How to Build a Wellness Program

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How to Build a Wellness Program
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How to Build a Wellness Program(That really
works)
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7 Steps

• Get leadership support
• Create a wellness team
• Collect data to drive health efforts
• Develop an operating plan
• Choose programs that work
• Change the environment
• Evaluate

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7 Steps

• Get leadership support
• Create a wellness team
• Collect data to drive health efforts
• Develop an operating plan
• Choose programs that work
• Change the environment
• Evaluate

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• ROI Calculator
• Inputs
• Number of benefited employees
• Total annual health care costs and cost increases
• Obesity and smoking prevalence

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2. Create a Wellness Team
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• Adds credibility and importance to your efforts
• Provide program PR
• Team lightens the load
• Provides stability

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Potential team members

• senior and mid-level managers
• front-line employees
• benefits managers
• union representatives
• human resources personnel
• marketing and communications directors
• safety coordinators
• information systems representatives
• health care representatives

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What does the team do?

• Oversees the wellness efforts
• Establishes the vision and operating plan
• Decides on goals and outcomes to measure

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3. Collect data to drive health efforts
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YOUR COMPANY DATA(health care cost data)
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YOUR COMPANY DATA(health care cost data)
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ABSENTEEISM DATA
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• HRA
• Free?
• Vendor?
• Biometric measures?
• Data ownership?

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• HRA
• Free?
• Vendor?
• Biometric measures?
• Data ownership?

An HRA is NOT a wellness program!
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4. Develop an operating plan
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• Mission statement, goals
• Measurable objectives linked to strategic
  priorities
• Timeline
• Roles and responsibilities
• Budget
• Marketing and communication

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How long will it take to get the program going?

• The planning process can take from 3-7 months
• Data collection, risk, health care costs,
  pharmaceuticals, behaviors
• Look at worksite health culture
• Understand the benefits package and how wellness
  fits in. What will the package look like with a
  wellness program?

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Integration throughout the company

• Work across departments
• Safety
• Medical
• EAP
• Facilities
• Benefits, HR etc

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How Do We Communicate with Employees?

• Multi-site locations
• Decentralized
• English as a second language
• No access to the web
• Spouses, significant others, and dependents

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Whats it going to cost?

• Good programs can cost 100-150 per employee per
  year
• What does your insurance company offer?
• What does your health care provider offer?
• What about vendors?
• Can it be done for free?

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Whos going to do this?

• Time and resources requirements depends on number
  of employees, number of worksites, and scope of
  the program
• Internal staff, interns, or a new hire
• Vendors

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Is Big Brother watching?

• Secure, confidential data
• How hard should you push healthy behaviors?
• How far do you go to verify compliance?
• No food police or fitness freaks allowed
• What about unions?

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5. Choose programs that work
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Behavior ChangeThe Soul of Health Promotion
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The Bottom Line
Unhealthy behaviors
Health risks
Chronic disease
Health care costs
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Weight loss with and without lifestyle change
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You would think . . .

• that having had a heart attack would be enough to
  persuade a man to quit smoking, change his diet,
  exercise more, and take his medication

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You would think . . .

• that hangovers, damaged relationships, an auto
  crash, and memory blackouts would be enough to
  convince a woman to stop drinking

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You would think . . .

• that very real threats of blindness, amputations,
  and even early death would be enough to motivate
  diabetics to lose weight, exercise and eat better

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You would think . . .

• that time spent in prison would dissuade people
  from re-offending

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• What was the last major life change you
  implemented? (i.e. job, health, family)
• Why did you do it?
• What did you have to overcome?
• What did you have to learn?
• What motivated you?
• Whos help did you have to enlist?
• When did it become permanent?
• Did you change your environment?

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Behavior Change Models

• Social Marketing theory
• Social Cognitive Theory/social learning theory
• Stages of Change/transtheoretical model
• Theory of Reasoned Action
• Health Belief model
• and many, many others

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Does Anyone Use These Models?
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Do they really help us change behaviors?
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What Really Triggers Behavior Change?

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Why is behavior change so hard?

• Fix me up Doc mentality
• Too much pressure to be unhealthy
• Lack of education
• Lack sufficient motivation
• Dont know how
• Barriers are too great to overcome
• I-dont-care-itis

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Our health behaviors
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Individual
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16 oz
32 oz
44 oz
52 oz
64 oz
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Individual
Family
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Individual
Family
Worksite
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Individual
Family
Worksite
Community
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5-a-day 1 million
Food Marketing 25 Billion
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Texas Double Whopper
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Somewhere in Florida
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Nation/ world
Individual
Family
Worksite
Community
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Percent of adults who are overweight or obese by
country
US 74
Russia 50
Percent
India 16
WHO, 2007
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Nation/ world
Individual
Family
Worksite
Community
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• Behavior Change Simplified

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• Educate
• Motivate
• Build skills
• Change the environment

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Educate

• Create individual awareness
• Create community and organizational awareness and
  support
• Create buzz

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• Flyers
• Posters
• Email notifications
• Television/video programs
• Books

• Payroll stuffers
• Internet sites
• Magazines
• Lunch and learns
• Special speakers
• Newsletters

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Motivate

• Before/after stories in newsletters
• Team competitions
• Incentives
• Extrinsic and intrinsic
• Triggers
• Emotional
• Social
• Physical/health

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Impact of cash incentives
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Health Reimbursement Account (HRA)
900
1,500
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• Participate in age appropriate screenings, PSA,
  colonoscopy, mammography, etc
• THESE ARE FREE, no out of pocket
• Participate in the wellness program

1,500
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What about HIPAA?

• Wellness program can discriminate based on health
  risk status provided.
• The amount is
• Program must promote health
• Employees can try every year
• Provide an alternative way to get the award
• Disclose the award rules

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Build Skills (How do I do this?)

• How to overcome barriers
• How to strategies
• Goal setting, contracts
• Healthy substitutions
• Making healthy choices
• How to make healthy foods
• Finding inexpensive healthy foods

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Sample Programs..

• Move It!
• The Culprit and The Cure
• TV Timeout
• Random Acts of Kindness
• The Fast Food Guide
• Maintain Dont Gain
• Food Makeover

• Earth Wise
• What's Your Pressure
• Good to the Bone
• Silver Buckle
• Fall into Fitness
• Drive Sober
• Chopping Block
• Finding Fiber
• Fat Fighters

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• Low hanging fruit
• Preventive screenings
• Flu shots
• Seat belts
• High hanging fruit
• Onsite fitness facility
• One-on-one coaching/training

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6. Change the Environment

• Physical Environment
• Policy
• Culture

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Supportive Environments

• Physical environments
• Healthy food in cafeteria
• Freedom from media and advertising that peddle
  risky behaviors
• Farmers market
• Free from overly demanding work
• Opportunities to be physically active
• Walking paths
• Bike paths
• Recess and PE at schools

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• Smoke free air to breath at home
• Safe place to exercise
• Convenient access to healthy, inexpensive foods

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• Policies
• Medical coverage for preventive services
• Absenteeism policy that supports being healthy
• No smoking policies
• Flex time
• Time to be healthy
• Free from overly demanding work

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• Culture
• Health role models (champions)
• Worksite culture
• Peer support
• Supportive friends
• Church, community support

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• Policies
• Medical coverage for preventive services
• Absenteeism policy that supports being healthy
• No smoking policies
• Flex time
• Time to be healthy
• Free from overly stressful work

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• Culture changes
• Take baby steps
• Get leadership on board
• Find the champions
• Integrate with other departments

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7. Evaluation

• Participation and satisfaction
• HRA data (behavior and biometric)

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Fairview Health Services
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-2
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N3,577
Source StayWell Health Management
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Calories Consumed
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BMI
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Evaluation

• Success stories

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Crains Chicago Business Feb 26, 2007
Kenneth Olson believes the cost of Horton Group's
rewards program will be offset by reduced medical
claims
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Evaluation

• Productivity
• Widgets
• Morale
• Turnover
• Recruitment
• Worksite Culture
• Absenteeism

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Evaluation

• Health Care Costs/ROI

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10 annual increase in premium
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Dreaming
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10 annual increase in premium
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7 annual increase in premium
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Health Care Cost Caveats

• Data is not normally distributed
• Outliers (high cost cases)
• Claims analysis is complex and expensive
• No way of knowing if the improvement was due to
  your wellness program
• Trend comparison is easier and still accurate

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Evaluation

• Calculate Return on Investment (ROI)

cost
benefit
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Repeat Steps 5-7

• Get leadership support
• Create a wellness team
• Collect data to drive health efforts
• Develop an operating plan
• Choose programs that work
• Change the environment
• Evaluate

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