Wellness Programs : Effective Health Promotion Programs.

Corporate America is increasingly investing in staff member health promotion because it is good corporation.  In order to meet productivity demands, companies must rely on a healthful, productive workforce to succeed in the highly competitive global marketplace.  

Over a hundred studies in both corporate and governmental establishings have documented the economic advantages of worker health promotion programs, including reduced absenteeism, reduced injuries and workman’s compensation costs, reduced health care costs, reduced worker turnover, in addition to increased productivity, greater worker satisfaction, and improved morale.1-10  

The more recent literature reflects improvements in health promotion programming along with greater return on investment.  In general, the more focused and intensive the health promotion program, the greater benefit realized.  

To enhance their effectiveness federal government worker health promotion programs may  be able to incorporate some of the features described. Worker health promotion programs shown to have positive returns on investment often include the following features -    

1   Health and productivity management model

Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors like tobacco use, lack of physical activity, excess weight, unhealthful diet, high cholesterol, high blood pressure, stress, depression, and so on.     

High-risk workforce are particularly targeted for intervention, although the most successful health promotion programs also direct efforts towards healthful workforce in order to maintain their low-risk status.  This model emphasizes outcomes as opposed to simply offering wellness activities for their own sake.     

2   Health risk assessment

Use of a computerized health risk appraisal  instrument with individualized feedback and recommendations is nearly universal in successful health promotion programs. Employees take the questionnaire annually in many cases.     

The HRA serves to increase awareness, provide direction, and motivate individuals to improve specific behaviors.  In some cases, the personalized report is directly linked to appropriate resources related to identified risks.     

Research indicates that the use of an Health Risk Assessment (HRA) is effective if it is followed by some type of educational or therapeutic intervention for identified risks.  It often serves as the entry point into wellness programs.   

3   Biometric analysis

A lot of wellness programs combine the results of the health risk assessment with measurement of each employee’s biometrics, including weight and BMI , blood pressure, cholesterol, fasting glucose, and assorted other metrics.     

Combining the results of the HRA with biological measures results in a more exact risk profile.   Computerized health risk appraisals often incorporate biometric data in their risk analysis.   

4   Health Promotion Program Incentives

Workers are frequently given monetary or other significant rewards for completing an HRA, participation in a wellness program or class, specific accomplishments like stopping tobacco use, losing weight, or exercising, and for maintaining healthful status and/or behaviors.     

In many cases the monetary incentives are associated with reductions in health insurance premiums.  Some health promotion programs use disincentives in addition to incentives, like charging staff members who smoke higher rates for their health insurance contribution.   

5   High wellness program participation rates

Successful wellness programs use incentives to drive participation rates up.  They also market their wellness programs robustly, and may use contest or challenge strategies to heighten enthusiasm and encourage participation.   

6   Wellness coaching

Employees with identified risks or desire to improve their health habits might  be periodically coached via telephone by trained health Coaches.     

Coaching assists staff members set and achieve realistic lifestyle-related objectives including those addressing stress, work life balance, tobacco use, weight, physical activity, and various behavior modifications.     

Three or more sessions are typically offered.  In some intensive health promotion programs, the coaching extends to actual disease management (DM) intervention for personnel with identified high-risk diseases.    

7   Multiple formats

Programs may offer wellness content in online, paper, and seminar formats to provide stimulating variety and alternatives in order to accommodate the needs of all workers.     

In addition to onsite physical activity and healthy consuming events, on-line health promotion programs, e-mail reminders and notices, printed newsletters and materials, and workplace courses and seminars are common dissemination strategies.   

8   Senior management support

Enthusiastic and frequent endorsement by upper management is crucial to achieving high rates of participation.  When senior executives are wellness role models themselves the effects of endorsement are enhanced.   

9   Frequent contact

Successful health promotion programs have frequent contact of some sort with every worker.  This may  be through marketing and advertising efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, staff meeting presentations, discussion in new worker orientation, supervisory sessions, etc.      

The key is to enhance employee awareness of wellness opportunities and reinforce the corporate emphasis on wellness through frequent and multiple “touches”.   

10   Open enrollment

To encourage high participation rates staff must’ve easy access to the health promotion programs and activities.  Open and uncomplicated enrollment processes achieve this.     

Some corporations automatically enroll all employees and then allow those who do not wish to participate to “opt-out”.  This practice has been shown to improve enrollment rates in some settings.   

11   Family involvement

A lot of health promotion programs encourage spouses and other family members to take part in the business wellness activities and to adopt a healthful lifestyle along with the designated worker. It is far easier for the worker to have a healthful lifestyle if his/her family does so as well.   

12   Smoking cessation

Because tobacco use and other tobacco use is the number one threat to health it is crucial to offer staff effective and convenient assistance with quitting.     

Access to smoking cessation pharmaceuticals is often part of such wellness programs.  In-house wellness programs provide the most convenient access to these services, although on-line or telephone-based wellness programs may  be available as well.     

13   Exercise

Regular exercise is a core component of every health promotion program. Workers ought to be strongly encouraged to engage in regular exercise.     

Most health promotion programs provide either periodic or continuous on-site opportunities, and some locations have on-site fitness clubs, swimming pools, walking trails, etc.  Discounted or paid memberships to community exercise facilities is a common alternative to on-site facilities.   

14   Weight management

Because obesity is a major threat to health it’s very important that programs offer effective assistance with weight control. Comprehensive encouragement from senior level management to shed excess weight is important.     

Web-Based health promotion programs, workplace programs, or discounted access to weight control programs in the community may all be available.  Long-term follow-up is critical for maintenance of weight loss.   

15   Stress management

Worksite stress is perhaps the most common complaint among staff and a major contributor to absenteeism, presenteeism (reduced productivity), and low morale.     
   
Nearly all successful health promotion programs offer assistance with personal and workplace stress.  Some programs refer staff to outside resources for additional serious conditions like depression and anxiety disorders, but most offer online or frequent on-site general stress reduction programs.     
   
Some companies endeavor to structure the work environment to minimize stress, both physically and operationally.   

16   Health testings/immunizations

Staff Members are actively encouraged to complete recommended medical testings for blood pressure, cholesterol, Body Mass Index, colorectal and breast cancer, and others.     

Annual influenza immunizations are also encouraged.  Some sites provide these services at the workplace.  Incentives are often awarded for completion of these screenings/immunizations.    

17   On-Site health care

Actual provision of on-site main care medical services is a growing trend.  The rapidly escalating costs of medical care insurance for workers has stimulated this trend.     

Some corporations have found that it’s less costly to provide main care services themselves than to fund those services through health insurance.     

Onsite care also reduces the amount of time staff would otherwise spend away from the workplace getting such services.    

References   

1   Aldana, Steven G.  (2001)   Financial Impact of Health Promotion Programs -   A Comprehensive Review of the Literature.   Am J Health Promotion 15(5) - 296-320.

2   Chapman, Larry.  (1998)   the Role of Incentives in Wellness.  The Art of Wellness  2(3) - 1-8.

3   Chapman, Larry.   (2003)   Biometric Screening in Health Promotion -   is it Really as Important as We Think?  the Art of Health Promotion  7(2) - 1-12.

4   Chapman, Larry.  (2005)   Meta-Investigation of Employee Wellness Economic Return Studies -  2005 Update.  The Art of Wellness, July/August, 1-15.

5   Chapman, Larry.   (2006)  Employee Participation in Employee Wellness and Wellness Programs -  How Important are Incentives, and Which Ones work Best?   North Carolina Medical Journal   67(6) -   431-432.

6   Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth.   (2007)   the Role of Health Promotion Coaching in Employee Wellness.   the Art of Wellness, July/August, 1-12.

7   Chapman, Larry.  (2007)   Proof Positive -   an Analysis of the cost-Effectiveness of Employee Wellness.  Northwest Health Management Publishing, Seattle, WA.

8   Chapman, Larry.  (2007)   an In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change.   Workshop presentation at the World Research Group “Rewarding Healthful Behaviors for Health Plans and Companys” Conference, Orlando, FL, January 23-24.

9   Edington, Dee.   (2001)   Emerging Research -   A View from One Research Center.  American Journal of Wellness 15(5) -  341-349.

10   Edington, Dee W.  (2007)   Health Management as a Serious Corporation Strategy.  Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Corporations” Conference, Orlando, FL, January 23-24.

11   Pelletier, Barbara, Boles, Myde, and Lunch, Wendy.  (2004)  Changes in Health Risks and Be sure to work Productivity.   Journal of Occupational and Environmental Medicine, 46(7) -  746-754.

12   Pelletier, Kenneth R.  (2005)   A Review and Analysis of the Clinical and Cost-Effectiveness Studies of extensive Health and Illness ManagementPrograms at the Workplace -  Update VI 2000-2004.  JOEM 47(10)1051-1058.

13   DeVol, Ross, Bedroussian, Armen, et.  Al.  (2007)  an Unhealthful America -   the Economic Burden of Chronic Condition.  Report released by the Milken Institute.   www.milkeninstitute.org.

14   Partnership for Prevention.  (2008) Investing in Health -   Proven Health Promotion Practices for Worksites.   http - //www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.