Worksite Wellness Programs

Worksite Wellness Program employer plan review (from Key #19)
• A Worksite Wellness Program employer plan is a roadmap for success.
• Your Worksite Wellness Program employer plan should convincingly demonstrate that your Worksite Wellness Program will help the organization to achieve its goals.

More smart Worksite Wellness Program employer planning strategies

Planning the Worksite Wellness Program

• Determine how your organization plans so that your planning process will be in sync with what already happens in the organization.
• Involve other workers. A planning team brings their combined experience and perspective to the process. Including potential partners as you plan will make it easier to get their buy-in later.

Thinking of the big picture

• Look at the barriers and challenges that might be encountered during Worksite Wellness Program implementation. Develop strategies ahead of time to overcome these potential problems.
• Do a SWOT analysis and examine Strengths, Weaknesses, Opportunities, and Threats.

This analysis will help you identify potential problem areas or resource shortfalls as well as opportunities for growth or increased partnerships with other installation personnel.

The WORST employer planning strategy: sitting in your office; working by yourself.

The best Worksite Wellness Program employer planning strategies

• Get out of your office; get out of the employer. The more workers you involve in the Worksite Wellness Program planning process, the better. Always look for ways to expand your network.
• Keep your budget workers informed. Get to know their philosophy of financial management.
• Be able to articulate the impact if your budget is not fully funded.
o Stay away from basing your impact-if-not-funded argument solely on: “We have to.”
o Instead, describe the impact-if-not-funded with phrases like: injuries to workers, increased compensation costs, increased medical care costs for patients, lost work time, loss of licenses/accreditations, loss of workload to the Tricare network.
• Always have purchase requests ready to be submitted. There is often a short window of time to process these requests. Having the information gathered ahead of time will make it easy to submit the information right away.

A well thought-out Worksite Wellness Program employer plan is essential in these times of shrinking budgets and resources. A good employer plan will help you gain leadership support and help you get and keep resources needed to implement the Worksite Wellness Program.

A employer plan is a roadmap for success. Use the guidelines below to develop a realistic employer plan and budget for your Worksite Wellness Programs.

What is a employer plan?

• A plan for success
• A document that convincingly demonstrates that your Worksite Wellness Program will help the organization to achieve its goals.

Questions to ask when developing a Worksite Wellness Program employer plan

• Why do you need to do the Worksite Wellness Program?
• What are you going to do?
• Where are you going to do it?
• Who is the target audience?
• How are you going to do it?
• Who is going to implement the Worksite Wellness Program?
• How much will the Worksite Wellness Program cost Upper Management?
• What is Upper Management going to get out of the Worksite Wellness Program? Why should Upper Management invest in the Worksite Wellness Program?

Worksite Wellness Program employer Plan Components

• Title and duration of the Worksite Wellness Program
• Points of contact
• Background information (description of need; bibliography/literature review; how the Worksite Wellness Program will help achieve the organization’s goals)
• Worksite Wellness Program description
• Goals and objectives
• Implementation site
• Target population
• Work plan
• Partnerships and collaborations
• Timelines and milestones
• Budget and resource requirements (dollars and workers)

Gaining the support of leadership

• Clearly link the Worksite Wellness Program goals and objectives to the organization’s strategic plan.
• Focus on the desired outcomes.
• Use the right language for the right audience. For example, Upper Management is interested in decreased clinic visits, increased provider productivity, management of the health of the population. However, Upper Management is interested in increased readiness, decreased lost duty/training time, and decreased disability and FECA claims.
A well thought-out Worksite Wellness Program employer plan will help you gain leadership support, help you get and keep resources needed to implement the Worksite Wellness Program, and keep the Worksite Wellness Program on track towards meaningful outcomes.

Most organizations do not have the Worksite Wellness Program resources to address all of their health needs at once. Priorities must be set to determine the most pressing health needs. Use the steps below to prioritize installation Wellness needs.

Assess the health needs of the population.

Collect information about the health needs in the community. How?

• Community- or target group-specific surveys

Identify health needs and at-risk populations.

Use the information to identify leading health needs and also high risk populations. For example:
• Obesity and overweight
• Injury prevention
• Self care

Reduce the list.

Not every health need can (or should) be addressed. Use the following questions to determine which health needs should be addressed first.
• How does the health need impact operational readiness? How big is the impact?
• What are the Upper Management priorities? How does the health need fit into those priorities?
• What are the behavioral factors affecting the health need? What is the evidence that a behavior change will make a difference? Has the behavior been successfully changed by other Worksite Wellness Programs?
• What other social, physical, or environmental factors influence the health need or the target population?
• Is the health need a greater problem at the local level than in the U.S. population as a whole?
• Does the employer have the subject matter expertise and resources to address the health need?

Develop Worksite Wellness Program recommendations.

Only a handful of specific health needs should be focused on in a given year. Keep the following in mind as recommendations are developed as to which specific health needs will be addressed:
• Avoid duplication of other ongoing Worksite Wellness Programs whenever possible. Identify Worksite Wellness Programs already addressing the health need and/or the target population.
• Identify and assess available resources. Build on existing services whenever possible.

Use the recommendations to offer tailored, targeted, integrated initiatives to address the prioritized list of health needs. Prioritizing health needs will keep Worksite Wellness Programs focused, maximize efficient use of resources, and align Wellness efforts with Upper Management goals and priorities.

References
• US Department of Health and Human Services, Planned Approach to Community Health, http://www.cdc.gov/nccdphp/publications/PATCH/index.htm.
• Implementing a Comprehensive Community Wellness and Well Being Program, presentation by CHPPM-EUR at the 2006 Force Health Protection Conference

Think ahead: what unexpected challenges might come up as you implement your Worksite Wellness Program? How could you adapt and change the Worksite Wellness Program to meet those challenges?

• Look at the “what if’s?”
• What if your classroom space is suddenly no longer available?
• What if you can’t hold the Health Fair in the usual place?
• Have a ‘Plan B’ (or even Plan C or Plan D) in mind for when the “what if’s” happen.

• Build a team that can help with the Worksite Wellness Program
• Who else could teach the health education class if the regular instructor cancels at the last minute?
• Know what areas of expertise your staff has besides their ‘main’ job. For example, find out who has fitness instructor credentials besides just the physical therapist.
• Don’t wait for a crisis before you build a network of workers that you can call on.

• Be ready to roll your sleeves up
• Jump in to fill a gap if you need to.
• YOU may have to help restock the milk case in the dining center when the Dairy Month ‘Milk Mustache’ contest results in increased sales during lunch.

• Be willing (and ready) to respond to feedback about the Worksite Wellness Program
• Get participant feedback while the Worksite Wellness Program is ongoing. Then be ready to adapt to those suggestions.
• For example, if kids in a pediatric obesity Worksite Wellness Program fight the idea of completing exercise logs, then get a verbal summary of their activity for the week instead.

• Simplify Worksite Wellness Program
• If part of your Worksite Wellness Program is not working, try making that part less complicated.
• For example, if getting follow-up information is not going the way you planned, then make the process to get information easier OR decrease the number of pieces of information that you collect.

• Use lemons to make lemonade
• What do you do when the Worksite Wellness Program doesn’t turn out exactly as you planned? Look for what did turn out. Often, the ‘unexpected outcomes’ produce positive results.
• For example, one installation’s database to collect sick call data was made obsolete by a regional system. However, the installation database was able to be used in a different way to track vaccination information that improved delivery of care to Employees.
• At another installation, world events halted a new physical training program. Instead, Worksite Wellness Program materials were made into a fitness guide.

Why use small steps toward health behavior change?

Small steps give participants immediate feedback on the changes they make towards better health. Measuring these small steps is also an excellent way to collect interim Worksite Wellness Program effectiveness information.

Worksite Wellness Program small steps make a big difference

Small steps for Worksite Wellness Program participants
• Walk to work.
• Use fat free milk instead of whole milk.
• Each day think of two things you are grateful for.
• Do sit-ups while you watch TV.
• Drink water before a meal.
• Take 10 deep breaths to relieve tension.
• Eat half your dessert.
• Skip second helpings and buffets.

Measuring small Worksite Wellness Program steps
• Use short pre- and mid-point surveys to ask:
• How many glasses of water do you drink a day?
• How often you do eat fast food?
• How often do you skip a meal?
• How often do you engage in physical activity?
• How many servings of fruits and vegetables do you eat each day?

Use the results to show participants how their health behaviors are changing for the better.

• Ask participants to rate their health status and/or stress levels before and after an intervention.
• Add up individual (or team) steps and mark the progress on a map towards a far away destination.
• Be creative! Do not rely only on weight loss, BMI, or cholesterol tests as health status progress indicators or health behavior change feedback.

Wise words for taking small Worksite Wellness Program steps

• The first wealth is health. (Ralph Waldo Emerson)
• We are what we repeatedly do. (Aristotle)
• The victory is not always to the swift, but to those who keep moving. (CDC)
• There are 1440 minutes in every day…schedule 30 of them for physical activity. (CDC)

Why Worksite Wellness Program follow up?

Getting feedback from Worksite Wellness Program participants serves two purposes: to obtain information that quantifies a Wellness Program’s impact, and to find ways to improve a Worksite Wellness Program.

Building follow up into your Worksite Wellness Program

Keep it simple
• Keep follow up to information you absolutely require. A three-question survey is more likely to get a response than one with 20 questions.
• Use email or phone for follow-up. Use personal, AKO, and installation email addresses; use cell phone and unit phone numbers.
• Go to the Employees: go to the unit or somewhere else they will all be gathered (like the APFT test location), and get follow up information there.
• Give participants a stamped envelope addressed to you, with a printed form listing the information you will need.

Keep it structured
• Tell participants right from the beginning that you will be doing follow up after the Worksite Wellness Program is finished. Be specific about the information you will collect.
• If you need to do hands-on measurements, find out if participants will be coming back to your location for another reason (like another clinic appointment). Ask them to stop by while they are in the building – or, better yet, go to where they will be.
• Ask participants where they will be the next time you will be collecting information. They may already know their next duty station if they will be PCSing soon.
• Plan ahead for follow up and put it on the schedule. Planning to do follow up “when you have time” usually means follow up will never get done.

Keep it catchy
• Give participants something to go along with the request for information. For example, if you send an email to ask for information, send along a yummy recipe or a timely fitness tip.
• Schedule a ‘reunion’ day to collect follow up information. Invite participants to come back and share successes and challenges. Have some (healthy) munchies available.
• Have a silly contest – the team with the most follow up information wins something, like having their photos posted on a prominently-placed bulletin board or an eggplant trophy, or some other fun thing.

Why bother to market your Worksite Wellness Programs?
Because of the transient nature of the many employee populations, you must market your Worksite Wellness Programs all the time. Your goal should be to keep your Worksite Wellness Programs as visible as possible.

Creative marketing can increase awareness of your Worksite Wellness Program for:
• Potential Worksite Wellness Program participants
• Upper Management
• Line and medical personnel
• Potential partners and volunteers

Creative Worksite Wellness Program marketing ideas

Involve Upper Management in your marketing Worksite Wellness Program as often as possible.
• For example: invite Upper Management to judge a Worksite Wellness Program logo contest.

Link your Worksite Wellness Programs to national advertising campaigns
• …like the Great American Smokeout and the Dairy Council’s Milk Mustache campaign.

Work closely with personnel in the home office.
• Submit articles about your Worksite Wellness Programs that coincide with National Health Observances. For example: highlight your Asthma Program in May, which is National Asthma Awareness Month.
• Let the home office know you can always provide an article to them when they run short on material. (Then make sure you always follow through.)
Word of mouth is the most effective advertisement for your Worksite Wellness Program
• Use real workers in your advertising: enlist the help of successful Worksite Wellness Program participants or use Employees and other post personnel for your marketing materials, when possible.
• Start “buzz” by incorporating an element of competition: which ‘team’ had the most steps over the past week? Which department engaged most frequently in physical activity?
Take advantage of technology
• Use post television and radio resources.
• Use email whenever you can.
Don’t just market your Worksite Wellness Program to potential participants, but market the opportunities for others to be involved, as well.
• For example: does the Red Cross know you can always use a volunteer? Do other departments/clinics know that you can always use personnel with some temporary down time?
Don’t be “old news”
• If you put advertising materials up, be sure to take them down in a timely manner.
• Update marketing logos and themes as appropriate.

For well over a decade, research has been showing the effectiveness of Worksite Wellness Programs. For every dollar spent on Worksite Wellness Programs, the returns have been cost savings of between $2.30 and $10.10 in the areas of decreased rates of absence, fewer sick days, reduced WSIB/WCB claims, lowered health and insurance costs, and improvements to employee performance and productivity.

Statistics do show that Worksite Wellness Programs increase employee morale, improve the ability to attract and retain key workers, all while having more alert and productive staff members. Some Worksite Wellness Program return on investment statistics of note:

• Canada Life Insurance reported a return of $3.43 on Worksite Wellness Program, and an overall Worksite Wellness Program return on investment of $6.85 on each corporate dollar invested on reduced turnover (32.4% lower), productivity gains and decreased medical claims,
• DuPont’s Worksite Wellness Program pilot sites saw a saving of 11,726 disability days and a return of U.S. $2.05 for every dollar invested by the end of the second year,
• The Canadian government’s Worksite Wellness Program return on investment was $1.95-$3.75 per employee per dollar spent (as found by Dr. Roy Shephard),
• Municipal staff members in Toronto, missed 3.35 fewer days in the first six months of their Worksite Wellness Program than staff members not enrolled in the program,
• British Columbia Hydro staff members enrolled in a Worksite Wellness Program had a turnover rate of just 3.5% compared with a Organization average of 10.3 percent,
• Johnson & Johnson estimated an average saving of U.S. $224.66 per employee per year for the four years examined after the program introduction, with the bulk of the savings being in the third and fourth years,
• Pacific Bell found that overall rates of absence decreased after starting a Worksite Wellness Program,
• Coca Cola report saving $500 every year per employee after starting a Worksite Wellness Program, with only 60% of their staff members taking part,
• Coors Brewing Co. found that for each dollar spent on their Worksite Wellness Program they saw a $5.50 return, and the staff members who participated reduced their absentee rate by 18 percent, and
• Prudential Insurance Company found that the benefits costs for staff members taking part in their program were $312, as opposed to $574 for non-participants

Demographic and technological transformations are changing the nature of work in our society. As these changes occur the comprehensive model of Worksite Wellness Programs described above will evolve and continue to develop. If current trends continue, the workers of tomorrow will be older, more racially and ethically diverse, increasingly female, and will often be located off-site. In the later case, technological advances are making it possible for more and more professionals to conduct their work from their homes. Thus the very character of the worksite will change and so must our efforts to deliver Worksite Wellness Programs. As an example, in the future it is likely that a great deal of health education programming will be delivered through personalized interactive multimedia formats, conveniently supplied to any number of staff members through telecommunication systems.

As technological innovations increase in the worksite, Worksite Wellness Program professionals will face new health related challenges. In the past, some have assumed that technology would make workers more efficient, thereby allowing staff members to work less, while being more productive. In reality, increases in technological innovation have simply allowed more of us to take our work with us where ever we go and feel guilty for not being increasingly productive.

This trend may absorb increasingly greater amounts of leisure time that is normally devoted to recreation and relaxation. Subsequent increases in fatigue and stress will ensure the continued need for effective Worksite Wellness Programs.

When considering the scope of Worksite Wellness Programs described in this article, many will think of substantial investments made by large organizations. The reality is that 60% of individuals working in the U.S. work for a employer of less than 100 staff members (U. S. Bureau of Census, 1988). Due to economy of scale, it has been difficult and expensive for small employer owners to supply adequate healthcare insurance as well as prevention programming for workers.

Worksite Wellness Program professionals must understand this challenge and develop the way to overcome these obstacles. The evidence is clear that much more could be done to advance the health of our society through the worksite. As change agents, health educators must work to empower employers and staff members through education of the benefits of Worksite Wellness Programs.

An employee’s psychological health can never be neglected in a comprehensive model of Worksite Wellness Programs. Originating out of a need for alcohol abuse initiatives in the worksite, today’s employee assistance programs (EAP) encompass assessment and counseling for substance abuse and dependency, stress related disorders, family conflicts and other personal issues.

Evidence of the need for such initiatives is wide spread. In a national survey conducted by the Northwestern Life Insurance Company (1992) 46% of staff members reported that their job was very stressful, 34% thought about quitting their jobs because of worksite stress, and 14% did leave their job because of stress. Alcohol and substance abuse problems as well as issues of worksite violence and harassment are common areas of concern. For many the only viable treatment solution is the Worksite Wellness Program. Exemplary Worksite Wellness Programs will include:

• Personalized assessment of employee concerns
• Assistance in treatment choice
• Emphasis on prevention as well as treatment
• Personal and family counseling initiatives
• Treatment for addictions:
Drugs
Alcohol
Gambling
• Crisis intervention initiatives
• Stress management
• Ongoing support groups
• Management and employee training to identify individuals at risk.
• After treatment care