Wellness Program Incentives

Establish a Corporation Company Wellness Program for Your Staff Members Today

The benefits to starting a workplace health and wellness program are abounding.

A few corporate health & wellness tips to get staff members started on the path to a healthier lifestyle:

1. Look around, and determine if staff members lead a healthy lifestyle before starting an Worksite Wellness Program. How many staff members run outside at lunch for a smoke break? Would a smoking cessation program help? How often do the junk food-laden snack machines must be replenished? Is anyone exercising or taking advantage of local walking trails as part of their healthy living objectives and goals? The answers to these questions will give organizations a better idea of the Worksite Wellness Program that’s right for them.

2. Survey employees to evaluate their healthy lifestyle habits. Are they exercising regularly? Eat three square meals a day? Have regular physicals? Really? Then what planet are they on? Because we would love to visit! A corporate wellness program benefits most employers because employees don’t have the time or energy to stay on top of health & wellness problems at work or when they leave the office to go home.

3. Give Employee Wellness Programs a big kick-off with a healthy living “fair.” Provide staff members no cost flu shots, Blood Pressure checks, blood lipid screenings, body/fat ratio assessments, tobacco cessation programs and no cost mammograms- and contact the local hospital, because there’s plenty more where this came from. Businesses keep their staff members hopping during the week. Give staff members a chance to amp up their healthy lifestyle on the employer dime. A corporate health & wellness program is an added benefit that staff members get for working for the employer!

4. Incent to live- offer cash money for staff members to lose weight, commit to a smoking cessation program and generally enjoy a healthier lifestyle. Encourage humankind’s innate competitive nature by offering prizes for health & wellness employee “winners.” And, bolster a healthier lifestyle by sponsoring staff members who want to enter a local 5K for charity race, run a marathon or play a sport.

Introduction to Worksite Health Promotion Programs

The previous ten years has brought primary changes in organization attitudes toward Workplace Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in health care costs have encroached substantially into profits. Changes in the organization structures of health care facilities, in particular 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 worksite health care programs and facilities. Projections for the next decade indicate that worksite health programs will continue to become significant factors in the provision of health care, including prevention activities, for both government and private industry. In employers with existing Workplace 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 assessment, smoking cessation, Blood Pressure (BP) control, nutrition programs and stress management. Benefits given range from improved health and productivity to lowering health care costs.

Demographics of the American Workforce
• 110 million Americans composed the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.
• 44 percent of the 1984 labor force was female; ten percent was Black.
• The median age of the workforce is 32 years and is expected to increase to 32 years by 2030.
• 57.9% of all workers work in companies with between 2 and 500 workers; 45% work in companies with fewer than 100 workers. An additional 7.5 million American citizens are self-employed and 3 million are farmers.
• 18% of all wage and salaried staff members in 1985 were union participants.
• 45% of all workers are employed in offices.

Prevalence of Worksite Wellness Programs Activities

Based on a 1985 survey, almost 66 percent of worksites with 50 or more staff members had Corporate Wellness Programs activities in 1985.  The frequency of workplace-based activities by selected categories in 1985 was:

Activity

Smoking Control       35.6 percent
Health Risk Assessment    29.5 percent
Back Care             28.6%
Stress Management       26.6 percent
Exercise             22.1%
Off the Job Accidents    19.8 percent
Nutrition             16.8%
Blood Pressure Control    16.5%
Weight Control          14.7 percent

Worksite size is the strongest indicator of program prevalence.

Most workers believe the advantages of their Worksite Health Promotion Programs activities outweigh the costs, although few formal evaluations exist.

The most frequently cited reason for starting programs and perceived benefit from programs is improved employee health.

At most worksites with activities (85.4%), all workers are eligible to take part. 30% of worksites with activities offer them to company dependents, and an equal percent offer them to retirees.

When worksites seek outside 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 Cessation Programs

Smoking related health issues cost U.S. companies $26 billion per year in lost productivity and $7 to $8 billion in smoking-related healthcare costs.

Staff Members who use tobacco are 50% more likely to be hospitalized than nonsmokers, have 2 times as a myriad of job-related accidents as nonsmokers and have absenteeism rates approximately 50% higher than nonsmokers.

People who used tobacco an average of one or more packs of cigarettes per day had 118% higher healthcare expenses than people that do not smoke.

76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that corporations should restrict smoking to certain areas.

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

In 1986, 17 states had laws regulating smoking in offices or workplaces either in government-controlled offices or offices of private staff members.

Examples of tobacco cessation intervention program used by employers include:

• making available people that do not smoke a discount of health and life insurance;
• paying full or partial fees for tobacco cessation programs;
• offering cessation programs on corporation or shared time;
• making available cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a smoke-free corporation policy and setting deadlines for implementing the policy.

Physical Fitness Programs

An active 55-year-old man has the potential to lead as vigorous a lifestyle as a sedentary 35-year-old.

Differences in work-related exercise has been determined to provide a two- to three-fold difference in cardiovascular deaths between active employees and their more sedentary counterparts.

In addition to improving strength, balance, and flexibility, physical activity programs have the potential to cut the probability of back injuries among certain occupational groups.

93 million workdays in the United States are lost annually due to back issues.

Research findings support the notion that worksite exercise programs improve fitness and help reduce other health risks, although results related to improved productivity are weak due to lack of methods for accurately measuring productivity.

A very small percentage of worksites have onsite physical fitness facilities.

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

Some employers subsidize employee participation in area “Ys,” health clubs or other area programs if no on-Site facilities are available.

Job Site physical activity programs may reduce expenditures to employers by lowering employee health care claims and expenditures.

Participants whose weekly physical activity was equivalent to climbing less than five flights of stairs or walking less than a half mile, spent 114 percent 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 people are roughly 11% higher than those for thin people.

Nutrition and Weight Control

One-third of America population is obese to the extent of decreasing their life expectancy.

Improvements in eating habits are able to reduce the risk of weighty health issues such as high Blood Pressure (BP) and blood lipid levels and is instrumental in the control of non-insulin-dependent diabetes.

The workplace offers several advantages for diet education; support and influence of co-staff members and senior staff, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Worksite nutrition programs have the potential to be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight control programs;
• blood lipid reduction programs;
• programs for pregnant and lactating women; and
• other diet education topics.

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

Stress Management

Estimates suggest that 50 percent to 80 percent of physician visits are able to be attributed to psychosomatic or stress-related origins.

Corporation pays many of the costs related to employee stress, both directly in the form of medical costs and in decreased productiveness.

Job factors which are associated with stress include:

• not allowing staff members to take part in decisions about the work process;
• positions which require more or less skill than the employee has;
• changes in work demands;
• lack of clarity about expectations and standards; and
• conflict with co-staff members or supervisors.

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

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

Worksite stress management programs are frequently delivered in one of three formats:

• sessions conducted by trained professionals;
• self-learning tools; and
• personal teaching to support  with self-assessment, planning for changes, learning new skills and responding to life crises.

The two major techniques used in workplace stress management programs are:

• teaching people to lower the detrimental physical effects of stress; and
• teaching people to recognize and control sources of stress at work and in personal life.

Seat Belt Usage

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

Motor vehicle accidents account for 27 percent of all work-related deaths and 45 million days of lost work each year.

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

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

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

Motor vehicle crashes cost $15.2 billion in lost work rate, 88% of which is attributed to losses from workforce activities and future earnings.

In work settings where safety belt policies, requiring use of belts by anyone riding in a business vehicle or using a personal vehicle for business business, have been enforced, 60% to 90% use has been stated.

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

Factors influencing the sources of worksite safety belt programs include:

• active commitment on the part of upper management;
• clearly defined and well enforced policy of necessitated belt use on the job;
• positive rewards and incentives; and
• ongoing education and training programs.

Case Studies of Workplace Wellness Programs

Based on an extensive assessment of its accross the board employee Employee Wellness Program, LIVE FOR LIFE, Johnson & Johnson reported the break-even point for the program occurs in year 3 and by year 5 they have a net advance of $316 per employee. Their year 9 projected advance is $677 per employee.

employees at four Johnson & Johnson organizations who were exposed to the Corporate Health Promotion Program expanding their daily energy expenditure in vigorous activity by 104% compared to an increase of 33% among employees at organizations that were provided only an annual health screen.

Members in the United Methodist Publishing House’s Corporate Wellness Program submitted more claims (1.14 per participating employee 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 of the lower than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the Workplace Health Promotion Program even though the results are not conclusive.

In 1985, the Adolph Coors Company conducted a phone interview of a random sample of its 10,000 staff members to determine changes in health practices since the introduction of an employee Worksite Health Promotion Program 4 years earlier. The sample of 495 staff members was stratified to match the company profile in terms of age, sex and job description. The survey published that 65 percent of respondents started exercising in The last 4 years, 37 percent had improved their diets, 20 percent were regular users of the wellness center, 9 percent had stopped smoking as the result of the company’s tobacco cessation program and active participants of the wellness center miss an average of 1.96 workdays annually because of illness or injury compared to 3.08 days for non-participating staff members.

The Coors Organization also achieved a cost savings from a cardiac rehabilitation program that was implemented in 1981. In 1980 workers 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.

Corporation Physical Activity Programs Plans Improve Employee Health and Wellness

Instituting a Corporate Health Promotion Program improves the health of employees, lowers employee absenteeism and saves the employer money, too. Learn more about starting an Corporate Health Promotion Program in the office.

Benefits of Corporate Health Promotion Programs

• A employer expenditure of $100-$150 per employee each year to participate in an Workplace Health Promotion Program can save corporations $300 to $450 for each employee every year, according to Ron Goetzel, Director, Cornell University Institute for Health and Productivity Studies. The savings are able to take a few years to actualize, says Goetzel, and are seen in decreased health expenditures.
• The Wellness Councils of America stated a $24 return for every $1 spent on a Corporate Wellness Program for small employers.
• According to a 2005 survey by The Art of Health Promotion, companies who adopted Corporate Health Promotion Programs realized a 30 percent reduction in medical and absenteeism costs in less than 4 years.

A efficacious Employee Wellness Program begins with Senior Management. Company owners must lead by example, taking part in their corporation’s exercise program and working closely with a wellness coach. Senior Management must make sure workers are well knowledgeable about their wellness efforts, displaying weight loss results or smoking cessation results on corporation intranet or bulletin boards for everyone to see.

Company Wellness Programs that Really Work

• Urge staff members to kick start their own wellness programs by visiting their doctor. A complete physical must include information about blood glucose, cholesterol levels and general health.
• Target specific health-related problems in a corporate physical activity program. Information about how to fight obesity, smoking, alcoholism and prescription drug abuse should be at the forefront of an Workplace Wellness Program, along with related conditions.
• Hire a wellness coach to instruct staff members on how to lead a healthy lifestyle.
• Reward staff members for participating in company wellness plans. Let staff members accrue wellbeing and health points that they have the potential to redeem for prizes. Make the prizes healthy, too- a free massage, personal training session with the company’s wellness coach or health meal gift certificate encourages even healthier lifestyle choices.
• Acknowledge employee wellness and health leaders in company newsletters, in posted bulletins and on the company intranet.

Worksite Health Promotion Programs Provide Big Results

For business owners who want to increase employee participation in a Company Wellness Program, consider Johnson & Johnson’s approach. Faced with only 26% of staff members participating in their employee health & wellness program, Johnson & Johnson offered staff members a $500 discount on health care insurance expenditures if they completed a health risk profile. The number of staff members participating in the Johnson & Johnson business fitness program jumped after they provided the incentive — to more than 93%.

Ron Goetzel encourages those looking to pitch a corporate physical activity program to Upper Management to use basic facts about the advantages of Company Wellness Programs as part of their argument. Keep it simple, and share results from other company’s employee wellness plan success stories.

5 reasons to have a wellness program

1.   The United States spends more dollars on healthcare 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 expense of healthcare is driven by preventable illness

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

4.   The worksite is an ideal setting to address health and well being
   • Most American citizens work
   • Poor health habits take a toll on U.S. Companies
   • Employers have a vested interest in health related issues.

5.   Research validates that Corporate Wellness Programs are able to improve health, save money, and even produce a return on investment.
   • Aldana,S.G. (1998). Financial impact of Workplace Wellness Programs and methodological quality of the evidence. The Art of Health Promotion. Vol 2, Number 1.
   • Wilson, M.G. (1996). A comprehensive 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 inclusive review of the effects of Worksite Wellness 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 worksite wellness. 3rd ed. Seattle: Summex Corporation, 1996.
   • Pelletier, K.R. A review of the health and cost-effective outcomes studies of accross the board 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 Workplace Health Promotion Program

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

Sample Physical Worksite Health Promotion Programs / Workshops
• Annual health screening
• Regular physical exercise
• Smart safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

Sample Emotional Workplace Wellness Programs / Workshops
• Stress management courses
• Accepting aging
• Addictive behaviors
• Parenting

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

Sample Financial Corporate Wellness 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
• Encourage daily devotional readings
• Provide regular service opportunities
• Provide a daily/weekly/monthly chapel (meditation) time during work hours

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

Sample Nutritional Workplace Wellness Programs / Workshops
• Individual nutritional Assessment
• Individual and group counseling
• Instructional classes
• Weight loss programs

Many employers, as part of their efforts to contain rising medical care expenditures, are launching worksite programs variously described as Workplace Health Promotion 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 lower utilization of medical care services and lower medical care expenditures?

The popular media have done much to promote the concept of organization 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 Business, as announced

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 modifiable risk factors is published to account for at least 25% of employee 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. Over the past two decades, a variety of groups at the local, state, and national echelons have promoted the concept that health risk reduction and care management programs can better employee health, and that worksite health education, health risk management, and benefit counseling should complement standard healthcare insurance benefits.

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

All-Inclusive Company Health Promotion 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 workers who adhere to recommended health care screening standard procedures.

Along with this, some employers are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing health care.5 These changes are intended to cut employees’ need for and utilization of health care, yielding reduced group health care expenditures. Demonstrated reductions in health care expenditures should then support employers with a powerful bargaining chip in negotiating lower healthcare 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 return on investment. Nonetheless, evidence continues to grow that well-designed and well-resourced Workplace Health Promotion Program and disease prevention programs provide multi-faceted payback on investment. Peer-reviewed evaluations and meta analyses show that return on investment is achieved through improved worker health, reduced benefit expense, and enhanced productiveness.

• Goetzel and colleagues, in their meta-analysis of two dozen articles summarizing economic evaluations of health and work rate management programs, observed an average return of $3.14 per $1 invested in traditional Workplace Health Promotion Programs. The ROI estimates for the individual programs ranged from $1.49 to $13.7,8
• Aldana reviewed 72 articles and concluded that Workplace Wellness Programs achieve an average ROI of $3.48 when thinking of medical expenditures 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 ROI between $4.56 and $4.73.10  Follow-up studies reported improvements in the risk profiles of participants, with the high-risk group improving more than the “usual care” group11 as a result of more intensive programming.
• Chapman’s 2004 meta-assessment of 42 studies, ranking overall validity of the studies, reports cost-benefit ratios from $2.05-$4.64.

In addition to immediately quantifiable expenditure 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 beneficial effects on employee perceptions of the company14 and worker morale, even among nonparticipants. 13 These outcomes go beyond savings in direct medical care costs to provide non-health related ROI.

Tailoring program to maximize return on investment Employee Wellness Programs aim to decrease the health risks of employees 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 good risk reduction and costeffectiveness.

In 2001, University of Michigan researchers published on stable trends in medical costs for over 2 million current and former employees 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 employees 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 provide 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 staff members within the context of comprehensive programming is the vital element in achieving positive clinical and expenditure outcomes in worksite interventions.

Dose-Response?

Several factors might affect the impact of various programs and the ultimate return on investment, including cultural and environmental factors, workforce demographics, level of participation and longevity of the program.

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

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

Length of intervention appears to be a more salient variable: an influence on healthcare costs generally requires three-to five years of programming.

Future developments

Despite the abundance of positive 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 ROI for Corporate Wellness Programs. Indeed, the corporation case for such programs is now well enough defined that some insurance brokers offer discounted rates to organizations 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 return on investment. Here, employers, staff members, and researchers will need to collaborate to define mutual goals/objectives in terms of both clinical and expense outcomes.

As corporations today continue to compete in the worldwide economy, expenditure containment strategies will be increasingly significant. Controlling the rising expenditure of employee sickness is becoming a priority for corporate leaders. The emerging corporate culture in this country is one which has an employee population centered in health, safety and wellness.

Establishing a corporate strategy for Worksite Wellness Programs and disability management makes good organization sense. The following eight-step process ensures a strategic, integrated, needs-driven and outcome-oriented approach.

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

1. Identify Your Worksite Wellness Program Champion

This person must 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 ideal health.

The program champion must have the resources and authority to propel the program forward. The program champion’s key role is to make sure the strategic plan for health is aligned with the business’s objectives, strategic focus and business values. By way of example if the organization promotes that “our strength is our people” the wellness program must confirm how pushes will nurture and protect that important resource.

2. Form Your Worksite Health Promotion Program Strategy Team

The Worksite Wellness Program Strategy Team must include decision makers and stakeholders from parts of the company that can effect 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 food services and the union. A team of six to eight representatives is recommended.

The role of the Strategy Team is to develop and enable the strategic plan, look for opportunities to reward health, ensure the program is integrated into key areas of the organization, streamline efforts, maximize employer resources and program assessment.

3. Complete an Organization Health Audit

The purpose of an Business 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 organization culture or “how things are done” around the organization.

Members of the Strategy Team complete the Audit independently and then meet to discuss their assessment. During the assessment process, health issues 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 countless objectives and goals. It provides a baseline from which to measure personal lifestyle changes, provides workers with relevant health information, motivates workers to take charge of their health and assists in program planning. Most health risk appraisals offer individual reports and a corporate report identifying elevated-risk areas in the business.

Many businesses opt to administer customized needs and interest survey to evaluate employee needs. The benefit of this approach is that the corporation 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. Design Your Strategic Plan for Wellness

The strategic plan must incorporate information collected from the Corporation Health Audit, your organization’s expenditure pressures, and health risk appraisal data or employee survey results. The strategic plan must include your program mission, three or four objectives and several pushes under each goal. The strategic plan provides a framework to encourage, backing and evaluate “best health practices.”

It is also important that the plan align itself with the vision, goals/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 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 company’s aspirations.
2. An incentive system to encourage and reward the accomplishment of healthy milestones.
3. A recognition system to applaud effectiveness.
4. Friendly competitions between Levi Strauss & Co. locations to ensure a fun environment.
5. Opportunities to participate in small group educational programs to advance team support.
6. Initiation of support groups for employees completing wellness programs (i.e. smoking control support group).
7. Programs dealing with work and family balance.

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

1. Employer 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. Prepare a Employer Case to Support Your Plan

Your business case for wellness provides the necessary details for approval at the upper management level. The business 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 valuable to highlight how the plan aligns itself with the strategic direction of the organization.

The program budget ought to 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, elevated 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 significant role in the implementation of your wellness program.

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

Awareness programs establish an awareness of the significance of healthy lifestyle practices and arouse workers to take the next step. Examples of awareness programs include posting educational posters, newsletter articles and lunch and learn sessions.

Lifestyle change programs are more comprehensive and longer in duration. They are designed to assist  staff members in changing behavior. Examples of lifestyle change programs are nutrition 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 great 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.

Evaluating the effectiveness of a Worksite Wellness Program is ongoing. A formal assessment should be conducted each year 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 essential 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 team is to solicit feedback from all echelons 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 beneficial 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 wellbeing and not merely the absence of disease and infirmity.” In order for us to set up healthy workplaces, wellness drives must have a program champion, have employee ownership, be upper management supported, results driven and strategically aligned with the overriding organization objectives of the organization.

Wellness plan that embrace these qualities will have a positive impact on an organization’s bottom line. Canadian research points to countless case studies where onsite programs have resulted in diminished absenteeism, cut claims and increased productivity.

Companies who have embraced wellness as part of “how they do business” have one thing in common. They prove a responsibility to their most important resource – their people. They know 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 staff members are happier, absent less and more advantageous.

References:
Design of Employee 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 improve upon your current wellness program? The list below provides ‘best practices’ that are able to help meet any wellness program budget! The Corporate Health Promotion Program ideas are divided into topic areas.

General Wellness Progam Ideas

• Administer an Employee Needs & Interest Survey
• Establish a Employee Health Promotion Program Committee
• Choose medical programs that cover costs for weight management and smoking cessation
• Waive co-pay or reimburse for preventive health care visits
• Put up pamphlets on a variety of wellness issues for staff members to take
• Organize a wellness resource center or library with videos, books, magazines, DVD’s on a variety of subject matters of interest to workers
• 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
• Create and reward periodic or regular educational sessions.
• Establish monthly educational sessions on the national health observance topic
• Put up a Wellness Bulletin Board & update it monthly
• Put up messages from national health observances during the month
• Offer healthy tips in newsletters, paycheck stuffers, bulletin boards, etc.
• Develop a benefits fair
• Sponsor business fitness and healthy eating challenges
• Develop employer health & wellness fairs or other on-Site activities

Nutrition Programs

• Provide free, healthy snacks for workers (fruit, nuts, popcorn)
• Provide healthy meal choices in cafeterias and at business events
• Offer information to employees about the nutritional content of food served in the cafeteria
• Create 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)
• Offer a weekly or monthly healthy lunch club
• Have handouts available on a variety of healthy eating subject matters
• Include nutrition articles in corporation newsletters
• Have a healthy food tasting contest Free
• Provide educational sessions at lunchtime-time on a variety of diet issues 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 employees are able to participate in weight-loss programs
• Subsidize registration expenditures for weight-management programs
• Offer a support group to help staff members who are trying to lose weight
• Locate registered dieticians near your workplace as a resource for staff members who want information on healthy eating, meal planning or weight control
• Provide individual counseling for staff members trying to lose weight
• Provide onsite 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

• Allow flexible work schedules to encourage physical activity
• Create a fitness space with aerobic equipment, and weights
• Create accessible walking paths, trails, and/or bike routes
• Encourage staff members to walk more by parking farther away from the entrance
• Create 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 employees
• Provide facilities for workers to secure bikes
• Schedule 5 – 10 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 corporation sports team
• Encourage stairwell use and incentives/rewards
• Install a basketball hoop outside
• Promote & support area walks or fitness activities
• Urge walking during breaks and other off-time periods
• Give periodic fitness incentive programs to encourage physical activity
• Provide educational sessions on fitness activities

Smoking Cessation Programs / Tobacco Cessation Programs

• Create a smoke-free grounds
• Organize 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
• Fully reimburse (or partially reimburse) for tobacco replacement products
• Partially fund the cost of smoking cessation sessions
• Give brochures and information on health effects from tobacco use and smoking cessation
• Schedule awareness sessions to excite employees to try to quit tobacco use
• Provide worksite tobacco cessation seminars

Employee Health Screening

• Discount medical 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
• Offer Health Risk Assessments to all employees, including counseling and follow-up
• Provide periodic Blood Pressure screenings and follow-up
• Provide periodic screenings for cholesterol, blood glucose, body composition, etc.

Stress Management Programs / Work Life Balance Programs

• Allow flexible schedules for family/work life balance
• Offer and reward an Employee Assistance Program
• Provide information on substance abuse prevention
• Offer pamphlets and information on stress management and mental health
• Offer brochures 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.
• Evaluate business policies and work schedules to identify business stressors
• Review the EAP to ensure it is meeting the needs of the workers and corporation
• Have educational sessions on stress management and work life balance
• Schedule seminars on relaxation, stress management, and work life balance topics

Health screenings are significant programs to identify chronic disease in their early stages. Once identified, wellness intervention programs can help prevent a disease from progressing. Working with local hospitals and other employers, you can obtain information on offering evaluation and intervention programs that could improve your employees’ health and save your company money in absenteeism, treatment for disease complications, and reduced productivity. 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 workers with pre-hypertension or hypertension (elevated 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, organization physician practice, or health department may offer assistance. Nevertheless, if you have staff members you may want to concentrate on programs that will keep them healthy instead of 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 employees. 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 provides a more all-inclusive snap shot of health risks. The summary results support the valuable information to plan appropriate interventions.

Workplace Health Promotion Program Interventions

The key to the effectiveness of screenings and Health Risk Assessments / Health Risk Appraisals 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 offer the essential backing and assistance needed for workers to actually make and maintain those changes. The interventions have the potential to include individual follow-up and ongoing counseling, individual or group health coaching on the risk factors, behavior change programs, and/or business backing. Examples include:

• Strategies to decrease Blood Pressure
• Managing diabetes
• Taking care of your heart
• Healthier eating
• Weight loss strategies
• Improving physical exercise
• Smoking Cessation

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

Based on the results and your Workplace Wellness Program Committee objectives you are able to plan the best strategies for your corporation and staff members. Consider the area resources available to offer services, such as health associations, hospitals, medical care 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  people in making healthy changes that influence their health and prevent chronic conditions.

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

Staff Members complete a lifestyle questionnaire that includes for example nourishment practices, height and weight, exercise habits, family history, stress perceptions, smoking history, and work satisfaction. Another important feature to consider is readiness to change questions to determine participation interest. Including health screenings such as blood lipids and Blood Pressure (BP) results increases the advantages of an Health Risk Appraisal / Health Risk Assessment by providing a more accurate health assessment and therefore improving lifestyle choice decisions and program options. Still, it is important 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 cut risk factors. Individual reports are fully confidential. Depending on the reason for launching the Health Risk Appraisal / Health Risk Assessment, it’s significant to consider the type of report the employer will receive as well. A group report summarizing major risk factors and recommendations for programs to start in order to cut employee and employer risks supplies significant information for your wellness program.

The Health Risk Appraisals / Health Risk Assessments have the potential to be used to:
• Raise awareness to individual employee’s health status
• Motivate employees to make healthier lifestyle changes
• Coach high-risk staff members
• Plan Company Wellness 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 numerous advantages to considering a part-time or full-time occupational and environmental health nurse (OHN). Occupational health nursing is the specialty practice that supports 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 have the potential to include: Case management, Counseling, Corporate Health Promotion 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 have the potential to design, conduct and evaluate activities that help better the health of all your workers. They are subject matter experts who may be a important asset regardless your program needs and objectives and goals. They have the potential to help form a Employee Health Promotion Program Committee and enable a myriad of of its programs and services, for example or depending on the structure and time commitments of your Employee Health Promotion Program Committee, they have the potential to also plan the entire program as well. Integrating the activities of the Committee and/or Employee Health Promotion Program professional services within your operations, including within your safety and occupational health program will offer additional benefits!