Posts from — December 2008

What Are Workplace Wellness Programs?

Workplace Wellness Programs are designed to support and promote worker health and wellness through education and awareness programs primarily based at the worksite. The program is a win-win in that workers benefit from learning and staying well, and the employer has improved loyalty and less absenteeism.

As organizations become more aware of the importance of worker health on productivity, there is improved interest in encouraging and supporting healthy lifestyle choices. Employer costs for Workplace Wellness Programs can rapidly be offset with fewer work-related injuries, improved attendance, less turnover, and improved morale.

Types of Workplace Wellness Programs

Workplace Wellness Programs: Lunch and Learn Wellness Presentations

The easiest Workplace Wellness Programs are one’s where the employer arranges to have quarterly seminars during lunchtime on topics such as stress management, nutrition, and exercise. A local mental health clinic, hospital, or the Employee Assistance Program (Employee Assistance Program) may provide these. This type of corporate health and Worksite Wellness Plan is usually arranged through Human Resources, the health department, or the safety manager. Participation is generally voluntary.

Before deciding on topics for wellness presentations, it is a good idea to do some type of worker polling to see what topics people are interested in. This can be as simple as an e-mail to all staff asking for suggestions or as formal as having an outside group come in to conduct interviews and design a complete corporate health and Workplace Wellness Program.

Workplace Wellness Programs: Health Risk Assessments / Health Risk Appraisals

An employer can provide comprehensive Health Risk Assessments / Health Risk Appraisals for workers. Health Risk Assessments / Health Risk Appraisals are detailed questionnaires that covers all areas of behavior (seatbelt use, smoking, alcohol use, frequency of exercise, family history of disease and illness, etc.). This is usually done in conjunction with employee biometric testing for things like cholesterol and blood sugar screening.

Once the Health Risk Assessments / Health Risk Appraisals are scored, the results are shared with workers along with suggestions for changes. The employer is able to get aggregate statistics that will show trends that he or she may want to address. For example, if a lot of people have high blood pressure, the employer may consider an educational seminar, biweekly onsite blood pressure readings, and low-salt, low-fat selections in the cafeteria or snack machines as interventions to include in the corporate health and Workplace Wellness Program.

If the Health Risk Assessments / Health Risk Appraisals show that there is a “trend” toward not wearing seatbelts, perhaps having the State police come in and give a seminar about what occurs in an accident when you don’t have a seatbelt on would change some behavior.

Workplace Wellness Programs: smoking Cessation

smoking cessation programs are very popular components of Workplace Wellness Programs. Often, the local chapter of the American Cancer Society or American Lung Association will come in to run a group. Another option is for workers to attend a smoking cessation group in the community. Costs for the smoking cessation group can be offset by the employer after workers complete the program.

Workplace Wellness Programs: Stress Management

Stress is a major area of concern for organizations. Stressed out workers get sick more frequently, make more errors, and generally do not perform up to capacity. As a result, Workplace Wellness Programs frequently take steps to address worker stress. There are many ways to address stress within your Workplace Wellness Programs, and the beauty of these ideas is that everyone can benefit from them.

Certainly, stress management seminars are educational and informative and should be included in any corporate health and Workplace Wellness Program.

Workplace Wellness Programs and Work/Life Programs

Many organizations offer a work/life program that offers assistance with things from finding day care for a child or elderly parent and information on obscure college scholarship funds to information on which PC to buy and where to find someone to walk your dog. These programs fit into Workplace Wellness Programs because they help your workers handle many of the things that are taking up work time and increasing stress.

Workplace Wellness Programs and Employee Assistance Programs

An Employee Assistance Programs are integral parts of effective Workplace Wellness Programs. By helping workers address individual/mental health problems and concerns, an Employee Assistance Program can go a long way toward improving overall health and productivity. Representatives from your Employee Assistance Program can also work closely with you to design Workplace Wellness Programs that are integrated and effective.

Time Management and Workplace Wellness Programs

Time is one of our most precious commodities, and anything you can do as an employer to help your workers manage their time is going to be welcome. Although not traditionally thought to be part of Workplace Wellness Programs, providing flextime and telecommuting are two ways to lower stress and raise productivity.

These programs take thought and planning and are not appropriate for all workers or all positions; however, in many workplaces, they are underused. Either your Human Resources manager or an outside consultant can help you design a program. If you belong to a business group or Chamber of Commerce, you may find assistance there. Also, talk to colleagues who are doing this in their organizations to see how it is working.

The Culture of Wellness

Staff Member wellness has to be part of your company culture, not just something you throw in as an afterthought. It isn’t a Band-Aid, but rather a thoughtful piece of your business strategy. For example, if productivity is down due to smoking breaks, providing smoking cessation classes can help. But it’s also important to establish a no smoking policy.

When workers feel valued, they are more loyal and tend to work harder. They take pride in their work and talk about what a great company they work for. A healthy workforce is a productive workforce.

Even the best and most innovative organizations are experiencing the impact worker well-being on their organizations’ performance.  The bad news is that many of these organizations are unaware of the extent to which less-than-optimal worker health and well-being is impacting workforce capacity and performance.  The goods news is that there is an increasing body of research and practice than can help organizations mitigate this frequently unseen issue and establish significant opportunities for improved workforce attraction, retention and performance!  This article focuses on how organizational leaders can increase physical and financial worker wellness in the workplace.

The Problems of Chronic Disease

According to the World Health Organization (WHO), 60% of deaths in 2005 could be attributed to chronic disease (cardiovascular disease, cancer, chronic respiratory diseases, and diabetes).1  The largest attributing factors to the chronic diseases include smoking, physical activity, and diet.2  The costs of these diseases are staggering.  For example, if there were a 10% reduction in mortality from heart disease and cancer, it could save the US $10.4 trillion each year.3  Further the WHO projects that over 80% of the US population will be either considered overweight or obese by the year 2015.

The Problems of Financial Distress and Dissatisfaction

As hard as it may be to fathom, a 2004 research study found that 67% of U.S. Workers are dealing with Personal Financial Issues.4 In another research study, it was found that these issues can exist in all segments of any workforce, regardless of income, education, or position level.5 Couple these facts with our workforce reality:

* The workforce is aging and demand for professionals in many industries continues to exceed the supply – and will for the foreseeable future.
* Due to the shortages of quality personnel the stress on our current workforce is increasing.
* With these workforce shortages, the majority of organizations cannot continue to pay spiraling market prices for professionals.
* Lastly, those personality attributes that make many professionals great caregivers or service-providers also tend to make them less apt to focus on matters of individual financial management.

The Return On Investment (ROI)

There are significant reasons why organizations should employ Strategies to begin Workplace Wellness Programs for their workers:

* Raise Productivity including reductions in medical care and workers compensation claims, absenteeism, and presenteesism;
* Lower employer paid medical care and re-insurance premiums; and
* Raise worker, physicians and patient satisfaction; and
* Raise worker retention and productivity.

A recent Towers Perrin case study6 found that a ten percentage point improvement on worker engagement was linked to a 4.6 percentage point improvement on customer satisfaction and revenue growth and labor cost improvements equal to a 2.8% impact on controllable margin.

What all this shows is that providing Workplace Wellness Programs and rewards is more than just “the right thing to do.”  Rather, there is a profound business case.  As workforce capacity and engagement increase, a bottom-up cultural change takes place in your organization.  These changes drive improvements in customer satisfaction, productivity, absenteeism, and presenteesism – all of which drive improvements in profitability.

The Course of Change

As an employer, you can have a tremendous impact on the health of the community.  Here are a few suggestions on how you can engage your workers (possibly include flowchart):

1. Define the Plan – Determine if you have the internal resource availability and knowledge to develop a formal Workplace Wellness Program.  Many organizations, due to confidentiality legal and other reasons, pick to engage outside organizations to manage these processes.
2. Communication – Once you have developed the plan, communicate the plan to all workers – using multiple media and approaches.
3. Lead by Example –Begin Workplace Wellness Programs at the top (walk the walk).  Give yourselves the opportunity to go through a health risk assessment and a financial assessment.  If you can, communicate your results and your action steps to staff.
4. Develop rewards for Staff Participation – Here are a couple of financial rewards you can provide staff that are low cost and optimally have a return on investment (ROI):

1. Pay workers to take a risk assessment
2. Lower employee contributions to health plan for those with reduced risk of chronic disease and correspondingly raise employee contribution to health plan for those with increased risk of chronic disease

5. Make available Personal Risk Assessment Counseling – Make available resources that can meet one on one with each worker to understand their health risks and opportunities
6. Remove Trans-Fat from Your Dietary Offerings – If you have onsite food facilities, and haven’t been required by legislative statute, you should eliminate trans-fatty oils from the worker and customer meals
7. Eliminate Smoking Areas for Staff Members – More and more organizations, including large cities, are now banning smoking on their facilities.
8. Make available Proper Monitoring Programs – Probably the hardest part of the plan, the ongoing monitoring is critical.  Some organizations are large enough to own or build wellness centers – but even then, many workers feel uncomfortable in using them.  Typically the users of wellness centers are those least in need.  The good news is that there are many external and internet-based tools and options that are available today.
9. Encourage Other Local Businesses to Make available Workplace Wellness Programs.  In some cases (e.g. hospitals), there are options where this can even generate revenue and/or deepen relationships with the communities you serve.

Legal Issues

When thinking about a Workplace Wellness Program, one must take into account certain requirements under ERISA, the Internal Revenue Code (Code) and the Public Health Service Act (PHSA). All three laws were amended by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to provide for improved portability and continuity of health coverage. HIPAA also added Code section 9802, ERISA section 702 and PHSA section 2702, each of which prohibits discrimination in health coverage based on health status.

To be a bona fide Workplace Wellness Program, the plan must satisfy the following requirements:

* An individual’s total incentive must be limited. A limit of 10 percent to 20 percent of the total cost of employee-only coverage may be appropriate, according to the DOL.
* The program must be reasonably designed to promote good health or prevent disease.
* The incentive must be available to all similarly situated individuals. The program must allow any individual for whom it is unreasonably difficult because of a health condition to meet the Worksite Wellness Plan standard (or for whom it is medically inadvisable to attempt to meet the Worksite Wellness Plan standard) an opportunity to satisfy a reasonable alternative standard.

1 2005 Preventing chronic disease:  A important investment. World Health Organization
2 2007 Working Towards Wellness:  Accelerating the prevention of chronic disease.  World Economic Forum
3 2007 The Value of Health and Longevity.  Kevin M. Murphy and Robert H. Topal, University of Chicago
4 2004 Employer/Employee Equation Research on Worker Types, Preferences and Engagement Issues – Concours Group, Age Wave and Harris Poll
5 1997 Neal E. Cutler, Ph.D
6 2003 Talent Report: New Realities in Today’s Workforce – Towers Perrin

Why have Worksite Wellness Plan goals?

Worksite Wellness Plan goals take your organization’s priorities for employee health improvement and make them specific and measurable. Well-defined Worksite Wellness Plan goals provide direction for deciding on Strategies and a basis for which to measure progress.

Writing Worksite Wellness Plan goals

Writing Worksite Wellness Plan goals is not complicated or difficult. It does require some thought, about your organization’s Worksite Wellness Plan vision for a culture of health and they should be:

Specific Worksite Wellness Plan Goals
Measurable Worksite Wellness Plan Goals
Attainable Worksite Wellness Plan Goals
Realistic Worksite Wellness Plan Goals
Timely Worksite Wellness Plan Goals

Specific Worksite Wellness Plan Goals: What is the specific outcome your organization is looking for? “Reduce smoking among workers” is more specific than “Improve the health of workers.” You may wish to write some goals about specific outcomes (reducing smoking among workers) and other goals about specific progress (implementing a tobacco-free campus policy or reducing the price of fresh fruit in the cafeteria to 25 cents a piece).

Measurable Worksite Wellness Plan Goals: Making your goals measurable provides a means of evaluating your progress and success. There is a saying: “what gets measured, gets done.” Measurable goals can be powerful motivators for your organization. “Provide more time for workers to be physically active” is much less measurable than “implement a daily 15-minute walking break into the schedule of all workers.” “Increase the number of workers who want to quit smoking” is less measurable than “increase enrollments in the stop-using tobacco program to 120 workers per year.”

Attainable Worksite Wellness Plan Goals: Determine goals that challenge your organization to change and that will demonstrate a real commitment to employee health. At the same time, set goals that are achievable. Goals that are set too far out of reach can be overwhelming and may become a barrier rather than a motivator.

Realistic Worksite Wellness Plan Goals: Write goals that are do-able, given the skills, time, finances and overall strategy of the organization. A realistic project may push the skills and knowledge of the people working on it but it shouldn’t break them.

Timely Worksite Wellness Plan Goals: When do you hope to achieve the goal? Next week? Next year? Without a timeframe, the goal is still vague and is much less likely to galvanize resources and energy within your organization.

“Reduce the percent of workers who use tobacco from 20% to 10%” is much less of a challenge than “By the end of 2010, reduce the percent of workers who use tobacco from 20% to 15%”.

Workplace Wellness Programs that support workers and the setting that they work in have been shown to be a good return on investment (ROI). Workplace Wellness Programs can be extensive and sometimes expensive. However, there are ways for small organizations to make positive changes at little or no cost.

Workplace Wellness Program: Physical Fitness/Weight Management Activities

1. Give access to on- and off- worksite gyms and recreational programs before, during, and after work hours.
2. Make available and encourage participation in after work recreation or leagues.
3. Make available cash incentives or reduced insurance costs for participation in physical activity and/or weight management or maintenance programs.
4. Make available shower and/or changing facilities onsite.
5. Make available outdoor exercise areas such as fields and trails for worker use.
6. Make available bicycle racks in safe, convenient, and accessible locations.
7. Make available onsite fitness opportunities, such as group classes or personal training.
8. Make available an on-site exercise facility.
9. Set up programs that have strong social support systems and rewards, such as:
o Buddy or team physical activity goals
o Programs that involve workers and family
o Programs to encourage physical activity, such as pedometer walking challenges
o Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10. Make available flexible work hours to allow for physical activity during the day.
11. Support physical activity breaks during the workday, such as stretching or walking.
12. Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have workers map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to encourage stair usage.
16. Make available exercise/physical fitness messages and information to workers.
17. Make available or support recreation leagues and other physical activity events onsite or in the community.
18. Start worker activity clubs such as walking or bicycling clubs.
19. Make available onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward workers who participate.
21. Set up a box and solicit fitness and health tips.

Workplace Wellness Program: General Health Education Activities

1. Have a current policy outlining the requirements and functions of a comprehensive workplace Workplace Wellness Program.
2. Have a wellness plan in place that addresses the purpose, nature, duration, resources needed, participants in, and expected results of a workplace Workplace Wellness Program.
3. Orient workers to the Worksite Wellness Plan and give them copies of the physical activity, nutrition, and tobacco use policies.
4. Promote and encourage worker participation in the physical activity/fitness and nutrition education/weight management program.
5. Make available health education information to workers.
6. Have a committee that meets at least once a month to oversee the Workplace Wellness Program.
7. Make available regular health education seminars on various physical activity, nutrition, and wellness-related topics. Ask voluntary health associations, medical care providers, and/or public health agencies to offer onsite education classes.
8. Host a health fair as a kick-off event or as a celebration for completion of a wellness campaign.
9. Designate specific areas to support workers such as diabetics and nursing mothers.
10. Conduct preventive wellness screenings for blood pressure, body composition, blood cholesterol, and diabetes.
11. Make available confidential health rist assessments.
12. Make available onsite weight management/maintenance programs for workers.
13. Add weight management/maintenance, nutrition, and physical activity counseling as a member benefit in health insurance contracts.

Workplace Wellness Program: Tobacco Cessation

1. Establish a company policy prohibiting tobacco use anywhere on the property.
2. Make available prompts/posters to support no tobacco use policy.
3. Policy supporting participation in smoking cessation programs during duty time (flex-time).
4. Make available counseling through an individual, group, or telephone counseling program onsite.
5. Make available counseling through a healthcare plan sponsored individual, group, or telephone counseling program.
6. Make available cessation medications through health insurance.

Workplace Wellness Programs that support workers and the setting that they work in have been shown to be a good return on investment (ROI). Workplace Wellness Programs can be extensive and sometimes expensive. However, there are ways for small organizations to make positive changes at little or no cost.

Workplace Wellness Program: Nutrition Activities

Fruit and Vegetable Consumption

1. Make available healthy eating reminders and prompts to workers via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2. Make available appealing, low-cost fruits and vegetables in vending machines and in the cafeteria.
3. Make available cookbooks, food preparation, and cooking classes for workers’ families.
4. Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.
5. Make available healthy foods at meetings, conferences, and catered events.
6. Use point-of-decision prompts as a marketing technique to promote healthier choices.
7. Make available healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8. Make available taste-testing opportunities at the workplace.
9. Make available worker-led campaigns, demonstrations or programs.
10. Make available local fruits and vegetables at the workplace (i.e. workplace farmer’s market or community-supported agriculture drop-off point).
11. Use competitive pricing (price non-nutritious foods in vending machines and cafeterias at higher prices).
12. Make available protected time and dedicated space away from the work area for breaks and lunch.
13. Make kitchen equipment available to workers.
14. Make available an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption

1. Make water available throughout the day.
2. Make available appealing, low-cost healthful drink options in vending machines and the cafeteria.
3. Modify worksite vending contracts to raise the number of healthy options.
4. Price non-nutritious beverages at a higher cost.
5. Use point-of-decision prompts to promote healthier choices.

Portion Control

1. Label foods to show serving size and/or nutritional content.
2. Make available food models, food scales for weighing and pictures to help workers assess portion size.
3. Make available appropriate portion sizes at meetings, workplace events and in the cafeteria.

Breastfeeding

1. Support nursing mothers by providing them rooms for expressing milk in a secure and relaxed setting, a refrigerator for storage of breast milk, policies that support breast feeding, and lactation education programs.
2. Make available flexible scheduling and/or onsite or near-site child care to allow for milk expression during the workday.
3. Adopt alternative work options (i.e. teleworking, part-time, extended maternity) for breastfeeding mothers returning to work.
4. Educate personnel on the importance of supporting breastfeeding co-workers.

Television & Food Advertising

1. Place televisionss in non-eating areas of the workplace.
2. Limit food advertising in the cafeteria (i.e. print and other media).

(Adapted from The Health Promotion First Act prepared by David Anderson, Ph.D., StayWell Health Management)

Staff Member Lifestyles Impact Staff Member Health
•    Approximately 40% of all deaths in the United States are premature (at least 900,000 deaths each year) and are due to unhealthy lifestyle choices such as tobacco use, poor diet, sedentary lifestyle, misuse of alcohol and drugs, and accidents. Other contributors to early death include genetic predisposition (30%), social circumstances (15%), poor access to quality health care (10%), and environmental  exposures (5%).
•    Unhealthy lifestyle is the primary contributor to the six leading causes of death in the U.S. – heart disease, cancer, stroke, respiratory diseases, accidents, and diabetes – which collectively account for over 70% of all deaths.
•    People with healthier lifestyles live an average of 6 to 9 years longer,  postpone disability by 9 years and compress disability into fewer years at the end of life.
•    The prevalence of obesity among U.S. adults rose to 30% in 1999-2000, a 33% increase from a decade earlier,  and the prevalence of diabetes also rose by 33% during approximately the same period (1990 to 1998).
•    About two-thirds of American adults are overweight or obese, 55% do not get enough physical activity,  26% are completely inactive,10 and only 25% eat recommended amounts of fruit and vegetables  If diet/physical activity patterns continue worsening at their current rate, these behaviors will soon surpass tobacco use as contributors to mortality.
•    Among young people, the prevalence of overweight has more than quadrupled in the past 20 years to 16%,  daily participation in high school physical education classes has dropped from 42% in 1991 to 28% in 2003,  more than 60% eat too much saturated fat, and almost 80% do not eat recommended amounts of fruit and vegetables.
•    Lifestyle diseases disproportionately affect women, ethnic and racial minorities, the poor and seniors:
•    The prevalence of diabetes among African Americans is about 70% higher than among white Americans, and the prevalence among Hispanics is nearly double that for white Americans.
•    Women comprise more than 50% of the people who die each year of cardiovascular disease.
•    Chronic conditions significantly limit daily activity for 35% of persons over 65 years of age.

Financial Impact of Lifestyle
•    It is estimated that lifestyle-related chronic diseases account for 70% of the nation’s health care costs, which translates to over 11% of the entire U.S. gross domestic product.
•    Two comprehensive scientific reviews identified 83 peer-reviewed studies reporting that people with unhealthy habits have higher health costs.
•    Research conservatively estimates that high health risks (high blood cholesterol, high blood pressure, etc) account for at least 25% of total health costs.
•    Recently published research indicates a direct relationship between modifiable lifestyle risks and lower worker productivity, and relevant data suggest that the costs to organizations in lost productivity due to poor employee health may be substantially more than the direct health and disability costs.
•    Unhealthy lifestyles frequently lead to chronic disease, many of which cannot be cured and require years or decades of expensive treatments. Below are estimated annual costs of selected unhealthy lifestyles and chronic diseases including obesity,  smoking,  hypertension,  diabetes,  stress,  and inactivity.

Workplace Wellness Programs Improve Health and Yield Major Savings
•    Comprehensive scientific reviews identified 378 peer-reviewed studies showing that Workplace Wellness Programs improve health knowledge, health behaviors, and underlying health conditions.
•    Research has demonstrated that lifestyle modification may frequently be more effective and cost-effective than health intervention in reducing morbidity  and mortality.
•    Several scientific reviews indicate that Workplace Wellness Programs reduce health costs and absenteeism and produce a positive return on investment (ROI).  The most definitive review of financial impact reported that:
•    18 studies indicated that these Workplace Wellness Programs reduce health costs, and 14 studies indicated that they lower absenteeism costs.
•    13 studies that calculated benefit/cost ratios all showed the savings from these Workplace Wellness Programs are much greater than their cost, with health cost savings averaging $3.48 and the absenteeism savings averaging $5.82 per dollar invested in the Workplace Wellness Programs.
•    Medical costs are expected to exceed 16 percent of U.S. gross domestic product (GDP) in 2005 and to grow at 7.2 percent each year through 2015, when health expenditures will account for 20 percent of GDP:
•    Per capita health costs in the U.S. are the highest in the world and more than double the median for OECD nations,  yet the United States ranks 26th in terms of healthy life expectancy.
•    Medicaid is the second largest item in the majority of state budgets, and its portion of the total budgets is increasing each year.
•    Rising health costs for U.S. organizations continue to outpace general inflation, averaging 12 percent per year for the past 10 years.   This trend is causing a tremendous financial hardship on U.S. organizations.

1. Senior management involvement in the Workplace Wellness Program- Evidence of enthusiastic commitment and involvement of senior management helps workers understand their organizations’ serious commitment to health.  Staff Members need to perceive that their senior management, supervisors, and coworkers have positive attitudes toward health since these factors have all been associated with improved employee health status.   Management-related factors have been shown to contribute more to success than the content of the intervention.

2. Participatory planning – A Worksite Wellness Plan should be undertaken in partnership with the workforce.  Staff Members from all levels of staff should be actively engaged in the health and management aspects of the project as well as all on-going processes of any Workplace Wellness Program.  Planning must also include processes for maintaining communication with all staff and building their commitment to the process.   Beginning Worksite Wellness Plan steering committees to guide interventions during the planning and delivery of workplace health promotion programming improves worker awareness, participation, and satisfaction. Staff Member committees can identify perceived worker interests regarding educational programming, determine work site-specific characteristics that may affect the intervention or influence participation, and suggest the best methods for promotion and delivery of Workplace Wellness Programs and activities.  Ways to maximize worker input and involvement might include interest surveys, focus groups, and peer counsellors.

3. Primary focus on workers’ needs – A Worksite Wellness Plan should meet the needs of all workers, regardless of their current level of health and recognize the needs, preferences, and attitudes of different groups of participants. Program designers should consider the major health risks in the target population, the specific risks within the particular group of workers, and the organization’s needs.   In other words, interventions should be tailor-made to the characteristics and needs of the recipients.   This means that different programs must be offered at different levels.   Participation and commitment can be improved if a group of workers has the opportunity to address a specific modifiable risk factor of their choice.

4. Optimal use of on-site resources – Planning and implementation of Workplace Wellness Programs should optimize use of on-site personnel, physical resources, and organizational capabilities.   For example, whenever possible, initiatives should use on-site health and safety, management, work organization, communication, Human Resources, and other specialists.   Well-qualified external leadership may be introduced when in-house expertise is lacking.

5. Integration – An overall workplace health policy should be developed.  The policies governing employee health must align with the company mission, vision, and values, supporting both short- and long-term goals. These consistent policies must affirm the value of worker health and a commitment to engage workers in health enhancement.  Worksite Wellness Plan Strategies should be integrated into a company’s regular management practices and eventually should be formally incorporated into the company’s corporate plan  with adequate resources attached to them.

6. Recognition that a person’s health is determined by an interdependent set of factors – Any Worksite Wellness Plan must address multiple components of an individual’s life:
•    the workplace physical and psychosocial setting;
•    their individual resources such as social support, sense of empowerment, etc.; and
•    their lifestyle practices influencing health.

7. Tailoring to the special features of each workplace setting  – Workplace Wellness Programs must be responsive to the unique needs of each workplace’s procedures, organization and culture.   Integrating health behaviors and program participation into the existing company culture will normalize program participation.

8. Worksite Wellness Plan Evaluation – Project management should flow through needs assessment, setting priorities, planning, implementation, continuous monitoring, and assessment.   Evaluation must include a clearly-defined range of process measures and outcomes  as well as mechanisms for monitoring the impact of non-intervention workplace changes such as plant closure, major workplace re-organization, and new technology on staff health.

9. Long-term commitment – To sustain the benefits of the Workplace Wellness Program, the worksite must continue the initiative over time, reinforcing risk-reduction behaviours and adapting the programs to ongoing individual, social, economic, and workplace changes.

If your organization is interested in measuring the impact of your Worksite Wellness Plan efforts in future years, you’ll want to gather relevant baseline data on the health and health behaviors of your worker population.

Worksite Wellness Plan Data on your worker population

Health Risk Assessments / Health Risk Appraisals

Some health plans offer organizations free internet-based Health Risk Assessments / Health Risk Appraisals, complete with summary aggregate reports. If your healthcare plan does not offer a free HRA, you could pay for an HRA either through your healthcare plan or through a third party vendor.

To encourage taking part in an HRA, assure workers of confidentiality and consider providing rewards for completing the assessment. The higher the participation rate, the more likely that the aggregate data will accurately represent the behaviors and risks of your worker population.

Worksite Wellness Plan Health Surveys

You can get a general sense of workers’ health-related attitudes and behaviors using a “lowtech” paper survey. As with a health risk assessment, workers will be more likely to respond to a survey if there is an incentive and if they are confident that their responses are confidential. Remember that without widespread participation you’ll only get a “feel” for worker behaviors rather than a statistically accurate picture.

Worksite Wellness Plan Focus Groups and Informational Interviews

The information you can collect from focus groups or informational interviews with workers is an important supplement to the anonymous survey or HRA data. Listening to workers discuss their attitudes, values, receptivity and obstacles related to health provides a wealth of information on which to base decisions on how to increase your organization’s Workplace Wellness Program. Worksite Wellness Plan focus groups are especially useful for securing information from hard-to-reach worker populations, such as those for whom English is a learned language.

Keep Worksite Wellness Plan focus groups small (8-19 workers, ideally all of a similar job class). If possible, offer rewards such as movie tickets or lunch, to recruit participants. Develop a list of open-ended questions in advance and allow 60-90 minutes for the discussion.

Informational interviews are an alternative to Worksite Wellness Plan focus groups. The Worksite Wellness Plan coordinator of your health improvement Strategies or selected members of the Health and Wellness Committee can conduct one-on-one interviews with workers in a variety of positions to better understand their attitudes, interests and obstacles related to a) health behaviors and b) the workplace policies, settings and practices.

Population data

If data on the employee population are not available, you can use state or national data to estimate the prevalence of risk behaviors among workers.

Introduction to Workplace Wellness Programs

Risky health behaviors by workers cost a company. Changing those behaviors can save the employer money and raise the worker’s productivity.

Because work gives an worker a stable environment and support system, Workplace Wellness Programs can have a great impact on reducing high-risk behaviors. This impact results in decrease health claims cost, less absenteeism, and less short-term disability.

Workplace Wellness Programs can include:

Awareness Rasing Activities: Health and wellness newsletters, health topics covered in payroll stuffers, healthy emails.

Health Risk Assessment: Employee health screenings, wellness fairs / health fairs, health rist assessments.

Educational Programs: Lunch and Learn wellness presentations, guest speakers at staff meetings.

Skill Building: Healthy cooking demostrations, activity challenges, CPR instruction opportunites, stress management classes, weight management classes.

Interventions: Massage, smoking cessation, and skills to help you get the most out of your doctor visit.

Physical setting: Healthy items in the vending machines and cafeterias, clean air practices, ergonomics, bike racks, flex time, welllit stairways.

Evaluation: Staff Member needs assessment, baseline Worksite Wellness Plan assessment measures, ongoing Worksite Wellness Plan assessment of overall effectiveness.

Why Make available Workplace Wellness Programs

The typical employer spends about $8,000 a year on an employee’s medical care. This includes health insurance, disability and worker’s compensation. As these costs climb, health insurance is expected to rise at least 10% per year.

A 1999 research study showed that organizations using Workplace Wellness Programs had a return on investment (ROI) from $1.49 – $13 in benefits per dollar spent. The amount depended on the nature of the Workplace Wellness Programs used. (S. Aldana, American Journal of Wellness, 2001; 15:296-320)

One research study showed that a “stop smoking” component to Workplace Wellness Programs can save between $404 -$40,829 per employee, depending on the age and sex of the worker.

The Workplace Wellness Programs at Traveler’s Company included a self-care book, a newsletter, single-topic brochures, and videotapes. The Workplace Wellness Programs saved the company $7.8 million in employee benefi t costs, decreased doctor visits, and it reduced absenteeism by 1.2 days per worker per year. The estimated Workplace Wellness Programs ROI was $3.40 per dollar spent.

In 1998, the Health Enhancement Research Organization (HERO) reported a study of 46,026 workers from six large organizations for three years. Staff Members with an inactive lifestyle had 10% higher costs; workers with depression had 70% higher costs.

Benefits of Workplace Wellness Programs

Raised Productivity – The Canada Life Assurance Company realized a 4% rise in productivity after creating an employee fitness program.

Raised Job Satisfaction – According to employee opinion surveys conducted by the Silverstone Group about thier Workplace Wellness Programs, workers’ morale improved, which helped support a more creative work environment.

Improved Recruitment & Retention – In the midst of a tight labor market, Workplace Wellness Programs could be a important tool to draw new recruits.

Decreased Absenteeism – Canada Life Assurance Company’s absenteeism dropped 42% among workers in the Workplace Wellness Programs.

Decreased Workers Comp & Disability – In one year, Boeing Company’s number of back injuries decreased by 34%. Six million dollars was saved by tracking injuries as they occurred.

Managed Health Care Costs – Golden, Colorado Adolf Coors Company’s Workplace Wellness Programs returned $6.19 for every dollar spent.

In addition to looking at the health behaviors of workers, take a good look at your organization. The following questions can help you identify opportunities for your organization to support and encourage healthy behaviors among workers.

A strong foundation for employee health improvement

1. To what extent does the senior management in your organization actively and visibly support the Workplace Wellness Program?

__ No support for the Worksite Wellness Plan
__ Support, but not at senior level
__ Support at senior level, but not visible to workers
__ Strong and visible Worksite Wellness Plan support
Comments:

2. Is the Worksite Wellness Plan tied to your organization’s mission statement?

__ No
__ Yes, the Worksite Wellness Plan is tied to business plan OR mission statement
__ Yes, the Worksite Wellness Plan is tied to both business plan and mission statement
Comments:

3. Is there an worker within your organization whose job responsibilities include Worksite Wellness Plan coordination?

__ No
__ Yes, but has little time available to dedicate to Worksite Wellness Plan
__ Yes, and has at least part of the job dedicated to Worksite Wellness Plan
__ Yes, and has at least one full-time position dedicated to Worksite Wellness Plan
__ Yes, and has at least part of the job dedicated to wellness AND has a background that includes Worksite Wellness Plan qualifications
__ Yes, our organization has at least one full-time position dedicated to health improvement AND the worker’s background includes Worksite Wellness Plan qualifications
Comments:

4. Does your organization have an active wellness committee with diverse representation?

__ No (does not have a Health and Wellness Committee, or has a committee that doesn’t meet)
__ Yes, we have a Health and Wellness Committee, but with limited representation
__ Yes, we have a Health and Wellness Committee with widespread representation
__ Yes, we have a Health and Wellness Committee with widespread representation AND committee involvement is part of each representative’s job responsibilities
Comments:

5. Does your organization have an annual budget for Worksite Wellness Plan expenses? (Workplace Wellness Plan expenses may be associated with providing a health assessment, paying for behavior change programs/coaching programs, covering rewards that encourage healthy behaviors, subsidizing healthy food options, communications and programs around specific health topics, fitness centers/walking paths, etc).

__ No
__ Yes, but funds are earmarked for Workplace Wellness Programs (e.g. only for Weight Watchers or fitness discounts) and do not meet all existing Worksite Wellness Plan needs
__ Yes, funds are available to meet current Worksite Wellness Plan needs
Comments:

6. Does your organization have a plan for engaging workers in the Workplace Wellness Program?

__ No
__ Yes, we have a communications plan for our Worksite Wellness Plan
__ Yes, we have a communication plan AND we offer meaningful incentives or rewards (such as premium discounts or debit cards) for the Worksite Wellness Plan to engage in healthy behaviors.
Comments:

A data-based approach to the Worksite Wellness Plan

7. Does your organization have clearly stated Worksite Wellness Plan goals and priorities for employee health improvement?

__ No
__ Yes
__ Yes, data (e.g. HRA, claims, productivity) are the basis for defining Worksite Wellness Plan goals or priorities
__ Yes, data AND evidence-based best practices are a basis for defining Worksite Wellness Plan goals or priorities
__ Yes, data and best practices are basis for defining Worksite Wellness Plan goals or priorities as well as measuring Worksite Wellness Plan progress (assessment)
Comments:

8. Has your organization completed a Health Risk Assessment?

__ No
__ Yes, but more than 2 years ago
__ Yes, within the last two years, and achieved a participation rate of less than 50%
__ Yes, within the last two years, and achieved a 50% – 79% participation rate
__ Yes, within the last two years, and achieved an 80% or greater participation rate
Comments:

A workplace setting that supports healthy behaviors

9. Does your organization’s tobacco reduction strategy reflect best practices?

(Check all that apply)
__ A no-smoking policy that includes both buildings AND grounds
__ 100% coverage for the cost of over-the-counter nicotine replacement therapy
__ Staff Member access to – and strong promotion of — a tailored stop-smoking program
Comments:

10. Does your organization provide opportunities (time and places) for physical activity during the work day?

__ No
__ Yes, indoor places for physical activity (on-site fitness center) OR outdoor places for physical activity (walking paths)
__ Yes, both indoor AND outdoor places for physical activity
__ Yes, indoor and outdoor opportunities AND employees can use work time for physical activity
Comments:

11. Does your organization promote healthy eating by providing access to fruits and vegetables?

__ No
__ Yes, fruits and vegetables are available at the workplace (in vending machines, break areas, or cafeterias)
__ Yes, fruits and vegetables are available and discounted at the workplace
Comments:

Benefits that support employee health improvement

12. Does your organization provide workers with self-care resources?

(Check all that apply)
__ Distribution of self-care books
__ internet-based access to health information
__ Nurse advice line
Comments:

13. Which of the following preventive services are covered at 100% by your organization’s health benefits?

(Check all that apply)
__ Vision screening
__ Hearing
__ Immunizations (per CDC/ACIP recommendations)
__ Radiology
__ Laboratory services
__ STD screening
__ Preventive health examination for adults
__ Cancer screen (includes: colon, cervical, breast, prostate and ovarian cancers)
__ Contraceptive management
Comments:

14. Which of the following are included in your organization’s pharmacy benefit?

(Check all that apply)
__ Mail order or other 90-day supply option for medications
__ Specialty pharmacy network
__ Incentive-based tiered formulary design
Comments:

15. Do your organization’s health benefits provide coverage for behavioral health (such as depression, mental illness, counseling, stress management, and chemical dependency)?

__ Yes, at the same level as health benefits
__ Yes, but at a lower level (less coverage) than health benefits
__ No coverage for mental or behavioral health
Comments: