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Designing Effective Wellness Programs Bruce Coulter, CPE Department of Labor and Industries.

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Presentation on theme: "Designing Effective Wellness Programs Bruce Coulter, CPE Department of Labor and Industries."— Presentation transcript:

1 Designing Effective Wellness Programs Bruce Coulter, CPE Department of Labor and Industries

2 My Discussion Wellness/Health Promotion Programs Wellness/Health Promotion Programs Challenges in the Trucking Industry Challenges in the Trucking Industry Designing the Effective Program Designing the Effective Program Business Plan Business Plan Integration Integration Benefits Benefits Culture Culture

3 Workplace Health Promotion in Washington State Current Research Findings Current Research Findings

4 Commercial Truck and Bus Safety Health and Wellness Programs for Commercial Drivers Health and Wellness Programs for Commercial Drivers

5 welcoa.org

6 Why Health Promotion? Reduces costs Reduces costs direct costs: medical insurance, health care, workers’ compensation, accidents, absenteeism direct costs: medical insurance, health care, workers’ compensation, accidents, absenteeism indirect costs: employee job satisfaction and driver retention indirect costs: employee job satisfaction and driver retention Increases Increases Morale, productivity, overall health Morale, productivity, overall health

7 Wellness/Health Promotion Wellness/Health Promotion Employee Health and Wellness (H&W) programs have been around for the past 30 years Employee Health and Wellness (H&W) programs have been around for the past 30 years Driven by: Driven by: Concern for employees Concern for employees Need to control healthcare/workers’ comp costs Need to control healthcare/workers’ comp costs Desire to decrease absenteeism, lost productivity Desire to decrease absenteeism, lost productivity

8 What Are The Issues? What Are The Issues? Health Risk Factors (characteristics associated with increased rates of disease) Tobacco use Tobacco use Obesity Obesity Lack of physical activity Lack of physical activity High Blood Pressure High Blood Pressure Poor eating habits Poor eating habits Use of alcohol, drugs and other chemical substances Use of alcohol, drugs and other chemical substances Various forms of psychological and job stress Various forms of psychological and job stress

9 CDC 435,000 deaths per year 365,000 deaths per year

10 435,000 + 365,000 = 800,000/416 = 1923 416 1923/365 = 5.27 per day or 2192 people

11 Qantas Gripe Sheets P: Left inside main tire almost needs replacement. P: Left inside main tire almost needs replacement. S: Almost replaced left inside main tire. S: Almost replaced left inside main tire. P: Test flight OK, except auto-land very rough. P: Test flight OK, except auto-land very rough. S: Auto-land not installed on this aircraft. S: Auto-land not installed on this aircraft. P: Something loose in cockpit. P: Something loose in cockpit. S: Something tightened in cockpit. S: Something tightened in cockpit. P: Dead bugs on windshield. P: Dead bugs on windshield. S: Live bugs on back-order. S: Live bugs on back-order. P: Autopilot in altitude-hold mode produces a 200 feet per minute descent. P: Autopilot in altitude-hold mode produces a 200 feet per minute descent. S: Cannot reproduce problem on ground. S: Cannot reproduce problem on ground. P: Evidence of leak on right main landing gear. P: Evidence of leak on right main landing gear. S: Evidence removed. S: Evidence removed.

12 Qantas Gripe Sheets P: DME volume unbelievably loud. P: DME volume unbelievably loud. S: DME volume set to more believable level. S: DME volume set to more believable level. P: Friction locks cause throttle levers to stick. P: Friction locks cause throttle levers to stick. S: That's what they're there for. S: That's what they're there for. P: IFF inoperative. P: IFF inoperative. S: IFF always inoperative in OFF mode. S: IFF always inoperative in OFF mode. P: Suspected crack in windshield. P: Suspected crack in windshield. S: Suspect you're right. S: Suspect you're right. P: Mouse in cockpit. P: Mouse in cockpit. S: Cat installed. S: Cat installed.

13 Qantas Gripe Sheets P: Noise coming from under instrument panel. Sounds like a midget pounding on something with a hammer. P: Noise coming from under instrument panel. Sounds like a midget pounding on something with a hammer. S: Took hammer away from midget. S: Took hammer away from midget. P: Number 3 engine missing. P: Number 3 engine missing. S: Engine found on right wing after brief search. S: Engine found on right wing after brief search. P: Aircraft handles funny. P: Aircraft handles funny. S: Aircraft warned to straighten up, fly right, and be serious. S: Aircraft warned to straighten up, fly right, and be serious. P: Target radar hums. P: Target radar hums. S: Reprogrammed target radar with lyrics. S: Reprogrammed target radar with lyrics.

14 Wellness Program Evolution Traditional wellness programs Traditional wellness programs Topic of the month, non targeted, general wellness topics (nutrition, exercise, stress) Topic of the month, non targeted, general wellness topics (nutrition, exercise, stress) Disease management Disease management Comprehensive campaign on a major health risk Comprehensive campaign on a major health risk Web based Web based On line participation in HRA’s, initiatives, coaching On line participation in HRA’s, initiatives, coaching

15 The Hard Truth The Hard Truth Success is varied and often tied to the efforts of internal champion Success is varied and often tied to the efforts of internal champion Challenge is that H&W is ultimately a personal lifestyle choice Challenge is that H&W is ultimately a personal lifestyle choice Companies can educate, encourage and even incentivize wellness, however, ultimate decision rests with individual Companies can educate, encourage and even incentivize wellness, however, ultimate decision rests with individual Human behavior is very hard to change AND

16 Factors Affecting Trucker Health Long workdays…sitting Long workdays…sitting Whole Body Vibration Whole Body Vibration Static Posture Static Posture Bursts of highly physical work Bursts of highly physical work Poor dietary choices on the road Poor dietary choices on the road Sleep issues Sleep issues Deprivation Deprivation Disruption Disruption Circadian and biological rhythm interruption Circadian and biological rhythm interruption Days, weeks away from home Days, weeks away from home Decentralized Decentralized

17 Most Common H&F Risks for Drivers Poor health habits Poor health habits Driver injuries Driver injuries Driver fatigue Driver fatigue Driver illness Driver illness Regular tobacco use Regular tobacco use Overweight/obese Overweight/obese Hypertension Hypertension Poor eating habits Poor eating habits Lack of physical activity Lack of physical activity Abuse of Abuse of Alcohol prescription and non- prescription drugs OTC cold remedies Energy drinks

18 ATRI Survey of the Greatest Health Risks Facing Drivers ATRI Survey of the Greatest Health Risks Facing Drivers Manager results: 1. Unhealthy diet 2. Obesity 3. Stress 4. Uncontrolled hypertension 5. Sleep disorders 6. Drug/Alcohol use Driver results: 1. Sleep disorders 2. Drug/Alcohol use 3. Stress 4. Obesity 5. Unhealthy diet 6. Uncontrolled hypertension

19 Top H&W Program Activities Top H&W Program Activities Exercise/physical activity opportunities Exercise/physical activity opportunities Nutrition training/information Nutrition training/information Weight management Weight management Nicotine prescriptions Nicotine prescriptions Tobacco cessation Tobacco cessation Responsible alcohol use Responsible alcohol use Cardiovascular disease prevention Cardiovascular disease prevention Medication management Medication management Disease management for issues such as diabetes and hypertension Disease management for issues such as diabetes and hypertension Flu shots Flu shots Fatigue awareness Fatigue awareness Screening for sleep disorders Screening for sleep disorders Focus on ergonomics (cab comfort) Focus on ergonomics (cab comfort)

20 Driver Survey Driver Survey What can be done to get more drivers involved in H&W program? Offering weight room/exercise equipment for drivers Offering weight room/exercise equipment for drivers Start a company sports team Start a company sports team Government mandate on H&W program participation Government mandate on H&W program participation

21 Drivers – Components Offered and Utilized the Most Drivers – Components Offered and Utilized the Most Employee health risk appraisal Nutrition & diet advice/assistance Weight management program Physical fitness programs Blood pressure screening Regular distribution of H&W materials Safe driving practices and promotion of seat belt use Makes healthy food options available Makes healthy food options available Encourages drivers’ family members to participate in H&W programs Ensures all vehicles are maintained in ergonomically sound condition

22 United States Preventive Services Task Force (USPSTF) Hypertension Hypertension Lipid disorders Lipid disorders Obesity Obesity Tobacco use Tobacco use Breast, cervical, colorectal cancers Breast, cervical, colorectal cancers

23 Advisory Council on Immunization Practices (ACIP) Annual Influenza Vaccination for those over 50 Annual Influenza Vaccination for those over 50

24 National Commission on Preventive Priorities Ranked preventive care by health impact and cost-effectiveness Ranked preventive care by health impact and cost-effectiveness Tobacco use screening and cessation programs 42,000 deaths averted annually Tobacco use screening and cessation programs 42,000 deaths averted annually Colorectal screening 14,000 deaths averted annually Colorectal screening 14,000 deaths averted annually Influenza vaccination 12,000 deaths averted annually Influenza vaccination 12,000 deaths averted annually

25 Washington Workers Behavioral Risk Factor Surveillance System (BRFSS) data 76.3% do not eat enough fruits and vegetables 76.3% do not eat enough fruits and vegetables 61.7% are overweight or obese 61.7% are overweight or obese Smoking Smoking 32.4% uninsured 32.4% uninsured 14.8% insured 14.8% insured 3 times as common in homes with annual income 3 times as common in homes with annual income $75,000 $75,000

26 Resources Guide for Community Preventive Services Guide for Community Preventive Services Guide for Community Preventive Services Guide for Community Preventive Services

27 Design of an Effective Program Business Plan (ROI, P/L, PDCA) Business Plan (ROI, P/L, PDCA) Integration Integration Benefits Benefits Culture Culture

28 Business Plan Health Promotion is at the level of Senior Management Team Health Promotion is at the level of Senior Management Team Reports relevant measures regarding the human resource Reports relevant measures regarding the human resource Costs and cost savings using health metrics Costs and cost savings using health metrics Budget to cover all screenings and prevention activities Budget to cover all screenings and prevention activities In current corporate environments capital is distributed by demonstrated need and whether the capital distributed was effectively used to help the bottom line In current corporate environments capital is distributed by demonstrated need and whether the capital distributed was effectively used to help the bottom line Reported in Annual Report to Shareholders Reported in Annual Report to Shareholders

29 Integration New Employee Orientation New Employee Orientation Benefits sign up Benefits sign up Tiered Premiums Tiered Premiums Newsletter to Family Newsletter to Family Annual HRA (mandatory for benefits) Annual HRA (mandatory for benefits) Baseline data Baseline data Benefit programming (free)derived from HRA Results Benefit programming (free)derived from HRA Results

30 Benefits Free Primary, Secondary and Tertiary Prevention Free Primary, Secondary and Tertiary Prevention Free screenings Free screenings Mammography Mammography Colonoscopy Colonoscopy BP BP Cholesterol Cholesterol Free Tobacco Cessation Programs Free Tobacco Cessation Programs Support for existing conditions (HBP, diabetes) Support for existing conditions (HBP, diabetes)

31 Tertiary Prevention Employees who have developed chronic disease need help in managing their disorders…why? Decreased disease, death, health care costs, and productivity losses. Decreased disease, death, health care costs, and productivity losses.

32 Benefits Percent of employee health insurance costs should be consistent with their participation in the program Percent of employee health insurance costs should be consistent with their participation in the program Discounts begin with completion of an HRA Discounts begin with completion of an HRA Discounts increase with participation in relevant programming Discounts increase with participation in relevant programming Full discount after demonstration of reduced risk (lowered BP, smoking cessation) Full discount after demonstration of reduced risk (lowered BP, smoking cessation)

33 Evaluating Effectiveness Employee behavior is often measured by health risk appraisals that have low participation rates and overrepresentation of health-conscious workers Employee behavior is often measured by health risk appraisals that have low participation rates and overrepresentation of health-conscious workers Participants are often compared with nonparticipants, resulting in strong selection bias and overestimation of intervention effect Participants are often compared with nonparticipants, resulting in strong selection bias and overestimation of intervention effect Workplace evaluation efforts often focus either on Workplace evaluation efforts often focus either on inputs such as program delivery that does not capture participation and behavior change inputs such as program delivery that does not capture participation and behavior change disease outcomes, which are slow to change and may be affected by factors outside the intervention. disease outcomes, which are slow to change and may be affected by factors outside the intervention. Pitfalls

34 Evaluating Effectiveness Practitioners working with employers can offer more effective workplace evaluation by: continually tracking intervention delivery and employee participation continually tracking intervention delivery and employee participation measuring relevant behavior change measuring relevant behavior change

35 Incentives Better to remove disincentives than install incentives Better to remove disincentives than install incentives Barrier-reduction interventions, such as eliminating out-of-pocket costs for tobacco use cessation, should take priority for 2 reasons. Barrier-reduction interventions, such as eliminating out-of-pocket costs for tobacco use cessation, should take priority for 2 reasons. 1. they have the broadest reach — to workers, dependents, and retirees — and can affect all workers, even those who do not participate in interventions 2. financial barriers are most important for low-income workers with limited means

36 Benefits Wellness Programming should be part of the benefits package Wellness Programming should be part of the benefits package HRA should be a requirement for employees to receive benefits HRA should be a requirement for employees to receive benefits Tobacco/alcohol cessation should be fully funded Tobacco/alcohol cessation should be fully funded Screenings should be fully funded Screenings should be fully funded

37 Culture Culture comes from management walking their talk. Culture comes from management walking their talk. Signs don’t work, actions do. Signs don’t work, actions do. Celebrating success, learning from failure. Celebrating success, learning from failure. If your drivers are your most valuable resource, they need to feel that. If your drivers are your most valuable resource, they need to feel that.

38 Other areas to address Depression Depression MSDs MSDs Sleep Disorders Sleep Disorders Stress Stress Substance Abuse Substance Abuse

39 How Do I Get Started? Remember – H&W program does not need to be all encompassing to begin to address driver health issues Remember – H&W program does not need to be all encompassing to begin to address driver health issues Small, incremental steps will make a difference Small, incremental steps will make a difference Make sure commitment to improving driver H&W starts at the top and is communicated as such Make sure commitment to improving driver H&W starts at the top and is communicated as such

40 How Do I Get Started? Analyze health care and w/c claims to identify most prevalent health risks Analyze health care and w/c claims to identify most prevalent health risks Develop your comprehensive plan with representatives from labor and management and your champion Develop your comprehensive plan with representatives from labor and management and your champion Scope Scope Mission statement, measureable goals and objectives Mission statement, measureable goals and objectives Measurement Measurement Realistic budget Realistic budget Criteria for success (five year plan) Criteria for success (five year plan)

41 How Do I Get Started? Implement an HRA which will be mandatory if employees are to receive free health benefits Implement an HRA which will be mandatory if employees are to receive free health benefits Legal needs to weigh in on HIPAA, and health insurance security. Legal needs to weigh in on HIPAA, and health insurance security.

42 Starting Small Mail monthly H&W info to drivers’ homes for driver and family Mail monthly H&W info to drivers’ homes for driver and family Dedicate section of company newsletter to H&W issues Dedicate section of company newsletter to H&W issues Remember the power of peer pressure and peer influence - drivers provide the best testimonials for one another Remember the power of peer pressure and peer influence - drivers provide the best testimonials for one another Meet employees where they are. Meet employees where they are.

43 Stages of Change Pre-contemplation Pre-contemplation Contemplation Contemplation Preparation Preparation Action Action Maintenance Maintenance Termination Termination

44 It Didn’t Work… Not convenient/not accessible, particularly for over-the-road drivers Not convenient/not accessible, particularly for over-the-road drivers Takes too long to see the results – set goals too high Takes too long to see the results – set goals too high Lack of management support (management not healthy either) Lack of management support (management not healthy either) No one assigned to manage the wellness program No one assigned to manage the wellness program Failure to involve front-line management Failure to involve front-line management Championing the program often doesn’t start at the top Championing the program often doesn’t start at the top Actions don’t support the message (e.g., serving donuts or pizza as a snack or meal during wellness training) Actions don’t support the message (e.g., serving donuts or pizza as a snack or meal during wellness training)

45 It Didn’t Work… Champion gets program going and then gets promoted or leaves; no depth in management to carry on Champion gets program going and then gets promoted or leaves; no depth in management to carry on Missing a clear statement of philosophy, purpose and goals Missing a clear statement of philosophy, purpose and goals Ineffective communication Ineffective communication Failure to involve employee’s spouse/family - drivers need support on home front to reinforce the message, change diet, reduce stress, etc. Failure to involve employee’s spouse/family - drivers need support on home front to reinforce the message, change diet, reduce stress, etc. Unrealistic budget Unrealistic budget Work culture/environment is unsupportive – vending machines, smoking areas Work culture/environment is unsupportive – vending machines, smoking areas

46 It Will Work… Do your homework to know what the H&W issues are Do your homework to know what the H&W issues are Set realistic goals and objectives AND performance measures Set realistic goals and objectives AND performance measures Commitment must be top-down Commitment must be top-down Smart small and dedicate resources (human and financial) to each step Smart small and dedicate resources (human and financial) to each step Empower drivers to be a part of the process including determination of program components Empower drivers to be a part of the process including determination of program components Encourage and foster teamwork among drivers toward common goal Encourage and foster teamwork among drivers toward common goal

47 My Recommendations Find and maintain a champion Find and maintain a champion Budget for programs completely Budget for programs completely If you believe in programs, fully fund them If you believe in programs, fully fund them Eliminate dis-incentives Eliminate dis-incentives Meet people where they are Meet people where they are Stay with it Stay with it Understand that the participation rate will be low for some time Understand that the participation rate will be low for some time Integrate wellness and safety and health, they belong together anyway (Health and Productivity). Integrate wellness and safety and health, they belong together anyway (Health and Productivity). Wellness is a performance measure. Wellness is a performance measure.

48 Thanks for being here! Any Questions? thank you for listening Do you have questions?


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