Employee Health Promotion

Corporation America is increasingly investing in employee wellness because it is great business. In order to meet productivity demands, organizations must rely on a healthy, constructive workforce to succeed in the highly competitive global marketplace. Over a hundred research studies in both corporate and governmental settings have documented the economic benefits of Employee Health Promotion Programs, including reduced absenteeism, reduced injuries and workman’s compensation costs, reduced healthcare costs, reduced employee turnover, as well as better productivity, 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 benefit realized. To enhance their performance federal government Employee Health Promotion Programs may be able to incorporate some of the features described. Employee wellness programs shown to have positive returns on investment often include the following features:

1. 1. Health and productivity management model

Programs characterized by this model focus attention on identification and reduction of specific risks or behaviors such as smoking, lack of physical exercise, excess weight, unhealthy diet, elevated cholesterol, high Blood Pressure, stress, depression, and so on. High-risk employees are specifically targeted for intervention, even though 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. Workers take the questionnaire annually in a myriad of cases. The HRA serves to broaden awareness, offer direction, and arouse people to better specific behaviors. In some cases, the customized 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 outcome of the health risk appraisal with measurement of each employee’s biometrics, including weight and Body Mass Index (BMI), Blood Pressure, 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 generally given monetary or other valuable 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 a myriad of cases the monetary incentives are associated with reductions in medical insurance premiums. Some programs use disincentives as well as incentives, such as charging employees who use tobacco higher rates for their medical insurance contribution.

5. 5. High participation rates

Effective programs use incentives to drive participation rates up. They also market their programs extensively, and may use contest or challenge strategies to heighten enthusiasm and advocate participation.

6. 6. Wellness coaching

employees with identified risks or desire to better their health habits may be periodically coached via telephone by trained health & wellness coaches. Wellness Coaching helps employees set and achieve realistic lifestyle-related goals/objectives including those approaching stress, work life balance, smoking, weight, physical exercise, 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 backing stimulating variety and alternatives in order to accommodate the needs of all employees. In addition to on-Site physical exercise and healthy eating programs, on-line programs, e-mail reminders and notices, printed newsletters and materials, and business classes are common dissemination strategies.

8. 8. Senior Leadership backing

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

9. 9. Frequent contact

Effective programs have successive 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 wellbeing and health opportunities and reinforce the corporate emphasis on wellness through successive and multiple “touches”.

10. 10. Open enrollment

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

11. 11. Family participation

Many programs advocate spouses and other family members to participate in the business 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 vital 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, even though on-line or telephone-based programs may be available as well.

13. 13. Exercise

Regular physical exercise is a core component of every wellness program. Workers must be strongly encouraged to engage in regular physical exercise. 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 area exercise facilities is a common alternative to worksite facilities.

14. 14. Weight management

Because obesity is a primary threat to health it is imperative that programs offer effective assistance with weight management. Enthusiastic encouragement from upper management to shed excess weight is valuable. Online programs, worksite programs, or discounted access to weight management programs in the area may all be available. Long-term follow-up is vital for maintenance of weight loss.

15. 15. Stress management

Workplace stress is perhaps the most common objection among employees and a primary contributor to absenteeism, presenteeism (reduced productivity), 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 successive worksite general stress reduction programs. Some organizations 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, cholesterol, BMI, colorectal and breast cancer, and others. Annual influenza immunizations are also encouraged. Some sites offer these services at the worksite. 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 costs of medical care insurance for employees has stimulated this trend. Some organizations have observed that it is less expensive to offer primary care services themselves than to fund those services through medical insurance. On-Site care also reduces the amount of time employees would otherwise spend away from the worksite getting such services.

References

1. 1. Aldana, Steven G. (2001) Financial Impact of Employee Health Promotion Programs: 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 Employee Health Promotion Programs Economic Return Studies: 2005 Update. The Art of Health Promotion, July/August, 1-15.
5. 5. Chapman, Larry. (2006) Employee Participation in Employee Health Promotion Programs and Employee Health Promotion Programs: 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 Employee Health Promotion Programs. The Art of Health Promotion, July/August, 1-12.
7. 7. Chapman, Larry. (2007) Proof Positive: An Analysis of the cost-Effectiveness of Worksite 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 Worksite: 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.