Corporate Wellness Blog

Introduction to Workplace Wellness Programs

The last ten years has brought big changes in employer attitudes toward Worksite Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in healthcare costs have encroached substantially into profits. Changes in the employer structures of healthcare facilities, in particular the growth of the for-profit healthcare sector, and the need to contain costs are changing the ways in which purchasers of healthcare plans are viewing their own efforts toward provision of workplace healthcare programs and facilities. Projections for the next decade indicate that workplace health programs will continue to become significant factors in the provision of healthcare, including prevention activities, for both government and private industry. In organizations with existing Worksite Health Promotion Programs, administrative rationale for sponsoring these activities ranged from improving employee health (28%) to improving employee morale (9.7%). Programs include interventions associated with safety, health risk assessment, smoking cessation, Blood Pressure (BP) control, diet programs and stress management. Benefits given range from improved health and productiveness to reducing healthcare costs.

Demographics of the American Workforce
• 110 million Americans composed the civilian labor force in 1981; by the year 2000 the civilian labor force is expected to be nearly 140 million.
• 44 percent of the 1984 labor force was female; 10 percent was Black.
• The median age of the workforce is 32 years and is expected to increase to 32 years by 2030.
• 57.9 percent of all employees work in businesses with between 2 and 500 employees; 45 percent work in businesses with fewer than 100 employees. An additional 7.5 million American citizens are self-employed and 3 million are farmers.
• 18 percent of all wage and salaried staff members in 1985 were union participants.
• 45 percent of all staff members are employed in offices.

Prevalence of Worksite Wellness Programs Activities

Based on a 1985 survey, almost 66% of worksites with 50 or more workers had Workplace Wellness Programs activities in 1985.  The frequency of worksite-based activities by selected categories in 1985 was:

Activity

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

Worksite size is the strongest indicator of program prevalence.

Most workers believe the advantages of their Company Wellness Programs activities outweigh the expenditures, even though few formal evaluations exist.

The most usually cited reason for starting programs and perceived profit from programs is improved employee health.

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

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

Tobacco Cessation Programs

Smoking related health concerns cost United States organizations $26 billion per year in lost productiveness and $7 to $8 billion in smoking-related healthcare costs.

Employees who smoke are 50 percent more likely to be hospitalized than nonsmokers, have 2 times as a myriad of job-related accidents as nonsmokers and have absenteeism rates approximately 50 percent higher than nonsmokers.

People who smoked an average of one or more packs of cigarettes per day had 118 percent higher health care expenditures than nonsmokers.

76 percent of current smokers and 80 percent of former smokers and people that do not smoke feel that organizations ought to restrict smoking to certain areas.

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

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

Examples of tobacco cessation intervention program used by corporations include:

• providing nonsmokers a discount of health and life insurance;
• paying full or partial fees for smoking cessation programs;
• providing cessation programs on organization or shared time;
• making available cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a tobacco-free business policy and setting deadlines for implementing the policy.

Physical Fitness Programs

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

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

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

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

Research findings support the notion that worksite physical activity programs better fitness and help decrease other health risks, although results related to improved work rate are weak due to lack of methods for accurately quantifying work rate.

A very small proportion of worksites have on-Site physical fitness facilities.

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

Some organizations subsidize employee participation in community “Ys,” health clubs or other community programs if no onsite facilities are available.

Job Site physical activity programs may cut expenditures to employers by reducing employee healthcare claims and expenditures.

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

Healthcare costs for obese people are roughly 11 percent higher than those for thin people.

Nutrition and Weight Control

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

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

The workplace offers several advantages for nutrition education; support and effect of co-workers and management, availability of a daily eating situation, and opportunities for follow-up and monitoring.

Worksite diet programs can be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight management programs;
• cholesterol reduction programs;
• programs for pregnant and lactating women; and
• other diet education issues.

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

Stress Management

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

Company pays many of the costs related to employee stress, both directly in the form of medical care costs and in reduced productivity.

Job factors which are associated with stress include:

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

Most worksite stress management programs are implemented as a result of requests from employees.

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

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

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

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

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

Seat Belt Usage

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

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

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

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

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

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

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

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

Factors influencing the sources of worksite safety belt programs include:

• active responsibility on the part of upper management;
• clearly defined and well enforced policy of needed belt use working;
• beneficial incentives and rewards; and
• ongoing education and training programs.

Case Studies of Workplace Wellness Programs

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

staff members at four Johnson & Johnson corporations who were exposed to the Employee Health Promotion Program expanding their daily energy expenditure in vigorous activity by 104 percent compared to a growth of 33 percent among staff members at corporations that were provided only an annual health screen.

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

The United Methodist Publishing House attributes some of the reduced than projected use in healthcare costs for 1985 ($902,116 projected with actual costs $142,884) to the Employee Wellness Program although the results are not conclusive.

In 1985, the Adolph Coors Corporation conducted a telephone interview of a random sample of its 10,000 employees to determine changes in health practices since the introduction of an employee Corporate Wellness Program 4 years earlier. The sample of 495 employees was stratified to match the employer profile in terms of age, sex and job description. The survey stated that 65 percent of respondents started exercising in The last 4 years, 37 percent had improved their diets, 20 percent were regular users of the wellness center, 9 percent had stopped smoking as the result of the employer’s tobacco cessation program and regular participants of the wellness center miss an average of 1.96 workdays every year due to illness or injury compared to 3.08 days for non-participating employees.

The Coors Organization also saw a cost savings from a cardiac rehabilitation program that was launched in 1981. In 1980 employees were out of work 7.2 months after a heart attack or bypass operation. In 1984, cardiac patients were out an average 1.9 months saving $152,000 in lost work time and in 1985 cardiac patients missed an average of 2.6 months, saving $125,000 that year.

Company Physical Activity Programs Plans Improve Employee Health and Wellness

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

Benefits of Employee Health Promotion Programs

• A employer investment of $100-$150 per employee each year to participate in an Corporate Health Promotion Program can save businesses $300 to $450 for each employee every year, according to Ron Goetzel, Director, Cornell University Institute for Health and Productivity Studies. The savings can take a few years to actualize, says Goetzel, and are seen in reduced health expenditures.
• The Wellness Councils of America reported a $24 return for every $1 invested on a Company Wellness Program for small corporations.
• According to a 2005 survey by The Art of Health Promotion, employers who adopted Worksite Health Promotion Programs realized a 30% decline in healthcare and absenteeism expenditures in less than four years.

A efficacious Worksite Health Promotion Program starts with Senior Leadership. Organization owners ought to lead by example, taking part in their corporation’s physical activity program and working closely with a wellness coach. Senior Leadership ought to make sure staff members are well cognizant of their wellness efforts, displaying weight loss results or smoking cessation results on corporation intranet or bulletin boards for everyone to see.

Corporate Wellness Programs that Really Work

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

Worksite Health Promotion Programs Yield Big Results

For organization owners who want to broaden employee participation in a Worksite Health Promotion Program, consider Johnson & Johnson’s approach. Faced with only 26% of employees participating in their employee health & wellness program, Johnson & Johnson offered employees a $500 discount on health care insurance costs if they completed a health risk profile. The number of employees participating in the Johnson & Johnson organization fitness program jumped after they provided the incentive — to more than 93%.

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

5 reasons to have a wellness program

1.   America spends more dollars on medical care than any other nation yet we are not the world’s healthiest
   • Largely sedentary
   • Tobacco use is still popular
   • Stress is at epidemic levels (WHO)
   • Alcohol continues to take its toll on Americans

2.   Much of the illness in The United States is preventable
   • Tobacco and alcohol are leading causes of death
   • As much as 70 percent of the cost of medical care is driven by avoidable illness

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

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

5.   Research validates that Employee Health Promotion Programs are able to better health, save money, and even produce a ROI.
   • Aldana,S.G. (1998). Financial impact of Company Health Promotion Programs and methodological quality of the evidence. The Art of Health Promotion. Vol 2, Number 1.
   • Wilson, M.G. (1996). A accross the board review of the effects of Employee Wellness Programs on health related outcomes: An update. The American Journal of health promotion. Vol 10, Number 6.
   • Wilson, M.G. (1996). A inclusive review of the effects of Employee Wellness Programs on health related outcomes: An update. The American Journal of health promotion. Vol 11, Number 2.
   • Chapman, L.S. Proof Positive: An analysis of the cost-effectiveness of workplace wellness. 3rd ed. Seattle: Summex Corporation, 1996.
   • Pelletier, K.R. A review of the health and cost-effective outcomes studies of all-inclusive health promotion and disease prevention programs at the workplace: 1993-1995 Update. The American Journal of Health and Promotion. Vol. 10, Number 5.

   
Key Components of a Employee Wellness Program

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

Sample Physical Worksite Wellness Programs / Workshops
• Annual health screening
• Regular physical activity
• Good safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

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

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

Sample Financial Corporate Health Promotion Programs / Workshops
• Financial management
• Savings and Investing
• Credit and Purchasing
• Insurance and Estate Planning

Spiritual Wellness – Focuses on promoting a healthy inner self

Sample Spiritual Worksite Wellness Programs / Workshops
• Promote daily devotional readings
• Provide regular service opportunities
• Offer a daily/weekly/monthly chapel (meditation) time during work hours

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

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

Many employers, as part of their efforts to contain rising healthcare costs, are launching worksite programs variously described as Corporate Health Promotion Programs, lifestyle programs, health and productivity management, population health management and, simply, wellness programs.

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

The popular media have done much to reward the concept of organization wellness. Last year, In Business: Madison magazine printed a story accompanied by a table reporting an impressive range of returns on investment (ROI):

Return on Investment (Per dollar ROI for lifestyle programs)
• Coors $6.15
• Kennecott $5.78
• Equitable Life $5.52
• Citibank $4.56
• General Mills $3.90
• Travelers $3.40
• Motorola $3.15
• PepsiCo $3.00
• Unum Life $1.81
Source: 2004 T.E. Brennan Company, as reported

Would these ROIs stand up to rigorous empirical analysis of the data? What factors create such disparate returns among these programs? And does the published literature, subject to peer review of scientific methods, support the ROIs announced here?

Health and Productivity Leadership

Illness and injury associated with an unhealthy lifestyle or potentially-modifiable risk factors is published to account for at least 25% of employee healthcare expenditures. The most significant of these risk factors are stress, tobacco use, overweight or obesity, physical inactivity, excessive alcohol use, and poor nutritional habits. Over the past two decades, a variety of groups at the local, state, and national levels have promoted the concept that health risk reduction and care management programs have the potential to improve employee health, and that workplace health education, health risk management, and benefit counseling should complement standard health insurance benefits.

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

All-Inclusive Workplace Wellness Programs may include classes on health risk reduction and job safety, fitness and exercise activities, health club memberships, and reductions in co-payments or premiums for employees who adhere to recommended healthcare screening ground rules.

Along with this, some employers are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing medical care.5 These changes are intended to decrease employees’ need for and utilization of medical care, yielding reduced group medical care costs. Demonstrated reductions in medical care expenditures should then offer employers with a powerful bargaining chip in negotiating reduced health insurance premiums during future terms.

Evidence basis: A range of return on investment estimates

The empirical research has produced results as varied as the popular media on ROI. Nonetheless, evidence continues to grow that well-designed and well-resourced Worksite Wellness Program and disease prevention programs support multi-faceted payback on investment. Peer-reviewed evaluations and meta analyses show that ROI is achieved through improved worker health, reduced benefit expense, and enhanced productiveness.

• Goetzel and colleagues, in their meta-analysis of two dozen articles summarizing economic evaluations of health and productivity management programs, saw an average return of $3.14 per $1 invested in traditional Corporate Health Promotion Programs. The ROI estimates for the individual programs ranged from $1.49 to $13.7,8
• Aldana reviewed 72 articles and concluded that Worksite Wellness Programs achieve an average return on investment of $3.48 when considering medical care expenditures alone, $5.82 per $1 when examining absenteeism, and $4.30 when both outcomes are considered.
• Ozminkowski and collagues conducted a 38 month case study of 23,000 participants in Citibank, N.A.’s health management program and reported that within a 2 year period, Citibank realized a ROI between $4.56 and $4.73.10  Follow-up studies observed improvements in the risk profiles of participants, with the high-risk group improving more than the “usual care” group11 as a result of more intensive programming.
• Chapman’s 2004 meta-assessment of 42 research studies, ranking overriding validity of the research studies, reports cost-benefit ratios from $2.05-$4.64.

In addition to immediately quantifiable expense reductions, researchers have stated a variety of spin-off benefits: greater productiveness, intellectual capacity, and reductions in disability12 and absenteeism.9,13,14,15 Such programs may also have positive effects on employee perceptions of the company14 and worker morale, even among nonparticipants. 13 These outcomes go beyond savings in direct medical care expenditures to provide non-health related ROI.

Tailoring program to maximize ROI Worksite Wellness Programs aim to reduce the health risks of employees at elevated 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 corporations now seek to calibrate their interventions in order to achieve optimal risk reduction and costeffectiveness.

In 2001, University of Michigan researchers stated on stable trends in healthcare costs for over 2 million current and former workers 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 workers moved from low risk to high risk were much greater than the decreases in costs when groups moved from high risk to low risk. Their conclusion: Programs designed to keep healthy people healthy will likely offer the greatest return on investment.

On the other hand, Pelletier’s meta-analysis16 and other program evaluations18 suggest that individualized risks reduction for high-risk workers within the context of accross the board programming is the essential element in achieving beneficial clinical and cost outcomes in workplace interventions.

Dose-Response?

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

Most cost-benefit studies have been conducted in large companies with more than fifty employees. But researchers have determined that similar results have the potential to be obtained by small companies with as few as five employees actively involved in a well-managed program.

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

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

Future developments

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

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

Meanwhile, the preponderance of data and the strength of the published research stand in favor of a positive ROI for Worksite Health Promotion Programs. Indeed, the company case for such programs is now well enough defined that some insurance brokers offer discounted rates to companies that institute or subscribe to wellness programs.

Future questions will focus on how best to combine comprehensive and focused interventions, the intensity of components, and how to calibrate the dose-response model to achieve a target ROI. Here, employers, workers, and researchers will need to collaborate to define mutual goals/objectives in terms of both clinical and cost outcomes.

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

Creating a corporate plan for Workplace Health Promotion Programs and disability management makes great company sense. The following eight-step process ensures a strategic, integrated, needs-driven and outcome-oriented approach.

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

1. Identify Your Corporate Health Promotion Program Champion

This person ought to be a leader in your organization and a strong advocate of health. Typically this is an individual who actively pursues his or her own personal quest for good health.

The program champion must have the resources and authority to propel the program forward. The program champion’s key role is to ensure the strategic plan for health is in line with with the employer’s objectives, strategic focus and employer values. By way of example if the organization promotes that “our strength is our people” the wellness program must demonstrate how pushes will nurture and protect that significant resource.

2. Form Your Employee Health Promotion Program Strategy Team

The Company Health Promotion Program Strategy Team ought to include decision makers and stakeholders from parts of the company that have the potential to impact health and the company’s bottom line. These areas may include; finance, human resources, training and development, health services, compensation and benefits, employee assistance services (EAP), marketing, facilities, health and safety, rehabilitation, cafeteria or meal services and the union. A team of six to eight representatives is recommended.

The role of the Strategy Team is to foster and start the strategic plan, look for opportunities to promote health, ensure the program is integrated into key areas of the organization, streamline efforts, maximize corporation resources and program evaluation.

3. Complete an Employer Health Audit

The purpose of an Organization Health Audit is to evaluate your existing programs and services, physical environment and policies & procedures that support health. It is also valuable to look at your employer culture or “how things are done” around the employer.

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

4. Analyze Your Organization’s Cost Pressures

Cost pressures are identified by analyzing a number of areas including; benefit costs, Workplace Safety Insurance Board (WSIB) claims, prescription usage, type of paramedic claims, absenteeism data and EAP utilization. This process helps to target areas that have the potential to be positively impacted by a Company Wellness Program and to offer a baseline for evaluating change.

5. Conduct a Health Risk Appraisal or Employee Needs & Interest Survey

The next step is to determine your employee’s health risks, interests and readiness to change. A confidential health risk appraisal can accomplish many goals. It provides a baseline from which to measure personal lifestyle changes, provides staff members with relevant health information, motivates staff members to take charge of their health and assists in program planning. Most health risk appraisals offer individual reports and a corporate report identifying elevated-risk areas in the corporation.

Many employers prefer to administer customized needs and interest survey to evaluate employee needs. The benefit of this approach is that the employer is able to gather information on the employees’ perceived wellness needs and program interests. This information can be incorporated into the strategic plan. Administering a survey also has the added benefit of fostering a sense of employee ownership to the program.

6. Establish Your Strategic Plan for Wellness

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

It is also important that the plan align itself with the vision, goals/objectives of the organization.

The sample strategic plan that follows was developed for blue jeans maker Levi Strauss & Co. (Canada) Inc. Levi Strauss & Co.’s mission statement and aspirations (how employees interact with each other in a organization environment) guided the development of the plan.

Levi Strauss & Co.’s aspirations include the following statement: Most importantly, we want satisfaction from accomplishments and friendships, balanced personal and professional lives, and to enjoy our endeavors. The wellness program plan included a number of components to see that it embraced this statement including the following:

1. A vision statement, which tied in with the company’s aspirations.
2. An incentive system to encourage and reward the accomplishment of healthy milestones.
3. A recognition system to applaud effectiveness.
4. Friendly competitions between Levi Strauss & Co. locations to ensure an enjoyable environment.
5. Opportunities to participate in small group educational programs to cultivate team backing.
6. Initiation of support groups for staff members completing wellness programs (i.e. smoking control support group).
7. Programs concerning work and family balance.

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

1. Corporation demographics
2. Focus groups
3. Cultural audit
4. Top prescription drug report
5. EAP utilization
6. Employee benefit services report
7. Health and dental claims
8. Operational effectiveness summaries
9. Health risk appraisals
7. Prepare a Organization Case to Support Your Plan

Your corporation case for wellness supplies the necessary details for approval at the senior staff level. The corporation case includes:

1. The Strategic Plan for Health
2. A proposed program budget
3. Marketing strategies
4. Program leadership options
5. An implementation plan
6. Assessment methodology.

In presenting the strategic plan it is important to highlight how the plan aligns itself with the strategic direction of the organization.

The program budget must include educational resources, marketing costs, rewards and incentives, leadership costs and supplies.

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

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

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

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

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

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

Analyzing the effectiveness of a Employee Wellness Program is ongoing. A formal evaluation must be conducted annually and may include; re-administering steps three to five, program participation statistics and a year end survey to revisit “soft” concerns such as morale, program satisfaction and future program direction.

8. Solicit Input and Communicate Your Plan

Employee input is vital to the long-term success of your program. An Employee Advisory Committee ought to be formed to roll out the plan. Another key responsibility of this group 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 significant. This group needs to buy-in to the notion that they play a key role in supporting positive health practices. Regular gatherings are advised with front line managers to receive ongoing input, address problems and orient new managers.

Conclusions

The World Health Organization’s definition of health is “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.” In order for us to create healthy workplaces, wellness drives must have a program champion, have employee ownership, be upper management supported, results driven and strategically aligned with the overriding employer objectives of the organization.

Wellness initiative that embrace these qualities will have a positive impact on an organization’s bottom line. Canadian research points to countless case studies where workplace programs have resulted in lowered absenteeism, lower claims and increased productiveness.

Businesses who have embraced wellness as part of “how they do business” share one thing in common. They confirm a commitment to their most significant resource – their people. They understand the increased pressures associated with downsized businesses, a rapidly changing workplace, an aging work force and the challenge of balancing work and family obligations. And they share a common belief that healthy staff members are happier, absent less and more productive.

References:
Design of Employee Health Promotion Programs by Michael P. O’Donnell. 1995. Published by the American Journal of Health Promotion.
Pro Fit-ability by Veronica Marsden. Group Healthcare Management. May 1997.
Meeting Expectations by Laura Mensch. Employee Health and Productivity. August 1999
7 Steps to Health Promotion by Daphne Woolf and Veronica Marsden. Group Healthcare Management. February 1996.
Published in The Journal of Health Promotion for Northern Ireland, Issue 9, March 2000

Want some wellness program ideas and wellness policy ideas to get you started? Or perhaps you want to jump start or improve upon your current wellness program? The list below provides ‘best practices’ that have the potential to help meet any wellness program budget! The Corporate Health Promotion Program ideas are divided into topic areas.

General Wellness Progam Ideas

• Conduct an Employee Needs & Interest Survey
• Develop a Workplace Wellness Program Committee
• Identify health insurance plans that cover expenditures for weight management and smoking cessation
• Waive co-pay or reimburse for preventive healthcare visits
• Display handouts on a variety of wellness issues for workers to take
• Organize a wellness resource center or library with videos, books, magazines, DVD’s on a variety of topics of interest to staff members
• Identify workers who are mentors or champions for healthy activities and ask them to present or to list as a contact for other workers
• Establish and encourage periodic or regular educational sessions.
• Plan monthly educational sessions on the national health observance topic
• Put up a Wellness Bulletin Board & update it monthly
• Post messages from national health observances during the month
• Provide healthy tips in newsletters, paycheck stuffers, bulletin boards, etc.
• Sponsor a benefits fair
• Develop company fitness and healthy eating challenges
• Sponsor company health & wellness fairs or other onsite events

Nutrition Programs

• Provide free, healthy snacks for workers (fruit, nuts, popcorn)
• Offer healthy meal choices in cafeterias and at company activities
• Give information to employees about the nutritional content of food served in the cafeteria
• Establish a fresh fruit “snack basket” in the breakroom or cafeteria
• Stock vending machines with healthier options
• Subsidize healthy foods in the cafeteria or snack machines (10¡ apples may be more appealing than $1.00 candy bars)
• Start a weekly or monthly healthy lunch club
• Give brochures available on a variety of healthy eating topics
• Include nutrition articles in organization newsletters
• Provide a healthy meal tasting contest Free
• Provide educational sessions at lunch-time on a variety of nutrition issues of interest
• Sponsor an employee healthy diet cookbook. Either sell the cookbook and use profits for programs, or purchase a cookbook for all workers

Weight Loss Programs / Weight Management Programs

• Offer flexible work schedules so that staff members are able to participate in weight-loss programs
• Subsidize registration expenditures for weight-management programs
• Form a support group to help workers who are trying to lose weight
• Arrange for registered dieticians near your worksite as a resource for employees who want information on healthy eating, meal planning or weight management
• Offer individual counseling for employees trying to lose weight
• Provide workplace fitness and weight-management programs through your local hospital, Weight Watchers, TOPS or local, registered dietician
• Have an educational session on diet myths and healthy eating

Physical Activity Programs

• Provide flexible work schedules to encourage physical activity
• Organize a fitness space with aerobic equipment, and weights
• Establish accessible walking paths, trails, and/or bike routes
• Urge staff members to walk more by parking farther away from the entrance
• Develop a gym with aerobic equipment, weights, aerobic classes, fitness professionals
• Have walking meetings
• Make the stairwells more appealing (carpet, fresh paint, artwork, posters)
• Offer reduced gym membership fees to all workers
• Offer facilities for staff members to secure bikes
• Schedule 5 – ten minute stretch breaks during the day
• Partially fund health club membership for workers who participate a minimal number of days per week (ex., 3 days per week)
• Support lunchtime walking/running clubs or company sports team
• Encourage stairwell use and incentives
• Install a basketball hoop outside
• Promote & support area walks or fitness activities
• Urge walking during breaks and other off-time periods
• Provide periodic fitness incentive programs to encourage exercise
• Schedule educational sessions on fitness activities

Smoking Cessation Programs / Tobacco Cessation Programs

• Establish a smoke-free grounds
• Develop a tobacco-free workplace
• Promote the use of 1-800-QUIT-NOW, North Carolina’s no cost Tobacco Use Quitline. Or check www.QuitlineNC.com
• Reimburse employees for tobacco replacement products
• Partially fund the expenditure of tobacco cessation classes
• Offer pamphlets and information on health effects from tobacco use and tobacco cessation
• Schedule awareness sessions to innervate employees to try to quit tobacco use
• Schedule onsite smoking cessation classes

Employee Health Screening

• Discount medical insurance premiums or reduce co-payments for staff members who take part in screenings and who take part in managing their risk factors
• Install Blood Pressure monitoring equipment
• Offer flu shots for employees and family members
• Offer Health Risk Assessments to all workers, including counseling and follow-up
• Offer periodic Blood Pressure (BP) screenings and follow-up
• Provide periodic screenings for blood lipids, blood sugar, body composition, etc.

Stress Management Programs / Work Life Balance Programs

• Offer flexible schedules for family/work life balance
• Offer and promote an Employee Assistance Program(EAP)
• Offer information on substance abuse prevention
• Provide brochures and information on stress management and mental health
• Give pamphlets and information on work life balance, such as monetary planning, childcare, parenting, elder care, etc.
• Give supervisor and manager training on communication, relationship building, business stressors, etc.
• Assess corporation policies and work schedules to identify corporation stressors
• Review the Employee Assistance Program(EAP) to ensure it is meeting the needs of the employees and employer
• Schedule educational sessions on stress management and work life balance
• Have sessions on relaxation, stress management, and work life balance topics

Health screenings are important programs to identify chronic disease in their early stages. Once identified, wellness behavior modification programs can help prevent a disease from progressing. Working with local hospitals and other corporations, you can get information on providing screening and behavior modification programs that might better your employees’ health and save your business money in absenteeism, treatment for disease complications, and reduced productivity. Below are some ideas to help get you started.

Based on your Employee Needs & Interest Survey and the demographics of your workplace, consider offering periodic screenings to find specific health risks such as:

• Blood Pressure Checks to identify staff members 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, such as body mass index (BMI) or body fat measures
• Bone density for potential risk of osteoporosis,
• Cancer screenings such as, skin examinations, mammograms, or PSA screenings,
• Vision checks for glaucoma, or visual acuity
• Other health screenings depending on your worker population and needs

Your local hospital, employer physician practice, or health department may support assistance. However, if you have employees you may want to concentrate on programs that will keep them healthy rather than screening for early identification of chronic conditions. The focus of your wellness program might be healthy lifestyle practices to cut risk and prevent disease.

In addition to the health screenings, consider offering a Health Risk Appraisal / Health Risk Assessment to all employees. The Health Risk Appraisal / Health Risk Assessment will help to identify factors that may lead to additional risks, such as smoking history, stress levels, image of health, family history, job satisfaction, support systems, and mental health. Often the screening results are included on the Health Risk Appraisal / Health Risk Assessment, which supports a more inclusive snap shot of health risks. The summary results provide the valuable information to plan appropriate interventions.

Company Wellness Program Interventions

The key to the performance of screenings and Health Risk Appraisals / Health Risk Assessments is the interventions or follow-up programs. The information from the screenings increases awareness and frequently motivates employees to consider making healthier changes. It’s the follow up interventions that support the essential reinforcement and assistance required for employees to actually make and maintain those changes. The interventions have the potential to include individual follow-up and ongoing counseling, individual or group health coaching on the risk factors, behavior modification programs, and/or business reinforcement. Examples include:

• Strategies to decrease Blood Pressure
• Managing diabetes
• Taking care of your heart
• Healthy eating
• Weight loss ideas
• Growing physical exercise
• Smoking Cessation

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

Based on the results and your Worksite Health Promotion Program Committee goals/objectives you have the potential to plan the best strategies for your corporation and workers. Consider the neighborhood resources available to support services, such as health associations, hospitals, medical providers, and/or public health agencies.

Health Risk Appraisals / Health Risk Assessments (HRA’s), are an assessment tool or questionnaire scientifically designed to identify health risks and outline information to help  people in making healthy changes that effect their health and prevent chronic disease.

Health Risk Appraisals / Health Risk Assessments (HRA’s) have four standard components in worksite settings:
• A Questionnaire
• A Computer Program to Review Health Risk Factors
• Confidential Individual Reports
• Group Summary Report

Workers complete a lifestyle questionnaire that includes for example nutrition practices, height and weight, exercise habits, family history, stress perceptions, smoking history, and work satisfaction. Another valuable feature to consider is readiness to change questions to determine participation interest. Including health screenings such as blood lipids and Blood Pressure (BP) results increases the advantages of an Health Risk Appraisal / Health Risk Assessment by providing a more accurate health assessment and therefore improving lifestyle choice decisions and program options. However, it is valuable to determine if the Health Risk Appraisal / Health Risk Assessment can be used without including this information.

The health risk questionnaire information is entered into a computer program and an individual confidential report is generated that summarizes health risks as well as information on how to reduce risk factors. Individual reports are completely confidential. Depending on the reason for implementing the Health Risk Appraisal / Health Risk Assessment, it’s significant to consider the type of report the business will receive as well. A group report summarizing major risk factors and recommendations for programs to implement in order to reduce employee and business risks supports significant information for your wellness program.

The Health Risk Appraisals / Health Risk Assessments have the potential to be used to:
• Raise awareness to individual employee’s health status
• Encourage staff members to make healthier lifestyle changes
• Coach elevated-risk staff members
• Develop Worksite Health Promotion Programs based on the identified needs
• Review program effectiveness by comparing Health Risk Appraisals / Health Risk Assessments (HRA’s) completed at set intervals such as yearly.

There are many advantages to thinking of a part-time or full-time occupational and environmental health nurse (OHN). Occupational health nursing is the specialty practice that provides for and delivers health and safety programs and services to employees, and worker populations. The practice focuses on promotion and restoration of health, prevention of illness and injury, treatment of work and non-work related injuries and illnesses, and protection from work related  and environmental hazards.

Onsite Heath Professional roles have the potential to include: Case management, Counseling, Employee Wellness Program, Legal and regulatory compliance, Clinical services, and Hazard detection and controls. The American Association of Occupational and Environmental Health Nurses is the national association, www.AAOHN.org. The State Chapter also has a website with information including local chapter information to help you find a contact near you, www.NCAOHN.org.

Health educators are able to design, conduct and evaluate activities that help improve the health of all your workers. They are subject matter experts who may be a important asset regardless your program needs and objectives and goals. They are able to help form a Employee Wellness Program Committee and start a myriad of of its programs and services, for example or depending on the structure and time commitments of your Employee Wellness Program Committee, they are able to also plan the entire program as well. Integrating the activities of the Committee and/or Employee Wellness Program professional services within your operations, including within your safety and occupational health program will support additional benefits!

We are creating Workplace Health Promotion Programs to help you feel better and stay healthy. In order to plan programs that best meet your needs and interests we would like your ideas! Please take a minute to answer some questions about your interests. Your answers will be combined with those of others’ and reviewed to help plan programs for you. Do not sign your name.

Please complete the survey today and return it to__________. We appreciate your valuable input! Your help is valuable for planning successful 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 are very interested. Indicate your response by circling or ‘Xing’ the number.

I am interested in:

Participating in wellness programs before work 1 2 3
Participating in wellness programs after work 1 2 3
Participating in wellness programs during my lunch break 1 2 3
Learning healthy eating options to lose weight 1 2 3
Sports nutrition 1 2 3
Healthier cooking 1 2 3
Helping my children eat healthier 1 2 3
Quick, healthy meals for full lifestyles 1 2 3
Healthy snack options 1 2 3
Learning how to quit smoking 1 2 3
Attending classes to help me quit smoking cigarettes 1 2 3
Stress Mangement skills 1 2 3
Balancing work, family, and personal life 1 2 3
Time upper management skills 1 2 3
Participating in a beginning exercise program 1 2 3
Creating time to exercise for busy people 1 2 3
Getting health information that I can read or watch at home 1 2 3
Learning about cancer prevention 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 stimulate intake of fruits and vegetables 1 2 3
Parenting Topics (age of children: ) 1 2 3
Onsite exercise classes: walking Yoga aerobic other: 1 2 3
Health screening such as Blood Pressure, blood lipids, blood glucose 1 2 3