Corporate Health Promotion

The Worksite Health Promotion Committee ought to set out a plan for the entire year that outlines accomplishing goals and objectives, as well as supports details for marketing and evaluating the program. The plan is the detailed map of what types of programs will be offered, when and where they will be scheduled, how they will be marketed and evaluated, and what the budget is. It is valuable to plan your wellness activities based on your goals and objectives, as well as the budget since different strategies will provide different outcomes. For example, if your mission is to increase awareness on a topic, then distributing brochures or scheduling a one-time education session may be appropriate. However, if your goal is to change behavior, then different strategies may be necessary, such as ongoing weekly meetings and support groups. Click here to link to Program Design Options for additional ideas.

Worksite Health Promotion Marketing

Now is the time to coordinate your marketing strategies! How can you market the wellness program and ongoing activities? No matter how you decide to, market frequently, keep it fresh, and remind staff members repeatedly! Consider having an overall kickoff activity to let everyone know about the wellness program. Upper Management ought to provide the introduction or invitation so that all staff members are knowledgeable about their support and leadership in the program. Possible marketing methods:

• Distributing email messages, including reminders
• Establish bulletins
• Putting up bulletin board postings
• Writing articles
• Mailing letters or
• Distributing special invitations.

Other Worksite Health Promotion Considerations:

• Is the Worksite Health Promotion promoted to all staff members or to a specific group?
• Do you have a Worksite Health Promotion champion (someone who is joined with different groups in the organization, and well respected) who can help in your promotion efforts?
• If your marketing efforts aren’t working, do you have a way to revisit and change your plan?
• How will you determine effectiveness and evaluate your program? And how will you collect the information necessitated to evaluate your program?

Topics most frequently included in Worksite Health Promotion :

• Nutrition
• Physical Activity/Exercise
• Tobacco Use Cessation
• Bone Health
• Cardiovascular Health
• Healthy Back
• Stress Reduction
• Chronic Disease Awareness & Prevention
• Self-care; Wise Medical Care Consumer
• Screening Services (BMI, Blood Pressure (BP), bone density, cholesterol, glucose, posture, vision, and other…)
• Ergonomic Assessments
• Health Fairs
• Kids/family Events
• Others subject matters that staff members have interest in

The subject matters and type of Worksite Health Promotion planned hinge upon the needs and interest, overriding goal and resources available. Program Design Options include awareness programs such as brochures and/or education sessions, behavior modification programs such as tobacco cessation and weight loss classes, and environmental or organization support such as no smoking policies or healthy selections in snack machines. The programs planned also hinge upon the demographics of your workforce. If you have a young, healthy workforce, you may want to focus the wellness attention on keeping staff members healthy and not need to screen for disease. Instead you might want to focus on healthy lifestyle behavior such as exercise and good nourishment to prevent the start of disease. Click here for more information on strategies for keeping staff members well, identifying disease early, or returning staff members to work who already have a chronic disease. It is also valuable to consider, and plan how you will evaluate the effectiveness of your wellness program. The system needs to be shown for tracking certain data and recording activities depending on the program goals and objectives. Step 7 discusses program assessment in more detail. And Step 6 will launch your program!

Introduction to Corporate Health Promotion

The last ten years has brought big changes in company attitudes toward Corporate
Health Promotion . Interest in self-help and self-care programs has increased
as growth in medical care costs have encroached substantially into profits.
Changes in the company structures of medical care facilities, in particular
the growth of the for-profit medical care sector, and the need to contain costs
are changing the ways in which purchasers of medical care plans are viewing
their own efforts toward provision of worksite medical care programs and facilities.
Projections for the next decade indicate that worksite health programs will
continue to become valuable factors in the provision of medical care, including
prevention activities, for both government and private industry. In employers
with existing Corporate Health Promotion , 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 productivity
to decreasing medical care costs.

Demographics of the U.S. Workforce

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

Prevalence of Corporate Health Promotion Activities

Based on a 1985 survey, almost 66 percent of worksites with 50 or more workers
had Corporate Health Promotion activities in 1985. The frequency of worksite-based
activities by selected categories in 1985 was:

Activity

Smoking Control 35.6 percent

Health Risk Assessment 29.5 percent

Back Care 28.6 percent

Stress Management 26.6 percent

Exercise 22.1 percent

Off the Job Accidents 19.8 percent

Nutrition 16.8 percent

Blood Pressure Control 16.5 percent

Weight Control 14.7 percent

Worksite size is the strongest indicator of program prevalence.

Most workers believe the benefits of their Corporate Health Promotion activities
outweigh the costs, although few formal evaluations exist.

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

At most worksites with activities (85.4%), all workers are eligible to 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
employers (57.1%), private for-profit providers-consultants (50%), local hospitals
(44%), and insurance employers (43%).

Tobacco Cessation Programs

Smoking related health problems cost United States employers $26 billion per
year in lost productivity and $7 to $8 billion in tobacco-related healthcare
costs.

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

People who used tobacco an average of one or more packs of cigarettes per day
had 118 percent higher healthcare costs than non-smokers.

76 percent of current smokers and 80 percent of former smokers and non-smokers
feel that employers should restrict smoking to certain areas.

In 1985, 65 percent of smokers, 85 percent of non-smokers and 78 percent of
former smokers, felt that smokers should refrain from smoking in the presence
of non-smokers.

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

Examples of smoking cessation intervention program used by employers include:

• offering non-smokers a discount of health and life insurance;
• paying full or partial fees for smoking cessation programs;
• offering cessation programs on company 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 company policy and setting deadlines for implementing
  the policy.

Physical Fitness Programs

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

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

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

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

Research findings support the notion that worksite physical activity programs
better fitness and help lower 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 onsite physical fitness facilities.

The majority of workers sponsored physical activity programs involve skills
training such as aerobic dance, low impact aerobics, weight training, preand
post-natal physical activity 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.

Worksite physical activity programs may lower costs to employers by decreasing
employee medical care claims and expenditures.

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

Health Care 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 have the potential to lower the risk of serious
health problems such as high Blood Pressure and blood lipid levels and is instrumental
in the control of non-insulin-dependent diabetes.

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

Worksite diet programs have the potential to be grouped in 6 broad categories:

• cafeteria programs;
• multi-component programs;
• weight control programs;
• blood lipid reduction programs;
• programs for pregnant and lactating women; and
• other diet education topics.

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

Stress Management

Estimates suggest that 50 percent to 80 percent of physician visits have the
potential to be attributed to psychosomatic or stress-related origins.

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

Job factors which are associated with stress include:

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

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

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

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

• classes 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 primary 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 United States business.

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

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

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

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

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

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

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

Factors influencing the sources of worksite safety belt programs include:

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

Case Studies of Corporate Health Promotion

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

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

Members in the United Methodist Publishing House’s Corporate 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 decreased than
projected use in medical care costs for 1985 ($902,116 projected with actual
costs $142,884) to the Corporate Health Promotion Program although 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 Corporate Health Promotion Program 4 years earlier.
The sample of 495 workers was stratified to match the company profile in terms
of age, sex and job description. The survey reported that 65 percent of respondents
started working out in The last 4 years, 37 percent had improved their diets,
20 percent were regular users of the wellness center, 9 percent had stopped
smoking as the result of the company’s smoking cessation program and regular
participants of the wellness center miss an average of 1.96 workdays each year
because of illness or injury compared to 3.08 days for non-participating workers.

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

Employer Physical Activity Programs Plans Improve Employee Health and Wellness

Instituting a Corporate Health Promotion Program improves the health of workers,
decreases employee absenteeism and saves the company money, too. Learn more
about starting an Corporate Health Promotion Program in the office.

Benefits of Corporate Health Promotion

• A company expenditure of $100-$150 per employee each year to participate
  in an Corporate Health Promotion Program can save employers $300 to $450 for
  each employee every year, according to Ron Goetzel, Director, Cornell University
  Institute for Health and Productivity Studies. The savings have the potential
  to take a few years to actualize, says Goetzel, and are seen in decreased
  health expenditures.
• The Wellness Councils of America reported a $24 return for every $1 invested
  on a Corporate Health Promotion Program for small employers.
• According to a 2005 survey by The Art of Health Promotion, employers who
  instituted Corporate Health Promotion realized a 30 percent decline in healthcare
  and absenteeism costs in less than 4 years.

A thriving Corporate Health Promotion Program starts with Senior Leadership.
Employer owners should lead by example, taking part in their company’s physical
activity program and working closely with a wellness coach. Senior Leadership
should 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 Health Promotion that Really Work

• Urge workers to kick start their own wellness programs by visiting their
  doctor. A complete physical should include information about blood sugar,
  cholesterol levels and general health.
• Target specific health-related problems in a corporate physical activity
  program. Information about how to fight obesity, smoking, alcoholism and prescription
  drug abuse should be at the forefront of an Corporate Health Promotion Program,
  along with related conditions.
• Hire a wellness coach to instruct workers on how to lead a healthy lifestyle.
• Reward workers for participating in company wellness plans. Let workers
  accrue wellbeing and health points that they have the potential to redeem
  for prizes. Make the prizes healthy, too- a no cost massage, personal training
  session with the company’s wellness coach or health food gift certificate
  encourages even healthier lifestyle choices.
• Acknowledge employee wellbeing and health leaders in company newsletters,
  in posted bulletins and on the company intranet.

Corporate Health Promotion Yield Big Results

For company owners who want to expand employee participation in a Corporate
Health Promotion Program, consider Johnson & Johnson’s approach. Faced
with only 26 percent of workers participating in their employee wellbeing and
health program, Johnson & Johnson offered workers a $500 discount on healthcare
insurance costs if they completed a health risk profile. The number of workers
participating in the Johnson & Johnson company physical activity program
jumped after they provided the incentive — to more than 93%.

Ron Goetzel encourages those looking to pitch a corporate physical activity
program to Senior Leadership to use basic facts about the benefits of Corporate
Health Promotion 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 America is preventable

• Tobacco and alcohol are leading causes of death
• As much as 70 percent of the expense of health care is driven by preventable
  illness

3. Health Care costs continue to rise

• Health Care premiums continue to rise and to be passed on to the employee
• Health Care expenditures are usually the number one benefit cost to most
  employers

4. The worksite is an ideal setting to address health and well being

• Most American citizens work
• Poor health habits take a toll on U.S. Businesses
• Employers have a vested interest in health related problems.

5. Research validates that Corporate Health Promotion have the potential
to better health, save money, and even produce a ROI.

• Aldana,S.G. (1998). Financial impact of Corporate Health Promotion and
  methodological quality of the evidence. The Art of Health Promotion. Vol 2,
  Number 1.
• Wilson, M.G. (1996). A accross the board review of the effects of Corporate
  Health Promotion on health related outcomes: An update. The American Journal
  of health promotion. Vol 10, Number 6.
• Wilson, M.G. (1996). A accross the board review of the effects of Corporate
  Health Promotion on health related outcomes: An update. The American Journal
  of health promotion. Vol 11, Number 2.
• Chapman, L.S. Proof Positive: An analysis of the cost-effectiveness of worksite
  wellness. 3rd ed. Seattle: Summex Corporation, 1996.
• Pelletier, K.R. A review of the health and cost-effective outcomes studies
  of accross the board health promotion and disease prevention programs at the
  worksite: 1993-1995 Update. The American Journal of Health and Promotion.
  Vol. 10, Number 5.

Key Components of a Corporate Health Promotion Program

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

Sample Physical Corporate Health Promotion / Workshops

• Annual health screening
• Regular physical exercise
• Good safety habits

Emotional Wellness - Focuses on all aspects of mental fitness

Sample Emotional Corporate Health Promotion / Workshops

• Stress management classes
• Accepting aging
• Addictive behaviors
• Parenting

Financial Wellness - Focuses on improving the quality of life of workers by
assisting families and individuals in becoming financially stable

Sample Financial Corporate Health Promotion / Workshops

• Financial management
• Savings and Investing
• Credit and Purchasing
• Insurance and Estate Planning

Spiritual Wellness - Focuses on promoting a healthy inner self

Sample Spiritual Corporate Health Promotion / Workshops

• Encourage daily devotional readings
• Provide regular service opportunities
• Provide a daily/weekly/monthly chapel (meditation) time during work hours

Nutritional Wellness - Will see to the needs of the workers through group
and individual nutritional services

Sample Nutritional Corporate Health Promotion / Workshops

• Individual nutritional Assessment
• Individual and group counseling
• Instructional classes
• Weight loss programs

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

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

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

1. Identify Your Corporate Health Promotion Program Champion

This person should be a leader in your organization and a strong advocate of
health. Usually 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 ensure the strategic plan
for health is in line with with the company’s objectives, strategic focus and
company values. For example if the organization promotes that “our strength
is our people” the wellness program must demonstrate how drives will nurture
and protect that valuable resource.

2. Form Your Corporate Health Promotion Program Strategy Team

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

The role of the Strategy Team is to cultivate and implement the strategic plan,
look for opportunities to reward health, ensure the program is integrated into
key areas of the organization, streamline efforts, maximize company resources
and program assessment.

3. Complete an Employer Health Audit

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

Members 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 drug 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
Corporate Health Promotion Program and to offer a baseline for evaluating change.

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

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

Many employers choose 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. Organize Your Strategic Plan for Wellness

The strategic plan should incorporate information gathered from the Employer
Health Audit, your organization’s expense pressures, and health risk appraisal
data or employee survey results. The strategic plan should include your program
mission, three or four objectives and several drives under each intention. 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 company environment)
guided the development of the plan.

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

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

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

Employer demographics

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

Your company case for wellness supports the necessary details for approval
at the 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 valuable to highlight how the plan aligns
itself with the strategic direction of the organization.

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

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

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

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

Awareness programs establish an awareness of the effect of healthy lifestyle
practices and excite workers to take the next step. Examples of awareness programs
include posting educational posters, newsletter articles and lunch and learn
seminars.

Lifestyle change programs are more accross the board and longer in duration.
They are designed to assist workers 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 great health practices. Follow-up sessions and support groups
for workers who have completed 6-10 week wellness programs also offer a supportive
environment for long-term change.

Analyzing the effectiveness of a Corporate Health Promotion Program is ongoing.
A formal assessment should be conducted each year and may include; re-administering
steps three to five, program participation statistics and a year end survey
to revisit “soft” problems such as morale, program satisfaction
and future program direction.

8. Solicit Input and Communicate Your Plan

Employee input is vital to the long-term success of your program. An Employee
Advisory Committee 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 valuable. This group needs to buy-in to the notion that they play a
key role in supporting beneficial health practices. Regular gatherings are advised
with front line managers to receive ongoing input, address problems and orient
new managers.

Conclusions

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

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

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

References:

Design of Corporate Health Promotion 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

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

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

The popular media have done much to reward the concept of company 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 Employer, as published

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 modifiable risk
factors is reported to account for at least 25 percent of employee medical care
expenditures. The most significant of these risk factors are stress, tobacco
use, overweight or obesity, physical inactivity, excessive alcohol use, and
poor nutritional habits. Over the past two decades, a variety of groups at the
local, state, and national echelons have promoted the concept that health risk
reduction and care management programs have the potential to better employee
health, and that worksite health education, health risk management, and benefit
counseling should complement standard healthcare insurance benefits.

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

All-Inclusive Corporate Health Promotion 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 workers who adhere to recommended
healthcare screening instructions.

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

Evidence basis: A range of ROI estimates

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

• Goetzel and colleagues, in their meta-analysis of two dozen articles summarizing
  economic evaluations of health and productivity management programs, observed
  an average return of $3.14 per $1 invested in traditional Corporate Health
  Promotion . The ROI estimates for the individual programs ranged from $1.49
  to $13.7,8
• Aldana reviewed 72 articles and concluded that Corporate Health Promotion
  achieve an average ROI of $3.48 when thinking of medical care 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 reported that within
  a 2 year period, Citibank realized a ROI between $4.56 and $4.73.10 Follow-up
  studies observed improvements in the risk profiles of participants, with the
  high-risk group improving more than the “usual care” group11 as
  a result of more intensive programming.
• Chapman’s 2004 meta-assessment of 42 different studies, ranking overriding
  validity of the different studies, reports cost-benefit ratios from $2.05-$4.64.

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

Tailoring program to maximize ROI Corporate Health Promotion aim to lower the
health risks of workers at high 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 employers
now seek to calibrate their interventions in order to achieve ideal risk reduction
and costeffectiveness.

In 2001, University of Michigan researchers reported on stable trends in medical
care costs for over 2 million current and former workers in an 18 year data
set. The mean cost increase per risk factor gained ($350) was found to be more
than double the mean cost decrease per eliminated risk factor ($150). In other
words, increases in costs when groups of workers moved from low risk to high
risk were much greater than the decreases in costs when groups moved from high
risk to low risk. Their conclusion: Programs designed to keep healthy people
healthy will likely offer the greatest return on investment.

On the other hand, Pelletier’s meta-analysis16 and other program evaluations18
suggest that individualized risks reduction for high-risk workers within the
context of accross the board programming is the 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 studies have been conducted in large employers with more
than fifty workers. But researchers have demonstrated that similar results have
the potential to be obtained by small employers with as few as five workers
actively involved in a well-managed program.

Various studies also suggest that even relatively modest levels of participation
have the potential to achieve substantial program effect. Contrary to reports
by the popular media that such programs require more than 70 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 effect on
healthcare costs generally requires three-to five years of programming.

Future developments

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

Uncertainty persists regarding the specific effect 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 Corporate Health Promotion . Indeed,
the company case for such programs is now well enough defined that some insurance
brokers offer discounted rates to employers that institute or subscribe to wellness
programs.

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

We are drafting Corporate Health Promotion to help you feel better and maintain
your health. In order to plan programs that best meet your needs and interests
we would like your recommendations! Please take a few minutes to answer some
questions about your interests. Your answers will be combined with those of
others’ and reviewed to help plan programs for you. Do not sign your name.

Please complete the survey today and return it to__________. We appreciate
your valuable input! Your help is valuable for drafting thriving programs. Return
the completed form by _____________.

Rate your interest on a scale of 1 – 3 with one (1) being of little or
no interest; two (2) being of some interest and three (3) indicating that you
are very interested. Indicate your response by circling or ‘Xing’
the number.

I am interested in:

Participating in wellness programs before work 1 2 3

Participating in wellness programs after work 1 2 3

Participating in wellness programs during my lunch break 1 2 3

Adopting healthy eating options to lose weight 1 2 3

Sports nutrition 1 2 3

Healthier cooking 1 2 3

Helping my children eat healthier 1 2 3

Quick, healthy meals for full lifestyles 1 2 3

Healthy snack options 1 2 3

Learning how to quit smoking 1 2 3

Attending classes to help me quit smoking cigarettes 1 2 3

Stress Mangement skills 1 2 3

Balancing work, family, and personal life 1 2 3

Time management skills 1 2 3

Participating in a beginning physical activity program 1 2 3

Planning time to exercise for busy people 1 2 3

Getting health information that I can read or watch at home 1 2 3

Learning about cancer prevention 1 2 3

Heart health options 1 2 3

CPR and First Aid 1 2 3

Team sports activities at work 1 2 3

Learning how to stretch 1 2 3

Learning how to increase intake of fruits and vegetables 1 2 3

Parenting Topics (age of children: ) 1 2 3

Onsite exercise classes: walking Yoga aerobic other: 1 2 3

Health screening such as Blood Pressure, cholesterol, blood sugar 1 2 3

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 Health Promotion Program
ideas are divided into topic areas.

General Wellness Progam Ideas

• Conduct an Employee Needs & Interest Survey
• Organize a Corporate Health Promotion Program Committee
• Select health plans that cover costs for weight management and smoking cessation
• Remove co-pay or reimburse for preventive health care visits
• Put up pamphlets on a variety of wellness topics for workers to take
• Organize a wellness resource center or library with videos, books, magazines,
  DVD’s on a variety of topics of interest to workers
• Identify workers who are mentors or champions for healthy activities and
  ask them to present or to list as a contact for other workers
• Develop and reward periodic or regular educational sessions.
• Develop monthly educational sessions on the national health observance topic
• Display a Wellness Bulletin Board & update it monthly
• Display messages from national health observances during the month
• Publish healthy tips in newsletters, paycheck stuffers, bulletin boards,
  etc.
• Develop a benefits fair
• Develop company fitness and healthy eating challenges
• Develop company wellbeing and health fairs or other onsite activities

Nutrition Programs

• Provide free, healthy snacks for workers (fruit, nuts, popcorn)
• Provide healthy meal choices in cafeterias and at company activities
• Provide information to workers about the nutritional content of food served
  in the cafeteria
• Organize 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)
• Offer a weekly or monthly healthy lunch club
• Provide pamphlets available on a variety of healthy eating topics
• Include diet articles in company newsletters
• Provide a healthy meal tasting contest Free
• Provide educational sessions at lunch-time on a variety of diet topics of
  interest
• Develop an employee healthy food cookbook. Either sell the cookbook and
  use profits for programs, or purchase a cookbook for all workers

Weight Loss Programs / Weight Management Programs

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

Physical Activity Programs

• Consider offering flexible work schedules to encourage physical activity
• Organize a fitness space with aerobic equipment, and weights
• Organize 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 stairways more appealing (carpet, fresh paint, artwork, posters)
• Provide reduced health club membership fees to all workers
• Provide facilities for workers to secure bikes
• Provide 5 – ten minute stretch breaks during the day
• Partially fund health club membership for workers who participate a minimal
  number of days per week (ex., 3 days per week)
• Support lunchtime walking/running clubs or company sports team
• Urge stairwell use and rewards and incentives
• Install a basketball hoop outside
• Promote & support neighborhood walks or fitness activities
• Promote walking during breaks and other off-time periods
• Provide periodic fitness incentive programs to encourage physical activity
• Provide educational sessions on fitness activities

Smoking Cessation Programs / Tobacco Cessation Programs

• Organize a smoke-free grounds
• Organize a smoke-free workplace
• Encourage the use of 1-800-QUIT-NOW, North Carolina’s no cost Tobacco
  Use Quitline. Or check www.QuitlineNC.com
• Reimburse workers for tobacco replacement products
• Partially fund the expense of smoking cessation classes
• Provide pamphlets and information on health effects from tobacco use and
  tobacco cessation
• Provide awareness sessions to excite workers to try to quit tobacco use
• Provide onsite smoking cessation classes

Employee Health Screening

• Discount healthcare insurance premiums or lower co-payments for workers
  who participate in screenings and who participate in managing their risk factors
• Install Blood Pressure monitoring equipment
• Provide flu shots for workers and family members
• Provide Health Risk Assessments to all workers, including counseling and
  follow-up
• Provide periodic Blood Pressure screenings and follow-up
• Provide periodic screenings for cholesterol, blood sugar, body composition,
  etc.

Stress Management Programs / Work Life Balance Programs

• Consider offering flexible schedules for family/work life balance
• Provide and reward an Employee Assistance Program(EAP)
• Provide information on substance abuse prevention
• Provide pamphlets and information on stress management and mental health
• Provide pamphlets and information on work life balance, such as financial
  planning, childcare, parenting, elder care, etc.
• Provide supervisor and manager training on communication, relationship
  building, company stressors, etc.
• Assess company policies and work schedules to identify company stressors
• Assess the Employee Assistance Program(EAP) to ensure it is meeting the
  needs of the workers and company
• Provide educational sessions on stress management and work life balance
• Provide classes on relaxation, stress management, and work life balance
  topics

A Corporate Health Promotion Program without goals/objectives is somewhat akin
to taking a family trip without any planning; you won’t know where you’re
going, how to get there, what you want to do once you have arrived, or even
whether or not you have arrived! The trip may end up ok, or it may end up disastrously.
Yet, with a bit of thoughtful planning, you expand your chances for a efficacious
experience. Clear goals/objectives are necessitated to plan your wellness program
in order to ensure success!

Wellness program goals/objectives are different from one company to another
depending on the population, needs, interests and resources. Nevertheless, well
thought out objectives based on your company’s needs assessment will form
the foundation of a efficacious wellness program!

Corporate Health Promotion Program Mission Statement

The first consideration is a mission statement for your Corporate Health Promotion
Program. The mission statement is the overriding expression of what the Corporate
Health Promotion Program Committee wants to accomplish by implementing a wellness
program. It is valuable to consider how your Corporate Health Promotion Program
fits in with the company mission statement, contributes to the overriding mission
and supports the company bottom line. This will integrate your efforts throughout
the company operations.

Below are some examples of Corporate Health Promotion Program mission statements:

“At XYZ Employer, maintaining an environment that supports employee health
and safety is our underlying value. It is the mission of the Corporate Health
Promotion Program to assist in starting Corporate Health Promotion Program services
that fosters and upholds that value.”

“It is the mission of the XYZ Corporate Health Promotion Program Committee
to cultivate healthier lifestyle choices to lower health risk factors, better
overriding well-being, and maintain a constructive, active work force.”

Corporate Health Promotion Program Goals

The goals/objectives further define your mission and are based on your needs
assessment. Depending on the needs assessment, management expectations and employee
interests, examples of goals/objectives can include:

The goal(s) of XYZ Corporate Health Promotion Program in year XXXX is to: (one
or more of the following examples)

• Decrease absenteeism by one day per employee
• Decrease musculoskeletal injuries by ten percent
• Decrease unnecessary emergency room visits
• Decrease or contain health care costs
• Improve dietary habits of workers
• Decrease health risk factors

Corporate Health Promotion Program Objectives

Specific Corporate Health Promotion Program objectives help meet your long-term
goals/objectives. Both short term and long term objectives should be developed
as the stepping stones to accomplish the goals/objectives. In addition to objectives
for the expected colleague outcomes, process objectives should also be developed
for the program process itself. For example, process objectives may include
the number of workers you want to participate in the programs, the number of
sessions on a topic will be offered, the type of wellness sessions that will
be implemented, etc.

Objectives must be easily measurable within a set time frame. Try using the
SMART formula to establish both your long and short-term goals/objectives:

• Specific (one behavior or outcome)
• Measurable (one result that can be inspected or evaluated),
• Attainable (but also challenging),
• Realistic (do you have the resources to achieve?), and
• Time specific (within 3 months – up to 5 years)

This is the who, what, when, where, why, and by how much method. For example,
an objective for a weight loss program that has an overriding goal of improving
healthy eating and promoting a healthy weight is that:

Members (who) will lose an average of .5 – 1 lbs per week (specific what
that is measurable) at the end of the 12 week lunchtime program (time specific
what, when and where) for a minimum of 6 lbs weight loss per colleague (attainable
and realistic).

Or:

Members (who) will attend 11 of the 12 sessions (specific what that is measurable)
and name at least one healthier eating change at the end of the program (specific
what, when, where)

An example of an objective for coaching workers with high cholesterol might
be:

To lower the total cholesterol (specific what) of high risk workers with cholesterol
over 240 mg/dl (specific who) to 200 mg/dl (measurable how much) through one-on-one
counseling sessions offered at the worksite (where) by X date (ex, after 6 months)
(attainable, realistic & time specific when) to lower the risk factor for
heart disease (why).

And one last example of a process goal for a smoking cessation program with
an overriding goal to assist participants in committing to quit for life:

By the end of the 4-week smoking cessation program, ten percent of the participants
will have quit smoking. Each colleague will be contacted at 3 months, 6 months
and 12 months from the program’s end to determine quit status (process
goal) and ten percent of those who quit will still be smoke-free after one year.

You have now completed Steps 1 through 4, including establishing your Corporate
Health Promotion Program Committee. It is now time to plan your wellness activities!

Program assessment may be The last step, but it should be planned at the beginning
of your efforts! Evaluation helps you identify what parts of the program are
working well and what parts could use improvement. Then, based on the assessment
data, adjustments have the potential to be made to fine-tune your wellness program.
Adjusting the program based on assessment data is vital to its continued success.

Analyzing your program does not have to be be terribly complex. However, it
is valuable to plan how you will oversee your wellness efforts and determine
success during the planning phase or Step 5. Also remember to evaluate the program
based on the goals/objectives you already identified during your drafting process.

In order to evaluate your program you must have a system to document specifics
as you progress. This can be as simple as maintaining file folders on programs
that are available, or a computer document with a table or spreadsheet summarizing
information collecting. Consider:

• Program topic and numbers of workers who participated
• The numbers of pamphlets taken by workers or distributed and on what topics
• The number of participants in a behavior modification program and how many
  met their goals/objectives as well as how many attended all of the sessions
• Numbers of workers who continued the healthy behavior modification following
  the program?
• Overall employee satisfaction with the program or each topic.

Depending on your goals/objectives, gather desired data and compare it to previous
data gathered during the initial assessment to determine if the goals/objectives
were met. Such data might include

• Absentee rates
• Injury rates
• Health risk factors Insurance costs

Summarize and Report Corporate Health Promotion Program Results

Once you have collected all of the assessment information it needs to be reviewed
with the Corporate Health Promotion Program Committee and summarized. You will
probably have beneficial results and some areas where a change is necessitated
or additional focus necessitated for continuous improvement. This not-so beneficial
information can be used to make any necessitated changes as well as to plan
for next year and is valuable to include in your report.

It is valuable to communicate the wellness program results to both management
and workers. Consider how management usually receives reports on operations
and productivity problems and include the annual wellness program report in
the same format. At some employers the reports are made during management gatherings
using presentation styles such as power point slides. At other employers, graphs
and bar charts are the norm or a list of the objectives and the summary outcomes
published.

No matter the format, it’s valuable to convey the outcomes and successes
achieved, including any anecdotal stories, as well as areas for improvement.
Be sure to link the outcomes to the company mission and bottom line whenever
possible.

Staff Members desire to receive the same information! Consider using the same
communication channels used when informing workers of the wellness program:

• Employer newsletters,
• Bulletin boards,
• E-mails

Also consider celebrating successes and recognizing achievements by:

• Posting pictures from activities
• Highlighting success stories
• Posting pictures of successes
• Scheduling a celebration
• Recognizing champions