Category — Wellness Plans

A lot of companys, as part of their efforts to contain rising healthcare costs, are beginning wellness programs variously described as wellness, lifestyle programs, health and productivity management, population health management and, simply, wellness 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 theory of employee wellness. Last year, In Business –  Madison1 magazine printed a story accompanied by a table reporting an impressive range of ROI –

Return on Investment (Per dollar Return On Investment 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 Company, 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 unhealthy lifestyle or modifiable risk factors is announced to account for at least 25 percent of staff member healthcare expenditures.

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

Over the past two decades, a selection of groups at the local, state, and national levels have promoted the theory that health risk reduction and care management programs can improve employee 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, flyer or newsletter information to onsite fitness facilities, health risk reduction classes, and personal lifestyle change coaching.

Health promotion programs today often include a health risk assessment  to evaluate each staff member’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.

Extensive health promotion programs might include classes on health risk reduction and job safety, fitness and exercise activities, health and fitness center memberships, and reductions in co-payments or premiums for workforce who adhere to recommended biometric screening guidelines.

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

Demonstrated reductions in health care expenditures should then provide corporations with a powerful bargaining chip in negotiating lower medical insurance premiums during future terms.

Evidence basis –  A range of ROI estimates

The empirical research has produced results as varied as the popular media on Return On Investment. However, evidence continues to grow that well-designed and well-resourced wellness and illness avoidance programs provide multi-faceted payback on investment.

Colleague-reviewed investigations and meta analyses show that ROI is achieved through improved employee health, reduced benefit expense, and enhanced productivity.

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

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

• Ozminkowski and collagues conducted a 38 month case study of 23,000 participants in Citibank, N.A.’s health promotion program and reported that within a 2 year period, Citibank realized a ROI 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.

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

In addition to immediately quantifiable cost reductions, scientists have announced a variety of spin-off benefits –  greater productivity, intellectual capacity, and reductions in disability12 and absenteeism.9,13,14,15

Such wellness programs may also have positive effects on worker perceptions of the business and worker morale, even among nonparticipants.  These outcomes go beyond savings in direct healthcare costs to provide non-health related Return On Investment.

Tailoring health promotion program to maximize Return On Investment Health promotion programs aim to reduce the health risks of staff members at high risk while maintaining the health status of those at low risk.

A variety of disease management interventions are available to fit the specific risk profiles of various worksites. Insurers and businesses now seek to calibrate their interventions for achieve optimal risk reduction and costeffectiveness.

In 2001, University of Michigan researchers announced on stable trends in health care costs for over 2 million current and former staff 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 lowers 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-analysis and other health promotion program examinations18 suggest that individualized risks reduction for high-risk employees within the context of comprehensive health promotion programming is the vital element in achieving positive clinical and cost outcomes in worksite interventions.

Dose-Response?

A few factors may affect the impact of various health promotion programs and the ultimate Return On Investment (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 large companies with more than fifty workforce. But researchers have shown that similar results can be obtained by small companies with as few as five workforce actively involved in a well-managed health promotion 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 (ROI) with 51% participation.

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

Future developments

Despite the abundance of positive wellness program evaluations, a few caveats remain. Negative results are less likely to be reported or published, therefore biasing the Return On Investment upward.

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

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

Truly, the organization case for such health promotion programs is now well enough defined that some insurance brokers offer discounted rates to businesses that institute or subscribe to health promotion programs.

Future questions will focus on how to best to combine robust and focused interventions, the intensity of elements, and how to calibrate the dose-response model to achieve a target Return On Investment (ROI).

Here, employers, workforce, and researchers will need to collaborate to define mutual objectives 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 Health Promotion 2000; 15(1) –  45-52.

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

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

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

6. Powell C. Professionals urge corporations to promote employee health promotion 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 – Health Promotion Councils of America. Vol 1(8); 2002.

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

10. Ozminkowski RJ, Dunn RL, Goetzel RZ, Cantor RI, Murnane J, Harrison M. American Journal of Wellness 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 Wellness 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 Health Promotion 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 organizations today continue to compete in the global economy, cost containment strategies are going to be increasingly important. Controlling the rising cost of worker ill health is becoming a priority for corporate leaders.

The emerging corporate culture in the USA  is one which has an employee 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 organizations with strong leadership and a long-term commitment to staff member health.

1. Identify Your Health Promotion Program Champion

This person ought to be a leader in your corporation and a strong advocate of health. Generally this is a personal who actively pursues his or her own personal quest for optimal health.

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

For  instance when the corporation promotes that “our strength is our people ” the wellness 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 business that can influence health and the corporation’s bottom line.

These areas could include; finance, human resources (HR), training and development, health services, compensation and benefits, staff member assistance services (EAP), marketing, facilities, safety and health, 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 create and implement the strategic plan, look for opportunities to promote health, ensure the wellness program is integrated into key areas of the organization, streamline efforts, maximize organization resources and wellness program examination.

3. Complete an Organizational Health Audit

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

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

Members of the Strategy Team complete the Audit independently and then meet to discuss their analysis. During the analysis process, health issues 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 (EAP) utilization.

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

5. Conduct a 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 objectives.

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 assists in health promotion program planning.

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

A lot of companies prefer to administer personalized needs and interest survey to evaluate employee needs.  The advantage of this approach is that the business 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 advantage of fostering a sense of employee ownership to the wellness program.

6. Create Your Strategic Plan for Wellness

The strategic plan should incorporate information accumulated from the Organizational Health Audit, your company’s cost pressures, and health risk assessment data or worker survey results.

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

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

The sample strategic plan that follows was created for blue jeans maker Levi Strauss and Co. (Canada) Inc. Levi Strauss and Co.’s mission statement and aspirations (how workforce interact with each other in a corporation 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 organization’s aspirations.

2.  An incentive system to encourage and reward the accomplishment of healthful 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 health promotion programs to foster team support.

6. Initiation of support groups for staff members completing health promotion programs (i.e. use of tobacco control support group).

7. Programs dealing with work and family balance.

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

1. Business demographics

2. Focus groups

3. Cultural audit

4. Top drug report

5. employee assistance program (EAP) utilization

6. Worker benefit services report

7. Health and dental claims

8. Operational performance summaries

9. Health risk appraisals

7. Pull together a Company Case to Support Your Plan

Your corporation case for wellness provides the necessary details for approval at the senior management level.  The corporation case includes –

1.  The Strategic Plan for Health

2. A proposed health promotion program budget

3. Marketing strategies

4. Program leadership options

5.  An implementation plan

6. Analysis methodology.

In presenting the strategic plan it’s vital that you highlight how the plan aligns itself with the strategic direction of the organization.

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

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

Program leadership should address how volunteers are going to be used, internal resources  and whether advisors have been proposed. All play an equally important role in the implementation of your health promotion program.

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

Awareness wellness programs create an awareness of the importance of healthy lifestyle practices and motivate workers to take the next step. Examples of awareness wellness programs include posting educational posters, newsletter articles and lunch and learn seminars.

Lifestyle change health promotion programs are more robust and longer in duration. They are designed to assist personnel in changing behavior. Examples of lifestyle change health promotion programs are nutrition education programs, stress management programs, back care courses and use of tobacco 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 staff members who 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 evaluation must be conducted annually and may include; re-administering steps three to five, health promotion program participation statistics and a year end survey to revisit “soft” issues like morale, health promotion program satisfaction and future health promotion program direction.

8. Solicit Input and Communicate Your Plan

Staff Member input is critical to the long-term success of your health promotion program.  An Staff Member Advisory Committee must be formed to roll out the plan. Another key responsibility of this team is to solicit feedback from all levels of the organization to ensure buy-in.

Front line Manager’s Information Sessions and focus groups are also 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 wellness and not merely the absence of illness and infirmity.”

In order for us to develop healthful worksites, health promotion programs must have a health promotion program champion, have staff member ownership, be upper management supported, results driven and strategically aligned with the overall corporation goals of the corporation.

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

Organizations that 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 individuals .

They understand the increased pressures associated with downsized companies, a quickly 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 productive.

References –

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

Pro Fit-ability by Veronica Marsden. Group Health Care 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 Health Care 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 help meet any wellness program budget! the Health Promotion Program ideas are divided into topic areas.

General Wellness Progam Ideas

• Policy – Conduct an Employee Needs and Interest Survey

• Policy – Create a management/employee Wellness Committee

• Policy – Choose healthcare programs that cover costs for weight control and tobacco use cessation

• Policy – Waive co-payment or reimburse for preventive health care visits

• Program – Display handouts on a variety of wellness topics for personnel to take

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

• Program – Identify staff members who are mentors or champions for healthy activities and ask them to present or to list as a contact for other employees

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

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

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

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

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

• Program – Sponsor a benefits fair

• Program – Sponsor organization fitness and healthy eating challenges

• Program – Sponsor corporation health fairs or other onsite events

Nutrition Programs

• Policy – Offer free, healthy snacks for staff (fruit, nuts, popcorn)

• Policy – Provide healthful meal choices in cafeterias and at corporation events

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

• Policy – Begin a fresh fruit “snack basket” in the breakroom or cafeteria

• Policy – Stock vending machines with healthier choices

• Policy – Subsidize healthy foods in the cafeteria or vending machines (10¡ apples might  be more appealing than $1.00 candy bars)

• Program – Coordinate a weekly or monthly healthy lunch club

• Program – Have pamphlets available on a variety of healthful eating topics

• Program – Include nutrition articles in company newsletters

• Program – Schedule a healthful food tasting contest Free

• Program – Schedule educational sessions at lunch-time on a variety of nutrition topics of interest

• Program – Sponsor an worker healthful food cookbook. Either sell the cookbook and use profits for programs, or purchase a cookbook for all employees

Weight Loss Programs / Weight Management Programs

• Policy – Consider flexible work schedules so that employees can take part in weight-loss programs

• Policy – Subsidize registration costs for weight-management programs

• Program – Form a support group to help employees who are trying to lose weight

• Program – Locate registered dieticians near your worksite as a resource for employees who want information on healthy eating, meal planning or weight control

• Program – Offer individual counseling for personnel trying to lose weight

• Program – Give on-site fitness and weight-management programs through your local hospital, Weight Watchers, TOPS or local, registered dietician

• Program – Schedule an educational session on diet myths and healthful eating

Physical Activity Programs

• Policy – Allow flexible work schedules to encourage exercise

• Policy – Create a fitness space with aerobic equipment, and weights

• Policy – Create accessible walking paths, trails, and/or bicycle routes

• Policy – Be certain to encourage workers to walk more by parking farther away from the entrance

• Policy – Establish a health and fitness center with aerobic equipment, weights, group fitness classes, fitness experts

• Policy – Hold walking meetings

• Policy – Make the stairwells more appealing (carpet, fresh paint, artwork, posters)

• Policy – Give decreased fitness center membership fees to all staff members

• Policy – Give facilities for employees to secure bikes

• Policy – Schedule 5 – 10 minute stretch breaks during the day

• Policy – Subsidize health and fitness center membership for personnel who participate a minimal number of days per week (ex., 3 days per week)

• Policy – Support lunchtime walking/running clubs or business sports team

• Program – Be sure to encourage stairwell use and incentives

• Program – Install a basketball hoop outside

• Program – Promote and support community walks or fitness events

• Program – Promote walking during breaks and other off-time periods

• Program – Give periodic fitness incentive programs to encourage exercise

• Program – Schedule educational sessions on fitness activities

Smoking Cessation Programs / Tobacco Cessation Programs

• Policy – Develop a tobacco-free grounds

• Policy – Develop a smoke-free worksite

• Policy – Be sure to encourage the use of 1-800-QUIT-NOW, North Carolina’s free Tobacco Use Quitline. Or check www.QuitlineNC.com

• Policy – Reimburse for tobacco replacement products

• Policy – Subsidize the cost of smoking cessation workshops

• Program – Provide brochures and information on health effects from tobacco use and smoking cessation

• Program – Schedule awareness sessions to motivate personnel to try to quit tobacco use

• Program – Schedule on-site tobacco use cessation workshops

Worker Health Screening

• Policy – Discount medical insurance premiums or reduce co-payments for staff members who participate in screenings and who participate in managing their risk factors

• Policy – Install blood pressure monitoring equipment

• Program – Offer flu shots for personnel and family members

• Program – Offer HRAs to all employees, including counseling and follow-up

• Program – Offer periodic blood pressure (BP) screenings and follow-up

• Program – Give periodic screenings for cholesterol, blood sugar, body composition, etc.

Stress Management Programs / Make sure to work Life Balance Programs

• Program – Allow flexible schedules for family/work life balance

• Program – Provide and promote an worker assistance program

• Program – Give information on substance abuse prevention

• Program – Provide pamphlets and information on stress management and psychological health

• Program – Provide brochures and information on work life balance, such as financial planning, childcare, parenting, elder care, etc.

• Program – Give supervisor and manager training on communication, relationship building, organizational stressors, etc.

• Program – Review corporation policies and work schedules to identify organizational stressors

• Program – Review the employee assistance program to ensure it is meeting the needs of the employees and company

• Program – Schedule educational sessions on stress management and work life balance

• Program – Schedule seminars on relaxation, stress management, and work life balance topics

Medical screenings are important health promotion programs to identify chronic condition in their early stages. Once identified, wellness intervention programs can help prevent a illness from progressing.

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

Listed here are some ideas to help get you began.

Based on your Worker Needs and Interest Survey and the demographics of your workplace, consider offering periodic screenings to find specific health risks like –

• Blood Pressure Checks to identify personnel with pre-hypertension or hypertension (high blood pressure),

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

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

• Body composition, like Body Mass Index  or body fat measures

• Bone density for potential risk of osteoporosis,

• Cancer screenings such as, skin evaluations, mammograms, or PSA screenings,

• Vision checks for glaucoma, or visual acuity

• Other screenings depending on your employee population and needs

Your local hospital, business doctor practice, or health department my provide assistance. Notwithstanding, if you have a young workforce you may want to concentrate on health promotion programs that’ll keep them healthy rather than screening for early identification of chronic condition.

The focus of your wellness program may  be healthful lifestyle practices to reduce risk and prevent illness.

In addition to the health testings, consider offering a Health Risk Assessment (HRA) to all workforce.  The Health Risk Assessment (HRA) will help to identify factors that may lead to additional risks, like use of tobacco history, stress levels, perception of health, family history, job satisfaction, support systems, and mental health.

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

Wellness Program Interventions

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

It’s the follow up interventions that provide the essential support and assistance needed for employees to actually make and maintain those changes.

The interventions can include individual follow-up and ongoing counseling, individual or group medical coaching on the risk factors, behavior modification programs, and/or organizational support. Examples include –

• Strategies to lower blood pressure

• Managing diabetes

• Taking care of your heart

• Healthful eating

• Weight loss strategies

• Increasing physical activity

• Use of tobacco Cessation

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

Based on the results and your Wellness Committee objectives you can plan the best strategies for your company and employees. Consider the community resources available to provide services, like health associations, hospitals, health care providers, and/or public health agencies.

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

HRAs have four standard elements in worksite establishings –

• A Questionnaire

• A Computerized Program to Evaluate Health Risk

• Confidential Individual Reports

• Group Summary Report

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

Another important feature to consider is readiness to change questions to determine participation interest. Including health testings such as cholesterol and blood pressure (BP) results increases the benefits of an Health Risk Appraisal (HRA) by providing a more precise health assessment and consequently bettering lifestyle choice decisions and health promotion program options.

Notwithstanding, it is crucial that you determine when the HRA may be used without including this information.

The 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 lower risk factors.

Individual reports are completely confidential. Depending on the reason for beginning the Health Risk Appraisal, it’s important to consider the kind of report the corporation will receive as well.

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

The Health Risk Appraisals (HRAs) can be used to –

• Bring awareness to individual worker’s health status

• Motivate staff to make healthier lifestyle changes

• Coach high-risk employees

• Plan wellness programs based on the identified needs

• Measure wellness program success by comparing Health Risk Appraisals (HRAs) completed at set intervals like each year.

There are many benefits to considering a part-time or full-time occupational and environpsychological health nurse (OHN). Occupational health nursing is the specialty practice that provides for and delivers health and safety programs and services to workforce, and worker populations.

The practice focuses on promotion and restoration of health, prevention of disease and injury, treatment of work and non-work related injuries and diseases, and protection from work related  and environmental hazards.

OHN 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 increase the health of all your personnel. They are subject matter professionals who may  be a asset regardless your health promotion program needs and goals.

They can help form a Wellness Committee and implement many of its wellness programs and services, for instance or depending on the structure and time commitments of your Wellness Committee, they can also coordinate the entire wellness program as well.

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

We are planning corporation health promotion programs to help you feel better and stay healthy. In order to plan health promotion programs that best meet your needs and interests we’d like your suggestions!

Please take a few minutes to answer some questions about your interests. Your answers are going to be combined with those of other’s and reviewed to help plan health promotion programs for you. Don’t sign your name.

Please complete the survey today and return it to__________. Thank you for your valuable input! Your help is important for planning successful health promotion programs. Return the completed form by _____________.

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

I’m interested in –

Participating in wellness programs before work 1 2 3

Participating in wellness programs after work 1 2 3

Participating in health promotion programs during my lunch break 1 2 3

Learning healthy consuming choices to lose weight 1 2 3

Sports nutrition 1 2 3

Healthier cooking 1 2 3

Assisting my children eat healthier 1 2 3

Quick, healthy meals for busy life choices 1 2 3

Healthful snack options 1 2 3

Learning how to quit tobacco use 1 2 3

Attending courses to help me quit use of tobacco cigarettes 1 2 3

Stress Mangement skills 1 2 3

Balancing work, family, and personal life 1 2 3

Time management skills 1 2 3

Participating in a beginning fitness program 1 2 3

Developing time to exercise for busy people  1 2 3

Getting medical information that I can read or watch at home 1 2 3

Learning about cancer avoidance 1 2 3

Heart health options 1 2 3

CPR and First Aid 1 2 3

Team sports activities at work 1 2 3

Learning how to stretch 1 2 3

Learning how to increase intake of fruits and vegetables 1 2 3

Parenting Topics (age of kids –  ) 1 2 3

On-Site exercise classes –  walking Yoga aerobic other –  1 2 3

Biometric screening such as blood pressure, cholesterol, blood sugar 1 2 3

Program evaluation could  be the last step, but it should be planned at the beginning of your efforts! Evaluation assists you identify what parts of the health promotion program are working well and what parts need improvement.  

Then, based on the analysis data, adjustments could be made to fine-tune your wellness program.   Adjusting the wellness program based on analysis data is crucial to its continued success.  

Evaluating your wellness program doesn’t have to be complicated.  HOWEVER, it’s vital that you plan how you will monitor your wellness efforts and determine success during the planning phase.  

Moreover remember to evaluate the wellness program based on the goals and goals you already identified during your planning process.  

In order to evaluate your health promotion program you need to have a system to document specifics as you go along.  This may be as simple as maintaining file folders on health promotion programs that are offered, or a computer document with a table or spreadsheet summarizing information collecting.  Consider –

• Program topic and numbers of personnel who participated

• The numbers of pamphlets taken by workforce or distributed and on what topics

• The number of participants in a behavior modification program and how many met their goals as well as how many attended all the sessions

• Numbers of workers who continued the healthful behavior modification following the health promotion program?

• Overall employee satisfaction with the wellness program or each topic. Here’s a sample examination form.  

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

• Absentee rates

• Injury rates

• Health risk factors Insurance costs  

Summarize and Report Health Promotion Program Results

Once you’ve gathered all of the evaluation information it needs to be reviewed with the Health Promotion Committee and summarized. You will probably have positive results and some areas where a change is needed or additional focus required for continuous improvement.  

This not-so positive information could be used to make any needed changes in addition to to plan for next year and is vital that you include in your report.  

It’s crucial to communicate the wellness program results to both senior management and staff members.  Consider how senior management ordinarily receives reports on operations and productivity issues and include the annual wellness program report in the same format.  

At some corporations the reports are made during upper management meetings using presentation styles like power point slides.  At other corporations, graphs and bar charts are the norm or a list of the objectives and the summary outcomes reported.  

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

Staff Members want to receive the same information!  Consider using the same communication channels used when informing employees of the wellness program –

• Corporation newsletters,

• Bulletin boards,

• E-mails  

Additionally consider celebrating successes and recognizing achievements by –

• Posting pictures from events

• Highlighting success stories

• Posting pictures of successes

• Scheduling a celebration

• Recognizing champions  

Armed with data, Wellness Program topic preferences, objectives, and objectives – and a Wellness Committee rearing to get things done – it is now time to decide how best to take action.  This website provides tools to help you!  

You can peruse about the different kinds of health promotion programs offered by other businesses to get an idea of what might work for your corporation.  

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

Important Health Promotion Program considerations include –  

1. Formally Introduce the Wellness Program and consider policy statements that state the importance of the health promotion program.  Examples include a general policy regarding the commitment to staff member safety and health as well as specific policies such as No Tobacco use, Healthful Eating and Exercise.

2. Communicate Your Program –  the best planned health promotion program with excellent health promotion programs won’t be advantageous if your staff members do not know about it or do not understand the choices or how to participate.  Communicate your health promotion program using a selection of methods to ensure the message and “how-to’s” are heard!

Wellness Program Communication Strategies could include –

• Newsletter articles

• Postings on the corporation’s intranet or internet

• A designated Champion of the wellness program

• Formal or informal meeting to announce health promotion program, “the kick-off”

• pamphlets / table tents,

• Bulletin boards / kiosk where all material is promoted or found,

• Email / phone messages,

• Mailings or distributions  

3. Use Wellness Program Incentives –  You’ll be amazed to find out what people  will do for a free T-shirt.  Incentives can both support and motivate participation among staff.  

Consider both formal or organization incentives and informal or wellness program rewards/prizes from local resources to reinforce participation in Wellness Programs. Either way, it is crucial to provide incentives that are attractive and meaningful to your workers.

Company Structural or Formal Wellness Program Incentives –

• Discounts on employee medical insurance premiums or co-pays, or contributions to 401K programs, employee stock options, or other mechanisms.  Click here for more information on medical plan incentive ideas

• Health Club/Health Club discounts or enrollment fee coverage

• Public transportation vouchers

• Flexible work time options

• “Wellness Days” off work  

Rewards/Prizes or Informal Wellness Program Incentives –

• Cash – a very effective incentive!

• Prize incentives such as gift certificates to heart healthful restaurants; music player to use while exercising, emergency kits, or any other prizes that would motivate your staff members.

• T-Shirts, water bottles, or other inexpensive rewards

4. Assess community resources available to provide some wellness services.  The local health department or your company health care provider might  be able to assist you with this information.  There are also vendors throughout the State providing great wellness services for companies. They’re available to help you strategize and find the best options available.

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

The Health Promotion Committee should set out a plan for the entire year that outlines accomplishing objectives and objectives, in addition to provides details for marketing and advertising and evaluating  the wellness program.

The plan is the detailed map of what kinds of wellness programs are going to be offered, when and where they will be scheduled, how they will be marketed and analyzed, and what the budget is.  

It’s imperative that you plan your wellness activities based on your objectives and objectives, in addition to the budget since different strategies will yield different outcomes.  For  instance, if your objective is to increase awareness on a topic, then distributing pamphlets or scheduling a one-time education session might  be appropriate.  

Nevertheless, if your goal is to change behavior, then different strategies could  be necessary, like ongoing weekly sessions and support groups.  Click here to link to Program Design Choices for additional ideas.

Health Promotion Program Marketing

This is the time to plan your advertising and marketing strategies! Just how can you market the health promotion program and ongoing activities?  No matter how you decide to, market often, keep it fresh, and remind staff members again and again!  

Consider having an overall kickoff activity to let everyone know about the wellness program. Upper Management ought to provide the introduction or invitation so that all employees are aware of their support and leadership in the wellness program.

Possible marketing methods –

• Sending email messages, including reminders

• Posting flyers,

• Displaying bulletin board postings,

• Writing articles,

• Sending letters or

• Sending special invitations.  

Other Health Promotion Program Considerations –

• Is the health promotion program promoted to all workforce or to a specific target audience?

• Do you’ve a health promotion program champion (someone who is connected with different groups in the company, and well respected) who can help in your promotion efforts?

• If your advertising and marketing efforts don’t seem to be working, do you have a way to revisit and adjust your strategy?

• How’ll you determine success and evaluate your wellness program?  and how will you collect the information needed to evaluate your wellness program?  

Topics most often included in Health Promotion Programs –

• Nutrition

• Physical Activity/Exercise

• Tobacco Use Cessation

• Bone Health

• Heart Health

• Healthful Back

• Stress Reduction

• Chronic Illness Awareness and Prevention

• Self-care; Wise Health Care Consumer

• Screening Services (BMI, blood pressure, bone density, cholesterol, glucose, posture, vision, and other…)

• Ergonomic Assessments

• Wellness Fairs

• Kids/family Events

• Others topics that personnel have interest in  

The topics and type of Wellness Program planned depend on the needs and interest, overall goal and resources available.  

Program Design Options include awareness programs such as pamphlets and/or education sessions, behavior change or modification programs such as smoking cessation and losing weight classes, and environmental or organizational support such as no smoking policies or healthful selections in vending machines.  

The health promotion programs planned also depend on the demographics of your workforce. If you’ve a young, healthy workforce, you could want to focus the wellness attention on keeping employees healthy and not need to screen for illness.  

Instead you might want to focus on healthful lifestyle behavior like exercise and good nutrition to prevent the start of disease.  Click here for additional information on strategies for keeping employees well, identifying disease early, or returning employees to work who already have a chronic illness.

It’s also imperative that you consider, and plan how you’ll evaluate the success of your health promotion program.  The system needs to be established for tracking certain data and recording events depending on the health promotion program goals and desired outcomes.  

Step 7 discusses wellness program evaluation in more detail.   and Step 6 will launch your wellness program!