complete an Organizational Health Audit

The purpose of an Organizational Health Audit is to evaluate your existing health promotion programs and services, physical environment and policies and procedures that support health.

It’s also crucial to look at your organizational culture or “how things are done” around the business.

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

4. Analyze Your Corporation’s Cost Pressures

Cost pressures are identified by evaluating  a number of areas including; benefit costs, Workplace Safety Insurance Board (WSIB) claims, drug usage, kind of paramedic claims, absenteeism data and employee assistance program utilization.

This process assists to target areas that may be positively impacted by a wellness program and to provide a baseline for analyzing  change.

5. Conduct a Health Risk Assessment (HRA) or Staff Member Needs and Interest Survey

The next step is to determine your staff member’s health risks, interests and readiness to change. A confidential health risk assessment can accomplish many goals.

It provides a baseline from which to measure personal lifestyle changes, provides staff members with relevant health information, excites staff members to take charge of their health and helps in health promotion program planning.

Most health risk assessments provide individual reports and a corporate report identifying high-risk areas in the corporation.

Many companies prefer to administer customized needs and interest survey to evaluate worker needs.  The benefit of this approach is that the corporation can gather information on the employees’ perceived wellness program needs and interests.

This information may be incorporated into the strategic plan. Administering a recent survey also has the added benefit of fostering a sense of worker ownership to the wellness program.

6. Develop Your Strategic Plan for Wellness

The strategic plan should incorporate information accumulated from the Organizational Health Audit, your corporation’s cost pressures, and health risk appraisal data or staff member survey results.

The strategic plan should include your health promotion program mission, three or four goals and a few health promotion programs under each objective.  The strategic plan provides a framework to encourage, support and evaluate “best health practices.”

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

The sample strategic plan that follows was developed for blue jeans maker Levi Strauss and Co. (Canada) Inc. Levi Strauss and 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 and Co.’s aspirations include the following statement –  Above all, we want satisfaction from accomplishments and friendships, balanced personal and expert lives, and to have fun in our endeavors.

The wellness program plan included a number of components to ensure that it embraced this statement including the following

1. A vision statement, which tied in with the corporation’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 and Co. locations to ensure a fun environment.

5. Opportunities to take part in small group educational wellness programs to foster team support.

6. Initiation of support groups for personnel completing wellness programs (i.e. smoking control support group).

7. Programs dealing with work and family balance.

Other information that was investigated and used to create the plan included –

1. Corporation demographics

2. Focus groups

3. Cultural audit

4. Top drug report

5. EAP utilization

6. Employee benefit services report

7. Health and dental claims

8. Operational performance summaries

9. Health risk appraisals

7. Put together a Corporation Case to Support Your Plan

Your business case for wellness provides the necessary details for approval at the executive management level.  The business case includes

1.  The Strategic Plan for Health

2. A proposed health promotion program budget

3. Marketing and Advertising strategies

4. Program leadership options

5.  An implementation plan

6. Analysis methodology.

In presenting the strategic plan it’s crucial to highlight how the plan aligns itself with the strategic direction of the organization.

The health promotion program budget should include educational resources, marketing and advertising costs, rewards and incentives, leadership costs and supplies.

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

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

The wellness program implementation plan should incorporate the following kinds of programs that help develop awareness of positive health practices, assist workers in making way of life changes and initiatives, which support long-term change.

Awareness wellness programs develop an understanding of the importance of healthy way of life practices and motivate workers to take the next step. Examples of awareness wellness programs include posting educational posters, newsletter articles and brown bagger seminars.

Lifestyle change wellness programs are more comprehensive and longer in duration. They’re designed to assist employees in changing behavior. Examples of lifestyle change wellness programs are nutrition education programs, stress management programs, back care courses and smoking control programs.

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

Investigating the effectiveness of wellness is ongoing. A formal investigation ought to be conducted yearly and could include; re-administering steps three to five, health promotion program participation statistics and a year end survey to revisit “soft” issues such as morale, health promotion program satisfaction and future health promotion program direction.

8. Solicit Input and Communicate Your Plan

Worker input is critical to the long-term success of your health promotion program.  An Worker Advisory Committee should be formed to roll out the plan. One more key responsibility of this team is to solicit feedback from all levels of the business to ensure buy-in.

Front line Manager’s Information Sessions and focus groups are also important. This group needs to buy-in to the notion that they play a key role in supporting positive health practices.

Regular meetings are recommended with front line managers to receive ongoing input, address issues and orient new managers.

Conclusions

The World Health Corporation’s definition of health is “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.”

In order for us to create healthy worksites, wellness programs need to have have a wellness program champion, have worker ownership, be upper management supported, results driven and strategically aligned with the overall company objectives of the company.

Wellness program that embrace these qualities will have a positive impact on an organization’s bottom line. Canadian research points to many case studies where on-site wellness programs have resulted in reduced absenteeism, lower claims and increased productivity.

Organizations who have embraced wellness as part of “how they do business” have one thing in common. They demonstrate a commitment to their most valuable resource – their people .

They understand the increased pressures associated with downsized companies, a rapidly changing workplace, an aging work force and the challenge of balancing work and family obligations.  And they share a common belief that healthful workers are happier, absent less and more productive.

References

Design of Wellness Programs by Michael P. O’Donnell. 1995. Published by the American Journal of Wellness.

Pro Fit-ability by Veronica Marsden. Group Healthcare Management. May 1997.

Meeting Expectations by Laura Mensch. Worker Health and Productivity. August 1999

7 Steps to Wellness 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 improve upon your current wellness program?

The list below provides “best practices’ that can easily help meet any wellness program budget! the Health Promotion Program ideas are divided into topic areas.

General Health Promotion Progam Ideas

o Policy – Conduct an Worker Needs and Interest Survey

o Policy – Develop a management/employee Health Promotion Committee

o Policy – Select heath plans that cover costs for weight control and smoking cessation

o Policy – Waive co-pay or reimburse for preventive healthcare visits

o Program – Display handouts on a variety of wellness topics for staff members to take

o Program – Establish a wellness resource center or library with videos, books, magazines, DVD’s on a selection of topics of interest to employees

o Program – Identify workforce who are mentors or champions for healthful activities and ask them to present or to list as a contact for other employees

o Program – Plan and promote periodic or regular educational sessions.

o Program – Plan monthly educational sessions on the national health observance topic

o Program – Post a Wellness Bulletin Board and update it monthly

o Program – Promote messages from national health observances during the month

o Program – Publish and/or post healthy tips in newsletters, paycheck stuffers, bulletin boards, etc.

o Program – Sponsor a benefits fair

o Program – Sponsor business fitness and healthy eating challenges

o Program – Sponsor company wellness fairs or other on-site events

Nutrition Programs

o Policy – Make available free, healthy snacks for employees (fruit, nuts, popcorn)

o Policy – Give healthy meal choices in cafeterias and at company events

o Policy – Provide information to staff members about the nutritional content of food served in the cafeteria

o Policy – Start a fresh fruit “snack basket” in the breakroom or cafeteria

o Policy – Stock vending machines with healthier options

o Policy – Subsidize healthy foods in the cafeteria or vending machines (10

Biometric screenings are important wellness programs to identify chronic illness in their early stages. Once identified, wellness intervention programs may help prevent a disease from progressing.

Working with local hospitals and other corporations, you can obtain information on providing screening and intervention programs that could improve your employees’ health and save your corporation money in absenteeism, treatment for disease complications, and reduced productivity.

Below are some ideas to help get you started.

Based on your Staff Member Needs and Interest Survey and the demographics of your worksite, consider providing periodic screenings to find specific health risks like

o Blood Pressure (BP) Checks to identify workforce with pre-hypertension or hypertension (high blood pressure),

o Cholesterol Screenings for total, HDL (good cholesterol), LDL (bad cholesterol) and/or Triglycerides

o Blood Sugar Screenings fasting or non-fasting to screen for possible diabetes,

o Body composition, like BMI  or body fat measures

o Bone density for potential risk of osteoporosis,

o Cancer screenings such as, skin investigations, mammograms, or PSA screenings,

o Vision checks for glaucoma, or visual acuity

o Other screenings depending on your staff member population and needs

Your local hospital, corporation doctor practice, or health department my provide assistance. However, if you’ve a young workforce you might want to concentrate on wellness programs that will keep them healthful rather than screening for early identification of chronic condition.

The focus of your wellness program may  be healthy way of life practices to reduce risk and prevent disease.

In addition to the medical screenings, consider giving a Health Risk Assessment (HRA) to all staff members.  The Health Risk Assessment (HRA) 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 psychological health.

Oftentimes the screening results are included on the Health Risk Appraisal, which provides a more comprehensive snap shot of health risks.  The summary results provide the important information to plan appropriate interventions.

Health Promotion Program Interventions

The key to the success of screenings and Health Risk Appraisals (HRAs) is the interventions or follow-up programs.  The information from the screenings increases awareness and often excites workforce to consider making healthier changes.

It’s the follow up interventions that provide the essential support and assistance needed for personnel 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 change programs, and/or organizational support. Examples include

o Strategies to lower blood pressure

o Managing diabetes

o Taking care of your heart

o Healthy eating

o Weight loss strategies

o Increasing physical activity

o Smoking Cessation

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

Based on the results and your Health Promotion Committee goals you are able to plan the best strategies for your business and workers. Consider the community resources available to provide services, such as health associations, hospitals, health care providers, and/or public health agencies.

Health Risk Appraisals (HRAs), are an assessment tool or questionnaire scientifically designed to identify health risks and outline information to assist individuals in making healthful changes that impact their health and prevent chronic condition.

Health Risk Appraisals (HRAs) have four standard elements in workplace settings

o A Questionnaire

o A Computerized Program to Evaluate Health Risk

o Confidential Individual Reports

o Group Summary Report

Individuals complete a way of life questionnaire that includes for instance nutrition practices, height and weight, exercise habits, family history, stress perceptions, tobacco use history, and work satisfaction.

An additional important feature to consider is readiness to change questions to determine participation interest. Including medical testings like cholesterol and blood pressure causescreases the advantages of an Health Risk Appraisal (HRA) by providing a more exact health assessment and therefore improving way of life choice decisions and health promotion program choices.

However, it’s crucial that you determine if the Health Risk Appraisal (HRA) may be used without including this information.

The questionnaire information is entered into a computer program and a personal confidential report is generated that summarizes health risks as well as information on how to lower risk factors.

Individual reports are completely confidential. Depending on the reason for starting the Health Risk Appraisal, it’s crucial that you consider the kind of report the business will receive as well.

A group report summarizing major risk factors and recommendations for wellness programs to start for reduce staff member and organization risks provides valuable information for your wellness program.

The HRAs can be used to

o Bring awareness to individual staff member’s health status

o Motivate employees to make healthier lifestyle changes

o Coach high-risk employees

o Plan wellness programs based on the identified needs

o Evaluate health promotion program success by comparing Health Risk Appraisals (HRAs) completed at set intervals such as annually.

You’ll find many benefits to considering a part-time or full-time occupational health nurse (OHN). Occupational health nursing is the specialty practice that provides for and delivers safety and health programs and services to employees, and staff member populations.

The occupational health nurse 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.

Occupational health nurse roles can include Case management, Counseling, Wellness, 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 enhance the health of all your employees. They’re subject matter professionals who may  be a asset regardless your health promotion program needs and goals.

They could help form a Health Promotion Committee and implement many of its health promotion programs and services, for example or depending on the structure and time commitments of your Health Promotion Committee, they can also coordinate the entire health promotion program as well.

Integrating the activities of the Committee and/or Wellness Professional services within your operations, including within your safety and occupational medical program will provide additional benefits!