Corporate Wellness Blog

Company America is increasingly investing in employee wellness because it is great business.  In order to meet productivity demands, organizations must rely on a healthy, constructive workforce to succeed in the highly competitive global marketplace.  Over a hundred studies in both corporate and governmental settings have documented the economic advantages of Workplace Wellness Programs, including reduced absenteeism, reduced injuries and workman’s compensation expenditures, reduced medical expenditures, reduced employee turnover, as well as greater productivity, greater worker satisfaction, and improved morale.1-10  

The more recent literature reflects improvements in wellness programming along with greater return on investment (ROI).  In general, the more focused and intensive the program, the greater profit realized.  To enhance their effectiveness federal government Workplace Health Promotion Programs may be able to incorporate some of the features described.  Employee wellness programs demonstrated to have positive returns on investment frequently include the following features:

1.   Health and work rate management model
Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors such as smoking, lack of physical exercise, excess weight, unhealthy diet, elevated cholesterol, high Blood Pressure (BP), stress, depression, and so on.  High-risk employees are specifically targeted for intervention, although the most successful programs also direct efforts towards healthy employees in order to maintain their low-risk status.  This model emphasizes outcomes as opposed to simply offering wellness activities for their own sake.  

2.   Health risk appraisal
Use of a computerized health risk appraisal (HRA) instrument with individualized feedback and recommendations is almost universal in successful programs.  Employees take the questionnaire annually in many cases.  The HRA serves to increase awareness, provide direction, and arouse individuals to improve specific behaviors.  In some cases, the personalized report is directly linked to appropriate resources related to identified risks.  Research indicates that the use of an HRA is effective if it is followed by some kind of educational or therapeutic intervention for identified risks.  It often serves as the entry point into wellness programs.

3.   Health Testing
Many programs combine the outcome of the health risk appraisal with measurement of each employee’s biometrics, including weight and Body Mass Index (BMI), Blood Pressure, cholesterol, fasting glucose, and assorted other metrics.  Combining the results of the HRA with biological measures results in a more accurate risk profile.   Computer health risk appraisals frequently incorporate biometric data in their risk analysis.

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

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

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

7.   Multiple formats
Programs may offer wellness content in web-based, paper, and seminar formats to support stimulating variety and alternatives in order to accommodate the needs of all employees.  In addition to onsite physical activity and healthy eating activities, on-line programs, e-mail reminders and notices, printed newsletters and materials, and business classes are common dissemination strategies.

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

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

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

11.   Family involvement
Many programs promote spouses and other family members to take part in the corporation wellness activities and to adopt a healthy lifestyle along with the designated employee.  It is far easier for the employee to have a healthy lifestyle if his/her family does so as well.

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

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

14.   Weight management
Because obesity is a major threat to health it is imperative that programs offer effective assistance with weight management.  Enthusiastic encouragement from senior staff to shed excess weight is important.  Internet based programs, workplace programs, or discounted access to weight management programs in the area may all be available.  Long-term follow-up is critical for maintenance of weight loss.

15.   Stress management
Workplace stress is perhaps the most common objection among workers and a primary contributor to absenteeism, presenteeism (reduced work rate), and low morale.  Almost all thriving wellness programs offer assistance with personal and worksite stress.  Some programs refer workers to outside resources for more weighty conditions like depression and anxiety disorders, but most offer web-based or persistent onsite general stress reduction programs.  Some organizations endeavor to structure the work environment to minimize stress, both physically and operationally.

16.   Wellness screenings/immunizations
staff members are actively encouraged to complete recommended medical care screenings for Blood Pressure (BP), blood lipids, BMI, colorectal and breast cancer, and others.  Annual influenza immunizations are also encouraged.  Some sites provide these services at the worksite.  Incentives are frequently awarded for completion of these screenings/immunizations.

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

References

1.   Aldana, Steven G.  (2001)   Financial Impact of Corporate Health Promotion Programs:  A Comprehensive Review of the Literature.   Am J Health Promotion 15(5):296-320.
2.   Chapman, Larry.  (1998)   The Role of Incentives in Health Promotion.  The Art of Health Promotion  2(3):1-8.
3.   Chapman, Larry.   (2003)   Biometric Screening in Health Promotion:  Is it Really As Important as We Think?  The Art of Health Promotion  7(2):1-12.
4.   Chapman, Larry.  (2005)   Meta-Assessment of Corporate Health Promotion Programs Economic Return Studies: 2005 Update.  The Art of Health Promotion, July/August, 1-15.
5.   Chapman, Larry.   (2006)   Employee Participation in Workplace Wellness Programs and Workplace Wellness Programs:  How Important are Incentives, and Which Ones work Best?   North Carolina Medical Journal   67(6):  431-432.
6.   Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth.   (2007)   The Role of Health and Wellness Coaching in Corporate Health Promotion Programs.   The Art of Health Promotion, July/August, 1-12.
7.   Chapman, Larry.  (2007)   Proof Positive:  An Analysis of the cost-Effectiveness of Job Site Wellness.  Northwest Health Management Publishing, Seattle, WA.
8.   Chapman, Larry.  (2007)   An In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change.   Workshop presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
9.   Edington, Dee.   (2001)   Emerging Research:  A View from One Research Center.  American Journal of Health Promotion 15(5): 341-349.
10.   Edington, Dee W.  (2007)   Health Management as a Serious Business Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
11.   Pelletier, Barbara, Boles, Myde, and Lunch, Wendy.  (2004)  Changes in Health Risks and Work Productivity.   Journal of Occupational and Environmental Medicine, 46(7): 746-754.
12.   Pelletier, Kenneth R.  (2005)   A Review and Analysis of the Clinical and Cost-Effectiveness Studies of comprehensive Health and Disease Management Programs at the Worksite: Update VI 2000-2004.  JOEM 47(10)1051-1058.
13.   DeVol, Ross, Bedroussian, Armen, et. al.  (2007)  An Unhealthy America:  The Economic Burden of Chronic Disease.  Report released by the Milken Institute.   www.milkeninstitute.org.
14.   Partnership for Prevention.  (2008) Investing in Health:  Proven Health Promotion Practices for Workplaces.   http://www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.

Evaluations determine the outcome of a Workplace Health Promotion Program. They help you discover if your objectives were met. It is a good idea to add an assessment component to your Workplace Health Promotion Program.

Evaluations may conclude that some interventions didn’t work well. You may find that a popular Employee Health Promotion Program expenditures too much and didn’t really affect employees’ health. While these may not be the outcomes you hoped for, without this information you might continue ineffective interventions. Having this information will help you cultivate better solutions. When your results are good, it’s magnificent! You can spread the word to staff members and management that your program is achieving its objectives.

Three major areas of an evaluation

• Workplace Wellness Program structure – The basic framework of the program
• Employee Health Promotion Program process – How well the program is run
• Employee Health Promotion Program outcomes – Whether the program met the set objectives

Common questions used to evaluate a Worksite Wellness Program

Employee Wellness Program Structure Questions

• What is included in the Corporate Health Promotion Program? What is the intervention?
• Where does the Workplace Wellness Program take place?
• How is the Employee Health Promotion Program delivered? What content is included?
• Who manages the Worksite Health Promotion Program?

Company Health Promotion Program Process Questions

• How many people take part?
• Do participants complete the Worksite Health Promotion Program?
• Are participants satisfied?
• Which aspects of the Company Health Promotion Program are best attended?

Worksite Wellness Program Outcome Questions

• Does the Worksite Health Promotion Program improve knowledge about health problems?
• Does the Company Wellness Program change behavior?
• Does the Company Wellness Program save the company money?
• What is the return on investment (ROI)?

• Identify through an employee survey what incentives and rewards they value.
• Identify what incentives and rewards the employer can provide as well as what the budget will allow.
• Ensure that every colleague who achieves a objective receives some recognition.
• Avoid offering incentives/rewards for the “best” or the “most.”
• Avoid using food as a reward.
• Use incentives/rewards to encourage your Workplace Health Promotion Program, through logos and branding.

Incentives encourage employees to adopt beneficial behaviors or maintain an existing beneficial behavior that may potentially help the employee stay healthy and live longer. Adopting beneficial health behavior is fundamentally what wellness is about.

Incentives can be used to increase participation rates, help individuals complete a Corporate Wellness Program, or help individuals shift or adhere to healthy behaviors. Providing incentives and rewards will send an important message to the workers that your company is committed to assisting them with improving their health. It also plays a important role in motivating individuals to take part.

Tips on how to choose appropriate rewards and incentives:

• Ascertain through an employee survey what incentives/rewards they value.
• Determine what incentives/rewards the corporation can provide as well as what the budget will allow.
• Make sure that every participant who achieves a intention receives some recognition.
• Avoid offering rewards and incentives for the “best” or the “most.”
• Avoid using food as a reward.
• Use incentives/rewards to encourage your Corporate Wellness Program, through logos and branding.

Create goals

Goals are general ground rules that explain what you want to achieve. Objectives define strategies or steps to take to attain the identified intention.

A wellness program ought to have a “destination”. Use the outcome 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 employees
• Focus on group activities so employees can work together to support and encourage healthier lifestyles
• Organize a wellness program that is visible to both employees and to your customers
• Focus on written policies and standard procedures
• Set objectives for your wellness program.

Review Guidelines for Writing Goals.

Goals Should Be

Specific – A objective is specific when it supplies a description of what will be accomplished. It will state exactly what the business intends to accomplish. It must be written so that it can be easily and clearly communicated. A specific objective 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 is it to be done?
• When is it to be done?

Measurable – A intention is measurable if it is quantifiable. To determine if your intention is measurable, ask questions such as: How much? How many? How will I know when it is accomplished?

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

Realistic – Realistic, means “do-able.” The intention needs to be realistic for your corporation and where the corporation is at the moment. A intention to take out all the high fat items in the snack machines may not be realistic for your corporation right now; a better intention would be to substitute some of the chips, candy bars and pies for pretzels, yogurt and dried fruit.

Timely – Finally, a objective must have a timeframe: for next week, in three months, by age 35. It must have a starting and ending point. It must also have some intermediate points at which progress can be assessed. Limiting the time in which a objective must be accomplished helps to focus effort toward its execution. 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.

Successful wellness programs are designed to meet the needs and interests of the staff members. Ask staff members what they are interested in, and what needs they have. People are more willing to participate and support wellness efforts if they are involved in the decision-making process.

When beginning a survey, keep the following hints in mind:

• Ask mostly closed form questions, especially if you will be sending the survey to a sizable number of staff members. Closed form questions offer specific choices and are simple to tabulate.
• Invite comments, ideas and recommendations, or ask open-ended questions at the end of the survey. Open-ended items are more difficult to summarize.
• Include a brief explanatory cover letter with the survey with the signature of the corporation president. Make sure to include a statement about confidentiality and anonymity.
• Ask a group of representative employees to review the survey before it is distributed. Find out if the questions will be understood by employees and won’t be objected to.
• Include demographic information at the beginning, 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 boost the response rate.

One rule to consider concerning surveys is if you have fewer than 500 staff members, everyone must receive one. The benefit of everyone receiving a survey can be important. If you have over 500 staff members, a sample of the work population from each department will suffice. The higher the response, the more valid and reliable the outcome. A minimum response of 40% to 50% is considered important.

A critical first step in organizing your company’s wellness program is the formation of a Company Health Promotion Program Committee. The focus of the Company Health Promotion Program Committee is to plan, encourage, and enable the program. The Company Health Promotion Program Committee establishes continuity, motivation, and broad ownership of the program as well as supplies an excellent vehicle for communication.

So who should be on the Corporate Wellness Program Committee? Consider appointing the following people/departments to your Corporate Wellness Program Committee:

• Senior Management within your company
• Union representatives
• Human resources department
• Employee Assistance Program
• Information technology
• Communications
• Health and safety department
• staff members interested in health & wellness

Building a successful Employee Wellness Program requires employee time as well as money. Some larger organizations may spend 20 hours per week for three to six months preparing all the steps prior to launching a Employee Wellness Program.

Anywhere from 4 to 10 people meeting monthly equals a Corporate Health Promotion Program Committee. A mission statement for the Corporate Health Promotion Program Committee must be developed by the second meeting. This way, everyone knows what the Corporate Health Promotion Program Committee is working toward.

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

Support from upper management is important to building a efficacious wellness program! Visible upper management backing is one of the most vital factors in the success of a workplace Company Health Promotion Program. Upper Management executives are responsible for making sure that the corporation meets its objectives. They can support additional assistance by assisting you to link your Company Health Promotion Program objectives to corporation outcomes, thereby positioning Company Health Promotion Program as a fundamental part of the corporation.

It is valuable to foster support and excitement for the program from all echelons of the business including upper management, mid-level management, and grass-root workers.

The challenge for any Workplace Health Promotion Program coordinator is convincing upper management about the potential value of Workplace Health Promotion Program to the company and conceptualizing how Workplace Health Promotion Program pushes can effect the company in a meaningful manner. The American Journal of Health Promotion is a great resource to support you with obtaining convincing information on the benefits of a Workplace Health Promotion Program.

Worksite Health Promotion Program backing from management can come in countless different ways:

• Involvement in the wellness program planning process
• Distribution of funding for the wellness program
• Support for time given to the wellness program
• Participation in wellness events
• Leadership by management, such as the distribution of a letter of backing for the program.
• Flexibility of employee schedules to accommodate wellness activities

The first step in starting your wellness/Company Wellness Program is to be aware of your business and how Company Wellness Program will fit into the current structure. By researching your organization’s history with similar programs and eliciting feedback from co-employees, you can discover the best solution for your business.

Company Health Promotion Program: Research Questions

• Find out if Worksite Wellness Program has been done in the past. If so, what worked and what did not?
• Was it widely accepted?
• Was programming successful? Why or why not?
• What does your corporation hope to gain from launching a Employee Health Promotion Program?

Answers to these questions will help you start the process of creating a culture of wellness within your employer. It is imperative that you evaluate the environment before starting a program.

The costs of medical have been rising more than 10 percent each year for several years. A substantial amount of the money spent in the medical system treats costly illnesses and diseases.

• Approximately 95 percent of the $1.4 trillion that we spend as a nation on health goes to direct healthcare services, while about 5 percent is allocated to preventing disease and promoting health.
• Potentially, 50 percent to 70 percent of all diseases are preventable as they are associated with modifiable health risks.
• In an effort to optimize employee health, cut preventable medical utilization and enhance work execution, and in turn decreased medical costs and better employee satisfaction and retention, many corporations are planning, or are interested in planning, Employee Health Promotion Programs for workers.

The advantages of worksite wellness are well documented. Greater than 120 research studies repeatedly show themes such as improvements in health outcomes coupled with high returns on investment (ROI). Some primary findings include the following:

• Savings of $3.48 in reduced health care costs per dollar invested.
• Savings of $5.82 in decrease absenteeism costs per dollar invested.
• ROIs of at least $3 to $8 per dollar invested within five years of program implementation.
• Lifestyle behavior modification programs: $3 to $6 ROI within 2 to 5 years.
• Self care, decision reinforcement programs: $2 to $3 return on investment within a year.
• Disease management programs: $7 to $10 return on investment within a year.

By offering health improvement programs, corporations are not only offering an additional service for workers, but they are also gaining fiscally. Furthermore, the effect of a health improvement program goes beyond lowered medical care cost and ROI. A health improvement program can affect work rate, 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 evaluating worksite programs. National Business Group on Health, 1 (1), 1-7.