Posts from — December 2008

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 business 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, corporations have understood the benefits associated with keeping workers well – increased productivity from reduced absenteeism and lowered disability claims. For these reasons, coupled with the fact that many corporations realized double-digit health care costs last year, corporations should consider Employee Wellness Initiatives as a way to keep workers healthy.

But just how important are these initiatives to workers? How frequently are they willing to take part in initiatives designed to positively impact their health and wellness? Who do workers 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 workers nationwide about their perceptions of Employee Wellness Programs. More than three-quarters of all members indicated these initiatives are a good way to enhance 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 Employee Wellness Initiatives into the work site culture is a valuable way to help retain talented workers in addition to enhancing personal health and workplace productivity.

Health wish list

Employees appear to have their own agenda when it comes to their health. With new national security threats, new economic pressures 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 initiatives (84 percent), exercise/physical fitness initiatives (84 percent), health insurance education (81 percent) and disease management lunch and learns (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 workplace violence.

What you should do

With such a broad range of health concerns, a key goal for corporations is finding a way to proactively address the health needs of the largest number of workers, 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 employees 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 & Learn presentations and reimbursement or incentive programs.

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

This points to the need for a comprehensive, structured Company Health Promotion Initiative using a innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Company Health Promotion Initiative headed by a qualified health care professional such as an worksite nurse, corporations can give workers the access to the health information they want, and increase participation and generate interest at the same time.

The result: workers become savvier health care consumers who feel more in charge of their own health. And healthier workers make for a healthier bottom line.

Stress continues to drive workers’ work-related health concerns, which is probably why most respondents (78 percent) in a recent survey claim they would take part in a Company Health Promotion Initiative 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 workers nationwide were interviewed by telephone.

“Today’s workers 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 corporations to serve as an ally to their workers by providing them with resources to better manage their physical and emotional health – anything from stress management lunch and learns to nutrition and exercise 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 Employee Wellness Program.

Topping the list of most interesting Employee Wellness Initiatives cited by workers is stress management (85 percent), closely followed by screening initiatives (84 percent), exercise/physical fitness initiatives (84 percent), health insurance education (81 percent) and disease management lunch and learns (80 percent).

More than 50% of workers (61 percent) would prefer to receive health and wellness information from a health care consultant or worksite nurse, compared to pamphlets or brochures (18 percent) or human resources staff (15 percent).

Effective Employee Wellness Initiatives include the use of data sources in support of Company Health Promotion Initiative planning, implementation, and evaluation. Data sources can be used to complete a community needs assessment, develop realistic Company Health Promotion Initiative goals and objectives, and gain Upper Management support.

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

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

Company Health Promotion Initiative data collection and assessment is frequently avoided because of a perceived lack of resources for this very important Company Health Promotion Initiative component. Use the suggestions below to take advantage of a variety of resources available at your company or in the local community.

Medical Interns and Residents
• If your On-site Health Care Center has an internship Employee Wellness Program, get to know the Internship Director.
• Take advantage of these resources – including having the Director and/or interns/residents start the outcome information collection plan for your Employee 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 Company Health Promotion Initiative 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 business students. Let them calculate a cost avoidance or ROI for your Employee Wellness Program.

Other Medical Personnel
• Partner with other Medical Personnel. Find out who is collecting information, what information 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 information you need OR may have assessment 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 information entry or other administrative tasks.
• Make use of the volunteers to help collect and input data.

Previous Company Health Promotion Initiative members
• Previous Company Health Promotion Initiative members are also a good resource.
• They may be willing to lead a class session, provide encouragement to current Company Health Promotion Initiative members, or help collect data.
You can enhance data collection and assessment by taking advantage of local resources. Using these resources expands the reach and impact of your Employee Wellness Program.

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

Gap analysis can also be used for your Company Health Promotion Initiative to determine where the program stands now and how the Company Health Promotion Initiative can better follow evidence-based recommendations.

To start a gap analysis, ask these simple questions about your Employee Wellness Program:
• What is the current state of the Employee Wellness Program?
• How does the Company Health Promotion Initiative 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 Company Health Promotion Initiative move forward towards the desired state?”

Sometimes the gaps that need to be filled can be addressed through Company Health Promotion Initiative changes; other gaps might require policy changes. However, using a gap analysis will help you establish areas for Company Health Promotion Initiative improvement and the actions needed to make progress towards those goals.

Company Health Promotion Initiative business plan review (from Key #19)
• A Company Health Promotion Initiative business plan is a roadmap for success.
• Your Company Health Promotion Initiative business plan should convincingly demonstrate that your Company Health Promotion Initiative will help the organization to achieve its goals.

More smart Company Health Promotion Initiative business planning strategies

Planning the Company Health Promotion Initiative
• Find out how your organization plans so that your planning process will be in sync with what already happens in the organization.
• Involve other employees. 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
• Consider the barriers and challenges that might be encountered during Company Health Promotion Initiative implementation. Develop strategies ahead of time to overcome these potential problems.
• Do a SWOT assessment and examine Strengths, Weaknesses, Opportunities, and Threats.

This assessment will help you establish potential problem areas or resource shortfalls and opportunities for growth or raised partnerships with other company personnel.

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

The best Company Health Promotion Initiative business planning strategies
• Get out of your office; get out of the business. The more employees you involve in the Company Health Promotion Initiative planning process, the better. Always look for ways to expand your network.
• Keep your budget employees informed. Get to know their philosophy of financial management.
• Be able to articulate the impact if your budget is not fully funded.
o Avoid basing your impact-if-not-funded argument only 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.
• Have purchase requests ready to be submitted. There is frequently 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 Company Health Promotion Initiative business plan is critical in these times of shrinking budgets and resources. A good business plan will help you gain leadership support and help you get and keep resources needed to start the Employee Wellness Program.

Keeping Company Health Promotion Initiative information organized is critical in order to be able to determine Company Health Promotion Initiative impact and participant progress. Use the simple steps below to keep your information organized.

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

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

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

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

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

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

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

What is a business plan?
• A plan for success
• A document that convincingly demonstrates that your Company Health Promotion Initiative will help the organization to achieve its goals.

Questions to ask when developing a Company Health Promotion Initiative business plan
• Why do you need to do the Employee 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 start the Employee Wellness Program?
• How much will the Company Health Promotion Initiative cost Upper Management?
• What is Upper Management going to get out of the Employee Wellness Program? Why should Upper Management invest in the Employee Wellness Program?

Company Health Promotion Initiative business Plan Components
• Title and duration of the Company Health Promotion Initiative
• Points of contact
• Background information (description of need; bibliography/literature review; how the Company Health Promotion Initiative will help achieve the company’s goals)
• Company Health Promotion Initiative description
• Goals and objectives
• Implementation site
• Target population
• Work plan
• Partnerships and collaborations
• Timelines and milestones
• Budget and resource requirements (dollars and employees)

Gaining the support of leadership
• Clearly link the Company Health Promotion Initiative 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, raised provider productivity, management of the health of the population. However, Upper Management is interested in raised readiness, decreased lost duty/training time, and decreased disability and FECA claims.
A well thought-out Company Health Promotion Initiative business plan will help you gain leadership support, help you get and keep resources needed to start the Employee Wellness Program, and keep the Company Health Promotion Initiative on track towards meaningful outcomes.

As they say: “timing is everything.” Use the guidelines below to guide the timing of Company Health Promotion Initiative activities and data collection.

Timing: Company Health Promotion Initiative Start-up
• Consider the optimal time to start a new Employee Wellness Program. Take into account preferences of the target population and other factors that could affect enrollment and participation.
• For example, coordinating the start of an adult weight management initiative with the start of school in August or September may be a good tie-in with a “fresh start.”
• On the other hand, starting an adult weight management initiative In January may not be a great idea because of the constraints that weather may put on exercising outdoors.
• Take advantage of other timing cycles at your company. Planning a marketing blitz just after the PCS turnover has been completed is a good way to let new personnel know what Company Health Promotion Initiative options are available.

Timing: Company Health Promotion Initiative Participant Support
• Consider how frequently Company Health Promotion Initiative sessions should be offered to provide the best support and education for members and the best opportunity for success.
• Get feedback from members regarding what session frequencies work best for them.
• Consider the timing for other support mechanisms like email encouragement. What timing of those messages will benefit members most: Weekly? Bi-monthly? Monthly?

Timing: Company Health Promotion Initiative Data Collection
• Collecting information is an excellent way to track participant progress and also to establish potential problems within a Employee Wellness Program. So, give some thought to the frequency and timing of data collection.
• Select metrics that can realistically change during the Company Health Promotion Initiative implementation time period. For example, BMI and weight may not change very much during a 10-week Employee Wellness Program; however, step counts are more likely to noticeably change.
• Some information, such as participant responsiveness to out-of-class assignments (like food journals) and other interim data (like step counts) will provide important information needed to “adjust fire” as needed and make Company Health Promotion Initiative changes if something is not working.
• Be flexible regarding data collection frequency. Instead of requiring that members complete an exercise log every day, for example, consider asking for a “snapshot” summary from two or three days during the week. You will still get information to review, but members will have an easier time complying with the assignment.

Timing: Company Health Promotion Initiative Follow-up
• Because the we are such a mobile population, it’s best to plan some sort of post-Employee Health and Wellness Program follow-up data collection within two to four months after the Company Health Promotion Initiative ends.
• You can always try to collect additional follow-up data at 6 or 12 months after Company Health Promotion Initiative completion. However, if you collect the information sooner, you’ll at least have collected some short term Company Health Promotion Initiative impact information before members are lost to follow-up.

Company Health Promotion Initiative communication is important to all aspects of Wellness and preventive medicine and is relevant to:
• Healthcare provider-patient relationships
• An individual’s exposure to, search for, and use of Company Health Promotion Initiative information
• Effective counseling and patient education for behavior change
• Content of public health messages and community campaigns

Effective health communication should have these attributes:
• Accuracy: content is valid and error-free
• Availability: delivered or placed where the intended audience can access the information
• Balance: content presents benefits and risks of potential actions
• Consistency: content is locally consistent over time and is also consistent with information from other reliable sources
• Evidence-based: content and methods of delivery are based on relevant scientific evidence
• Reach: content gets to or is available to as many employees as possible in the target population
• Reliability: content source is credible; content is kept up-to-date
• Repetition: delivery of/access to the content is continued over time, to reinforce the impact with the audience and to reach new members of the target population
• Timeliness: content is provided when the audience is most receptive to, or in need of, the specific information
• Understandability: reading, language levels, and format are appropriate for the specific audience (i.e., Employees, Family Members, Garrison leadership, etc.)

What the research says about health communication
• Health communication best supports Wellness when multiple communication methods are used to reach specific audiences.
• Effective Wellness and communication initiatives should reflect an audiencecentered perspective, and reflect the preferred formats, contexts, and way of communication for the intended audience.

Material adapted from: United States Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: United States Government Printing Office, November 2000.
http://www.healthypeople.gov/document/HTML/Volume1/11HealthCom.htm