Workshop Paper - Prevention and Wellness

Author : Dr John Lang

Presenter : MaidoProfessor : Daphne YuanDate : 2015/03/30

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Outline

1. Introduction

2. Background

3. Corporate Wellness Program

4. “Best Practice” Worksite Health Program

5. Assessment of “Best Practice” WHP

6. Frameworks for workplace health & wellbeing initiatives

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Introduction

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Introduction• The National Health and Hospitals Reform Commission of

the Australian Government▫Dr John Lang to develop a proposal▫a national preventative health and wellness strategy to

Australian employees

• prevention and early identification of risk factors for chronic disease, as well as intervention options which can be deployed to mitigate risk.

• currently available programs▫recommendations for a preferred “best practice” model

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Background

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• Currently in Australia, approximately 70% of the Federal Health budget is spent on diagnosing and managing chronic condition

• Approximately 70% are caused by lifestyle/behaviour and are therefore amenable to preventative strategies

• The big four▫poor nutrition, inactivity, smoking and stress (emotional

wellbeing)• only 1.8% of the health care budget is allocated to

prevention (vaccinations)

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Corporate Wellness Program

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Corporate Wellness Program• The 35 corporate wellness providers in Australia

currently service about 500,000 employees or 5% of the workforce▫current capacity is double this.

•Workplace Health and Wellness ▫early identification of chronic disease and lifestyle

related (preventable) risks▫ intervention strategies deployed to mitigate these risks

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•Highly trained Exercise Physiologists and Nutritionists are used to deliver services at a cost that is one half to one quarter of the cost of a doctor

• The lack of infrastructure investment• The lack of support funding▫scaled up from its current 1.8%

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Funding Model• Both the gross amount, and the amount per employee▫$500M ($50/employee) for funding a wellness initiative

The maximum annual contribution from the fund might be $100 per employee with a co- contribution of $100 per employee from the employer

• The option to offer more costly interventions shouldn’t be included

• Those who stand to gain financially from improved health are providing a certain level of support for the detection/intervention that will deliver the outcomes they desire

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Can corporate wellness programs identify and intervene to impact outcomes in relation to preventative health?

• Data from over 600 studies published over the past 2 decades▫Risk reduction ▫Behaviour change ▫Health Costs ▫Health Insurance claims ▫Productivity ▫Absenteeism ▫Workcover claims

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Identification of risks•Health Reimbursement Account (HRA)▫These have become part of the “Intellectual Capital” of

each organisation▫Makes standardisation difficult▫Ex. excercise

National Physical Activity Guidelines for Australians National Health Survey

▫Good data will drive good decisions and allow appropriate allocation of resources

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Identification of risks•Health Check▫A face to face health and lifestyle assessment is useful to

gain additional data, particularly biometric data▫Ex. high BP/Cholesterol

self reported amongst employees (2-3%) the actual prevalence of these risks by direct

measurement (20-30%)

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Program Design• “End-to-end service”•With centralisation of data, outcomes can be monitored

and programs compared for efficacy

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Program Contents1. Core components▫Regardless who you are and where you work within the

organization, you have access to these▫Ex. HRA

2. Discretionary Elements▫Target special groups ▫Ex. high risk or obese employees, smokers or those in

physically demanding job3. Local Programs▫Workshops on specific issues (ie. Stress, Back Care, Sleep

for Shift Workers etc.) or group activities

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• Delivery Mechanisms▫Online ▫F2F individual (Assessments, Counseling/Coaching) ▫F2F group (Seminars/Workshops) ▫Self Managed Programs

• Choosing a Provider

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“Best Practice”Worksite Health Program

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Characteristics of Best Practice• Shepherd’s Program Attributable Benefits (PAB)

1. Prevalence of need2. Likelihood that those in need will participate3. Likelihood that participants have their needs met4. Likelihood that participants make lasting behavioural

change

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1. Prevalence of need▫Deploy an appropriate tool such as a HRA, onsite

assessment or a Health, Absence and Productivity Survey▫Not only helps to identify need and therefore facilitate

program design and allow targeting of information, it also provides the benchmark by which the program outcomes will be judged

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2. Participation▫Endorsement from the Boss▫Participation by leaders▫ Internal communications▫Team Level Support▫Write it into KPI▫Overcoming barriers▫Publish Results

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3. Meeting of Needs▫Good content, delivered by engaging, well informed

providers, will help to achieve individual and therefore company goals

4. Making lasting changes▫by use of an appropriate behavioural model, as well as

offering follow-up and support programs to assist participants along the often difficult path of lifestyle change

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How to Avoid FAILURE

• Fragmentation of Effort

• Activities Focus

• Illness Orientation

• Lack of Employee Involvement

•Under-emphasis on skills

• Regard only for the Individual

• Emphasis on short term results

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• Program Management▫critical to overall success

•Marketing and Promotion▫“top-down” promotion program

• Branding▫Brand recognition plays an important role

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•Ongoing Development▫Good programs offer new, interesting and often exciting

options as part of an “Annual Upgrade”•Outcomes – Reporting▫Results from any testing or surveys conducted▫Feedback (both formal and informal)▫Attendance rates, uptake and traffic for online health

programs ▫Likely impact on key business metrics (absence,

productivity etc.)

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Assessment of “Best Practice” WHP

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Literature Review1. Awareness of the Health Promotion Programs

2. Participation in Health Promotion Programs

3. Satisfaction with the Program

4. Attitudes towards management

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5. Behaviour change and health improvement▫ processes (behaviours) and outcomes (risk reduction)

6. Financial measures▫ Cost Benefits

The soft option, the medium and the hard option

7. Financial outcomes of interest▫ Ex. Absenteeism, Turnover or Safety incidents

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The Stages of Readiness for Change Model

• A best practice should provide participants with • “staged matched intervention”

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Health Assessments• Body Mass Index•Waist measurement/Waist to Hip Ratio (WHR)• Blood Pressure• Total Cholesterol• Blood Glucose• Lower Back/Hamstring Flexibility (Sit & Reach Test)• Abdominal Strength•Upper body strength/endurance• Cardiovascular Fitness test - Step Test

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Frameworks for workplace health & wellbeing initiatives

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Socio-behavioural approach• An awareness program increases an employees’ level of

awareness or interest in a program topic, and commonly uses methods such as newsletters, posters, flyers and educational seminar

• Lifestyle change programs go beyond awareness programs by setting lifestyle behavior change as the key outcome. Methods used include health education, behavior modification, experimental practice, and feedback opportunities

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Creating a supportive environment• Physical environment▫corporate gyms, showers and lockers, secure bike storage

for commuters, smoke-free buildings

• Policy environment▫flexible work time, working from home, reducing overtime

hours worked▫such action is generally aimed at challenging the existing

corporate culture the values, norms, organizational support, peer support

and climate of the organization

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• The combination of ‘core’ and ‘discretionary’ components with the addition of ‘local content’ strike a balance between the ‘off-the-shelf’ approach and the need to gather common health risk and behvioural data to inform program content

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