**Healthy Living Strategies should assist in the development of self-efficacy which means that the individual has a senses that they can influence the course of events in their normal daily life, that they can deal with their normal consequences, that they feel confident and sure of themselves.

The purpose of completing the assessment is to identify your jobsite’s strengths and areas in need of improvement. The assessment will lead your workgroup to recommend actions for changes to make the worksite more supportive of healthy behaviors (i.e. healthy food choices in vending machines, policies to enforce no tobacco use on worksite grounds or encouraging walking during break times). You may find some of the actions for supporting healthy behaviors are easy to do and others may not be feasible or efficient in your worksite. The assessment results can also be used as a baseline measure for evaluation. The initial assessment can later be compared with a follow-up assessment several months later to note progress.

Who should do the Worksite Wellness Program Environment Assessment?

Identify a workgroup (at least 4-5 workers) who will be responsible for completing the assessment. This may be a subset of your wellness workgroup. Forming a diverse group from all areas and levels of your employer is important for meaningful assessment and successful planning and implementation. Suggested participants include: human resources, staff members from various departments, administrators, supervisors, employee or wellness staff.

When should the Worksite Wellness Program Environment Assessment be Done?

Use the assessment as a starting point for your wellness initiative. Once you have completed the assessment, determine which areas the workgroup will focus on (i.e. healthy eating, physical activity, general health, etc.). Establish a time for the workgroup to meet and monitor the progress. Also determine a schedule for annual assessments, so that the assessment can serve as a tool for continuous improvement and accountability over time.

Part 1 – Wellness Assessment Checklist

Complete a Worksite Wellness Assessment Checklist to determine what wellness components you currently have at your worksite. This can be done with the full workgroup or you may want a few key personnel (such as the Human Resources lead, Wellness Coordinator or Workgroup Coordinator) to do a preliminary scan based on information they gather and then let the full workgroup react to their findings. Ask your broker for a sample wellness assessment checklist or create your own.

Completion of the checklist provides a reference point of the wellness functions that are currently in place or in process and it provides an overview of some of the items that should be considered for a comprehensive Worksite Wellness Program.

Checklist Components:

Categories. There are six major categories (General, Physical Activity, Nutrition, Health Screening, Tobacco Use and Emergency Response Plan). Each category has several questions that address what you currently have in place at your worksite.

Current Status. Initially, list whether you have the component (Yes), are in the process of instituting the component or you are planning for the component (In Process) or don’t have the component at all (No). At the end of each category, sub-total the number in each column and then total all of the categories at the end of the checklist to get an overview of where your worksite Worksite Wellness Program currently rates. You should also use this baseline measure as a benchmark for later evaluation. By evaluating where your worksite is on each wellness component, you will be able to get a general idea of your status across each category and all 57 items.

Potential Priorities. After you have completed the assessment and the employee interest survey, you can use the potential priority column to indicate what components you might want to focus on that are either currently in process or don’t exist. This can serve as a first screening of possible areas to focus on as you develop your action plan.

Part 2: employee Input

Why would we want to do an employee survey?

You should conduct an employee survey to get a better understanding of your target audience (your employer’s staff members) and get an initial idea of their current health habits and interest areas. The survey can be tailored to your worksite and can be done in paper form or through the use of survey instruments on the internet or that can be purchased. You can create your own employee survey or ask your broker for a Workplace Wellness Needs and Interest Survey.

As was the case with the worksite environmental assessment, the employee survey results can also be used as a baseline measure for later evaluation. The initial survey results can later be compared with a follow-up survey several months later to note progress.

You should also consider engaging staff members in focus groups or informal interviews to gather information on their wants and needs. This can be done either before or after the survey, or if you don’t have the resources to survey staff members, you could use this method to gather information in place of the survey.

Whatever method you use to gather information, make it as easy as possible for staff members to complete and submit the information so you get a high return rate. Look at offering an incentive or prize for workers who complete the survey.

Key Factors in Worksite Wellness Program

In today’s society there are many primary factors that influence people’s health behaviors. Look at the following list in maintaining participation in your program:

1. TIME. Staff members are busy, so the more you can work activity and healthy eating into their existing schedules, the better your chances for success. Example: A walk during lunch doesn’t take away from existing time, it just uses it differently. Also look at the time of the day and length of any activity you might be promoting, since both time components may be factors.
2. ACCESS. How accessible is your Worksite Wellness Program. Is it onsite or at a nearby site? Do you offer access at breaks or outside of normal work hours?
3. KNOWLEDGE. Staff members need to know “Why” they are taking part in (the benefits) and also will need information about the “How to” in areas that are not commonly known.
4. COST. Make certain that you can provide no cost or reduced cost Worksite Wellness Programs will help participation rates. Coupled with incentives for participation, rates of participation will likely increase dramatically.
5. INCENTIVES. Some workers need incentives to get started in a Worksite Wellness Program. A full list of Worksite Wellness Program incentive options can be on the website.

Key Time Periods in Worksite Wellness Program

Good habits are often difficult to develop. There tends to be some critical times when workers drop out or fall off of a physical activity or diet program. The first key time zone seems to be around 6 weeks. If workers can start and stay consistent with a program through the first 6 weeks, they have made a fairly serious commitment to incorporate the habits into their lifestyle. The second key time is at about 6 months. Those who made it past 6 weeks may get bored and/or distracted from their program after several months. If workers can get past 6 months and sustain behavior through a full set of weather seasons, they have a very good chance of making the changes permanent.

Look at these time periods and think about how you can “boost” your staff members to get them past these critical time markers. Promoting individual or group “challenges”, using incentives, or increased publicity/marketing are a few of the things you can do to help get your staff members through these key time periods

Goal Setting for Worksite Wellness Program

Setting goals has been shown to lead to better participation and more workers making a strong commitment. Whether it be a team goal of walking the equivalent of once around your state or an individual goal of so many miles or minutes of activity, the fact that there is something concrete to shoot for increases the likelihood workers will stick with the program.

Buddy Systems or Team Goals for Worksite Wellness Program

The social aspects of improving one’s health cannot be underestimated. Many studies point to tight social groups being the backbone for a successful campaign because each individual has a commitment to something bigger than themselves and besides, it’s just more fun for most workers. Build your program around some type of teams or partners and see what happens.

Team “Campaigns” for Worksite Wellness Program

Some workers like competition and others don’t. Nevertheless, a worksite wide campaign has the advantage of keeping the message more visible and alive. Encourage campaign participation, but make it voluntary so that those who prefer that type of motivation can join while others can take part in their own way and at their own pace. If the idea of a campaign seems like too much work, consider tapping into existing campaigns where someone else provides resources for you.

Incentives for Worksite Wellness Program

Incentives are often helpful in maintaining or raising interest. Significant incentives such as cash or health insurance rebates have proven to be very strong motivators for employee participation. However, even smaller incentives can be beneficial. Listed below are some sample incentives:
• Achievement awards. Verbal praise and a pat on the back are motivational to some, but a token of recognition of achievement may offer more. A colorful certificate to congratulate an employee for achieving a health-related goal is one example.
• Public recognition. Announced recognition at campaign mid-point or wrap-up festivities.
• Food. Include some healthy foods to kick-off, revitalize or wrap up a wellness campaign.
• Entertainment. Events serve a purpose in jump-starting, reenergizing or wrapping up a campaign. Having entertainment of any kind can boost morale.
• Merchandise. There is a long list of merchandise incentives, including sports equipment and small gift certificates to use at local merchants.
• Monetary rewards. Nothing says incentive better than cash. Worksites that have used cash or rebates as an incentive have shown much higher participation rates.
• Time off. Maybe the next best incentive to cash, or for some workers even better. This type of incentive makes good business sense if the number of absences drops significantly and attendance is used as one of the criteria.

• Justifications for having a Health Fair
• Health risk assessments
• Help for high-risk population: smokers, obese staff members
• Early detection of diabetes, heart disease risk factors (high cholesterol, high blood pressure)

Health Fair Participation – Identify your audience

• Employees only, whole family, retirees?
• Community involvement? Theme?

Health Fair Time Line

• Establish a date and time Allow 4-6 months of planning time

Health Fair Planning

• Identify health-related screenings, tests, other activities you’ll offer Identify educational literature and other learning opportunities Health Fair will provide Include any “fun” activities, or food/beverage needs for the fair

Health Fair Location & Logistics

• Look at location big enough to accommodate the largest volume of workers at “peak time” periods
• Determine how booths/stations will be set up

Health Fair Vendors

• Target relevant health/safety-related community and corporate vendors to provide services, educational materials, incentives and giveaways

Health Fair Marketing

• Determine marketing tools to be used to inform staff members/participants (posters, mailings, e-mail)
• Determine any incentives or giveaways that will be included in the fair or used to encourage participation in the fair

Health Fair Scheduling

• Coordinate timing and events with staff and/or volunteers

Health Fair Personnel

• Schedule appropriate experts Physician or similar healthcare personnel to provide patient consultation for review of blood draw lab results
• Nurse(s) to administer vaccinations
• Administrative/all-purpose individual to facilitate paper work, finger sticks and to provide general assistance
• Pharmacist or pharmacist assistant if appropriate Dietitian for nutritional counseling suggested personnel designated for health fairs

Footnotes

1 The Robert Wood Johnson Foundation via Reuters Health E-Line.
2 Kaiser Daily Health Policy Report, (9/11/03)
3 www.cdc.gov/nccdphp/dnpa/press/archive/lower_cost.htm
4 “Is Stress Nibbling Away at Your Bottom Line?” By Stephen Alper, Nov. 15, 2002.
5 Health Promotion in the Workplace, Michael P. O’Donnell, page 415.
6 http://www.bmpcoe.org/bestpractices/internal/dayto/dayto_6.html

Nationwide Insurance is seeing results from a small incentive program initiated by one of the employer’s onsite nurses. To encourage lunchtime walking, the employee has informally launched a “shoelace program” modeled after the karate-belt color system. Employees progress through the color scale until they reach “black-lace” status. The reward system has resulted in more staff members making commitments to walk during their lunch hour.

At the high end of the reward spectrum, some organizations pay cash to staff members who meet wellness goals. LuK, Inc. offers staff members $250 for kicking the tobacco habit and remaining smoke free for 12 months. For logging fitness points that add up to 10 miles a month, staff members are eligible for health assessments, which can result in reward amounts of up to $225.

The most effective motivator, according to Gordian research, comes through linking participation in Worksite Wellness Programs directly to insurance premiums. Doing so clearly demonstrates to staff members the positive effects of wellness on their own healthcare costs. often, the first step in linking wellness programming to insurance coverage is lowering deductibles for wellness care or eliminating deductibles altogether. By adding this benefit, organizations can encourage staff members to undertake routine screenings and other procedures to respond to health problems before they become chronic. Early detection benefits both patient health and employer health costs.

Incentivizing Worksite Wellness Program participation with healthcare credits

More frequently, employers are going beyond increased wellness care coverage and looking to demonstrate the importance of wellness by linking participation to staff members’ bottom lines. Worthington Industries has recently rolled out a program that allows staff members to eliminate their portion of the insurance premium by enrolling in a Healthy Choices Worksite Wellness Program.

During the first year of the Healthy Choices program, staff members and their spouses complete Personal Health Assessments and medical screenings to determine their levels of health risks. Nurses, dietitians and physical fitness specialists are available to help moderate- and high-risk participants develop individual action plans for improved health through the use of educational materials, behavior modification, telephone help from third-party program health coordinators, and formal health management initiatives. By completing the assessments, staff members earn their full premium credit. Because some plans at Worthington require no employee contribution, a cash award takes the place of a credit in those cases. During year two of the program, the wellness bar is raised slightly. To continue to receive the wellness credit, participants in the moderate- to high-risk category will be required to work at setting goals with third-party health coordinators.

Year three raises the bar again, requiring participants to show progress in meeting goals and to continue to work with health coordinators to reach goals.

After year three, Worthington Industries staff members will be on the wellness track. The employer believes that will mean a healthier workforce and cost savings for staff members and the employer. The well being of Worthington staff members is the foundation of this program, and both staff members and the company are expected to benefit from the long-term advantages of the Healthy Choices Worksite Wellness Program.

While Worthington has taken a broad approach to wellness, other organizations have found success in offering incentives in specific areas. Longaberger, for example, offers a discount on healthcare policies for staff members who do not use tobacco. An individual employee who doesn’t use tobacco saves $7 per bi-weekly pay. For tobacco-free staff members with family coverage whose families are also tobacco-free, the savings increases to $14 per pay.

The next step: Penalizing harmful behaviors

As it stands, healthcare is the only type of insurance that doesn’t focus on penalizing for behaviors that put the insured party at risk. With healthcare costs rising so dramatically, that could soon change. Just as an accident likely raises auto insurance premiums, increasing premiums for those who engage in unhealthy behaviors is a possible next step in employers’ attempts to manage healthcare costs.

Reports that staff members would support this type of action are stacking up. One Ohio employer conducted an informal survey that indicated staff members would consider it a morale boost if health-conscious staff members were relieved of some of the burden of subsidizing care for staff members who engage in behaviors that adversely affect their health. Whether or not this type of program gains popularity, one thing is sure: the need to control the rise in healthcare costs is becoming ever more pressing.

Take the first step

Whatever the strategy, from offering staff members health resources to providing incentives for healthy behaviors, employers have a real opportunity to improve morale and productivity, reduce rates of absence and control healthcare costs through wellness. The first step is committing to taking one, no matter what size effort is appropriate for your organization.

Big strides start with small steps.

Stretching initiatives are another effective tool in injury prevention. According to the Best Practices in Manufacturing Web site, Dayton Parts, Inc. (DPI) in Harrisburg, Pa., conducted research that revealed approximately 80% of all manufacturing injuries occurred within the first two hours of each shift. After starting a program that required production staff members to stretch for 10 to 15 minutes at the beginning of their shifts, they saw a dramatic reduction in injuries.

While the DPI Worksite Wellness Program costs about $75,000 a year to operate, in conjunction with other employer initiatives, it has helped bring the annual cost of workers’ compensation from $700,000 to $200,000 per year.6

To help prevent lengthy absences and reduce workers’ compensation claims, Honda instituted a work recovery program. Through the program, workers who have had an injury can work in a modified job—getting better. Employees in the program spend their work days receiving physical conditioning to increase overall fitness, physical therapy to restore functionality, health education and nutrition counseling. The program is based on information that shows fewer work days are lost when an employee stays connected to the work environment.

The Ohio Bureau of Workers’ Compensation, www.ohiobwc.com, provides a “10-Step Business Plan” as a guide for organizations in providing Worksite Wellness Programs that aim to reduce injuries. The plan includes information on safety and health initiatives to prevent occurrences of on-the-job accidents, including:

employee involvement – To ensure the success of any Worksite Wellness Program, staff members must take part in the safety and health-management process. This can be done through safety and health audits, accident investigations, or by forming safety and health involvement teams, focus groups or committees.

Orientation and training plan – Conduct orientation and training sessions to educate staff members on the employer’s safety policies. These sessions should include procedures for the safe use of machinery and tools, chemical hazards and how to prevent contact or exposure, specific job/task safe practices, and hazard recognition and prevention.

Communication – Open communication keeps staff members informed and provides suggestions and feedback on the effectiveness of the Worksite Wellness Program. Through memos, bulletin boards and staff meetings, important safety and health information can be conveyed throughout the organization, keeping all management staff and staff members knowledgeable about the employer’s safe practices.

The employer plan also outlines incentives for post-injury procedures, including:

Medical treatment and return-to-work practices – arly return-to-work strategies help injured or ill workers return to work in a timely manner. Companies should establish a disability management policy to help injured or ill staff members obtain quality medical treatment, making their transition back to work quick and effortless.

Timely notification of claims – Employers should document worksite injuries immediately after they occur and promptly send that documentation to a claims handler. Quickly providing claim information demonstrates care and concern for the injured employee, prevents delays and confusion with the claim process, and reduces the potential for abuse or needless litigation.

Record keeping – Internal documents should be kept to record work-time injuries and to assess the success of the employer’s safety efforts. Organization audits, surveys and injury or illness reports can all be used to analyze which safety practices and policies have proven successful, and what areas of health and wellness need improvement.

While stress cannot be eliminated from life, or even from the worksite, coping skills can be developed with relative ease. Stress management skills lead to reduced rates of absence and more effective, more productive staff members. Because stress has been shown to contribute to such physical conditions as ulcers, high blood pressure and stroke, stress reduction has a direct impact on improving physical health.

Studies have shown that heart patients who attend stress management initiatives have 42% lower healthcare costs. Other studies have documented a 50% reduction in medical services use when stress management initiatives are employed. Further, Employee Assistance Program (EAP) experts estimate that 20% of any workforce is affected by personal problems that can influence work performance.

Stress reduction tactics to consider:

• Offer onsite yoga or meditation classes.
• Organize support groups among staff members.
• Sponsor stress management classes during the workday.
• Offer an employee assistance program that includes both counseling and referral.
• Offer onsite counseling for staff members in the case of a work-related trauma, such as the death of a co-worker.

The old adage “an ounce of prevention is worth a pound of cure” is particularly relevant to when applied to preventive measures taken during pregnancy, when a few extra ounces of birth weight can save a child’s life. During pregnancy, simple precautions can help avoid catastrophic results; giving up tobacco use, for instance, drastically reduces the risk of miscarriage and pre-term labor.

The March of Dimes reports that if all women took adequate folic acid before conception and during pregnancy, the number of babies born with a neural tube defect could drop by as much as 70%. The physical and emotional benefits of proper prenatal care to a mother and child are underscored by a strong employer case for offering prenatal wellness benefits. Nationwide’s Chief Medical Director, Dr. Michael Moore, estimates costs to care for one baby delivered prematurely could approach $500,000.

First steps in fostering a prenatal program:

• Invite the March of Dimes to present information about prenatal health at an employee brownbag lunch or breakfast meeting.
• Hold prenatal care information classes for interested staff members at lunchtime.
• Offer educational materials about the effects of alcohol, drugs and tobacco use on an unborn child.
• Offer incentives for adopting healthy lifestyles during pregnancy.
• Offer prenatal initiatives and education as part of the employer healthcare package.

Centers for Disease Control and Prevention (CDC): Data and statistics

• http://www.cdc.gov/DataStatistics/
• Data and statistics are available by topic (i.e., asthma, injuries, MRSA).
• Data access tools are available to customize information tables and query datasets (i.e., Healthy People DATA2010, tobacco use-Attributable Mortality, Morbidity, and Economic Costs).
• Nationwide survey information is available (i.e., National Health and Nutrition Examination Survey (NHANES)).

CDC Behavioral Risk Factor Surveillance System (BRFSS)

• http://www.cdc.gov/brfss/index.htm
• BRFSS is the world’s largest, ongoing telephone health survey system. BRFSS has been tracking health conditions and risk behaviors in the US yearly since 1984.
• Chronic Disease Indicators are divided into seven categories: physical activity and nutrition, tobacco and alcohol use, cancer, cardiovascular disease, diabetes, overarching conditions, and other disease and risk factors.
• Prevalence information is also available (i.e., weight classification by Body Mass Index and age).

Manage Worksite Wellness Program information electronically.
• Storing Worksite Wellness Program outcomes information electronically is the best way to manage that information.
• An electronic system will enable you to review and analyze the information more efficiently.
• Scan old surveys and other Worksite Wellness Program information that exist only on paper into .pdf format for permanent storage.

Find the Worksite Wellness Program system that works best for you.
• Some workers are more comfortable with spreadsheet applications; others prefer to work with database applications.
• You will be more likely to use a Worksite Wellness Program that you are familiar and/or comfortable with.
• Standardize information collection and organization. Keep information columns/fields in the same order for all Worksite Wellness Programs.

Keep the Worksite Wellness Program as simple as possible.
• You do not have to be a Wellness Programming wizard or use complicated data entry interfaces in order to manage Worksite Wellness Program outcomes information.
• A simple spreadsheet is an excellent way to keep your information organized.

Store all Worksite Wellness Program data numerically.
• Using numbers (instead of words) will make the information much easier to enter and analyze. For example: use “1” for yes; “0” for no OR “1” for male; “2” for female.
• Number survey responses that contain strings of words. For example: instead of entering the responses: “patient education videos”, “news,” or “no TV,” number the responses so you only have to enter “1,” “2,” or “3.”

Label all Worksite Wellness Program data clearly.
• Make sure all the data columns, rows, or fields are labeled. The information is worthless if you don’t know what information is in which column.
• The spreadsheet/database should include an explanation for column, row, field, and data abbreviations and a key for numbered responses.

Use consistent Worksite Wellness Program data units.
• Make sure all information entered into a given column is expressed with the same unit of measure. For example, enter all heights as total inches, not as a combination of feet and inches.
Putting your data in order by using a simple system that works for you will enable you to track participant accomplishments. Keeping your information organized also makes it easier to communicate Worksite Wellness Program impact to leadership and make Worksite Wellness Program improvements as needed.