Health Wellness ProgramHealth and Wellness Programs and Wellness Program Consulting

Small organization wellness programs are catching on. A well-designed wellness program is able to boost productivity, boost morale and vitality, cut stress, cut absenteeism, and control avoidable health care expenditures within a organization. The beauty of it is that you’re simply helping workers to make smart choices so the expenditures of launching a wellness program are minimal in comparison to the benefits.

Employee health is a primary problem for small business owners. In a small business, even a few sick staff members are able to disrupt the flow of the workplace and bring the operation to a standstill.

Instead of sitting back and hoping for the best, some small organization owners are taking the matter of employee health into their own hands by launching Company Wellness Programs. Here’s how they work.

Overview of Worksite Wellness Programs

Employee wellness programs are programs initiated by the corporation to better the overall health of their work force and to help individual staff members overcome specific health-related hurdles. These programs are able to be offered in a variety of formats: In mandatory employee training sessions, as voluntary sessions, or through a third-party provider offering a wide-range of Employee Assistance Programs.

In every case, however, the employer foots the bill for the programs because an investment in employee health is a employer expenditure that directly impacts the employer’s bottom line.

Why offer Worksite Wellness Programs?

Apart from the obvious issue for the health of your staff members, there are numerous other reasons why Employee Wellness Programs make sense for small businesses. From the get-go, your company will advance from the decreased level of absenteeism that goes hand in hand with a healthy workforce.

Company Health Promotion Programs will also reduce the number of injuries that occur in the workplace, not just from accidents, but also from repetitive motion and other recurring sources. Since even a minor blip in worker attendance has the potential to have a big influence on a small employer, a more reliable workforce will inevitably translate into a smoother work cycle and a more robust bottom line.

Worksite Wellness Program Features

Company Health Promotion Programs can cover a broad range of health-related issues. Based on your staff members’ needs, it’s entirely up to you to determine the kind of programming you want to offer. Nevertheless, most Company Health Promotion Programs offer some at least some programs in the following areas:

• Nutrition. Diet is able to significantly effect an employee’s ability to do their job effectively. Nutritional programs educate workers about food options and equip them to make healthy dietary choices.
• Physical Fitness. In addition to diet, physical activity is an important factor in a healthy lifestyle. Employee Wellness Programs generally support employees with opportunities to incorporate physical activity into their daily lives.
• Smoking Cessation. Statistics prove that tobacco users tend to fall ill more usually than their non-smoking peers. Since sick staff members disrupt the workplace, tobacco cessation programs are a no-brainer for both employers and staff members.
• Physiological Testing. Many employers offer physiological as a regular part of their wellness programs. Cholesterol tests, Blood Pressure screenings, and other simple exams are able to support early warning signs for more somber problems.
• Stress Management. Stress itself takes a toll on employees. Still, stress is also linked to other health concerns such as depression, cardiovascular disease, diabetes, and obesity. Workplace Health Promotion Programs that help employees deal with stress improve not only the mental health of your employees, but their physical health as well.

Establish a Company Employee Health Promotion Program for Your Workers Today

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

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

1. Look around, and determine if employees lead a healthy lifestyle before initiating an Employee Health Promotion Program. How many employees run outside during lunch for a tobacco break? Would a tobacco cessation program help? How often do the junk food-laden snack machines really should be replenished? Is anyone working out or taking advantage of local walking trails as part of their healthy living goals and objectives? The answers to these questions will give corporations a clearer idea of the Employee Health Promotion Program that’s right for them.

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

3. Give Company Health Promotion Programs a large kick-off with a healthy living “fair.” Offer employees no cost flu shots, Blood Pressure (BP) checks, cholesterol screenings, body/fat ratio assessments, smoking cessation programs and no cost mammograms- and contact the local hospital, because there’s plenty more where this came from. Businesses keep their employees hopping during the week. Give employees a chance to amp up their healthy lifestyle on the corporation dime. A corporate health and wellbeing program is an additional benefit that employees receive for working for the corporation!

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

Introduction to Workplace Health Promotion Programs

The previous ten years has brought primary changes in business attitudes toward Company Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in medical expenditures have encroached substantially into profits. Changes in the business structures of medical facilities, in particular the growth of the for-profit medical sector, and the need to contain expenditures are changing the ways in which purchasers of medical plans are viewing their own efforts toward provision of worksite medical programs and facilities. Projections for the next decade indicate that worksite health programs will continue to become significant factors in the provision of medical, including prevention activities, for both government and private industry. In businesses with existing Company 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, tobacco cessation, Blood Pressure control, nutrition programs and stress management. Benefits given range from improved health and work rate to decreasing medical expenditures.

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

Prevalence of Corporate Wellness Programs Activities

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

Activity

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

Job Site size is the strongest indicator of program prevalence.

Most employees believe the advantages of their Workplace Health Promotion Programs activities outweigh the costs, even though few formal evaluations exist.

The most generally given reason for starting programs and perceived profit from programs is improved employee health.

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

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

Smoking Cessation Programs

Smoking related health concerns cost United States companies $26 billion per year in lost productiveness and $7 to $8 billion in tobacco-related healthcare expenditures.

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

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

76% of current tobacco users and 80% of former tobacco users and nonsmokers feel that companies must restrict smoking to certain areas.

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

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

Examples of tobacco cessation intervention program used by employers include:

• offering non-smokers a discount of health and life insurance;
• paying full or partial fees for tobacco cessation programs;
• offering cessation programs on organization or shared time;
• offering cash payments to quitters after 6 of 12 tobacco-free months;
• participating in national quit smoking days; and
• adopting a tobacco-free employer 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 activity has been shown to provide a two- to three-fold difference in cardiovascular deaths between active employees and their more sedentary counterparts.

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

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

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

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

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

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

Worksite exercise program may decrease costs to employers by reducing employee medical care claims and expenditures.

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

Health Care expenditures for obese people are roughly 11% 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 decrease the risk of weighty health issues such as elevated Blood Pressure and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

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

Worksite diet programs are able to 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 take part in weight-loss programs than are female workers.

Stress Management

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

Business pays many of the expenditures related to employee stress, both directly in the form of medical expenditures and in lower productiveness.

Job factors which are associated with stress include:

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

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

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

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

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

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

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

Safety 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 annually.

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

Staff Members who routinely fail to use seat belts may spend up to 54% more days in the hospital.

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

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

In work settings where safety belt policies, requiring use of belts by those riding in a organization vehicle or using a private vehicle for organization 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 workplace safety belt programs include:

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

Case Studies of Company Wellness Programs

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

employees at four Johnson & Johnson companies who were exposed to the Company Wellness Program increased their daily energy expenditure in vigorous activity by 104% compared to a rise of 33% among employees at companies that were offered only an annual health screen.

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

The United Methodist Publishing House attributes some of the lower than projected use in medical expenditures for 1985 ($902,116 projected with actual expenditures $142,884) to the Employee Health Promotion Program although the results are not conclusive.

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

The Coors Organization also saw a cost savings from a cardiac rehabilitation program that was begun 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.

Employer Exercise Programs Plans Improve Employee Health and Wellness

Instituting a Workplace Health Promotion Program improves the health of staff members, decreases employee absenteeism and saves the employer money, too. Learn more about initiating an Workplace Health Promotion Program in the office.

Benefits of Worksite Wellness Programs

• A company investment of $100-$150 per employee each year to take part in an Employee Wellness 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 have the potential to 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 spent on a Company Health Promotion Program for small organizations.
• According to a 2005 survey by The Art of Health Promotion, businesses who adopted Worksite Wellness Programs realized a 30 percent reduction in health care and absenteeism expenditures in less than 4 years.

A efficacious Corporate Health Promotion Program begins with Senior Management. Organization owners ought to lead by example, taking part in their company’s physical activity program and working closely with a wellness coach. Senior Management ought to make sure workers are well knowledgeable about their wellness efforts, displaying weight loss results or smoking cessation results on company intranet or bulletin boards for everyone to see.

Worksite Wellness Programs that Truly Work

• Encourage staff members to kick start their own wellness programs by visiting their doctor. A complete physical ought to include information about blood glucose, blood lipids levels and general health.
• Target specific health-related concerns in a corporate exercise program. Information about how to fight obesity, smoking, alcoholism and prescription drug abuse ought to be at the forefront of an Worksite Wellness Program, along with related conditions.
• Hire a wellness coach to instruct employees on how to lead a healthy lifestyle.
• Reward staff members for taking part in employer wellness plans. Let staff members accrue health & wellness points that they can redeem for prizes. Make the prizes healthy, too- a no cost massage, personal training session with the employer’s wellness coach or health meal gift certificate encourages even healthier lifestyle choices.
• Acknowledge employee health and wellbeing leaders in employer newsletters, in posted bulletins and on the employer intranet.

Workplace Wellness Programs Provide Big Results

For business owners who want to broaden employee participation in a Workplace Wellness Program, consider Johnson & Johnson’s approach. Faced with only 26 percent of employees participating in their employee wellbeing and health program, Johnson & Johnson offered employees a $500 discount on health care insurance expenditures if they completed a health risk profile. The number of employees participating in the Johnson & Johnson business exercise program jumped after they offered the incentive — to more than 93%.

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

5 reasons to have a wellness program

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

2.   Much of the illness in The U.S. is avoidable
   • Tobacco and alcohol are leading causes of death
   • As much as 70 percent of the expense of health 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 expenditures are usually the number one benefit cost to most employers

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

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

   
Key Components of a Company Health Promotion Program

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

Sample Physical Employee Wellness Programs / Workshops
• Annual health evaluation
• Regular physical exercise
• Smart safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

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

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

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

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

Sample Nutritional Company Health Promotion Programs / Workshops
• Individual nutritional Assessment
• Individual and group counseling
• Instructional classes
• Weight loss programs

Many employers, as part of their efforts to contain rising health care costs, are implementing worksite programs variously described as Worksite Wellness Programs, lifestyle programs, health and productiveness management, population health management and, simply, wellness programs.

The purpose of this article is to consider whether such programs better health. If so, do they in turn lower utilization of healthcare services and lower healthcare 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 announced

Would these ROIs stand up to thorough 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 reported here?

Health and Productivity Leadership

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

The intensity of Company Health Promotion Programs range from bulletin board, pamphlet or newsletter information to onsite fitness facilities, health risk reduction classes, and personal lifestyle change coaching.3 Company 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 discussions and individual follow-up.

Comprehensive Corporate 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 staff members who adhere to recommended medical screening ground rules.

Along with this, some employers are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing healthcare.5 These changes are intended to cut employees’ need for and utilization of healthcare, provideing reduced group healthcare expenditures. Demonstrated reductions in healthcare expenditures ought to then provide employers with a powerful bargaining chip in negotiating lower health care 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 Corporate Wellness Program and disease prevention programs provide multi-faceted payback on expenditure. Peer-reviewed evaluations and meta analyses show that ROI is achieved through improved worker health, reduced benefit expense, and enhanced productivity.

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

In addition to immediately quantifiable cost reductions, researchers have reported 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 beneficial effects on employee perceptions of the company14 and worker morale, even among nonparticipants. 13 These outcomes go beyond savings in direct medical care costs to offer non-health related return on investment.

Tailoring program to maximize return on investment Workplace Wellness Programs aim to decrease the health risks of workers 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 companies now seek to calibrate their interventions in order to achieve ideal risk reduction and costeffectiveness.

In 2001, University of Michigan researchers stated on stable trends in medical expenditures 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 expenditures when groups of workers moved from low risk to high risk were much greater than the decreases in expenditures when groups moved from high risk to low risk. Their conclusion: Programs designed to keep healthy people healthy will likely support 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 employees within the context of inclusive programming is the essential element in achieving positive 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 big employers with more than fifty staff members. But researchers have established that similar results are able to be obtained by small employers with as few as five staff members actively involved in a well-managed program.

Various research studies also suggest that even relatively modest levels of participation have the potential to 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 beneficial ROI with 51% participation.

Length of intervention appears to be a more salient variable: an impact on healthcare expenditures 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 return on investment upward.

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

Meanwhile, the preponderance of data and the strength of the published research stand in favor of a positive return on investment for Workplace Wellness Programs. Indeed, the employer case for such programs is now well enough defined that some insurance brokers offer discounted rates to corporations that institute or subscribe to wellness programs.

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

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

Establishing a corporate strategy for Employee Health Promotion Programs and disability management makes good employer sense. The following eight-step process ensures a strategic, integrated, needs-driven and results-oriented approach.

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

1. Identify Your Worksite Health Promotion Program Champion

This person should 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 optimal health.

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

2. Form Your Worksite Wellness Program Strategy Team

The Worksite Wellness Program Strategy Team ought to include decision makers and stakeholders from areas of the corporation that are able to effect health and the company’s bottom line. These areas may include; finance, human resources(HR), 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 enable the strategic plan, look for opportunities to promote health, make sure the program is integrated into key areas of the organization, streamline efforts, maximize employer 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 important 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 assessment. During the assessment process, health problems 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 expenditures, Workplace Safety Insurance Board (WSIB) claims, drug usage, type of paramedic claims, absenteeism data and EAP utilization. This process helps to target areas that can be positively impacted by a Employee Health Promotion 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 and objectives. It supports a baseline from which to measure personal lifestyle changes, supports workers with relevant health information, motivates workers to take charge of their health and assists in program planning. Most health risk appraisals support individual reports and a corporate report identifying high-risk areas in the company.

Many companies prefer to administer customized needs and interest survey to evaluate employee needs. The benefit of this approach is that the business 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. Organize Your Strategic Plan for Wellness

The strategic plan ought to incorporate information gathered from the Organization 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 initiatives under each intention. The strategic plan supports a framework to encourage, reinforcement and evaluate “best health practices.”

It is also valuable that the plan align itself with the vision, 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 company environment) guided the development of the plan.

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

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

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

1. Organization demographics
2. Focus groups
3. Cultural audit
4. Top drug report
5. EAP utilization
6. Employee benefit services report
7. Health and dental claims
8. Operational success 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 should include educational resources, marketing expenditures, incentives and rewards, leadership expenditures and supplies.

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

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

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

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

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

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

Analyzing the effectiveness of a Employee Health Promotion Program is ongoing. A formal assessment ought to 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 critical 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 team is to solicit feedback from all levels of the organization to ensure buy-in. Front line Manager’s Information Sessions and focus groups are also valuable. This group needs to buy-in to the notion that they play a key role in supporting beneficial health practices. Regular gatherings are advised with front line managers to receive ongoing input, address problems and orient new managers.

Conclusions

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

Wellness initiative that embrace these qualities will have a beneficial effect on an organization’s bottom line. Canadian research points to numerous case studies where onsite programs have resulted in lowered absenteeism, decrease claims and increased work rate.

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

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

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

General Wellness Progam Ideas

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

Nutrition Programs

• Provide free, healthy snacks for staff members (fruit, nuts, popcorn)
• Provide healthy meal choices in cafeterias and at organization events
• Give information to workers 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
• Partially fund 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 subject matters
• Include diet articles in business newsletters
• Provide a healthy food tasting contest Free
• Have educational sessions at lunchtime-time on a variety of nutrition issues of interest
• Develop an employee healthy food cookbook. Either sell the cookbook and use profits for programs, or purchase a cookbook for all employees

Weight Loss Programs / Weight Management Programs

• Consider offering flexible work schedules so that employees have the potential to participate in weight-loss programs
• Partially fund registration expenditures for weight-management programs
• Offer a support group to help workers who are trying to lose weight
• Arrange for registered dieticians near your workplace as a resource for employees who want information on healthy eating, meal planning or weight control
• Offer individual counseling for employees trying to lose weight
• Offer onsite fitness and weight-management programs through your local hospital, Weight Watchers, TOPS or local, registered dietician
• Schedule an educational session on diet myths and healthy eating

Physical Activity Programs

• Allow flexible work schedules to encourage physical activity
• Design a fitness space with aerobic equipment, and weights
• Develop accessible walking paths, trails, and/or bike routes
• Encourage staff members to walk more by parking farther away from the entrance
• Create a gym with aerobic equipment, weights, aerobic classes, fitness professionals
• Hold walking meetings
• Make the stairways more appealing (carpet, fresh paint, artwork, posters)
• Offer reduced gym membership fees to all workers
• Provide facilities for staff members to secure bikes
• Have 5 – 10 minute stretch breaks during the day
• Subsidize gym membership for employees who take part a minimal number of days per week (ex., 3 days per week)
• Support lunchtime walking/running clubs or corporation sports team
• Encourage stairwell use and rewards and incentives
• Install a basketball hoop outside
• Promote & support area walks or fitness activities
• Promote walking during breaks and other off-time periods
• Provide periodic fitness incentive programs to encourage physical activity
• Schedule educational sessions on fitness activities

Smoking Cessation Programs / Tobacco Cessation Programs

• Create a smoke-free grounds
• Organize a smoke-free workplace
• Promote the use of 1-800-QUIT-NOW, North Carolina’s free Tobacco Use Quitline. Or check www.QuitlineNC.com
• Reimburse workers for tobacco replacement products
• Partially fund the expenditure of smoking cessation courses
• Provide handouts and information on health effects from tobacco use and tobacco cessation
• Have awareness sessions to arouse staff members to try to quit tobacco use
• Have onsite smoking cessation seminars

Employee Health Screening

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

Stress Management Programs / Work Life Balance Programs

• Consider offering flexible schedules for family/work life balance
• Provide and reward an Employee Assistance Program(EAP)
• Provide information on substance abuse prevention
• Provide handouts and information on stress management and mental health
• Offer pamphlets and information on work life balance, such as monetary planning, childcare, parenting, elder care, etc.
• Provide supervisor and manager training on communication, relationship building, business stressors, etc.
• Evaluate company policies and work schedules to identify company stressors
• Review the Employee Assistance Program to be sure it is meeting the needs of the staff members and business
• Schedule educational sessions on stress management and work life balance
• Schedule workshops on relaxation, stress management, and work life balance issues

Wellness screenings are significant programs to identify chronic conditions in their early stages. Once identified, wellness intervention programs can help prevent a disease from progressing. Working with local hospitals and other businesses, you can obtain information on offering evaluation and intervention programs that might better your employees’ health and save your corporation money in absenteeism, treatment for disease complications, and reduced productiveness. Below are some ideas to assist you in getting started.

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

• Blood Pressure (BP) Checks to identify employees with pre-hypertension or hypertension (elevated blood pressure),
• Cholesterol Screenings for total, HDL (good cholesterol), LDL (bad cholesterol) and/or Triglycerides
• Blood Sugar Screenings fasting or non-fasting to screen for possible diabetes,
• Body composition, such as body mass index (BMI) or body fat measures
• Bone density for potential risk of osteoporosis,
• Cancer screenings such as, skin examinations, mammograms, or PSA screenings,
• Vision checks for glaucoma, or visual acuity
• Other wellness screenings depending on your worker population and needs

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

In addition to the health screenings, consider offering a Health Risk Appraisal / Health Risk Assessment to all workers. The Health Risk Appraisal / Health Risk Assessment will help to identify factors that may lead to additional risks, such as smoking history, stress levels, conception 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 supplies a more inclusive snap shot of health risks. The summary results support the valuable information to plan appropriate interventions.

Workplace Wellness Program Interventions

The key to the success of screenings and Health Risk Assessments / Health Risk Appraisals is the interventions or follow-up programs. The data collected during the screenings increases awareness and often motivates staff members to consider making healthier changes. It’s the follow up interventions that provide the critical reinforcement and assistance necessitated for staff members to actually make and maintain those changes. The interventions are able to include individual follow-up and ongoing counseling, individual or group health coaching on the risk factors, behavior change programs, and/or business reinforcement. Examples include:

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

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

Based on the outcome and your Employee Health Promotion Program Committee goals and objectives you are able to plan the best strategies for your employer and staff members. Consider the neighborhood resources available to provide services, such as health associations, hospitals, medical care providers, and/or public health agencies.