Successful Engagement Strategies and Return on Investment with Maryam J. Tabrizi, MS, CHES and Ron Goetzel, PhD

Successful Engagement Strategies

and Return on Investment

Improving Worksite Health

Ron Z. Goetzel, Ph.D. Emory University & Truven Health Analytics

Maryam J. Tabrizi, M.S. Truven Health Analytics

• Describe the main findings from the HERO II study recently published in

Health Affairs examining the relationships between ten modifiable health

risk factors and medical cost

• Demonstrate an understanding on how increasing engagement can

improve return on investment (ROI)

• Describe ways to increase engagement in worksite health promotion

programs

2

LEARNING OBJECTIVES

Truven Health Analytics, in partnership with the Emory University Institute

for Health and Productivity Studies (IHPS), conducts empirical research on

the relationship between employee health and work-related productivity,

our research helps inform public and private decision makers on issues

related to health and productivity management (HPM)

OUR MISSION: To bridge the gap between academia, the business

community, and healthcare policy world by bringing academic resources

into policy debates and day-to-day business decisions, and bringing health

and productivity management issues into academia

3

BACKGROUND

THINK ABOUT IT…BEFORE GOING BANKRUPT… WHAT DID KODAK THINK AMERICANS WANTED?

4

Ref: Asch and Volpp, NEJM, 367:10, Sep. 6, 2012, 888

WHAT DID AMERICANS REALLY WANT?

5

WHAT DOES THE HEALTHCARE INDUSTRY THINK AMERICANS WANT—MORE HEALTH CARE?

6

OR MORE HEALTH?

7

WHERE IS THE VALUE IN HEALTH CARE?

8

WHAT ARE WE GETTING FOR OUR MONEY

9

10

WHAT PROBLEM ARE WE ATTEMPTING TO SOLVE? WE’RE SPENDING A BOATLOAD OF MONEY ON SICK CARE

• The United States spent $2.59 trillion in

healthcare in 2010, or $8,402 for every man,

woman and child.

• Government paid $1.2 trillion (45% of total),

private businesses financed $534 billion (21%).

Employers contributed 77% to health insurance

premiums.

• Health expenditures as percent of GDP:

7.2 % in 1970

17.9 in 2010

19.3% in 2019 (est)

Source: Martin et al., Health Affairs, 31:1, January 10, 2012, 208

IT’S NOT JUST THE EMPLOYER’S PROBLEM EMPLOYERS’ AND EMPLOYEES’ COSTS ARE RISING RAPIDLY

11

2005 2010 Percent

Increase

Worker Contribution $2,713 $3,997 47%

Employer Contribution $8,167 $9,773 20%

Total $10,880 $13,770 27%

Average Annual Health Insurance Premiums and

Worker Contributions for Family Coverage, 2005-2010

Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2005-2010. http://ehbs.kff.org/

http://freelist.mcol.com/t/19564549/66620006/991110/0/

12

IT SEEMS SO LOGICAL…

If you improve the health and well being of your employees…

…quality of life improves

…health care utilization is reduced

…disability is controlled

…productivity is enhanced

SEEMS LIKE A NO BRAINER – RIGHT?

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14

WHAT IS THE EVIDENCE BASE?

• A large proportion of diseases and disorders is preventable. Modifiable health risk

factors are precursors to a large number of diseases and disorders and to

premature death (Healthy People 2000, 2010, Amler & Dull, 1987, Breslow, 1993,

McGinnis & Foege, 1993, Mokdad et al., 2004)

• Many modifiable health risks are associated with increased health care costs

within a relatively short time window (Milliman & Robinson, 1987, Yen et al., 1992,

Goetzel, et al., 1998, Anderson et al., 2000, Bertera, 1991, Pronk, 1999)

• Modifiable health risks can be improved through workplace sponsored health

promotion and disease prevention programs (Wilson et al., 1996, Heaney &

Goetzel, 1997, Pelletier, 1991, 1993, 1996, 1999, 2001, 2005, 2009, 2011)

• Improvements in the health risk profile of a population can lead to reductions in

health costs (Edington et al., 2001, Goetzel et al., 1999)

• Worksite health promotion and disease prevention programs save companies

money in health care expenditures and produce a positive ROI (Johnson &

Johnson 2002, Citibank 1999-2000, Procter and Gamble 1998, Chevron 1998,

California Public Retirement System 1994, Bank of America 1993, Dupont 1990,

Highmark, 2008, Johnson & Johnson, 2011)

LEADING A HEALTHY AND PRODUCTIVE LIFE – NOT EASY

15

GOOD NEWS – WORKSITE HEALTH PROMOTION WORKS!

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CDC COMMUNITY GUIDE TO PREVENTIVE SERVICES REVIEW – AJPM, FEBRUARY 2010

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18

SUMMARY RESULTS AND TEAM CONSENSUS

Outcome

Body of

Evidence

Consistent

Results

Magnitude of

Effect Finding

Alcohol Use 9 Yes Variable Sufficient

Fruits & Vegetables

% Fat Intake

9

13

No

Yes

0.09 serving

-5.4%

Insufficient

Strong

% Change in Those

Physically Active

18 Yes +15.3 pct pt Sufficient

Tobacco Use

Prevalence

Cessation

23

11

Yes

Yes

–2.3 pct pt

+3.8 pct pt

Strong

Seat Belt Non-Use 10 Yes –27.6 pct pt Sufficient

19

Outcome

Body of

Evidence

Consistent

Results Magnitude of Effect Finding

Diastolic blood pressure

Systolic blood pressure

Risk prevalence

17

19

12

Yes

Yes

Yes

Diastolic:–1.8 mm Hq

Systolic:–2.6 mm Hg

–4.5 pct pt

Strong

BMI

Weight

% body fat

Risk prevalence

6

12

5

5

Yes

No

Yes

No

–0.5 pt BMI

–0.56 pounds

–2.2% body fat

–2.2% at risk

Insufficient

Total Cholesterol

HDL Cholesterol

Risk prevalence

19

8

11

Yes

No

Yes

–4.8 mg/dL (total)

+.94 mg/dL

–6.6 pct pt

Strong

Fitness 5 Yes Small Insufficient


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Outcome

Body of

Evidence

Consistent

Results

Magnitude of

Effect Finding

Estimated Risk 15 Yes Moderate Sufficient

Healthcare Use 6 Yes Moderate Sufficient

Worker Productivity 10 Yes Moderate Strong

WHAT ABOUT ROI? CRITICAL STEPS TO SUCCESS

Reduced Utilization

Risk Reduction

Behavior Change

Improved Attitudes

Increased Knowledge

Participation

Awareness

Financial ROI

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HEALTH AFFAIRS ROI LITERATURE REVIEW Baicker K, Cutler D, Song Z. Workplace Wellness Programs Can Generate Savings. Health Aff (Millwood). 2010; 29(2). Published online 14 January 2010.

22

RESULTS - MEDICAL CARE COST SAVINGS

Description N Average ROI

Studies reporting costs and

savings

15 $3.37

Studies reporting savings only 7 Not Available

Studies with randomized or

matched control group

9 $3.36

Studies with non-randomized or

matched control group

6 $2.38

All studies examining medical

care savings

22 $3.27

23

RESULTS – ABSENTEEISM SAVINGS

Description N Average ROI

Studies reporting costs and

savings

12 $3.27

All studies examining

absenteeism savings

22 $2.73

24

J&J STUDY – HEALTH AFFAIRS, MARCH 2011

25

HEALTH RISKS – BIOMETRIC MEASURES -- ADJUSTED

Results adjusted for age, sex, region * p<0.05 ** p<0.01

26

HEALTH RISKS – HEALTH BEHAVIORS -- ADJUSTED


27

HEALTH RISKS – PSYCHOSOCIAL -- ADJUSTED


28

ADJUSTED MEDICAL AND DRUG COSTS VS. EXPECTED COSTS FROM COMPARISON GROUP

Average Savings 2002-2008 = $565/employee/year

Estimated ROI: $1.88 - $3.92 to $1.00

29

HERO STUDY – FIRST PUBLISHED IN 1998

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31

UPDATED STUDY PUBLISHED IN 2012

HERO STUDY UPDATE: November 2012

1998 2012

Data collection period 1990-1995 2005-2009

Claims data (MarketScan®) Medical Medical and Pharmacy

Enrollment Health Plan Health Plan

HRA StayWell StayWell

“N” Employees 46,026 92,486

Person Years 113,963 272,834

Methods Truven Health/HERO Truven Health/HERO (enhanced)

Publication JOEM Health Affairs

Sponsor HERO ASH/HealthyRoads

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VARIABLES

• Outcome Variables

– Annualized medical utilization and expenditures

• Total allowed charges (inpatient, outpatient, and pharmaceutical),

including both the employer and employee shares of costs

• Costs were inflation-adjusted to 2009 U.S. dollars using the

general Consumer Price Index from the Bureau of Labor

Statistics

• Predictors- Health Risks

Alcohol use Body weight, height, BMI

Tobacco use Diet/nutrition

Stress level Physical activity

Depression Blood glucose

Blood pressure (systolic and diastolic)

Total Cholesterol

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DESCRIPTIVE RESULTS SUMMARY

High Risk Category Prevalence: HERO I Prevalence: HERO II

Poor Exercise Habits 32% 36%

Obesity 20% 32%

Poor Nutritional Habits 20% 64%

High Stress 19% 17%

Current Tobacco User 19% 22%

High Cholesterol 19% 10%

High Blood Glucose 5% 10%

High Alcohol Use 4% 5%

High Blood Pressure 4% 8%

Depression 2% 11%

34

RISK-COST IMPACTS- HERO II

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EXHIBIT 1 Average Unadjusted And Adjusted Medical Expenditures, In 2009 Dollars, By Risk

Levels

Risk measure

Risk

level

Unadjusted

means ($)

Adjusted

means ($)

Unadjusted

difference

(%)

Adjusted difference

(% )

Depression High 6,207 6,738 59.1 48.0

Lower 3,902 4,553

Blood glucose High 6,532 6,849 70.0 31.8

Lower 3,842 5,196

Blood pressure High 5,264 5,734 27.4 31.6

Lower 4,132 4,356

Body weight High 4,956 5,078 41.7 27.4

Lower 3,498 3,988

Tobacco use High 4,192 4,184 10.8 16.3

Lower 3,784 3,597

Physical inactivity High 4,477 4,582 26.6 15.3

Lower 3,537 3,976

Stress High 5,024 5,249 13.0 8.6

Lower 4,444 4,836

Cholesterol High 4,780 4,913 2.0 -2.5

Lower 4,688 5,037

Nutrition and eating

habits High 3,245 3,261

-23.2 -5.2

Lower 4,226 3,440

Alcohol consumption High 3,857 3,843 -3.94 -9.48

Lower 4,015 4,246

COST IMPACTS: HERO I VS. HERO II

Difference in Medical Expenditures: High-Risk vs. Lower-Risk Employees

- 20

0

20

40

60

80

100

HERO

HERO II

Pe

rce

nt

36

HERO II: IMPACT OF COEXISTING MULTIPLE RISK FACTORS ON COST

37

with multiple risk factors

Without any of the risk factors %differerence

High risk for heart disease $10,134 $3,232 213.57%

High risk for stroke $6,137 $3,786 62.09%

High risk for psychosocial problems $6,165 $3,838 60.62% Risk-free individual is estimated to have medical expenditures of $3,207

Risks for heart disease include: tobacco use, high blood pressure, high blood glucose, high cholesterol, lack of exercise, obesity and stress

Risks for stroke include: tobacco use, high blood pressure, high cholesterol, and stress

Risks for psychosocial problems include: stress and depression

37

38

Estimated Effect of Each Risk Category on Annual Medical Expenditures, Independent of All other Risk Categories and Controlling for Covariate Factors*

Risk Category

Estimated Annual Effect Per High Risk Person ($)

Prevalence: Number of People at High Risk

High-Risk Group Annual Effect (Effect Per High_Risk Person x Prevalence) ($)

High-Risk Group Annual Effect as Percent of Annual Total Expenditures

High_risk Group Annual Effect on a Per Capita Basis (High-Risk Group Annual Effect/ 92486 Sample Size) ($)

Stress Level 413 8582 3,544,366 0.97% 38.32

Current Tobacco Use 587 16735 9,823,445 2.68% 106.22

Body Weight 1091 29416 32,092,856 8.76% 347.00

Exercise Habits 606 27251 16,514,106 4.51% 178.56

Blood Glucose Level 1653 5823 9,625,419 2.63% 104.07

Depression 2184 5427 11,852,568 3.24% 128.16

Blood Pressure 1378 5423 7,472,894 2.04% 80.80

Excessive Alsohol Use -402 3213 -1,291,626 -0.35% -13.97

Cholesterol -124 4734 -587,016 -0.16% -6.35

Nutritional Habits -179 38964 -6,974,556 -1.90% -75.41

Total expenditure attributable to high risk 82,072,456 22.40% 887.40

*The annual effect figures, both per capita and overall, are the effect of each of the risk categories, independent of all other risk categories and

coveriate factors. Expenditures are expressed in constant 2009 dollar figures. Total annual expenditures for the ASH

study sample were $366,373,301.

HERO II: ESTIMATED EFFECT OF EACH RISK CATEGORY ON ANNUAL MEDICAL

EXPENDITURES

Identifying “Best Practices” in Workplace Health Promotion: What Works?

Source: Goetzel RZ, Shechter D, Ozminkowski RJ, Reyes M, Marmet PF, Tabrizi M, Chung

Roemer E. Critical success factors to employer health and productivity management efforts:

Findings from a benchmarking study. Journal of Occupational and Environmental Medicine.

(2007) February; 49:2, 111-130.

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Health Promotion Programs — What Works?

Leadership Commitment

• Leading by example – with buy-in

by middle managers

• “Healthy company” norm/culture

• Explicit connection to the core

principles of the organization

• Employee-driven advisory board

• Specific program goals and

objectives – with realistic

expectations

• Alignment of organizational, HR

and health promotion

policies/practices

• Sustainability – future orientation

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Incentives

• Incentives to participate (not

change biometrics)

• Accountability at all levels –

linked to rewards

• Effective marketing and

communication (multi-

channel)

42


Effective Screening and Triage

• Casting a wide net to identify

the highest risk individuals

• Providing “public health”

interventions to keep people at

low risk

• Triaging individuals into

programs that produce greatest

impact/payoff

• Protecting confidentiality

• Coordinating with providers and

community resources

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• Theory and evidence-based

(e.g., Bandura, Prochaska,

Lorig, Strecher, Glasgow)

• Tailored and individualized

interventions

• Balancing high touch with high

tech

• Individual and

Environmental/ecological

interventions

• Effective, reliable, valid tools

State-of-the-Art

Intervention Programs

44


Effective Implementation

• Integrate programs – insure vendor

(stakeholder) engagement

• Accessible/attractive programs

• Start simple – pilot – grow on success

• Multi-component -- variety of topics

and engagement modalities

• Integrate staff into the fabric of the

organization

• Spend the right amount of money to

achieve a desired ROI

45


Integrated Data

Systems

Explicit connection of results to core

values

Measure, manage, and

measure again Rigorous

methods that stand up to peer review

Regular

communication

of results

Excellent Evaluation

ENGAGEMENT – DOES IT REALLY MATTER?

46

Health and Productivity Management Return on Investment Tool

PURPOSE OF THE MODEL

HOW TO USE THE MODEL

These cells contain model inputs that can be changed (click in the cell and type a new value).

These cells contain values calculated from the model inputs and cannot be changed.

These cells contain values that are fixed and cannot be changed.

Description of Model Input Pages:

Health Promotion Program Specify basic model settings including program cost and employee participation rate.

Employee Characteristics Specify demographic characteristics of the employee population.

Baseline Risk & Annual Change Specify the baseline risk level and annual rate of change.

Annual Rate of Productivity Loss Productive hours lost by risk factor from literature review.

Description of Model Result Pages:

Summary of Results Total medical & productivity savings and program cost with ROI (return on investment).

Predicted Medical Expenditure Medical cost savings per participant tabulated by risk factor and year of program operation.

Projected Productivity Loss Savings from improved productivity per participant tabulated by risk factor and year.

Risk Profile with No Program Percentage of employees at risk tabulated by risk factor & year with No Program.

Risk Profile with Health Promotion Percentage of employees at risk tabulated by risk factor & year with Health Promotion Program.

Savings by Risk Factor Cumulative medical and productivity savings per participant tabulated by risk factor.

Total Savings by Risk Factor Cumulative medical and productivity savings for all employees tabulated by risk factor.

Description of Simulation Tool & Appendix:

Scenario Simulation Specify 1- 5 scenarios by changing the model inputs and run them all automatically.

Appendix Supplemental information including default values, regression model, and risk definitions.

This tool will help you forecast the return on investment (ROI) you can expect by investing in programs that improve the health of

your employees. The tool is based on research showing an association between employees’ health risks and health care costs and

worker productivity. By reducing these risks, you can thereby expect to see cost reductions. But you also need to consider how

much money you invest in order to achieve these reductions.

The model opens with pages that specify demographic and health risk characteristics of an employee population then presents

pages of results, which are described below. Each of the pages can be viewed by pressing the navigation buttons on the left.

Questions about the ROI model: If you have questions about the use of this model, please contact Dr. Ron Z. Goetzel, Vice

President, Consulting and Applied Research, Truven Health Analytics, at [email protected].

Truven Health Analytics Proprietary Information - Subject to Section 6 (Ownership and Confidentiality) of the Services Agreement

between Truven Health Analytics Inc. and StayWell Health Management, LLC dated December 22, 2011.

Home

Employee Characteristics

Baseline Risk & Annual Change

Annual Rate of Productivity Loss

Summary of Results

Predicted Medical Expenditure

Projected Productivity Loss

Risk Profile with No Program

Risk Profile with Health Promotion

Savings by Risk Factor

Total Savings by Risk Factor

Scenario Simulation

Appendix

Health Promotion Program

Input Sheet Simulation

Home Page

DATA INPUTS

47

0.62 Health and Productivity Management Return on Investment Tool

Specify the basic model settings

Number of employees in the base year? 10,000 Press a button to restore default values

Annual % point change in number of employees? 0.0%

Medical payment per employee in the base year? $4,692

Please specify an average daily wage. $190.17

Participation rate of employees in the program? 62.0%

Annual program cost per employee? $156.00

Time horizon (1 to 10 years)? 5

Number of years until program levels off? 5

Discount rate applied for ROI calculation? 3.0%

Choose the type of analysis: TRUE

Home




Summary of Results







Scenario Simulation

Appendix

Health Promotion Program Restore Defaults from the HERO 2 Study

Restore Defaults from Credible National Sources


48


CHANGES IN THE RISK PROFILE

49


Specify the baseline risk level and annual rate of change with and without a health promotion program

Baseline Annual Change (% points) Change in

Risk No Program With Program Impact(%)

Obesity 31.8% 0.7% -0.5% 100.0%

(i.e., annual change with program in year x+1 / year x)

High Blood Pressure 7.6% -0.3% -2.8%

High Total Cholesterol 9.9% -0.5% -1.0% Press a button to restore default values for Baseline Risk

High Blood Glucose 9.5% 0.3% -3.0%

Poor Nutrition/Eating Habits 64.1% -0.1% -6.6%

Press a button to restore defaults for Annual Change

Physical Inactivity 36.4% -0.6% -3.7% No health promotion program

Tobacco Use 21.5% -0.7% -1.2%

High Alcohol Consumption 4.9% -0.1% -2.0% After implementation of a health promotion program

High Stress 17.4% 0.2% -3.4%

Depression 10.9% 0.2% -2.0%

A blank cell indicates there are no estimates from the literature that are statistically significant.

Biometric

Behavioral

Psychosocial

Home




Summary of Results







Scenario Simulation

Appendix


Restore Baseline Risk from the HERO 2 Study

Restore Baseline Risk from Credible National Sources

Restore Change with No Program from National Sources

Restore Change with Program from CDC Community Guide

Restore Change with Program from Recent Published Studies

Restore Change with No Program to 0.0%


RESULTS – 62% PARTICIPATION RATE MEDICAL ROI = $1.74 TO $1.00

50


Summary of results

With the current model settings the ROI is $1.74 for the cost of medical care and $3.21 for increased productivity.

No With a Break

Cumulative savings, program cost, and ROI (all discounted): Program Program Even*

Cumulative medical cost, no program $215,360,798 Obesity 0.7% -0.5% -1.1%

Cumulative medical savings, with program $12,444,468 High Blood Pressure -0.3% -2.8% -1.1%

Cumulative productivity savings, with program $22,967,121 High Total Cholesterol -0.5% -1.0% -1.1%

Cumulative program cost $7,144,343 High Blood Glucose 0.3% -3.0% -1.1%

Net Present Value (NPV), medical care $5,300,125 Poor Nutrition/Eating Habits -0.1% -6.6% -1.1%

NPV, medical + productivity $28,267,246 Physical Inactivity -0.6% -3.7% -1.1%

Return on Investment (ROI), medical care $1.74 Tobacco Use -0.7% -1.2% -1.1%

ROI, workplace productivity $3.21 High Alcohol Consumption -0.1% -2.0% -1.1%

ROI, medical care + workplace productivity $4.96 High Stress 0.2% -3.4% -1.1%

Break even program cost, medical care only $271.73 Depression 0.2% -2.0% -1.1%

Break even program cost, productivity only $501.50 * Annual change in risk that achieves ROI=$1.00 for medical care.

Break even program cost, medical + productivity $773.23

Current model settings:

Total employees at baseline 10,000

Annual medical cost/employee, baseline $4,692

Annual program cost/employee, baseline $156.00

Employee participation rate 62.0%

Time horizon (yrs) 5

Program levels off (yrs) 5

Discount rate 3.0%

Current annual rate

of change in risk:Home




Summary of Results







Scenario Simulation

Appendix


Click to calculate break-even risk reduction

Save a Copy of the Model

Save a PDF Copy of the Results


RESULTS – 35% PARTICIPATION RATE – MEDICAL ROI = $0.98 TO $1.00

51


Summary of results

With the current model settings the ROI is $0.98 for the cost of medical care and $1.81 for increased productivity.

No With a Break

Cumulative savings, program cost, and ROI (all discounted): Program Program Even*

Cumulative medical cost, no program $215,360,798 Obesity 0.7% -0.5% -1.1%

Cumulative medical savings, with program $7,025,103 High Blood Pressure -0.3% -2.8% -1.1%

Cumulative productivity savings, with program $12,965,310 High Total Cholesterol -0.5% -1.0% -1.1%

Cumulative program cost $7,144,343 High Blood Glucose 0.3% -3.0% -1.1%

Net Present Value (NPV), medical care -$119,240 Poor Nutrition/Eating Habits -0.1% -6.6% -1.1%

NPV, medical + productivity $12,846,070 Physical Inactivity -0.6% -3.7% -1.1%

Return on Investment (ROI), medical care $0.98 Tobacco Use -0.7% -1.2% -1.1%

ROI, workplace productivity $1.81 High Alcohol Consumption -0.1% -2.0% -1.1%

ROI, medical care + workplace productivity $2.80 High Stress 0.2% -3.4% -1.1%

Break even program cost, medical care only $153.40 Depression 0.2% -2.0% -1.1%

Break even program cost, productivity only $283.10 * Annual change in risk that achieves ROI=$1.00 for medical care.

Break even program cost, medical + productivity $436.50

Current model settings:

Total employees at baseline 10,000

Annual medical cost/employee, baseline $4,692

Annual program cost/employee, baseline $156.00

Employee participation rate 35.0%

Time horizon (yrs) 5

Program levels off (yrs) 5

Discount rate 3.0%

Current annual rate

of change in risk:Home




Summary of Results







Scenario Simulation

Appendix


Click to calculate break-even risk reduction

Save a Copy of the Model

Save a PDF Copy of the Results


INCREASING ENGAGEMENT– ENLIST SENIOR/MIDDLE LEADERSHIP SUPPORT

• Get out the message – you have my permission to lead a healthy

lifestyle -- e.g., billing codes on time sheets

• Hold managers accountable – through feedback, report cards,

health index scores (Dow, PepsiCo, PPG, Novartis)

• Recognize best practices, and best practitioners, with tangible and

intangible rewards

• Train the boss – provide a “how to” guide and hand hold

• For leaders, walk the talk – participate in programs and be visible

• Look and act the part -- be a role model for others to emulate

• Communicate, market, advertize, brand, and “sell” health

• Treat health as you would any other business investment – with a

plan, goals, benchmarks, and budget

52

INCREASING ENGAGEMENT– CREATE A SUPPORTIVE ENVIRONMENT AND CULTURE

• Indoor/campus-wide smoking bans

• Vending machines – containing a preponderance of healthy foods,

with subsidies for healthy items

• Hide the unhealthy stuff – highlight the good stuff

• Insist on healthy foods at company-sponsored events

• Create marked walking trails

• Provide fitness centers/rooms

• Build bike racks/storage areas

• Make available shower facilities

• Provide stairwell signs/posters—point of decision prompts

• Offer walking desks (scheduled via Outlook)

• Create a work environment that encourages health

53

INCREASING ENGAGEMENT– WORK FLEXIBILITY, SOCIAL NORMS, AND INCENTIVES

• Allow for flexible work schedules and telecommuting

• Make available health improvement programs during odd shifts

• Publish statistics on prevalence of healthy lifestyles – assuming

more than 50% practice them

• Make health social – create affinity groups, competitions, enlist

mavens, influencers, and persuaders

• Recruit health ambassadors (champions/advocates) – reward and

recognize them

• Incent behaviors, movement toward goal achievement, and

outcomes (carefully)

• Connect health and safety

54

INCREASING ENGAGEMENT– LEVERAGE BEHAVIORAL ECONOMICS

• Healthy snacks as the default

• Exercise commitment contracts

• Forcing active choices – pre-commitment

– planning future menus – I will choose fruit

instead of a donut, tomorrow

– I will get my flu shot on November 15

• Encourage competitions and games – make health

fun

55

SO, WHAT CAN YOU DO TO INCREASE ENGAGEMENT?

Promote physical activity

• Walking trails, open stairwells, slow down the elevator, promote public transport, subsidize gym membership, provide pedometers, sponsor competitions, work with your local schools

Promote access to healthy foods

• Make the healthy choices the easy choices, label “healthy” choices, only allow healthy food at company-sponsored events, change vending machine contractors, sell half portions in the cafeteria, give people smaller plates, provide free water, make people wait for unhealthy food, promote and subsidize nutritious food, provide healthy cupboards, pay for microwaves and refrigerators, educate

Advocate for legislation that supports healthy lifestyles

• Soda taxes, physical activity in schools, ensure food advertizing to children is responsible, support outdoor facilities and parks, end subsidies for unhealthy foods and increase subsidies for healthy foods, build bike and walking trails

Build a healthy company culture

• Change the norms of the organization, reward employees and managers for healthy lifestyles, provide social support for employees who want to lose weight, make the workplace fun

56

57

YOOHOO!!

Focusing on improving the health and

quality of people’s lives will improve the

productivity and competitiveness of our

workers and citizens.

A growing body of scientific literature

suggests that well-designed, evidence-

based health promotion and disease

prevention programs can:

• Improve the health of workers and lower their

risk for disease;

• Save businesses money by reducing health-

related medical losses and limiting absence

and disability;

• Heighten worker morale and work relations;

• Improve worker productivity; and

• Improve the financial performance of

organizations instituting these programs.

Documents

Successful Engagement Strategies and Return on Investment with Maryam J. Tabrizi, MS, CHES and Ron Goetzel, PhD