Wellness Program Structure.

When selecting  a program from a vendor you ought to ask the following questions –

&#149 How many worksites have done the program?

&#149 What types of worker population was the program offered?

&#149 What educational materials are used?

&#149 Will the program meet the needs of employees?

&#149 What are the techniques used to help change behaviors?

&#149 Does the program help individuals  move through stages of readiness to make health behavior changes?

&#149 How do you market the program to employees?

&#149 What follow-up do you provide?

&#149 How do you make referrals for medical care or other supportive services staff members may need?

&#149 How do you know the program works?

&#149 How do you measure participant satisfaction?

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Choosing a Wellness Business.

When staffing your wellness program you need to consider whether to hire a wellness staff or contract with wellness specialists from outside your organization.

Small and medium size worksites do not ordinarily have a wellness professional on staff. When your worksite is in this category, you’ll need to contract with providers outside your corporation.

Large corporations have a few options. They can hire a staff solely for the wellness program, they can contract with outside wellness providers, or they can use a combination of internal staff and outside providers.

When picking  a provider some key questions in the areas of staff, program structure, process, and effectiveness need to be addressed. Each of these key questions is discussed in the following sections.

Wellness Business Staff

Health experts become wellness experts when they are trained in the full range of wellness activities. Wellness experts are generalists who come from a wide variety of backgrounds and schooling.

They may be nurses, dietitians, health educators, counselors, exercise physiologists, or have other backgrounds. But as well to their primary training, they know something about all wellness topics, including smoking, stress, exercise, and nutrition.

They also know how to engage and support individuals  in making and sustaining health improvements and have good individuals  skills.

Generally, wellness specialists at worksites fall into three broad categories, wellness screeners, wellness counselors, and wellness instructors.

&#149 Wellness screeners introduce employees to the program, take health measurements, collect health-related information, provide initial counseling, and help employees define for themselves what they need and want in a wellness program.

&#149 Wellness counselors work with staff members after the screening to help them create and carry out a plan to reduce their risks and improve their health.

&#149 Wellness instructors teach courses and minigroups on different health topics.

A wellness program in a small company may be staffed by a single staff individuals who fills all three roles. Larger worksites will use different people  to fill these roles.

When choosing  staff or choosing  among wellness companies, ask the following questions –

&#149 Do prospective staff members have a range of health backgrounds that’ll provide appropriate specialistise in the topics to be addressed?

&#149 Have prospective staff members functioned well as wellness screeners, wellness counselors, and/or wellness instructors?

&#149 Will this staff include individuals  from the ethnic and racial backgrounds found in your worker population?

&#149 is each worker comfortable with the range of backgrounds found in your worker population, and able to communicate effectively with the various social and educational levels of your employees?

&#149 Do staff members have a warm, but expert, counseling style when interacting with employees?

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Wellness Program Planning.

An annual plan for the major wellness programs and activities is a useful management tool. This is an great wellness committee task. Often an activity and wellness theme per month is offered to workers.

Some organizations select to follow a National Health Observances calendar which offers advantages. the materials developed by these various national health organizations are very credible. the materials are normally high quality and available free or at a nominal cost.

The corporation benefits from additional publicity that occurs in various media throughout the community related to the national observance. for planning suggestions you may want to utilize the HOPE Publications Wellness Resource Planning Guide available for free at this Web site.

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Health Risk Appraisals

A Health Risk Appraisal is sometimes used coupled with a biometric testing. an HRA is a computerized assessment tool which looks at an individual’s family history, health status, and lifestyle.

An HRA seeks to identify precursors associated with premature death or serious disease and quantifies the probable impact for each individual.

An HRA instrument is derived from an understanding of the in a illness. Based on this understanding, useful prediction instruments could be constructed to assess the health risks of an individual. Individuals with a higher number of health risks tend to have more serious health problems over time.

Drawing attention to their health risks can help clients reduce risk factors which lead to the onset of unnecessary disease and subsequent premature death.

The questionnaire covers lifestyle habits (like use of tobacco, seat belt use, and exercise) and physical measures (like cholesterol, blood pressure (BP) levels, height, and weight).

For accuracy, it is crucial to obtain direct measures of blood pressure, cholesterol and HDL-cholesterol. the HRA also provides recommendations and indicates what risks are modifiable. Kinds of measures to assess health risks are discussed under Screening Programs.

The impact of a health risk appraisal is much greater when it’s given in-person, with immediate feedback to the patron. This also provides an opportunity to invite the patron’s participation in continuing health counseling and to gain their written consent to do pro-active outreach to them.

A health age can be computed based on the individual answers to the questionnaire and physiologic factors. the health age may indicate the individual to be younger or older than their chronological age.

HRA programs are one the most prolific types of wellness activities utilized by organizations. Continuing research on HRAs is examining the efficacy of this tool.

One of the large advantages of this tool is that it can provide an aggregate group report of a company and could be utilized as an evaluation tool.

Detailed information is available from the Society of Prospective Medicine (www.spm.org/desc.html) who publishes a handbook on HRAs.

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Wellness Program and Heart Health.

The most common screening performed in wellness programs is heart health assessment.

The screening can include a written heart health test, blood pressure measurement, cholesterol/HDL-cholesterol test, glucose (blood sugar), weight, educational materials specific to diet, nutrition, exercise, cholesterol, use of tobacco, and weight.

The health professional conducting the screening then provides a consultation and helps set objectives with the participant.

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Employee Health Testing.

The backbone of wellness programming at the worksite is medical screening. It’s the first major activity a business ought to do when first starting a wellness program.

Biometric testing is often used along with the administration of a Health Risk (Assessment|Appraisal} .

The most effective way to screen is to utilize a health expert trained in wellness screening techniques and counseling to privately and individually assess participants.

This wellness professional takes a brief health history and measures blood pressure (BP) and cholesterol. With computerized cholesterol desktop analyzers, results are acquired in about four minutes.

Immediate feedback, consultation, and educational materials are provided. for those identified at-risk, follow-up appointments can be scheduled at this time. the whole process takes about twenty minutes per individual.

The screening also provides an immediate opportunity to register participants in various health betterment programs based on their interests and identified health risks.

Biometric screening may be done annually and used as a means of monitoring health risks within the worksite.

A health screening program needs to provide multiple opportunities for participation. the service ought to be provided for all the various shifts of a company. the screening program ought to be conducted in highly visible areas so the process could be observed.

Reluctant employees often like to be able to see what the program is about before they participate. When wellness screeners are not busy, they should perform outreach going to areas where employees gather and try to recruit employees.

When well-planned and promoted, health screening can attract participation rates of 60 percent to 100 percent. These high participation rates have a positive impact on management producing support for further programming.

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Wellness Program Budgets.

Attempting to do more with less money? Here are three proven ways to align the dollars and cents of a wellness program in your budget.

Common thread –  the way you prepare – and control – your budget for a wellness program is vital to its success.

1. Top-down budget

Depending on the size of your organization and wellness program, you may have full budget responsibility or might need to work with a C-level who’s budgeting expertise.

Regardless of the arrangement, you’re likely to face one of two distinct challenges –  a top-down budget or a zero-based budget.

A top-down budget is when you’re given a finite dollar amount and told to run the wellness program within the limit. If that’s the case, here are three critical questions to ask –

&#149 Does this limit include money set aside for staff member incentives and future initiatives?

&#149 Should we keep long-tenured programs that keep going up in price, and

&#149 Does Benefits/HR have to deliver all education about the program, or is there extra funding to hire staff?

2.  Zero-based budgeting

In zero-based funding, you submit to  upper management an itemized list of the programs/features you want and the cost of each. Best practices –

&#149 Rank programs by priority (health-risk assessments should be at or near the top)

&#149 Indicate which expenses are fixed and which are variable, and

&#149 List ways to incorporate existing resources (like an employee assistance program program) for a better return on investment.

3. Estimating ROI

On average, wellness programs ordinarily take at least 18 months to break even. After three years, you ought to see savings.

When not, it’s time to take a fresh look at the program design.

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Wellness Program – Goals and Goals.   

Objectives are broad-based statements about what the program is expected to do. the goal of the wellness program is to enhance the health of the individual and the organization. Objectives like mission statements provide direction in a program.   

Goals are specific and provide a means of measurement of the program to determine effectiveness. There are two kinds of objectives, process and outcome.    

Process goals state the activities that need to occur to achieve a desired outcome.

Examples of process goals are –

&#149 Number of participants screened

&#149 Number of participants in and completing health betterment programs

&#149 Satisfaction of program participants

&#149 Number of participants who were medically referred and saw their physician

&#149 Number of promotional activities

&#149 Number of participants seen in follow-up

Example of outcome goals are –

&#149 Number of participants who improved fitness level

&#149 Number of participants who lowered cholesterol level

&#149 Number of participants who lost weight, body fat

&#149 Number of participants who quit tobacco use

&#149 Number of participants with high blood pressure who decreased their blood pressure

&#149 Number of participants whose initial level of alcohol consumption put them at-risk who are no longer at-risk

&#149 Number of participants with risk factors who saw their physician and are being treated for high blood pressure (BP) or cholesterol years later

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Worker obesity.

Thinking about an obesity-related disease management program for your organization? Here’s what you need to know.

In order to be effective, the program must meet participants’ individual medical and psychological needs, not to mention your own organization’s need to control long-term health costs.

How wide-reaching should the program be? After all, it doesn’t make sense to pay for services your employees don’t want or can’t use.

Mary Beth Chalk of Resources for Living suggests that obesity programs can be broken down into four tiers of employee need, from which your organization’s return on investment (ROI) can also be measured.

Tier 1 –  Education

Tier I employees struggle with weight management problems but don’t need a health coach.  Instead, they might benefit from a self-directed program that provides weight-management related materials online, targeted mailing, and/or access to nurse call line.

How to measure ROI –  utilization. Do employees click on the Web site? Do they return to the site regularly? Do individuals  use the nurse line? Your program vendor should provide you detailed use stats.

Tier 2 –  Clinical supervision

When the employee has been diagnosed as obese – a BMI  score over 30 is obese, over 35 is clinically obese – he or she would do better working with a health coach in a clinically supervised program.

Three keys to getting maximum results –

1. Periodically have participants rate their relationship with their health coaches. Not everyone clicks, so a change may  be in order.

2. Coordinate your disease management care with your employee assistance program (EAP)services. Reason –  Inability to control weight is often closely tied with mental health issues – and one can adversely affect the other. the more closely your EAP and obesity program managers work together, the higher the chance for success.

3. Beware of the fade-out effect. Many workers in weight-loss programs get off to a great start and then fall back into old habits. People  should re-commit to the program after three sessions, four months and nine months.

To measure ROI, look at utlization, goal achievement and lowered presenteeism. of course, presenteeism is notoriously difficult to measure with reliable dollar figures. So how can you overcome that problem?

&#149 Begin with employees’ salaries. Let’s suppose one participant earns $40,000 per year.

&#149 Ask staff members to self-report how energetic and productive they feel on the job, on a percentage scale. Then have supervisors estimate the employee’s productivity and split the difference. for this example, let’s assume it averaged to 50 percent.

&#149 Collect scores again six months and one year into the program and then multiply the difference by salary. the result is your estimated productivity ROI.

In the example above, if the staff member earning $40,000 improves from 50% to 75% after one year, the productivity related ROI is $10,000.  

Tier 3 –  Medical management

At this level, the obese worker needs a higher level of care than a health coach can offer. the worker has chronic health conditions related to obesity – like diabetes, high blood pressure, and/or sleep apnea – and needs a doctor case manager. Specifically, the worker needs to set up regular visits with the doctor and create a treatment plan.

To measure ROI, begin with the lower-tier criteria, then track quarterly and year differences in FMLA or compensated absences, and prescription drug costs. Then compare it to the per-participant cost of the obesity program.

Tier 4 –  Morbid obesity

At this level, the worker has been diagnosed as morbidly obese – Body Mass Index over 40 – and is considered a potential candidate for gastric bypass surgery.

ROI is measured through ongoing health claims as well as the previous criteria.

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Wellness Program Committee.

Wellness committees are important in that they create a sense of ownership in the program, and facilitate various tasks involved in wellness programming at the workplace.

The committee must be composed of a cross-section of employees representing various occupations, levels, and subgroups with the organization.

A common mistake is filling the committee with the most health/fitness-conscious individuals  in the company. Do not rely solely on volunteers to fill a committee. Make certain that your committee members have enough power in the company to run an effective wellness program.

The wellness committee is made up of workers from the workplace. It oversees the wellness program and assists carry it out.

The committee should meet about once a month to review the previous month’s activities and plan future ones. When the program is just beginning, the committee may meet each week until things get going.

Committee members don’t carry out medical procedures, counsel patrons, or handle confidential medical information. Wellness specialists perform these tasks.

In general, the committee’s duties fall into three areas –  planning, promoting, and assisting to run programs.

Planning the programs can include –

&#149 Locating space for activities

&#149 Planning and organizing worksite-wide events like contests

&#149 Reviewing reports prepared by the program staff and making recommendations

Promoting the program can include –

&#149 Recruiting employees to participate in screening and health improvement programs

&#149 Encouraging workers to participate in follow-up counseling

&#149 Organizing promotional strategies using newsletters, signs, bulletin boards, computers, and other media available within the workplace

Helping to run the program can include –

&#149 Setting up equipment for various activities

&#149 Helping to conduct worksite-wide activities

&#149 Monitoring all activities and investigating  the performance of the expert staff

&#149 Acting as wellness mentors to fellow employees

The size of the wellness committee will be dependent on the size of the organization. Pick members by asking day management to nominate or appoint workers.

Make an announcement through flyers, memos, and meetings to recruit potential members. Explain the purpose of the committee, duties and responsibilities, and the time commitment.

Recognize your wellness committee volunteers. Allow them to participate in programs at a lowered cost. Hold appreciation breakfasts/lunches/dinners.

Print names of committee members on business communications about the wellness program.

Buy special T-shirts, caps, and buttons for them. Write letters to supervisors saying that you appreciate the member’s service. Create awards certificates for members.

The following could be used as a guide for committee size –    

&#149 Less than 300 employees   2 to 4

&#149 300 to 1,000 employees   4 to 6

&#149 1,000 employees or more   6 to 12

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