Drug Education and Intervention in the Workplace

Small corporation wellness programs are catching on. A well-designed wellness program is able to improve productivity, boost morale and vitality, cut stress, lower absenteeism, and control avoidable healthcare expenditures within a corporation. The beauty of it is that you’re simply assisting employees to make smart choices so the expenditures of implementing a wellness program are minimal in comparison to the benefits.

Employee health is a primary issue for small company owners. In a small company, even a few sick staff members have the potential to disrupt the flow of the workplace and bring the operation to a standstill.

Rather than sitting back and hoping for the best, some small company owners are taking the matter of employee health into their own hands by launching Corporate Health Promotion Programs. Here’s how they work.

Overview of Corporate Health Promotion Programs

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

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

Why offer Corporate Wellness Programs?

Apart from the obvious concern for the health of your staff members, there are numerous other reasons why Worksite Health Promotion Programs make sense for small organizations. Right off the bat, your organization will advance from the decreased level of absenteeism that goes hand in hand with a healthy workforce.

Worksite Wellness 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 is able to have a large impact on a small business, a more reliable workforce will eventually translate into a smoother work cycle and a more robust bottom line.

Workplace Wellness Program Features

Worksite Health Promotion Programs are able to cover a broad range of health-related topics. Based on your workers’ needs, it’s completely up to you to determine the kind of programming you want to offer. However, most Worksite Health Promotion Programs offer some at least some programs in the following areas:

• Nutrition. Diet has the potential to significantly influence an employee’s ability to do their job effectively. Nutritional programs educate employees about meal options and equip them to make healthy dietary choices.
• Physical Fitness. In addition to diet, exercise is an valuable factor in a healthy lifestyle. Workplace Wellness Programs usually support staff members with opportunities to incorporate exercise into their daily lives.
• Tobacco Cessation. Statistics prove that tobacco users tend to fall ill more frequently 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 have the potential to offer early warning signs for more weighty concerns.
• Stress Management. Stress itself takes a toll on workers. However, stress is also linked to other health issues such as depression, cardiovascular disease, diabetes, and obesity. Worksite Health Promotion Programs that help workers deal with stress improve not only the mental health of your workers, but their physical health, too.

Create a Employer Workplace Wellness Program for Your Staff Members Today

The advantages to starting a workplace health and wellbeing program are abounding.

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

1. Look around, and determine if employees lead a healthy lifestyle before starting an Employee Health Promotion Program. How many employees run outside during lunch for a smoke 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 better idea of the Employee Health Promotion Program that’s right for them.

2. Survey staff members to evaluate 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 staff members don’t have the time or energy to stay on top of wellness and health problems at work or when they leave the office to go home.

3. Give Worksite Health Promotion Programs a sizable kick-off with a healthy living “fair.” Provide workers free flu shots, Blood Pressure (BP) checks, cholesterol screenings, body/fat ratio assessments, tobacco cessation programs and free mammograms- and contact the local hospital, because there’s plenty more where this came from. Organizations keep their workers hopping during the week. Give workers a chance to amp up their healthy lifestyle on the corporation dime. A corporate health and wellness program is an additional benefit that workers get for working for the corporation!

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

Introduction to Company Health Promotion Programs

The last ten years has brought big changes in company attitudes toward Company Health Promotion Programs. Interest in self-help and self-care programs has increased as growth in health care costs have encroached substantially into profits. Changes in the company structures of health care facilities, in particular the growth of the for-profit health care sector, and the need to contain costs are changing the ways in which purchasers of health care plans are viewing their own efforts toward provision of workplace health care programs and facilities. Projections for the next decade indicate that workplace health programs will continue to become important factors in the provision of health care, including prevention activities, for both government and private industry. In organizations 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, smoking cessation, Blood Pressure control, diet programs and stress management. Benefits cited range from improved health and productiveness to decreasing health care costs.

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

Prevalence of Corporate Health Promotion Programs Activities

Based on a 1985 survey, almost 66% of worksites with 50 or more staff members had Company 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 percent
Back Care             28.6%
Stress Management       26.6 percent
Exercise             22.1%
Off the Job Accidents    19.8%
Nutrition             16.8 percent
Blood Pressure Control    16.5 percent
Weight Control          14.7%

Job Site size is the strongest indicator of program prevalence.

Most staff members believe the advantages of their Workplace Health Promotion Programs activities outweigh the costs, although few formal evaluations exist.

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

At most worksites with activities (85.4%), all employees are eligible to participate. 30 percent of worksites with activities offer them to company dependents, and an equal percent offer them to retirees.

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

Smoking Cessation Programs

Smoking related health issues cost American businesses $26 billion per year in lost productivity and $7 to $8 billion in smoking-related medical expenditures.

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

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

76 percent of current smokers and 80 percent of former smokers and nonsmokers feel that companies ought to 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 should refrain from smoking in the presence of nonsmokers.

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

Examples of smoking cessation intervention program used by businesses include:

• providing people that do not use tobacco a discount of health and life insurance;
• paying full or partial fees for tobacco cessation programs;
• offering cessation programs on employer or shared time;
• offering cash payments to quitters after 6 of 12 smoke-free months;
• participating in national quit smoking days; and
• adopting a smoke-free organization 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 demonstrated 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 are able to cut the probability of back injuries among certain occupational groups.

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

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

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

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

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

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

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

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

Nutrition and Weight Control

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

Improvements in eating habits are able to lower the risk of serious health concerns such as elevated Blood Pressure (BP) and cholesterol levels and is instrumental in the control of non-insulin-dependent diabetes.

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

Worksite diet programs can be grouped in 6 broad categories:

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

Men are less likely to take part in weight-loss programs than are female employees.

Stress Management

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

Organization pays many of the costs related to employee stress, both directly in the form of health care costs and in lower work rate.

Job factors which are associated with stress include:

• not allowing workers 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 employees.

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

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

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

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

• teaching people to reduce the 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% of all work-related deaths and 45 million days of lost work annually.

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

Workers 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 productivity, 88% of which is attributed to losses from workforce activities and future earnings.

In corporate settings where safety belt policies, mandating use of belts by those riding in a company vehicle or using a personal vehicle for company business, have been enforced, 60% to 90% 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 senior staff;
• clearly defined and well enforced policy of needed belt use on the job;
• positive incentives; and
• ongoing education and training programs.

Case Studies of Company Health Promotion Programs

Based on an extensive assessment of its accross the board employee Corporate Health Promotion Program, LIVE FOR LIFE, Johnson & Johnson stated the break-even point for the program occurs in year 3 and by year 5 they have a net profit of $316 per employee. Their year 9 projected profit is $677 per employee.

workers at four Johnson & Johnson corporations who were exposed to the Employee Wellness Program increased their daily energy expenditure in vigorous exercise by 104 percent compared to a rise of 33 percent among workers at corporations that were offered only an yearly health screen.

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

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

In 1985, the Adolph Coors Employer conducted a phone interview of a random sample of its 10,000 workers to determine changes in health practices since the introduction of an employee Company Wellness Program 4 years earlier. The sample of 495 workers was stratified to match the business profile in terms of age, sex and job description. The survey reported that 65% of respondents started working out 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 business’s tobacco cessation program and active participants of the wellness center miss an average of 1.96 workdays annually because of illness or injury compared to 3.08 days for non-participating workers.

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

Business Physical Activity Programs Plans Improve Employee Health and Wellness

Instituting a Company Health Promotion Program improves the health of workers, lowers employee absenteeism and saves the employer money, too. Learn more about initiating an Company Health Promotion Program in the office.

Benefits of Employee Health Promotion Programs

• A business investment of $100-$150 per employee each year to take part in an Worksite Health Promotion Program can save corporations $300 to $450 for each employee every year, according to Ron Goetzel, Director, Cornell University Institute for Health and Productivity Studies. The savings are able to take a few years to actualize, says Goetzel, and are seen in decreased health expenditures.
• The Wellness Councils of America reported a $24 return for every $1 invested on a Employee Health Promotion Program for small corporations.
• According to a 2005 survey by The Art of Health Promotion, companies who instituted Company Health Promotion Programs realized a 30 percent decline in medical and absenteeism expenditures in less than 4 years.

A successful Worksite Health Promotion Program starts with Upper Management. Corporation owners ought to lead by example, taking part in their company’s exercise program and working closely with a wellness coach. Upper Management ought to make sure workers are well knowledgeable about their wellness efforts, posting weight loss results or smoking cessation results on company intranet or bulletin boards for everyone to see.

Corporate Wellness Programs that Really Work

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

Employee Wellness Programs Yield Big Results

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

Ron Goetzel encourages those looking to pitch a corporate fitness program to Senior Management to use basic facts about the benefits 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 American citizens

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 healthcare is driven by avoidable illness

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

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

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

   
Key Components of a Employee Health Promotion Program

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

Sample Physical Employee Health Promotion Programs / Workshops
• Annual health assessment
• Regular physical activity
• Smart safety habits

Emotional Wellness – Focuses on all aspects of mental fitness

Sample Emotional Workplace Health Promotion Programs / Workshops
• Stress management workshops
• Dealing with aging
• Addictive behaviors
• Parenting

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

Sample Financial Company 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 Workplace Health Promotion Programs / Workshops
• Encourage daily devotional readings
• Provide regular service opportunities
• Give 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 Employee Wellness Programs / Workshops
• Individual nutritional Assessment
• Individual and group counseling
• Instructional classes
• Weight loss programs

Many employers, as part of their efforts to contain rising medical costs, are launching workplace programs variously described as Employee Wellness Programs, lifestyle programs, health and work rate management, population health management and, simply, wellness programs.

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

The popular media have done much to reward the concept of corporation 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 Business, 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 published here?

Health and Productivity Leadership

Illness and injury associated with an unhealthy lifestyle or potentially-modifiable risk factors is published to account for at least 25 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 levels 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 ought to complement standard healthcare insurance benefits.

The intensity of Company Health Promotion Programs range from bulletin board, pamphlet or newsletter information to worksite fitness facilities, health risk reduction classes, and personal lifestyle change coaching.3 Company Health Promotion Programs today often 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.

Complete Company Health Promotion Programs may include classes on health risk reduction and job safety, fitness and exercise activities, health club memberships, and reductions in co-payments or premiums for employees who adhere to recommended health care assessment ground rules.

Along with this, some employers are restructuring health benefits and encouraging employees’ cost-sensitivity when accessing medical.5 These changes are intended to cut employees’ need for and utilization of medical, provideing reduced group medical costs. Demonstrated reductions in medical expenditures ought to then offer 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 return on investment. Nonetheless, evidence continues to grow that well-designed and well-resourced Company Wellness Program and disease prevention programs offer multi-faceted payback on expenditure. Peer-reviewed evaluations and meta analyses show that return on investment 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 productivity management programs, observed an average return of $3.14 per $1 invested in traditional Workplace Health Promotion 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 Workplace Wellness Programs achieve an average ROI of $3.48 when considering medical costs 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 published that within a 2 year period, Citibank realized a ROI between $4.56 and $4.73.10  Follow-up studies reported improvements in the risk profiles of participants, with the elevated-risk group improving more than the “usual care” group11 as a result of more intensive programming.
• Chapman’s 2004 meta-assessment of 42 different studies, ranking overall validity of the different studies, reports cost-benefit ratios from $2.05-$4.64.

In addition to immediately quantifiable expenditure reductions, researchers have published 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 costs to provide non-health related return on investment.

Tailoring program to maximize ROI Company Health Promotion Programs aim to lower the health risks of employees at elevated risk while maintaining the health status of those at low risk. A variety of disease management interventions are available to fit the specific risk profiles of various worksites. Insurers and companies now seek to calibrate their interventions in order to achieve optimal risk reduction and costeffectiveness.

In 2001, University of Michigan researchers reported on stable trends in healthcare expenditures for over 2 million current and former staff members 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 staff members 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 offer the greatest return on investment.

On the other hand, Pelletier’s meta-analysis16 and other program evaluations18 suggest that individualized risks reduction for high-risk employees within the context of comprehensive programming is the vital element in achieving beneficial clinical and expense outcomes in worksite interventions.

Dose-Response?

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

Most cost-benefit research studies have been conducted in big organizations with more than fifty employees. But researchers have demonstrated that similar results can be obtained by small organizations with as few as five employees actively involved in a well-managed program.

Various research studies also suggest that even relatively modest levels of participation have the potential to achieve substantial program influence. Contrary to reports by the popular media that such programs require more than 70 percent participation, published reports of at least one case showed beneficial ROI with 51 percent participation.

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

Future developments

Despite the abundance of positive 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 influence of the various program components. But as these programs take hold, further research and assessment will enable fine-tuning of program investments.

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

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

As corporations today continue to compete in the worldwide economy, cost containment strategies will be increasingly valuable. Controlling the rising cost of employee ill health 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 plan for Worksite Health Promotion Programs and disability management makes good business sense. The following eight-step process ensures a strategic, integrated, needs-driven and results-oriented approach.

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

1. Identify Your Employee Wellness Program Champion

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

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

2. Form Your Employee Wellness Program Strategy Team

The Workplace Wellness Program Strategy Team ought to include decision makers and stakeholders from parts of the corporation that have the potential to influence 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 cultivate and enable the strategic plan, look for opportunities to reward health, be sure the program is integrated into key areas of the organization, streamline efforts, maximize business resources and program assessment.

3. Complete an Employer Health Audit

The purpose of an Corporation 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 company culture or “how things are done” around the company.

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 costs, Workplace Safety Insurance Board (WSIB) claims, prescription usage, type of paramedic claims, absenteeism data and EAP utilization. This process helps to target areas that have the potential to be positively impacted by a Company Wellness Program and to support 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 a myriad of goals/objectives. It provides a baseline from which to measure personal lifestyle changes, provides employees with relevant health information, motivates employees to take charge of their health and assists in program planning. Most health risk appraisals support individual reports and a corporate report identifying elevated-risk areas in the business.

Many businesses opt to administer customized needs and interest survey to evaluate employee needs. The benefit of this approach is that the company 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. Develop Your Strategic Plan for Wellness

The strategic plan must incorporate information gathered from the Business Health Audit, your organization’s cost pressures, and health risk appraisal data or employee survey results. The strategic plan must include your program mission, three or four objectives and several pushes under each objective. The strategic plan supports a framework to encourage, backing and evaluate “best health practices.”

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

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

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

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

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

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

Your company case for wellness supports the necessary details for approval at the upper management level. The company 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. Evaluation methodology.

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

The program budget ought to include educational resources, marketing expenditures, rewards and incentives, 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 staff members, older staff members.

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

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

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

Lifestyle change programs are more all-inclusive and longer in duration. They are designed to support  employees in changing behavior. Examples of lifestyle change programs are diet 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 offer 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 vital to the long-term performance of your program. An Employee Advisory Committee should be formed to roll out the plan. Another key responsibility of this team is to solicit feedback from all echelons of the organization to ensure buy-in. Front line Manager’s Information Sessions and focus groups are also important. 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 concerns 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 set up healthy workplaces, wellness pushes must have a program champion, have employee ownership, be management supported, results driven and strategically aligned with the central company objectives of the organization.

Wellness plan that embrace these qualities will have a beneficial influence on an organization’s bottom line. Canadian research points to numerous case studies where workplace programs have resulted in diminished absenteeism, reduce claims and increased productiveness.

Organizations who have embraced wellness as part of “how they do business” have one thing in common. They prove a responsibility to their most important resource – their people. They understand the increased pressures associated with downsized organizations, 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 have the potential to help meet any wellness program budget! The Corporate Wellness Program ideas are divided into topic areas.

General Wellness Progam Ideas

• Administer an Employee Needs & Interest Survey
• Design a Employee Health Promotion Program Committee
• Select health insurance plans that cover costs for weight management and tobacco cessation
• Remove co-pay or reimburse for preventive medical care visits
• Display brochures on a variety of wellness topics for staff members to take
• Develop a wellness resource center or library with videos, books, magazines, DVD’s on a variety of topics of interest to staff members
• Identify workers who are mentors or champions for healthy activities and ask them to present or to list as a contact for other workers
• Plan 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
• Put up messages from national health observances during the month
• Provide healthy tips in newsletters, paycheck stuffers, bulletin boards, etc.
• Organize a benefits fair
• Organize business fitness and healthy eating challenges
• Develop company wellness and health fairs or other on-Site events

Nutrition Programs

• Offer free, healthy snacks for employees (fruit, nuts, popcorn)
• Provide healthy meal choices in cafeterias and at company events
• Provide information to employees about the nutritional content of food served in the cafeteria
• Develop a fresh fruit “snack basket” in the breakroom or cafeteria
• Stock snack 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 issues
• Include diet articles in organization newsletters
• Have a healthy food tasting contest Free
• Have educational sessions at lunch-time on a variety of nutrition subject matters of interest
• Organize an employee healthy meal cookbook. Either sell the cookbook and use profits for programs, or purchase a cookbook for all workers

Weight Loss Programs / Weight Management Programs

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

Physical Activity Programs

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

Smoking Cessation Programs / Tobacco Cessation Programs

• Establish a smoke-free grounds
• Organize a tobacco-free workplace
• Promote the use of 1-800-QUIT-NOW, North Carolina’s free Tobacco Use Quitline. Or check www.QuitlineNC.com
• Fully reimburse (or partially reimburse) for tobacco replacement products
• Subsidize the expenditure of tobacco cessation sessions
• Provide pamphlets and information on health effects from tobacco use and smoking cessation
• Schedule awareness sessions to encourage staff members to try to quit tobacco use
• Schedule onsite smoking cessation courses

Employee Health Screening

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

Stress Management Programs / Work Life Balance Programs

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

Health 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 corporations, you can obtain information on offering screening and intervention programs that could 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 upon 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 health screenings depending on your worker population and needs

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

In addition to the wellness screenings, consider offering a Health Risk Appraisal / Health Risk Assessment to all staff members. 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 supports a more accross the board snap shot of health risks. The summary results provide the valuable information to plan appropriate interventions.

Workplace Health Promotion Program Interventions

The key to the effectiveness of screenings and Health Risk Appraisals / Health Risk Assessments (HRA’s) is the interventions or follow-up programs. The information from the screenings increases awareness and often motivates staff members to consider making healthier changes. It’s the follow up interventions that support the critical reinforcement and assistance needed 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 organization reinforcement. Examples include:

• Strategies to lower Blood Pressure
• Managing diabetes
• Taking care of your heart
• Healthy eating
• Weight loss plans
• Increasing physical exercise
• Smoking Cessation

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

Based on the outcome and your Workplace Health Promotion Program Committee goals and objectives you have the potential to plan the best strategies for your organization and workers. Consider the community resources available to offer services, such as health associations, hospitals, medical providers, and/or public health agencies.

Health Risk Assessments / Health Risk Appraisals, are an assessment tool or questionnaire scientifically designed to identify health risks and outline information to help  individuals in making healthy changes that influence their health and prevent chronic disease.

Health Risk Assessments / Health Risk Appraisals have four standard elements in worksite settings:
• A Questionnaire
• A Computerized Program to Evaluate Health Risk Factors
• Confidential Individual Reports
• Group Summary Report

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

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

The Health Risk Appraisals / Health Risk Assessments can be used to:
• Raise awareness to individual employee’s health status
• Encourage employees to make healthier lifestyle changes
• Coach high-risk employees
• Plan Worksite Health Promotion Programs based on the identified needs
• Assess program success by comparing Health Risk Assessments / Health Risk Appraisals completed at set intervals such as yearly.