Worksite Wellness ProgramsWorksite Wellness Programs

Business processes are structured activities that achieve a specific result. By way of example, scheduling appointments is a organization process that results in an orderly work flow and timely patient care.

Worksite Wellness Program implementation often requires changes to established organization processes. These changes may be simple, such as adding prescreening appointments to the scheduling process, or more complicated, like determining how time devoted to a particular Worksite Wellness Program will be coded.

Not all change can be affected painlessly. However, developing a plan for achieving change will overcome barriers like:

“But we’ve always done it that way” or “But we’ve never done it that way.”

Each change situation will be different. The path to achieving change may not always be straightforward.

Lesson learned: Making small, incremental changes will be easier than trying to make one big change. It is also easier to modify a current process than to introduce a brand new one.

Develop a road map for change.

Describe the current organization process.
• By way of example: what is the current registration process for the weight management program? Include steps for both participants and staff.

Identify where the new or modified organization process could fit into the current process.
• By way of example, prescreening appointments for the weight management program could be scheduled when participants sign up OR the prescreening could be done at the first class.

Collaborate.
• Consider the change process to be a team effort. Determine everyone who will be affected by the change and get their input.
o By way of example, be sure to ask the personnel that set up the prescreening appointments AND the personnel that would do the prescreening for their ideas.
• Recruit one or more champions for the change. It helps if the champion has some clout.
• Get buy-in from as many workers as you can – including those that might be most resistant to the change.

Communicate.
• Don’t keep the change a secret. The more workers know, the more likely they will support a change.
• Anticipate barriers ahead of time. Be ready to articulate concrete benefits that will result from the change – especially advantages such as costs avoided or training time conserved.

Worksite Wellness Program evaluation is critical for effective Wellness and will help you get Upper Management support.

Why evaluate your Worksite Wellness Program?

Worksite Wellness Program evaluation answers these questions:
• What change(s) occurred in the target population?
• ‘What’s in it’ for Upper Management?
• Are the resources that are being used worth the outcomes that are reached?
• Were Worksite Wellness Program outcomes expected? (Unexpected outcomes may have occurred.)
• What Worksite Wellness Program areas need improvement?

Worksite Wellness Program Fact of Life:

Worksite Wellness Program evaluation left to “chance” or until “there is time” will never happen.

• Worksite Wellness Program evaluation should be considered as an essential part of the whole plan for Wellness and not as something extra.

Where do you start?

Keep it simple. Worksite Wellness Program evaluation does not have to be complicated.
• Get baseline data.
• Baseline data is the health status of the target population at the beginning of the Worksite Wellness Program.
• Begin by collecting just 3 or 4 key items as the baseline. You will have better success collecting follow-up information later if you only need to get a few pieces of data.
• Don’t rely only on health indicators that require lab evaluation. Also use self-report information and health indicators that are measurable without lab tests.

• Collect data that relates to readiness.
• You should always be ready to communicate to leadership the ways that your Worksite Wellness Program impacts readiness. Plan ahead to collect data that will demonstrate this connection.
• Think like Upper Management: what Worksite Wellness Program outcomes will be important from Upper Management point of view?

• It’s never too late to incorporate Worksite Wellness Program evaluation into Worksite Wellness Programs.
• If your Worksite Wellness Program is already up and running and you didn’t plan for data collection ahead of time, start collecting data NOW.
• If you don’t have baseline data, then collect interim data and compare that to end-of-program data.
• Or, you can compare final Worksite Wellness Program outcomes to similar programs elsewhere.

If you can’t make any comparisons to other data, use resources like The Community Guide (http://www.thecommunityguide.org/ ) that have already evaluated the effectiveness of Worksite Wellness Program components. Compare the components of your Worksite Wellness Program to those that have been proven effective elsewhere.

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?

• Consider the “what if’s?”
• What if your classroom space is suddenly no longer available?
• What if you can’t hold the Health and Wellness 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. By way of example, find out who has excercise 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.
• By way of 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.
• By way of 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.
• By way of 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 excercise guide.

Take the time to plan Worksite Wellness Programs before they are started.

Effective planning enables better use of all your resources. Include all the steps below when you plan a Wellness activity.
• Do your homework – Identify the science and research that support your initiatives. Look for similar Worksite Wellness Programs that already exist.
• Determine the specific health need(s) – Use these needs to target initiatives to problems that are an issue for your population.
• Organize a team – A team is a resource multiplier. Network and build as many partnerships as you can.
• Make a plan, but don’t start completely from scratch. Make a written plan for your Worksite Wellness Program. Look for every opportunity to take advantage of resources that already exist. Don’t reinvent the wheel.
• Select a focus – Choose one or two main target areas for Worksite Wellness Programs. Address all five stages of change in the target areas rather than trying to hit every possible Wellness topic.
• Determine your resources – What assets do you have? What assets will you need? How can you fill the gaps?
• Get Upper Management support – Think like Upper Management. Communicate the value of Wellness from Upper Management’s perspective.
• Begin the activity- Be flexible. Be prepared for unexpected challenges.
• Market the activity – Keep your Worksite Wellness Program visible for Upper Management, line and medical personnel, Worksite Wellness Program participants, and potential partners and volunteers.
• Collect and analyze outcomes – Outcomes indicate Worksite Wellness Program impact. Begin with just a few outcomes – you don’t have to collect everything. Remember that it’s never too late to start measuring Worksite Wellness Program impact.
• Assess, improve and re-evaluate – Use participant feedback and Worksite Wellness Program outcomes to determine Worksite Wellness Program impact. Identify areas in need of improvement. Use outcomes to determine if expended resources were worth the results.

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 data.

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 innovative! 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 data 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.

Make 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 data. 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.

Make it catchy
• Give participants something to go along with the request for information. By way of example, if you send an email to ask for information, send along a yummy recipe or a timely excercise 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 data 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.
• By way of 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 corporate office.
• Submit articles about your Worksite Wellness Programs that coincide with National Health Observances. By way of example: highlight your Asthma Program in May, which is National Asthma Awareness Month.
• Let the corporate 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.
• Create “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.
• By way of 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.

What is Worksite Wellness Program data?

Worksite Wellness Program data is information that is collected about your Worksite Wellness Program. All Worksite Wellness Programs should include data as an integral part of the Worksite Wellness Program plan.

Why should you care about Worksite Wellness Program data?

Information tells the Wellness story. Information is the tangible evidence of a Wellness Program’s impact.

Building data into Worksite Wellness Programs

Why bother with Worksite Wellness Program Data?

You need Worksite Wellness Program data to:
• Assess whether or not your Worksite Wellness Program is working.
• Answer the ‘so what?’ about the need for a Worksite Wellness Program.
• Offer information to Upper Management about the impact of the Worksite Wellness Program.
• Write a budget justification so you can secure Worksite Wellness Program resources.
• Use Worksite Wellness Program resources efficiently and market your Worksite Wellness Program more effectively.

Where to start collecting Worksite Wellness Program data:
• MAKE A PLAN to collect the data: decide what, when, and how data will be collected.
• Determine what data is ALREADY BEING COLLECTED.
o By way of example: use dairy sales data in the dining center to measure the impact of a milk marketing/dairy month campaign.
• Begin collecting JUST A FEW small pieces of information. Be innovative!
o By way of example: BMI, APFT scores (before & after), tobacco quit rates

IT’S NEVER TO LATE TO START collecting Worksite Wellness Program data.

Innovative Worksite Wellness Program data strategies
• Use local college/graduate students to help collect, input, and analyze Worksite Wellness Program data.
• If your organization has an internship program, get to know the Internship Director. Take advantage of intern resources – including having the Director and/or interns implement the data collection plan for your Worksite Wellness Program.
• Use data to let upper management know about the Worksite Wellness Programs affect on the workers.

Present this information at their monthly/quarterly meetings.
• Use innovative follow-up strategies to get data. Phone calls can be effective, but also consider email, mailed surveys with return postage provided, and going to the units in person to collect the information.
• Make data collection ‘fun’ for Worksite Wellness Program participants.
o By way of example: use a team approach – the team with the ‘best’ overall results gets some sort of award or recognition.
• ALWAYS relate the impact of your Worksite Wellness Program to readiness.

Collaboration and Effective Worksite Wellness Programs

Why should you collaborate?

Active, ongoing partnerships and cooperative efforts multiply Worksite Wellness Program resources in order to better serve Employees and their families.

How can you build collaboration into a Worksite Wellness Program?

Get Ready…
• Brainstorm a list of every potential Wellness partner you can think of. Be innovative!
• Be a politician: introduce yourself to everyone BEFORE you need their help.
• Develop a plan to get Upper Management support from as high up the chain as possible. Ensure that to include specific ways that your Worksite Wellness Program will impact force readiness.
• Determine how YOU can help your partners (not just what they can do for you).

Be Steady…
• Solicit input from everyone that your Worksite Wellness Program will affect. Make a special effort to talk to the workers closest to Worksite Wellness Program implementation (those with “boots on the ground”).
• The most frequently asked questions should be: “What would you suggest?” and “How do you think this would work best?”
• Identify someone who has done the same type of Worksite Wellness Program before and ask their advice. (Hint: the Worksite Wellness Program has a list of many Wellness POCs.)
• Plan NOW to show Worksite Wellness Program effectiveness. Identify who may ALREADY BE COLLECTING information that will show the Worksite Wellness Program is working.

Get Set…
• Step back and review your Worksite Wellness Program from a potential partner’s point of view.
• Brainstorm questions your collaborators might have, and have the answers ready.
• Be ready to frame your “selling points” in terms that are important to each specific partner.
• Put the Worksite Wellness Program benefits in language your collaborators will understand.
• Emphasize to potential partners how this Worksite Wellness Program will provide benefit to them.

And Go…
• Build as many partnerships as you can BEFORE you implement a Worksite Wellness Program.
• Make your partnerships a two-way street: always let your collaborators know what you can do for them – then follow-up and do what you say you would do.
• Maintain Upper Management support by providing a regular flow of information. Invite Upper Management participation in the Worksite Wellness Program and special events whenever possible. (Hint: they make great judges if you have a contest.)
• Offer regular feedback to your collaborators.
• Don’t hog the spotlight: let your collaborators share in the visibility of the Worksite Wellness Program.

Worksite Wellness Programs at the corporate level are beneficial, right? Wellness statistics clearly show that such Worksite Wellness Programs are not only cost-effective to the organization but can assist the employee in developing a healthier lifestyle. With the rising cost of medical care, Worksite Wellness Programs simply make sense. So where does the problem come in? Let’s examine the topic from both perspectives.

Worksite Wellness Programs: The Good

• A sampling of return on investment for Worksite Wellness Programs: Bank of America: 600 percent; General Motors:370 percent; Pepsico: 300 percent; Citibank: 465 percent; and the Washoe County School District leading the pack at a whopping 1,560%. (Campbell,J., Wellness Improvement Experts, www.wellnessimprovementexperts.com, Albuquerque, New Mexico.)
• Companies with Worksite Wellness Programs have found a 28% reduction in sick leave, a 26% reduction in adjunctive medical costs and a 30% reduction in disability and workers compensation costs. (Health Affairs, Volume 21, No.2, March, 2002.)
• The Washoe county School District in Northern Nevada found a $15.60 return on investment for every dollar spent due to a 20% reduction in absenteeism. (Hardy,A. (2005). At the Top Of The Class. WELCOA’s Absolute Advantage Magazine, 5(1), 14-20.)
• Worksite Wellness Programs provide the structure, encouragement, incentives and ongoing support that many individuals need in order to make lifestyle changes.
• Employees also realize returns on their efforts. FiServ, a financial services technology organization, gave workers who filled out a health risk assessment a significant discount on their medical insurance premium. (Holland, Kelley, The New York Times, July 22, 2007.)

Worksite Wellness Programs: The Bad

The flip side of the argument centers on basic human rights. Do we want/need our employer to tell us to eat our veggies or lose 30 pounds? Some organizations are doing just that and at least one lawsuit has resulted because of it.
• Three hundred organizations have requested assistance from a national employment and labor law firm to institute more aggressive Worksite Wellness Programs.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Clarian Health, based in Indianapolis, Will start decreasing employee paychecks by $10.00 for every employee who has a Body Mass Index (BMI) of greater than 29.9 because not enough workers were utilizing their wellness services.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Scott Rodrigues filed a suit against his prospective employer, Scotts Miracle-Gro, because he believed the organization’s antismoking policy violated his civil rights. The organization has a policy against hiring workers who smoke and Mr. Rodrigues’drug screen was positive for nicotine.(Holland, Kelley, The New York Times,July 22,2007.)
• employee advocates are concerned that health discrimination may not be covered under the Americans with Disabilities Act.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)

Penalizing workers by hitting them where it hurts the most, in their pocketbook, does not appear to be a a good approach to molding human behavior.
Such tactics may result in increased resentments and retaliation, primarily in the form of absenteeism and presenteeism (decreased productivity on the job.) Voluntary, incentive-based programs, such as the one in the Washoe County School District, can and do produce results. A positive attitude on the part of management along with an opportunity for workers to have a stake in the decision-making may yield the greatest dividends to both employer and employee.The motivation and resolve needed to change unhealthy lifestyle habits can best be derived from the basic tenets of encouragement, respect and support.