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Organization America is increasingly investing in employee wellness because it is great business. In order to meet work rate demands, corporations must rely on a healthy, beneficial workforce to succeed in the highly competitive global marketplace. Over a hundred research studies in both corporate and governmental settings have documented the economic advantages of Worksite Wellness , including reduced absenteeism, reduced injuries and workman’s compensation expenditures, reduced healthcare expenditures, reduced employee turnover, as well as increased work rate, greater worker satisfaction, and improved morale.1-10 The more recent literature reflects improvements in wellness programming along with greater return on investment (ROI). In general, the more focused and intensive the program, the greater profit realized. To enhance their performance federal government Worksite Wellness may be able to incorporate some of the features described. Employee wellness programs demonstrated to have beneficial returns on investment often include the following features:

1. 1. Health and work rate management model

Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors such as smoking, lack of physical activity, excess weight, unhealthy diet, elevated cholesterol, high Blood Pressure (BP), stress, depression, and so on. High-risk employees are specifically targeted for intervention, although the most successful programs also direct efforts towards healthy employees in order to maintain their low-risk status. This model emphasizes outcomes as opposed to simply offering wellness activities for their own sake.

2. 2. Health risk appraisal

Use of a computerized health risk appraisal (HRA) instrument with individualized feedback and recommendations is almost universal in successful programs. Staff Members take the questionnaire annually in many cases. The HRA serves to broaden awareness, offer direction, and excite people to improve specific behaviors. In some cases, the personalized report is directly linked to appropriate resources related to identified risks. Research indicates that the use of an HRA is effective if it is followed by some kind of educational or therapeutic intervention for identified risks. It often serves as the entry point into wellness programs.

3. 3. Health Screening

Many programs combine the results of the health risk appraisal with measurement of each employee’s biometrics, including weight and Body Mass Index (BMI), Blood Pressure (BP), cholesterol, fasting glucose, and assorted other metrics. Combining the results of the HRA with biological measures results in a more accurate risk profile. Computer health risk appraisals often incorporate biometric data in their risk analysis.

4. 4. Incentives

employees are frequently given monetary or other important rewards for completing an HRA, participation in a program or class, specific accomplishments such as stopping smoking, losing weight, or exercising, and for maintaining healthy status and/or behaviors. In many cases the monetary incentives/rewards are associated with reductions in health care insurance premiums. Some programs use disincentives as well as incentives/rewards, such as charging employees who use tobacco higher rates for their health care insurance contribution.

5. 5. High participation rates

Successful programs use incentives/rewards to drive participation rates up. They also market their programs extensively, and may use contest or challenge strategies to heighten enthusiasm and promote participation.

6. 6. Wellness coaching

employees with identified risks or desire to improve their health habits may be periodically coached via phone by trained health and wellness coaches. Health & Wellness Coaching helps employees set and achieve realistic lifestyle-related goals and objectives including those approaching stress, work life balance, smoking, weight, physical activity, and various behavior modifications. Three or more sessions are generally available. In some intensive programs, the coaching extends to actual disease management intervention for employees with identified elevated-risk diseases.

7. 7. Multiple formats

Programs may offer wellness content in online, paper, and seminar formats to offer stimulating variety and alternatives in order to accommodate the needs of all employees. In addition to on-Site physical activity and healthy eating events, on-line programs, e-mail reminders and notices, printed newsletters and materials, and organization courses are common dissemination strategies.

8. 8. Senior Leadership support

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

9. 9. Frequent contact

Successful programs have frequent contact of some sort with every employee. This may be through marketing efforts (e.g., posters, e-mail notices, reminders, or messages, etc.), bulletin boards, newsletters, employee meeting presentations, discussion in new employee orientation, supervisory sessions, etc. The key is to enhance employee awareness of wellness and health opportunities and reinforce the corporate emphasis on wellness through frequent and multiple “touches”.

10. 10. Open enrollment

To promote high participation rates employees must have easy access to the wellness programs and activities. Open and uncomplicated enrollment processes achieve this. Some corporations automatically enroll all employees and then allow those who do not wish to take part to “opt-out”. This practice has been demonstrated to boost enrollment rates in some settings.

11. 11. Family participation

Many programs promote spouses and other family members to take part in the organization wellness activities and to adopt a healthy lifestyle along with the designated employee. It is far easier for the employee to have a healthy lifestyle if his/her family does so as well.

12. 12. Smoking cessation

Because smoking and other tobacco use is the number one threat to health it is critical to offer employees effective and convenient assistance with stopping. Access to smoking cessation pharmaceuticals is often part of such programs. In-house programs offer the most convenient access to these services, although on-line or phone-based programs may be available as well.

13. 13. Exercise

Regular physical activity is a core component of every wellness program. Staff Members must be strongly encouraged to engage in regular physical activity. Most programs provide either periodic or continuous worksite opportunities, and some locations have worksite gyms, swimming pools, walking trails, etc. Discounted or paid memberships to community exercise facilities is a common alternative to worksite facilities.

14. 14. Weight management

Because obesity is a major threat to health it is imperative that programs offer effective assistance with weight management. Enthusiastic encouragement from upper management to shed excess weight is important. Internet based programs, workplace programs, or discounted access to weight management programs in the community may all be available. Long-term follow-up is critical for maintenance of weight loss.

15. 15. Stress management

Workplace stress is perhaps the most common objection among employees and a major contributor to absenteeism, presenteeism (reduced work rate), and low morale. Almost all successful wellness programs offer assistance with personal and worksite stress. Some programs refer employees to outside resources for more genuine conditions like depression and anxiety disorders, but most offer online or frequent worksite general stress reduction programs. Some corporations endeavor to structure the work environment to minimize stress, both physically and operationally.

16. 16. Health screenings/immunizations

employees are actively encouraged to complete recommended healthcare screenings for Blood Pressure (BP), cholesterol, BMI, colorectal and breast cancer, and others. Annual influenza immunizations are also encouraged. Some sites offer these services at the workplace. Incentives are often awarded for completion of these screenings/immunizations.

17. 17. On-Site healthcare

Actual provision of on-Site primary care medical services is a growing trend. The rapidly escalating expenditures of medical care insurance for employees has stimulated this trend. Some corporations have found that it is less expensive to offer primary care services themselves than to fund those services through health care insurance. On-Site care also reduces the amount of time employees would otherwise spend away from the workplace getting such services.

References

1. 1. Aldana, Steven G. (2001) Financial Impact of Worksite Wellness : A Comprehensive Review of the Literature. Am J Health Promotion 15(5):296-320.
2. 2. Chapman, Larry. (1998) The Role of Incentives in Health Promotion. The Art of Health Promotion 2(3):1-8.
3. 3. Chapman, Larry. (2003) Biometric Screening in Health Promotion: Is it Really As Important as We Think? The Art of Health Promotion 7(2):1-12.
4. 4. Chapman, Larry. (2005) Meta-Assessment of Worksite Wellness Economic Return Studies: 2005 Update. The Art of Health Promotion, July/August, 1-15.
5. 5. Chapman, Larry. (2006) Employee Participation in Worksite Wellness and Worksite Wellness : How Important are Incentives, and Which Ones work Best? North Carolina Medical Journal 67(6): 431-432.
6. 6. Chapman, Larry, Lesch, Nancy, and Passas Baun, Mary Beth. (2007) The Role of Health and Wellness Coaching in Worksite Wellness . The Art of Health Promotion, July/August, 1-12.
7. 7. Chapman, Larry. (2007) Proof Positive: An Analysis of the cost-Effectiveness of Job Site Wellness. Northwest Health Management Publishing, Seattle, WA.
8. 8. Chapman, Larry. (2007) An In-Depth Look at the Economic Evidence for Rewarding Health Behavior Change. Workshop presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
9. 9. Edington, Dee. (2001) Emerging Research: A View from One Research Center. American Journal of Health Promotion 15(5): 341-349.
10. 10. Edington, Dee W. (2007) Health Management as a Serious Business Strategy. Presentation at the World Research Group “Rewarding Healthy Behaviors for Health Plans and Employers” Conference, Orlando, FL, January 23-24.
11. 11. Pelletier, Barbara, Boles, Myde, and Lunch, Wendy. (2004) Changes in Health Risks and Work Productivity. Journal of Occupational and Environmental Medicine, 46(7): 746-754.
12. 12. Pelletier, Kenneth R. (2005) A Review and Analysis of the Clinical and Cost-Effectiveness Studies of comprehensive Health and Disease Management Programs at the Job Site: Update VI 2000-2004. JOEM 47(10)1051-1058.
13. 13. DeVol, Ross, Bedroussian, Armen, et. al. (2007) An Unhealthy America: The Economic Burden of Chronic Disease. Report released by the Milken Institute. www.milkeninstitute.org.
14. 14. Partnership for Prevention. (2008) Investing in Health: Proven Health Promotion Practices for Workplaces. http://www.prevent.org/images/stories/2008/investinginhealth_finalfinal.pdf.

Worksite Wellness : Outcome Assessment

Evaluations determine the outcome of a Worksite Wellness . They help you figure out if your objectives were met. It is a great idea to add an evaluation component to your Worksite Wellness . Evaluations may conclude that some interventions didn’t work well. You may find that a popular Worksite Wellness expenditures too much and didn’t really affect employees’ health. While these may not be the outcomes you hoped for, without this information you might continue ineffective interventions. Having this information will help you foster better solutions. When your results are great, it’s magnificent! You can spread the word to employees and management that your program is achieving its goals and objectives.

Three major areas of an evaluation

• Worksite Wellness structure – The basic framework of the program
• Worksite Wellness process – How well the program is run
• Worksite Wellness outcomes – Whether the program met the set objectives

Common questions used to evaluate a Worksite Wellness

Worksite Wellness Structure Questions

• What is included in the Worksite Wellness ? What is the intervention?
• Where does the Worksite Wellness take place?
• How is the Worksite Wellness delivered? What content is included?
• Who manages the Worksite Wellness ?

Worksite Wellness Process Questions

• How many people take part?
• Do participants complete the Worksite Wellness ?
• Are participants satisfied?
• Which aspects of the Worksite Wellness are best attended?

Worksite Wellness Outcome Questions

• Does the Worksite Wellness improve knowledge about health problems?
• Does the Worksite Wellness modify behavior?
• Does the Worksite Wellness save the organization money?
• What is the return on investment (ROI)?
• Ascertain through an employee survey what incentives/rewards they value.
• Ascertain what incentives/rewards the organization can offer as well as what the budget will allow.
• Be sure that every colleague who achieves a goal receives some recognition.
• Avoid offering incentives/rewards for the “best” or the “most.”
• Avoid using food as a reward.
• Use incentives/rewards to promote your Worksite Wellness , through logos and branding.

Wellness is a great concept. It brings happiness into health and encourages a truly holistic approach to life. Wikipedia defines wellness as a healthy balance of the mind-body and spirit that results in an overall feeling of wellbeing. It sounds like exactly what every one is looking for. But when you start to talk about corporate wellness, or worksite wellness, all life goes out of the concept. Total solutions, disease management and health assessment do not inspire visions of enjoying life and living it to the full. They start from the assumption that sickness is here to stay and needs to be discovered, managed and controlled but can never be healed. The wellness industry is growing phenomenally fast. Wellness guru, Paul Zane Pilzer, has labeled it the next trillion dollar industry. But wellness has two different faces. On the one hand there are the small corporations – people working from home or in small centers selling all kinds of wellness products and services at a speed of growth that is escalating rapidly. On the other hand corporate wellness is also exploding but in a very different direction. The baby boomers who are driving the popular wellness revolution have been described as the first generation to refuse to accept the inevitability of death. They are actively looking for ways to prevent aging, stay healthy into old age and enjoy themselves more than ever before after retirement. This is a radical departure from current notions of old age, which are often dominated by pictures of sickness, frailty and suffering. The corporations have been largely forced to take on wellness. This is partly through legislative pressure, with many countries introducing laws to make corporations liable for stress-related sickness in their employees. It is also monetarily motivated, as research has repeatedly demonstrated the enormous expenditures of absenteeism (and increasingly of presenteeism as well). Whereas the baby boomers are actively looking for new solutions and new lifestyles the corporations are struggling to organize largely traditional and mainstream health systems, such as doctors, nurses, insurance and screening systems. The concern is that the traditional health system does not have solutions for the problems that people are handling. Nobody ever went to see a doctor to get happy, because a doctor doesn’t have any clue how to make people happy. And many stress-related health problems are described as chronic diseases, which means that they last for a very long time – or maybe for the rest of your life – because there is no medical cure. Counseling is a common offering in corporations for emotional problems, but whilst it may offer a useful pressure valve it is not a powerful treatment for stress, unhappiness or depression. Imagine walking into a organization where the employees are happy, healthy, full of inspiration, fit, love working, have meaningful family lives, active social lives, and enjoyable relationships at work and in their community. That kind of organization would be a pleasure to work in and bound to be successful because people would be working to their optimum capacity. So can we establish a system of true wellness that will serve the development of the corporations and their employees and will pay for itself because of the advantages that both sides will gain? First of all we have to face the fact that we can’t place all the responsibility into the hands of the current health system. Absenteeism, stress, depression, the very roots of the wellness revolution, have not been solved by the current system. If they had been we wouldn’t have this revolution, we would all be much more well. So we need to look elsewhere for solutions. We also can’t rely on makeshift feel-good wellness offerings, such as the on-Site massage group which visits the office once a month or the wellness day that raises awareness for a little while but leaves most people unaffected. They are easy to organize but have little or no real significance on employee wellness. Organization needs are different than individual needs and many of the new small wellness corporations that are springing up simply don’t have the capacity to serve the corporate market. However it is in the best interest of both corporations and employees to find and foster systems of wellness and health that really work – that benefit people to be happy, handle stress, love working, and to have proper energy to go home at the end of the day and enjoy their family and social life. So far the corporate world has hijacked the concept of wellness and turned it into a modern version of occupational health. It is time to raise the vision and learn how to make truly healthy, happy workplaces where people thrive.