william b. baun, epd, cwp, fawhp worksite wellness: a ... · wellness officer, md anderson cancer...
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William B. Baun, EPD, CWP, FAWHP
Wellness Officer, MD Anderson Cancer Center
President, National Wellness Institute
Worksite Wellness: A
Business Sustainability
Strategy
William B. Baun, EPD, FAWHP
Wellness Officer
williambaun.blogspot.com
USA Workforce growing older,
sicker, and fatter
Older worker:
• More experienced,
knowledgeable,
reliable, and loyal
• Less likely to suffer
injury, but takes
longer to return to
work
High cost of chronic disease across
healthcare system
• 7 in 10 deaths
• ¼ with chronic disease
significant limitations
• 1960s 1.8% kids, 2011
43% kids
• 1 in 3 adults obese, 1 in
5 kids obese
• Kids with chronic
disease change families
The State of Working America
• In recent decades our economy has failed to increase the living standards of typical American workers at a pace matching the country’s overall economic growth
• USA has highest per person
healthcare cost of industrialized world and ranked 37th of 91 countries, $1 out of $7 spent on medical goods or services
• 1% of population account for 30% of costs and 5% account for 70%
• Employers health benefits cover more than 3/5 nonelderly
• Healthcare spending by 2015 predicted at $4T, 20% GDP, per capita $12,320
• Productivity losses related to personal or family health problems estimated at $225.8b or $1,685 PEPY
• Four modifiable health risk behaviors—lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption—are responsible for much of the illness, suffering, and early death related to chronic diseases
Healthy Workplace 2010 & Beyond (PFP 2009)
America’s State of Health
• 32.5% eating 2 or more fruits per day / CDC goal of 75%
• 35.7% of American adults are obese, (400,000+ deaths),
• 68.8% of adults overweight or obese and 31.8% of children / adolescents
• Race-ethnicity, gender, age, geographic region, and socioeconomic status disparities exits relative to body weight
• Physical inactivity ranges from 10.1-43% in U.S. counties
• 60% of American adults not regularly active, and 25% not active at all
• 19.3% adults are tobacco users / 1 in 5 deaths tobacco related (443,000 deaths, 50,000 second hand smoke)
• 26.3% eating 3 or more vegetables per day / CDC goal of 50%
Health and Human Services / Center for Disease Control (2012)
• Baby boomers working longer
• Work week expanding average 47 hours
• Technology revolution = sedentary lifestyles
• Stress levels increasing, disconnected from healthcare
• Wellness linked to health, quality of life, and productivity
• Cost savings
Why Worksite
Wellness?
What’s Driving Interest in
Worksite Wellness in Tampa?
Turn to your partner
on your right and
come up with the top
5 reasons worksite
wellness is growing in
Tampa.
Rand Report Summary: A Review of the U.S. Workplace Wellness Market
http://www.rand.org/content/dam/rand/pubs/research_reports
/RR200/RR254/RAND_RR254.sum.pdf
• Workplace wellness programs emerged as a common employer-sponsored benefit / 50+
employers ½ have programs, but impact rarely formally evaluated
• Lifestyle management interventions can reduce risk factors, are sustainable over time and
clinical meaningful
• Reason to believe reduction in medical costs would materialize, judging by program cost
data after 5-program years, programs cost-neutral
• CULTURE, ENGAGEMENT, and leadership all important to program success and use of
incentives tied to health standards still not understood, tobacco dis-incentives growing
Opportunities for Future Research
• Long term impact
• Design features that work on individual and organizational level
• Study broad range of outcomes and contextual factors that modify impact
• Comprehensive evaluation of intended and unintended effects of incentives
“You see culture in the way the furniture is arranged, what people brag about, what they are rewarded for doing and what they wear.” Whitmore (2008) SHRM “…corporate culture is no longer the relevant topic, I think the relevant topic is macro culture (where different nationalities and occupations play out), and micro cultures where you have problems in the operating room and in teamwork because you have people of different occupations and cultures that all interplay.” Edward Schein (2011) Forbes
…..organizational factors that promote healthy lifestyle choices have been collectively referred to as culture of health. Aldana, HERO (2012)
…..health, employee well-being and organizational success are inextricably linked aligning leadership, benefits, policies, incentives, programs and environmental supports to reduce barriers to active engagement and sustainability of healthy lifestyles across the healthcare continuum. Baun, Workset (2009)
Culture of safety is one in which employee behavior is guided by safety procedures, norms, and supports that encourage a safe working environment.
Safety behaviors are incorporated into the vision and goals of leadership.
Climate Culture
Monday vs. Friday Gives Mon permission to be miserable
Attitude or mood of the group Personality of the group
Provides state of mind Provides a way of thinking
Flexible, easy to change Takes many years to evolve
Based on perceptions Based on values and beliefs
Feel it when you come in the door Always there even on bad days
The way we feel around here The way we get things done around here
First step to improvement Determines if improvement is possible
It’s in your head It’s in your head, heart, and a part of “us”
Modified Gruenert (2008)
-Perceived as a business asset -Recognized as having a big & important impact to the success of the organization -Leadership participation & encouragement
-Build a business case for senior management -Illustrate the value proposition to the organization -Pitch a comprehensive program -Build unit level management champions
Culture of Health
“Ultimately, a company needs to engage people at all levels of the organization to drive a culture of health forward.”
Catherine Baase, MD Dow Chemical Health Director Employee Benefit News (2012)
Top Down ↓
Bottom Up↑
• Develop a sense of urgency • Honor the strengths of your existing
culture • Focus on a few critical shifts in
behavior norms • Integrate formal and information
interventions • Match strategy and culture • Measure and monitor cultural
evolution
Katzenbach, et. at. (2012)
Young Adult Adult Pre-Retirement Family
Healthy
At Risk
High Risk No Chronic disease
Disease MGT Eligible
Chronic Disease
Turn to your partner on
your left and discuss
the models you are
using to reach /
engage the different
groups of individuals
on the continuum of
health?
• Evidenced based
models
• Joint consensus
statements
• Government funded
white papers
• Research initiatives
documenting
components
• Business reviews
Promising Practices – Dr. Ron Goetzel,
nationally recognized & widely published expert in worksite
wellness ROI
Director of Emory University Institute of
Health and Productivity Studies, Vice
President of Truven Health Analytics
• Wellness culture built on trust not
fear, focused on responsibility, and
accountability
• Multilevel leadership
• Integrated, targeted, relevant, and
accessible programs
• Healthy choice the easy choice
• Strategic communications
• Internal and community
partnerships
• Appropriate use of incentives
• Metrics aligned with business
goals
Six Essential Hard Return Pillars Regardless of Organizations Size
• Multilevel Leadership
• Alignment
• Scope, Relevance, and Quality
• Accessibility
• Partnerships
• Communications
“We manage what we measure.”
Are you measuring things that have high value in your wellness
programs?
Harvard Business Review, December 2010 Berry, Mirabito, Baun
“What is going to free,
fuel, and inspire this
person to bring the best
of him or herself to work
every day, most
sustainably?”
Tony Schwartz, HBR 2013
Do you want productive
healthy employees? Treat
them like adults!
A culture of trust not
fear, focused on self
responsibility and
accountability
Tony Schwarz HBR
Blog (2012)
“what’s required now
is something called
sustainable
engagement….that
fully energizes
employees by
promoting their
physical, emotional,
social, mental and
spiritual well-being
that gives an added
capacity for focus
and a strong sense
of purpose.”
Engagement
more than
participation!
Career Well-being – liking what you do each day
Social Well-being – having strong relationship and
love in your life
Financial Well-being – effectively managing your
economic life to reduce stress and increase security
Physical Well-being – having good health and
enough energy to get things done on a daily basis
Community Well-being – the sense of engagement
and involvement you have with where you live
Engagement: The Key to Overall
Well-being
“Engaged participants
attend programs because
they are intent on
improving their health and
are excited about
contributing positive
energy and productivity to
their companies, families,
and communities.”
Terry & Anderson (2011)
Engagement Metrics aligned with
business goals Leadership support
Champ network
Environmental / policy supports
Social and partnership supports
Health benefit design
Appropriate financial metrics
Participation and satisfaction
Engagement and improvement
Wellness culture sustainability
Four E’s of Worksite Wellness Success: Engage, Enable, Educate, Empower
William B. Baun, EPD, CWP, FAWHP Wellness Officer MD Anderson Cancer Center
President National Wellness Institute
Journey of Worksite Wellness
Engagement
Power of culture
Behavior change strategies
Degrees of engagement
Collaborations
Innovations
Social media
Change agents
Engagement – connect / commit
Head + Heart = Heightened
Connections / Commitment
Engagement
Spiritual Occupational
Is
expressed
and
measured
in terms
of feelings
and
behaviors
National Wellness
Institute
Wellness Model
Wellness Touchstones Lead to engagement
Be Well
Engagement Pyramid Different mindset leads to different actions…..
Pass It On
Own It
Practice
Maybe a Baby Step
Considering
No Interest /
Opposed
Modified from
Rosenblatt
(2010)
Four E’s that Drive Wellness Programming Success
Engagement – opportunities that connect and commit
employees both intellectually (head) and emotionally (heart),
and grow heightened levels of wellness ownership, self-
responsibility, accountability
Enable – providing the means and opportunities to be well,
and make it possible, practical, or easy to make healthy
choices and maintain healthy habits
Educate – the learning processes designed, developed, and
implemented to increase wellness knowledge, skill, attitudes,
and commitment
Empower – open individuals to the wisdom, experience, and
motivation they possess
#1 - Enabling Factors Help Build a
Strong Foundation
•Availability of resources
• Accessibility of services
• Supportive policies
• Multilevel Leadership
Support
Availability of Resources Environmental Audit
• Availability of nutritious foods in vending machines and
cafeterias
• Availability of employee break rooms to store and prepare
nutritious foods from home
• Availability of tobacco-free areas
• "Walkability" of the work place
• Availability of fitness centers, shower facilities, multi-purpose
paths, and bicycle racks, that support physical activity
• Availability of lactation rooms
• Availability of quiet places / rooms
CDC (2011) Healthier
Worksite Initiative
Accessibility of Services Convenience matters…..
Appropriate screenings Parenting classes
Appropriate immunizations Cooking classes
Tobacco cessation Personal training
Weight management Coach counseling
Nutrition Quiet rooms
Stress management Eldercare
Relaxation Massage therapy
Meditation Swimming pool
Fitness center Healthy vending machines
Walking path / trail Healthy cafeterias
Legal assistance Aerobic classes
Bike racks Pilates classes
Showers & towels Yoga classes
Dressing rooms Spinning classes
Lactation rooms Walk / run / bike clubs
Blood pressure machines Prenatal classes
Work Life Employee Assistance
Supportive Policies • Tobacco
• Paid time off to attend employee development / wellness training
• Worksite wellness committee
• Program champs or ambassadors
• Use of Employee Assistance Program
• Vending machine
• Catering & food service
• Physical activity
• Participation in community-sponsored, company supported events
• Working Mother / lactation room use
• Flexible work hours / arrangements
• Commuting / biking
• Employee discounts, subsidies
• Childcare / eldercare\
• New moms & dads
#2 - Educate It’s all about multiple touch points that
facilitate adult learning …..
Learning – acquisition of new knowledge, skills, attitudes,
and commitments
Group based learning Lunch-n-learn activities
Individual learning Health fairs
OJT Mini health fairs
Distance learning Mentors
Technology assisted learning Wellness portals
Self-study Health risk assessments
Guided learning Work related training
Interactive learning
Coach counseling
Point of purchase information
World café
Problem solving activities
Educational Program Development
Outline
• Class / workshop title
• Short description of class
• Length of class
• Maximum number of students
• Suggested class frequency
Educational
Objectives
Content
(Topics)
Time Frame Presenter Teaching / Learning
Strategy
Group discussion
Small group discussion
Facilitated lead
Lecture
Buddy / partner work
Etc…..
• Best day of the week
• Best time to offer
• Classroom set up
• Special equipment
Wellness Education Opportunities What’s hot and what’s not…..
4F Heart Health Plan 21 Ways to Manage Stress
12 Great Foods Boosting Energy Beating Stress
Cooking Light Relax….Take a Breath
Reading Food Labels Creating a Positive Mindset
Kicking Cholesterol with Diet Getting a Good Night Sleep
Mindful Eating Healthy Aging
Portion Distortion Meditation Matters
Snack Attacks Walking Meditation
What = 100 Calories Smart Goals
Whole Grains The Calming Function of Water
Boosting Your Metabolism Put Yourself First
Finding your Fitness Personality Eat This Not That
Minutes a Day to a Healthy Back The Art of Reframing
Office Stretch and Tone Anger Hot Stones
The Basics of Stretching Put the Breaks on Stress
The Do’s and Don’t of Exercise The Joy Diet
Walking for the Health It Stand Tall
Getting Ahead by Getting Started Clear Your Mind of Can’t
Calming the Mind Stop the Clock
The Science of Meditation Attitude the Difference Maker
Fit2Run Unlocking Wisdom Through Journaling
Yoga4U Wellness Leadership
#3 - Empowerment
happens when
employees begin
taking small steps to
be well…..
What starts those
steps?
Program Calendar Strategizes Empowerment
J F M A M J J A S O N D J F M A M J
Awareness Motivation - Engagement
Behavior Change
Environmental Support
Worksite Wellness Empowerment Is all about passing it on…..
Self
Peer
Friends
Family
Neighborhood
Community
City / Organization
We don’t do wellness alone
Many successful
wellness steps and
accomplishments are
nudged through
relationships.....
Nudges are gradual,
intentional positive
interactions of
encouragement
to BE WELL
Wellness Social Networking Maximizes Community Engagement
Community: a place , feeling,
relationships, common characteristics
Community Mapping: boundaries,
potential building blocks of people and/or
other resources, collaborations,
integrations
CDC (2011) Community
Engagement
Four E’s that Drive Wellness Programming Success
Engagement – opportunities that connect and commit
employees both intellectually (head) and emotionally (heart),
and grow heightened levels of wellness ownership, self-
responsibility, accountability
Educate – the learning processes designed, developed, and
implemented to increase wellness knowledge, skill, attitudes,
and commitment
Enable – providing the means and opportunities to be well,
and make it possible, practical, or easy to make healthy
choices and maintain healthy habits
Empower – open individuals to the wisdom, experience, and
motivation they possess