Wellness Assessments

Benefits of Nutrition Programs 

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans. 

The American Journal of Health Promotion estimates the cost of obesity to U.S. company to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one study reports that obesity raises healthcare costs by 36 percent and medication costs by 77 percent. To offset the health risks of obesity and poor diet, many organizations have committed to helping employees ensure proper nutrition and undertake weight control programs. 

Popular nutrition programs: 

      Fruit and Vegetable Consumption

      1.    Provide healthy eating reminders and prompts to employees via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).

      2.    Provide appealing, low-cost fruits and vegetables in snack machines and in the cafeteria.

      3.    Provide cookbooks, food preparation, and cooking classes for employees’ families.

      4.    Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the U.S. Dietary Guidelines for Americans.

      5.    Provide healthy foods at meetings, conferences, and catered events.

      6.    Use point-of-decision prompts as a marketing technique to promote healthier choices.

      7.    Provide healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).

      8.    Provide taste-testing opportunities at the worksite.

      9.    Provide staff member-led campaigns, demonstrations or programs.

      10.   Provide local fruits and vegetables at the worksite (i.e. worksite farmer’s market or community-supported agriculture drop-off point).

      11.   Use competitive pricing (price non-nutritious foods in snack machines and cafeterias at higher prices).

      12.   Provide protected time and dedicated space away from the work area for breaks and lunch.

      13.   Make kitchen equipment available to employees.

      14.   Provide an opportunity for onsite gardening if possible. 

      Sweetened Beverage Consumption

      1.    Make water available throughout the day.

      2.    Provide appealing, low-cost healthful drink options in snack machines and the cafeteria.

      3.    Modify worksite snack contracts to increase the number of healthy options. 

      4.    Price non-nutritious beverages at a higher cost.

      5.    Use point-of-decision prompts to promote healthier choices. 

      Portion Control

      1.    Label foods to show serving size and/or nutritional content.

      2.    Provide food models, food scales for weighing and pictures to help employees assess portion size.

      3.    Provide appropriate portion sizes at meetings, worksite events and in the cafeteria. 

Nutrition programs in action 

While many organizations address weight management through fitness initiatives, organizations are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many organizations may help pay for obesity treatments for employees. By way of example, to improve the health of dangerously obese employees, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000. 

A 2003 Society of Human Resource Management study shows that 24 percent of employers offer weight loss programs. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat analysis and body mass index (BMI) measurements are available to employees at any time. 

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides employees basic nutrition information, including Weight Watchers points. Many organizations partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides employers free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives employees a free portion of fruit or vegetables after he or she has purchased a preset number.

Benefits of Exercise Programs 

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that physical fitness may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: physical fitness improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive workers. 

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that physical fitness is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of U.S. companyes help employees pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way organizations promote active lifestyles. 

Popular Exercise Initiatives: 

1.    Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.

2.    Provide and promote participation in after work recreation or leagues.

3.    Provide cash incentives or reduced insurance costs for participation in physical activity and/or weight management or maintenance activities.

4.    Provide shower and/or changing facilities onsite.

5.    Provide outdoor physical fitness areas such as fields and trails for staff member use.

6.    Provide bicycle racks in safe, convenient, and accessible locations.

7.    Provide onsite fitness opportunities, such as group classes or personal training.

8.    Provide an onsite physical fitness facility.

9.    Create programs that have strong social support systems and incentives, such as:

      • Buddy or team physical activity goals

      • Programs that involve workers and family

      • Programs to promote physical activity, such as pedometer walking challenges

      • Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs

10.   Provide flexible work hours to allow for physical activity during the day.

11.   Support physical activity breaks during the workday, such as stretching or walking.

12.   Host walk-and-talk meetings.

13. Map out onsite trails or nearby walking routes and destinations.

14. Have employees map out their own biking or walking route to and from work.

15. Post motivational signs at elevators and escalators to promote stair usage.

16. Provide exercise/physical fitness messages and information to employees.

17. Provide or support recreation leagues and other physical activity events onsite or in the community.

18. Begin staff member activity clubs such as walking or bicycling clubs.

19. Provide onsite child care facilities to facilitate physical activity.

20. Sponsor a bike to work day and reward employees who participate.

21. Create a box and solicit fitness and health tips.

Wellness programming means different things to different organizations. Effective wellness initiatives can be as simple as bringing bushel baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments. 

A driving factor behind the push toward wellness spans organizations of all types, sizes and cultures: that is, healthcare expenses are spilling over the corporate belt buckle. The annual cost of medical services in the U.S. is rising at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1 

This trend makes it increasingly challenging for employers to maintain current levels of insurance coverage. In 2003, healthcare inflation forced 65 percent of organizations to increase employees’ share of health costs. 

Seventy-nine percent of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity. 

Employers are searching for another way. While organizations cannot control many of the supply-side elements contributing to rising healthcare costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness. 

The case for Workplace Wellness Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks: 

• One study reports that obesity raises healthcare costs by 36 percent and medication costs by 77 percent. 

• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by employers through insurance premiums and lost productivity.

• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high. 

Information shows that healthier employees are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier employees use fewer medical services. The five leading causes of death in the U.S. — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes —  are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to improve employees’ well being, reduce the need for healthcare services and help control costs. 

Offering staff member wellness benefits — large or small — represents an intersection between corporate social responsibility and responsibility to stakeholders. Between staff member health and corporate health. It’s frequently the right thing to do for employees and employers. 

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Workplace Wellness Programs. For many organizations, the choice to offer staff member wellness benefits is easy—one where conscience and pragmatism align. 

The challenge arises in selecting the programs that will deliver the most impact based on trends in your employees’ health risks and medical claims costs. From large organizations to the corner deli, company owners welcome ways to boost productivity, reduce rates of absence and cut costs. Likewise, Workplace Wellness Programs can range from modest to elaborate. 

In deciding where to focus a company’s limited resources, looking at costs, benefits and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to employees and employers.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of health promotion, and who can counsel employees and provide primary care – all within the context of the current regulatory and legal environment. 

AAOHN’s survey reported that more than half of employees (61 percent) want to receive health and wellness information from a healthcare professional, such as a consultant or an worksite occupational health nurse (OHN), compared to pamphlets or brochures (18 percent) or human resources staff (15 percent).

 

OHNs can develop, implement and evaluate components of work site Workplace Wellness Programs such as screening programs, exercise/fitness courses, Stress Management Programs, smoking cessation, nutrition and weight control programs, as well as chronic illness management programs. Plus, OHNs can help employees navigate through complicated health plans and may even serve as a triage point between employees and their personal healthcare providers. 

Employees might refrain from seeing their healthcare provider when it means time away from work, inconvenient parking, waiting time in the office and co-pays. In situations where employees are under treatment for chronic diseases like heart disease, worksite nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis. 

It’s frequently easier for an staff member to ask an worksite nurse for information about symptoms or prescription medication than it is to schedule a follow-up visit to a personal healthcare provider. Benefits realized by employers include enhanced staff member morale and retention, a recruitment advantage, increased productivity and decreased time away from work. 

In organizations with a safety department, the OHN can evaluate and address work-related health issues, including participation in workstation evaluations to correct potential ergonomic problems, and proactively addressing muscle strains by developing stretching programs and involving employees in leading stretches. 

Good for waistlines & your bottom line 

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 company in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800) 241-8014, x0. 

In today’s hectic world, most of us are spending more time at work, and have increasingly less time to look after our health. For a long time, employers have understood the benefits associated with keeping workers well – increased productivity from reduced rates of absence and lowered disability claims. For these reasons, coupled with the fact that many organizations realized double-digit healthcare costs last year, organizations should consider Workplace Wellness Programs as a way to keep employees healthy. 

But just how important are these programs to employees? How frequently are they willing to participate in programs designed to positively impact their health and wellness? Who do employees trust to provide them with important information about their health? 

Answers to these questions and more were recently garnered from a study commissioned by the American Association of Occupational Health Nurses Inc. (AAOHN). 

The AAOHN survey questioned 500 employees nationwide about their perceptions of Workplace Wellness Programs. More than three-quarters of all members indicated these programs are a good way to improve their overall health, and nearly 60 percent consider these offerings an incentive to remain with their current employer. staff member retention and turnover impact the bottom line, so building Workplace Wellness Programs into the work site culture is a valuable way to help retain talented employees in addition to enhancing personal health and worksite productivity. 

Health wish list 

Employees appear to have their own agenda when it comes to their health. With new pressures resulting from an unstable economy, national security threats and work/balance issues, it’s not surprising that 85 percent of survey respondents cited Stress Management Programs as a priority topic for work site wellness. 

In addition to stress, other preferred topic areas include screening programs (84 percent), exercise/physical fitness programs (84 percent), medical insurance education (81 percent) and disease management seminars (80 percent). 

In addition to lifestyle and personal health issues, those asked expressed concern about work-related health issues, including strains and injuries resulting from lifting or task-oriented muscle repetition, exposure to harmful substances, personal injury, vision changes due to computer work and worksite violence. 

What you should do 

With such a broad range of health concerns, a primary goal for employers is finding a way to proactively address the health needs of the largest number of employees, and effectively change unhealthy behaviors, promote wellness and ward off disease and illness. 

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s important to remember that different workers require different formats for learning. A good rule of thumb: provide information in a variety of learning formats such as videos, pamphlets, health-related quizzes, display boards, lunch-and-learn presentations and reimbursement or incentive programs. 

This assumes you’ve overcome the first hurdle – getting workers to sign on to a Workplace Wellness Program. While survey respondents indicated health and Workplace Wellness Programs are important, just six out of 10 (60 percent) reported that they participated in the Workplace Wellness Programs at their organizations. The other 40 percent cited lack of interest and lack of time as deterrents. 

This points to the need for a comprehensive, structured Workplace Wellness Program using a innovative approach, with an incentive for participation and effective program marketing. 

By investing in an organized Workplace Wellness Program headed by a qualified healthcare professional such as an worksite nurse, organizations can give employees the access to the health information they want, and increase participation and generate interest at the same time. 

The result: employees become savvier healthcare consumers who feel more in charge of their personal health. And healthier employees make for a healthier bottom line.

Stress continues to drive employees’ work-related health concerns, which is probably why most respondents (78 percent) in a recent survey claim they would participate in a Workplace Wellness Program to help their overall health and wellness. 

In a recent study commissioned by the American Association of Occupational Health Nurses, Inc. (AAOHN), 500 full-time employees nationwide were interviewed by telephone. 

“Today’s employees are clearly dealing with a lot of pressures such as the effects of 9/11, an unstable economy, national security threats and work/balance issues. There is a real opportunity for employers to serve as an ally to their employees by providing them with resources to better manage their physical and emotional health – anything from stress management seminars to nutrition and physical fitness counseling,” says Deborah V. DiBenedetto, president of AAOHN. 

Nearly 80 percent of respondents believe their health would improve if they were offered the right information and tools through a viable Workplace Wellness Program. 

Topping the list of most interesting Workplace Wellness Programs cited by employees is stress management (85 percent), closely followed by screening programs (84 percent), exercise/physical fitness programs (84 percent), medical insurance education (81 percent) and disease management seminars (80 percent). 

More than half of employees (61 percent) would prefer to receive health and wellness information from a healthcare consultant or worksite nurse, compared to pamphlets or brochures (18 percent) or human resources staff (15 percent). 

Effective Workplace Wellness Programs include the use of data sources in support of Workplace Wellness Program planning, implementation, and evaluation. Information sources can be used to complete a community needs assessment, develop realistic Workplace Wellness Program goals and objectives, and gain Upper Management support. 

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

• http://www.cdc.gov/DataStatistics/

• Information and statistics are available by topic (i.e., asthma, injuries, MRSA).

• Information access tools are available to customize data tables and query datasets (i.e., Healthy People DATA2010, smoking-Attributable Mortality, Morbidity, and Economic Costs).

• Nationwide survey data 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 data is also available (i.e., weight classification by Body Mass Index and age).

Workplace Wellness Program data collection and analysis is frequently avoided because of a perceived lack of resources for this very important Workplace Wellness Program component. Use the suggestions below to take advantage of a variety of resources available at your installation or in the local community. 

Medical Interns and Residents

• If your Medical Center has an internship Workplace Wellness Program, get to know the Internship Director.

• Take advantage of these resources – including having the Director and/or interns/residents implement the outcome data collection plan for your Workplace Wellness Program.

Local college and graduate students

 

• Where appropriate volunteer agreements are in place, use local college/graduate students to help collect, input, and analyze Workplace Wellness Program data.

• Take advantage of the fact that these students are frequently looking for projects.

• If there are no “health-related” students/interns in your area, consider using company students. Let them calculate a cost avoidance or return on investment for your Workplace Wellness Program. 

Other Medical Personnel

• Partner with other Medical Personnel. Find out who is collecting data, what data they are collecting, and how they are collecting it.

• If they are using a survey and the survey administration process is already in place, ask if you can add a question or two.

• Be aware of other research going on at your facility. They may already be collecting data you need OR may have analysis resources that can be shared.

• Ensure that other departments in the Medical center know you can always use some extra help if they have personnel with any down time. Use these resources for data entry or other administrative tasks.

• Make use of the volunteers at your Medical Treatment Facility to help collect and input data. 

Previous Workplace Wellness Program members

• Previous Workplace Wellness Program members are also a good resource.

• They may be willing to lead a class session, provide encouragement to current Workplace Wellness Program members, or help collect data.

You can improve data collection and analysis by taking advantage of local resources. Using these resources expands the reach and impact of your Workplace Wellness Program.

Keeping Workplace Wellness Program data organized is essential in order to be able to determine Workplace Wellness Program impact and participant progress. Use the simple steps below to keep your data organized. 

Manage Workplace Wellness Program data electronically.

• Storing Workplace Wellness Program outcomes data electronically is the best way to manage that information.

• An electronic system will enable you to review and analyze the data more efficiently.

• Scan old surveys and other Workplace Wellness Program information that exist only on paper into .pdf format for permanent storage. 

Find the Workplace 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 Workplace Wellness Program that you are familiar and/or comfortable with.

• Standardize data collection and organization. Keep data columns/fields in the same order for all Workplace Wellness Programs. 

Keep the Workplace 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 Workplace Wellness Program outcomes data.

• A simple spreadsheet is an excellent way to keep your data organized. 

Store all Workplace Wellness Program data numerically.

• Using numbers (instead of words) will make the data much easier to enter and analyze. By way of example: use “1” for yes; “0” for no OR “1” for male; “2” for female.

• Number survey responses that contain strings of words. By way of 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 Workplace Wellness Program data clearly.

• Ensure that all the data columns, rows, or fields are labeled. The data is worthless if you don’t know what data 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 Workplace Wellness Program data units.

• Ensure that all data entered into a given column is expressed with the same unit of measure. By way of 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 data organized also makes it easier to communicate Workplace Wellness Program impact to leadership and make Workplace Wellness Program improvements as needed.

A gap analysis is an assessment tool that enables a company to compare its current capabilities and performance with industry benchmarks and expectations for performance. A gap analysis is used to identify areas that have room for improvement. 

Gap analysis can also be used for your Workplace Wellness Program to determine where the program stands now and how the Workplace Wellness Program can better follow evidence-based recommendations. 

To start a gap analysis, ask these simple questions about your Workplace Wellness Program:

• What is the current state of the Workplace Wellness Program?

• How does the Workplace Wellness Program measure up to evidence-based practices? (i.e., the desired state) 

The gap is the difference between the current and desired states. 

After the gap has been identified, the next step is to determine the action steps that are needed to close the gap. These actions answer the question: “How can the Workplace Wellness Program move forward towards the desired state?” 

Sometimes the gaps that need to be filled can be addressed through Workplace Wellness Program changes; other gaps might require policy changes. However, using a gap analysis will help you identify areas for Workplace Wellness Program improvement as well as the actions needed to make progress towards those goals.