State of Wellness: Wisconsin

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WisconsinWorksite Wellness

Resource KitHELLO

My name is:Jon Morgan

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Who Am I?

Jon Morgan, MSPhysical Activity Coordinator

Division of Public HealthVoice: (608) 266-9781Fax: (608) 266-3125

jonathon.morgan@wisconsin.gov

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Waking Hours in Various Settings (17 total hours possible)

HealthCare 10 seconds

In Transit 1

Family/Home

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Community 3

Work or School or Childcare

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Why the worksite…

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“Evolution” ???

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Parallel Path of Healthcare Costs & Obesity Rates (Annual cost per person & % obese population)

$0

$0

$0

$1

$1

$1

$1

19901991199219931994199519961997199819992000200120022003

Years

Obesity Rate

Healthcare Cost Rate

Cos

t/Obe

sity

Rat

e

Two-thirds of the increase in health care spending is due to increased prevalence of treating chronic

disease.

$2752

$5711

11%

26%

Source: CDC BRFSS dataSource: Organization for Economic Co-operation and Development. OECD Health Data 2006

The Timing is Right!

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Or ….If it doesn’t make cents,it doesn’t make sense!

Why try and improve wellness in

the worksite?

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Return on Investment

Most studies show a return on investment (ROI) of $2 to $5 for every $1 invested.

ROI usually includes:AbsenteeismMedical & Pharmacy costsPresenteeismWorker’s Comp and disability time

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Initial Consideration –What’s Your Role?

Which comes 1st? Or

1) Identify what you can do so you have visibility, credibility and a role.

2) Figure out who are the partners and facilitators are that you need and that might need you.

3) Figure out what they need and whether you can provide it.

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Our Role vs. Partner Role

Education / Awareness

Resources/ General

Technical Assistance

Direct Outreach,

TA, Consulting

1) You need to provide them with something(Awareness is not enough –What can give them that they don’t already have that will help make it happen?)

2) You may only get 1 shot – so be ready before you “launch”!

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Worksite Wellness Timeline

NPA Program Established 2004

Toolkit – Version #3 Fall 2010

State Plan - Business subcomm #1= kit 2006

Worksite Survey Completed by 581 WMC members

Spring 2006

Resource Kit Completed - 8,000+ downloadsProduced by NPA program & committee.

August 2006Version 1

Comprehensive Cancer Grants 6 mini-grants to test look/feel of the Kit in 16 sites

2006-2007

NGA Grants - $100K1) Gov Summit2) Plan for state employee wellness 3) 11 mini-grants ($4K each) to test effectiveness in 17 worksites

2006-2007

Version 2 of Resource Kit Completed Fall 2007

Governor’s Worksite Award Winter 2007

Regional & Targeted Trainings 2008, ‘09 & ‘10

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Based on Worksite Survey Results (N=581)

& Pilot Testing (33 sites)

Resource Kit Development

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Survey Questions

Asked Questions in Four Areas:

1. General infoSize & type of Company

2. Companies without a programWhy not?Stage of consideration for a programWhat would influence starting a programRanking of key program components

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Survey Questions (cont)3. Companies with a Program

Reason why?Funding/staffParticipation ratesList of key program componentsCommunication methodsOn-site resourcesPolicies

4. NeedsKit components?How-to pieces for what areas?Format?

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Worksite Wellness Pilot Projects

Healthy Lifestyles Project (#1)June 2006 -June 2007: tested look/feel

Healthy Wisconsin Worksite Project (#2)December 2006-September 2007: tested effectiveness

Objectives1st Pilot: Support 6 coalitions to partner

with 1-5 worksites to implement worksite wellness programs (with Cancer program)

Pilot test the Wisconsin Worksite Wellness Resource Kit

2nd Pilot: Support 11 coalitions to partner with 1-5 worksites to implement worksite wellness programs

Using evidence-based strategiesUse the Wisconsin Worksite Wellness Resource KitPre-post assessment checklist

Coalitions Funded

Fit City MadisonHealthy People Wood CountyCoulee Region Childhood Obesity CoalitionBurnett County Nutrition CoalitionHealthy Eating, Active Living of Marathon CountySheboygan County Coalition for Kids’ Activity & Nutrition

Healthy Hearts Project Oconto CountyRock County Healthy Living CoalitionBrown County Healthy Weight Coalition for YouthWaupaca County NuAct CoalitionWaukesha Wellness AdvocatesGreen Lake Area Health & Wellness CoalitionHealthiest Manitowoc County 2010University of Wisconsin – River Falls Health and Wellness CoalitionMerrill Area Healthy Lifestyle NetworkAltoona on the GoPolk County Nutrition & Physical Activity Coalition

1st Pilot

2nd Pilot

Worksite Partners1st Pilot = 16 worksite partners

Printing CompanyHealthcare Providers/Medical CenterManufacturing Technical College/University Dept. County GovernmentSchool DistrictHead Start

2nd Pilot = 17 worksite partnersCounty GovernmentCity GovernmentManufactureringSchools/Technical College/UniversityHospital/healthcare clinicNursing HomeHead Start

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Page 1: Strategies

Findings

Pilot 1 Pilot 2# of employees reached = 3,527 10,092# policy changes made = 27 37# environmental changes = 45 56

Toolkit usefulness = all used the kit and found it somewhat useful to extremely useful Partnership Model was effectiveSustainability listed by most

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Policy ChangesHealth insurance discountsHealthy food at meetingsHRA'sVending contractsBreastfeeding policies Worksite wellness policyFlex scheduling for PA, breastfeedingHealth Club discountsHealthy lifestyle cash or gift incentives

Pilot 1: Competitive pricingPilot 2: Time and space for breaks & lunch Nutrition guidelines for cafeteria, vending

Both Pilots

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Environmental Changes

Walking routes/mapsBike racksPoint of decision promptsVending foods/beveragesCompetitive pricingLabelingCSA drop off / on-site gardeningFitness facility/equipmentNutrition educationMake water availableBreastfeeding room, refrigerator, breast pumps

Pilot 2: Shower facilities

Both Pilots

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Resource Kit Pilot Sites –Lessons Learned

Effectiveness of the coalition-worksite partner model

For coalitions:Increased their visibility in the community.The coalition strengthened existing partnerships or created new partnerships with partner worksites.

For worksites:promoted networking among the partner worksites. Worksites received technical assistance

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PolicyPolicy changes are most easily implemented with wellness representatives in administrative roles. Policy changes should be realistic. Timing and persistence are crucial. May have to come back later to implement.

Environment Most popular environmental changes = healthy foods at company functions. Point-of-decision prompts were also initiated by many worksites.

Most Wellness Programs Gravitated to Activities

Lessons Learned: Implementation and effectiveness of

evidence-based interventions

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Measuring Change

Worksite assessment checklist of strategies

= One of the suggested ways to

measure success=

Pick list for grant reporting measures=

Criteria for Worksite Award Program

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Delivering the Message/Resource:An Intermediary is Key

Resource Kit

Public Health Coalitions

Individual Worksites Wellness Programs

Occupational Health Nurses

Human Resource Dept

Health Provider or Insurers

Chambers of Commerce

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20086 WorkshopsApril – July

(350 Attendees)

20092 Trainer

Workshops: St. Point - June 2Madison - June 10

2 General & 2 HR specific

2010Fall Workshops

Stevens Point

Eau Claire

Appleton

Waukesha

LaCrosse

Madison

Stevens Point

Madison

Pittsville

West Bend

Green Bay

Madison

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Worksite Wellness Resource Kit…Already doing outreach - What’s in it for

me in working with clients?

It’s a potential foot in the doorTool to add to your list of services Based on proven practices =Higher success rateIt can easily be integrated into what you’re already doing, for example ….Just because…..it’s the right thing to do!

And ………It’s FREE!

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Worksite Wellness

Resource Kit

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Who Is Already Using The Kit?

Additional Users:Well City MilwaukeeWellSteps.comZywaveCDCVictoria, Australia – we’ve gone International!

The States of:KentuckyWashington MichiganFloridaIndiana (15)VermontWest VirginiaNew MexicoHawaiiColoradoSouth CarolinaMarylandMissouriNebraskaNorth Dakota

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WI Worksite Wellness Resource Kit

What it’s designed to do …..Step-by-step process for comprehensive worksite wellnessGeneral description of program components and links to best resourcesFocus is on chronic disease prevention

What it doesn’t do …..Detailed content on “programming”Focus on safety & injury prevention

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Worksite Toolkit Outline

Introduction

Step 1: Why Worksite Health? Benefits of a Program

Step 2: How to get started

Step 3: Initial Assessment & Employee Survey

Step 4: Program Content for My Worksite

Step 5: Making Decisions on Where to Focus Worksite Initiatives

Step 6: Evaluating My Wellness Program – Is it doing any good?

Appendices: Additional resources

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Worksite Toolkit Step 1: Why Worksite Health?

6-Step High Level Introduction

Why start a program Health benefits & cost Return on Investment (ROI)Key data

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Worksite ToolkitStep 2: How to get started

How-to SectionDeveloping a wellness teamCost overview

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Worksite ToolkitStep 3: Initial Assessment &

Employee Survey

How-to on conducting a worksite assessment 1) (68 item tool*) - wellness assessment

on current worksite:PoliciesEnvironmentActivities

2) Ask your audience (Sample employee survey)

3) Other available data *

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Worksite Assessment

39After 1 Year Evaluation 29 18 21

Worksite Assessment - Results

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Employee Survey

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What is Worksite Wellness? ….

……Depends on who you ask.

A three pronged complete program =Health FairsLunch & Learns Payroll Stuffers

orProgram ActivitiesPolicy ChangeEnvironmental Change

They don’t know what they don’t

know

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Things (environment, et.al.) Have Changed …high tech digital recreation

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-Offer incentive-based exercise campaigns (President’s Challenge).-Offer physical activity-focused coaching.

-Provide showers onsite.-Provide a room where group fitness classes can take place.-Post maps of onsite trails or nearby walking routes.

-Offer flexible work hours to allow for physical activity during the day. Supervisors must support this as standard work practice.-Promote walk-and-talk meetings when appropriate

Social-Ecological ModelPhysical Activity

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Worksite Toolkit Step 4: Programming for My Worksite

2-3 page summaries of key strategies & resources

General Wellness ComponentsHealth Risk Appraisal / Health Screening *o Healthcare provider or insurer, on-line

Physical Activity / Active Livingo Local YMCA, fitness clubs

Nutrition / Healthy EatingMental Health *Tobacco Use o Healthcare provider or insurer, WI Quit line

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Page 1: Strategies

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Page 2: Resources

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Programming options for greatest impact o Campaigns vs. Policy & Environment changeso Levels of changeo Employee readiness

Recommendation worksheet *

Action plan worksheetMaintaining Interest & Motivationo Incentives

Worksite Toolkit Chapter 5: Where to Focus Your Efforts

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Levels of Chance for Maximum Impact

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“Scoring” Recommendations for Possible Implementation

1 5 scale with higher as better

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Action Plan

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Worksite ToolkitChapter 6: Evaluating My Wellness Program –

Is it doing any good?

Types of evaluation objectiveso Process (with samples)o Outcome (with samples)

Sample pre & post evaluation measures

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Sample Evaluation Measures

Process Measures are:Participation rates (Number of staff enrolled and participating).Web site hitsObservation or counts (ex. track number walking at noon) Participant satisfaction (via survey, focus groups, etc.)Policy or environmental changes/tracking (compare Worksite Wellness Assessment Checklist at 1 year)

Outcome Evaluation is more difficult & takes longer to show up in your data. Pre/Post test surveys – Measure changes in attitude, knowledge and current wellness habits over a specified time periodQuizzesVending items being chosen (arrange with vendor to track selections)Cafeteria menu optionsHealth Indicators / reduced risk factors. Comparison of company aggregate screening measures such as blood pressure, cholesterol, body weight, BMI, etc. before and after a specifiedprogram or campaign.Corporate costs and return on investment.

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Evaluation Samples

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Worksite Toolkit Appendices: Additional resources

Disease Management (1-2 page overview)ArthritisCancerDiabetesHeart Disease & StrokeMental Health *

Samples of Blank DocumentsWorksite assessment *Employee pre-surveyWorksite worksheet of prioritiesWorksite action plan

Additional Resources/Tips PagesWellness at home *Sample policies *Coordinator’s guide *

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What Are We Currently Working on & Next Steps

Toolkit Version #3Expand Regional Trainer ListIncrease “Favorites” listingPromote Governor’s Worksite AwardFall Workshops targeted to Trainers

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Version 3New & Improved

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Regional Trainers

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Regional Trainers

Until …. we control the State!

Ha, Ha, Ha

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Resources: NPA Web Site

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“Favorites Program”An Opportunity to Share

Define type of programPolicyEnvironmental changeBehavior change

What is the focus?HRAPhysical activityNutritionMental healthTobacco use

What went well, what didn’t go well?How did you get good participation?

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Program Favorites-Page 1

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Worksite Award

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So What?Evaluation:

• 3200 hard copies of the kit distributed

• 30,000 downloads kit

• over 250,000 hits

• 15 workshops, 700+ participants;

• Percent of workshop participants who rated the workshop as either good or excellent = 92%

• Number of winners of Governor’s Worksite Wellness Award (2008-10 = 59)

• Annual survey of kit users (N=157 response subset from email list of 700+):

• 1264 worksites reached: 133 own worksites + 1131 outreach worksites

• 204,813 employees reached based on number of worksites and their employees using the kit (117,088) plus number of employees served by outreach agents using the kit (87,725).

• 76% rated kit content as “very useful” or “extremely useful”

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“Wisconsin Worksite Wellness Resource Kit” –

How Can I Get A Copy?

On the Web at:http://dhfs.wisconsin.gov/health/physicalactivity/Sites/Worksitekit.htmOr you can Google “WI Physical Activity”

Via hard copyFill Out Online Order Form

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That’s All Folks

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Questions?