Corporate America is increasingly investing in wellness plans because it is good business.  In order to meet productivity demands, businesses must rely on a healthful, productive workforce to succeed in the highly competitive global marketplace.

Over a hundred studies in both corporate and governmental establishments have documented the economic advantages of wellness plans, including decreased absenteeism, decreased injuries and workman’s compensation costs, decreased healthcare costs, decreased worker turnover, in addition to increased productivity, greater worker satisfaction, and improved morale.1-10

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

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

1   Health and productivity management model

Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors like tobacco use, lack of physical activity, excess weight, unhealthful diet, high cholesterol, high blood pressure, stress, depression, and so on.

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

2   Health risk assessment

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

The HRA serves to elevate awareness, provide direction, and motivate individuals to improve specific behaviors.  In some cases, the customized report is directly linked to appropriate resources related to identified risks.

Research indicates that the use of an Health Risk Assessment (HRA) is effective when it’s followed by some kind of educational or therapeutic intervention for identified risks.  It often serves as the entry point into health promotion programs.

3   Biometric analysis

A lot of wellness plans combine the results of the health risk assessment with measurement of each employee’s biometrics, including weight and BMI , blood pressure, cholesterol, fasting glucose, and assorted other metrics.

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

4   Health Promotion Program Incentives

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

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

5   High wellness program participation rates

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

6   Wellness coaching

Employees with identified risks or desire to improve their health habits may  be periodically coached via telephone by trained wellness coaches.

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

Three or more sessions are normally offered.  In some intensive wellness programs, the coaching extends to actual disease management intervention for workforce with identified high-risk illnesses.

7   Multiple formats

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

In addition to on-site exercise and healthful consuming events, on-line wellness programs, e-mail reminders and notices, printed newsletters and materials, and workplace courses and seminars are common dissemination strategies.

8   Upper-level management support

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

9   Frequent contact

Successful wellness plans have frequent contact of some sort with every employee.  This might  be through advertising efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, staff meeting presentations, discussion in new employee orientation, supervisory sessions, etc.

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

10   Open enrollment

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

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

11   Family involvement

Many wellness plans encourage spouses and other family members to take part in the organization wellness activities and to adopt a healthy lifestyle along with the designated worker. It’s far easier for the worker to have a healthy lifestyle when his/her family does so as well.

12   Smoking cessation

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

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

13   Physical Activity

Regular exercise is a core component of every wellness program. Staff Members must be strongly encouraged to engage in regular exercise.

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

14   Weight management

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

Web-Based wellness programs, workplace programs, or discounted access to weight control programs in the community may all be available.  Long-term follow-up is vital for maintenance of weight reduction.

15   Stress management

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

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

Some businesses endeavor to structure the work environment to minimize stress, both physically and operationally.

16   Biometric screenings/immunizations

Staff Members are actively encouraged to complete advised health testings for blood pressure, cholesterol, BMI, colorectal and breast cancer, and others.

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

17   On-Site health care

Actual provision of onsite primary care medical services is a growing trend.  The rapidly escalating costs of medical care insurance for staff members has stimulated this trend.

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

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

Examinations may conclude that some interventions didn’t work well. You may find that a popular Health Promotion Program costs too much and didn’t really affect employees’ health.

While these might not be the outcomes you hoped for, without this information you may continue ineffective interventions. Having this information will help you develop better solutions.

When your results are excellent, it is magnificent! You can spread the word to workforce and executive management that your health promotion program is achieving its goals.

Three major areas of an examination

• Wellness Program structure – the basic framework of the program

• Wellness Program process – Precisely how well the program is run

• Health Promotion Program outcomes – Whether or not the health promotion program met the set objectives

Common questions used to evaluate a Health Promotion Program

Structure Questions

• What’s included in the Wellness Program? What’s the intervention?

• Where does the Wellness Program take place?

• How’s the Wellness Program delivered? What content is included?

• Who manages the Wellness Program?

Process Questions

• Exactly how many people  participate?

• Do participants complete the Wellness Program?

• Are participants satisfied?

• Which aspects of the Wellness Program are best attended?

Outcome Questions

• Does the Health Promotion Program improve information about health issues?

• Does the Wellness Program change behavior?

• Does the Health Promotion Program save the business money?

• What’s the ROI?

Download a sample health promotion program (http – //www.ibx.com/pdfs/custom/wellness_partners/services/turnkey_programs/walking/participant_eval.pdf) investigation from IBC’s Walking Towards Wellness program.

• Identify through an staff member survey what incentives they value.

• Identify what incentives the organization can provide as well as what the budget will allow.

• Ensure that every participant who achieves a goal receives some recognition.

• Prevent offering incentives for the “best” or the “most.”

• Prevent using food as a reward.

• Use incentives to promote your health promotion program, through logos and branding.

Incentives can be used to raise participation rates, help individuals complete a Health Promotion Program, or help individuals change or adhere to healthy behaviors.

Providing incentives and rewards will send an important message to the workforce that your corporation is committed to assisting them with bettering their health. It also plays a meaningful role in arousing individuals to participate.

Tips on how to pick appropriate incentives –

• Identify through an staff member survey what incentives they value.

• Identify what incentives the corporation can provide as well as what the budget will allow.

• Ensure that every participant who achieves a goal receives some recognition.

• Prevent offering incentives for the “best” or the “most.”

• Prevent using food as a reward.

• Use incentives to promote your Health Promotion Program, through logos and branding.

It’ll be vital that you review and revise existing policies governing such areas as tobacco use sections and the staff cafeteria.

Tips on designing a Health Promotion Program –

• Create activities based on your plan goals addressing the specific needs of your employees. Focus on those topics that are of greatest interest to your employees and the greatest needs of your business, in that order. Avoid topics with narrow appeal.

• Keep it simple. Design the Health Promotion Program so it’s easy for the participants to understand and track.

• Integrate a combination of activities to include awareness, educational, and behavior elements.

• Select activities in which every worker can participate.

Suggestions for your Health Promotion Program –

• Challenges. Activities that focus on practicing a desired behavior that continues for 4-8 weeks and focuses on specific topics (like physical activity, nutrition, or stress management).

• Learning experiences. This includes seminars, videos, and classes.

• Behavior changes (like use of tobacco cessation). You might or may not offer interventions at the workplace. However, you ought to encourage person to make lifestyle changes that they want to make even without an external incentive.

• Education on illness management. for  instance, support and education groups for diabetes, high blood pressure, etc.

• Learing new skills. for  instance, CPR and first aid.

• Preventive screenings like blood pressure, cholesterol, and vision.

Objectives are general guidelines that explain what you want to achieve. Objectives define strategies or steps to take to attain the identified goal.

A health promotion program should’ve a “destination”. Use the results of your surveys and your wellness committee’s mission statement as guides. Consider these ideas –  

• Focus on making health information and learning resources readily available to staff members

• Focus on group activities so staff members can work together to support and encourage healthier lifestyles

• Develop a health promotion program that is visible to both workers and to your clients

• Focus on written policies and guidelines

• Be certain to set goals for your health promotion program.

Review Guidelines for Writing Objectives.

Wellness Program Goals Should be

Specific – A goal is specific when it provides a description of what’ll be accomplished. It will state exactly what the corporation intends to accomplish.

It ought to be written so that it may be easily and clearly communicated. A specific goal will make it easier for those writing objectives and action plans to address the following questions –  

• Who is to be involved?

• What is to be accomplished?

• Where’s it to be done?

• When’s it to be done?

Measurable – A goal is measurable if it is quantifiable.  To determine if your goal is measurable, ask questions like – Just how much? Just how many? How’ll I know when it is accomplished?

Attainable – You can attain most any goal you set when you plan your steps wisely and establish a time frame that permits you to carry out those steps. Goals that might have seemed far away and out of reach eventually move closer and become attainable.

Realistic – Realistic, means “do-able.” the goal needs to be realistic for your business and where the business is at the moment.

A goal to take out all the high fat items in the vending machine might not be realistic for your company right now; a better goal would be to substitute some of the chips, candy bars and pies for pretzels, yogurt and dried fruit.

Timely – In conclusion, a goal must’ve a timeframe –  for next week, in three months, by age 35. It must’ve a beginning and ending point. It should also have some intermediate points at which progress could be examined.

Limiting the time in which a goal should be accomplished assists to focus effort toward its achievement. If you do not set a time, the commitment is too vague. It tends not to happen because you feel you can begin at any time. Without a time limit, there’s no urgency to begin taking action now.

Individuals  are more willing to participate and support wellness efforts when they are involved in the decision-making process. Review the sample employee survey provided below.

Worker Interest Survey – can be edited (http – //www.ibx.com/pdfs/custom/worksite_wellness/company_tools/employee_interest_survey.doc)

When developing a recent survey, keep the following hints in mind –

• Ask mainly closed form questions, in particular if you’ll be sending the survey to a big number of staff. Closed form questions provide specific options and are easy to tabulate.

• Invite comments, suggestions and recommendations, or ask open-ended questions at the end of the survey. Open-ended items are more challenging to summarize.

• Include a brief explanatory cover letter with the survey with the signature of the corporation president. Be sure to include a statement about confidentiality and anonymity.

• Ask a group of representative workforce to review the survey before it’s distributed. Find out if the questions are going to be understood by workforce and won’t be objected to.

• Include demographic information at the starting, or end of the survey (gender, age, shift, site, department, etc.).

• Conduct a random drawing for a valued incentive item for all those who returned the survey. This could increase the response rate.

One rule to consider concerning surveys is when you’ve fewer than 500 personnel, everybody should receive one.  The benefit of everybody receiving a recent survey can be significant. When you’ve over 500 personnel, a sample of the work population from each department will suffice.

The higher the response, the more valid and reliable the results. A minimum response of 40 percent to 50 percent is considered valuable.

The committee establishes continuity, motivation, and wide ownership of the wellness program as well as provides an excellent automobile for communication.

So who ought to be on the committee? Consider appointing the following people /departments to your committee –

• upper management within your organization

• Union representatives

• Human resources  department

• Worker assistance program

• Information technology

• Communications

• Health and safety department

• Employees interested in wellness

Building a successful health promotion program requires staff time in addition to money. Some bigger corporations may spend 20 hours per week for three to six months preparing all the steps before launching a health promotion program.

Anywhere from 4 to 10 individuals  meeting monthly equals a wellness committee. A mission statement for the committee must be created by the second meeting. This way, everyone knows what the committee is working toward.

Once a health promotion program has been established, the committee’s size and meeting schedule may change. Still, no fewer than 4 members ought to meet at least quarterly so the group – and the health promotion program – does not fade away.

Upper-level management executives are responsible for making sure that the company meets its objectives. They can provide additional assistance by helping you to link your Health Promotion Program objectives to company outcomes, thereby positioning Health Promotion Program as a fundamental part of the company.

It’s crucial that you create support and excitement for the wellness program from all levels of the business including upper management, mid-level management, and grass-root staff.

The challenge for any Health Promotion Program coordinator is convincing executive management about the potential value of Health Promotion Program to the corporation and conceptualizing how health promotion programs can impact the corporation in a meaningful manner.

The American Journal of Wellness is a excellent resource to assist you with obtaining convincing information on the advantages of a Wellness Program.

Health Promotion Program support from senior management can come in many different ways –

• Involvement in the planning process

• Distribution of funding for the wellness program

• Support for time given to the health promotion program

• Participation in wellness events

• Leadership by management, such as the distribution of a letter of support for the wellness program.

• Download a sample letter requesting executive management support. (http – //www.ibx.com/pdfs/custom/worksite_wellness/corporation_tools/sr_mgt_support.doc)

• Flexibility of employee schedules to accommodate wellness activities

By researching your corporation’s history with similar health promotion programs and eliciting feedback from coworkers, you are able to find the best solution for your company.

Wellness Program –  Research Questions

• Find out when Wellness Program has been done in the past. If so, what worked and what did not?

• Was it commonly accepted?

• Was wellness programming successful? Why or why not?

• What does your organization hope to gain from implementing a Health Promotion Program?

Answers to these questions will help you start the process of building a culture of wellness within your business. It’s critical that you assess the environment before beginning a health promotion program.

• Approximately 95% of the $1.4 trillion that we spend as a nation on health goes to direct medical services, while about 5% is allocated to preventing disease and promoting health.

• Potentially, 50% to 70% of all illnesses are avoidable as they are associated with modifiable health risks.

• In an effort to optimize employee health, reduce avoidable health care utilization and enhance work performance, and in turn lower health care costs and improve employee satisfaction and retention, many companies are developing, or are interested in developing, Health Promotion Programs for personnel.

The advantages of corporate health promotion are well documented. More than 120 scientific research studies repeatedly show themes like improvements in health outcomes coupled with high Return On Investment (ROI). Some major findings include the following –

• Savings of $3.48 in lowered healthcare costs per dollar invested.

• Savings of $5.82 in decrease absenteeism costs per dollar invested.

• Return On Investments of at least $3 to $8 per dollar invested within five years of wellness program implementation.

• Lifestyle behavior modification programs –  $3 to $6 Return On Investment within 2 to 5 years.

• Self care, decision support wellness programs –  $2 to $3 Return On Investment (ROI) within a year.

• Disease management programs –  $7 to $10 Return On Investment within a year.

By offering health promotion programs, employers aren’t only providing an additional service for staff members, but they’re also gaining financially. Further, the impact of a health promotion program goes beyond decreased health care cost and ROI.

A health promotion program can affect productivity, absenteeism, morale, recruitment success, turnover, and medical care costs.

* Source –  Rees, C., and Finch, R. (2004). Health Improvement –  A comprehensive guide to designing, implementing and reviewing health promotion programs. National Corporation Group on Health, 1 (1), 1-7.