Employee Health Screening

Employee Health and Wellness Program evaluation is critical for effective Wellness and will help you get Senior Management support.

Why evaluate your Employee Health and Wellness Program?

Employee Health and Wellness Program evaluation answers these questions:
• What change(s) occurred in the target population?
• ‘What’s in it’ for Senior Management?
• Are the resources that are being used worth the outcomes that are achieved?
• Were Employee Health and Wellness Program outcomes expected? (Unexpected outcomes may have occurred.)
• What Employee Health and Wellness Program areas need improvement?

Employee Health and Wellness Program Fact of Life:

Employee Health and Wellness Program evaluation left to “chance” or until “there is time” will never happen.

• Employee Health and Wellness Program evaluation should be considered as an essential part of the whole plan for Wellness and not as something extra.

Where do you start?

Keep it simple. Employee Health and Wellness Program evaluation does not have to be complicated.
• Get baseline information.
• Baseline information is the health status of the target population at the beginning of the Employee Health and Wellness Program.
• Start by collecting just 3 or 4 primary items as the baseline. You will have better success collecting follow-up information later if you only need to get a few pieces of information.
• Don’t rely only on health indicators that require lab evaluation. Also use self-report information and health indicators that are measurable without lab tests.

• Collect information that relates to readiness.
• You should always be ready to communicate to leadership the ways that your Employee Health and Wellness Program impacts readiness. Plan ahead to collect information that will demonstrate this connection.
• Think like Senior Management: what Employee Health and Wellness Program outcomes will be important from Senior Management point of view?

• It’s never too late to incorporate Employee Health and Wellness Program evaluation into Employee Health and Wellness Programs.
• If your Employee Health and Wellness Program is already up and running and you didn’t plan for information collection ahead of time, start collecting information NOW.
• If you don’t have baseline information, then collect interim information and compare that to end-of-program information.
• Or, you can compare final Employee Health and Wellness Program outcomes to similar initiatives elsewhere.

If you can’t make any comparisons to other information, use resources like The Community Guide (http://www.thecommunityguide.org/ ) that have already evaluated the effectiveness of Employee Health and Wellness Program components. Compare the components of your Employee Health and Wellness Program to those that have been proven effective elsewhere.

Think ahead: what unexpected challenges might come up as you implement your Employee Health and Wellness Program? How could you adapt and change the Employee Health and Wellness Program to meet those challenges?

• Consider the “what if’s?”

• What if your classroom space is suddenly no longer available?
• What if you can’t hold the Wellness Fair in the usual place?
• Have a ‘Plan B’ (or even Plan C or Plan D) in mind for when the “what if’s” happen.

• Build a team that can help with the Employee Health and Wellness Program
• Who else could teach the health education class if the regular instructor cancels at the last minute?
• Know what areas of expertise your staff has besides their ‘main’ job. By way of example, find out who has excercise instructor credentials besides just the physical therapist.
• Don’t wait for a crisis before you build a network of staff members that you can call on.

• Be ready to roll your sleeves up
• Jump in to fill a gap if you need to.
• YOU may have to help restock the milk case in the dining center when the Dairy Month ‘Milk Mustache’ contest results in increased sales during lunch.

• Be willing (and ready) to respond to feedback about the Employee Health and Wellness Program
• Get participant feedback while the Employee Health and Wellness Program is ongoing. Then be ready to adapt to those suggestions.
• By way of example, if kids in a pediatric obesity Employee Health and Wellness Program fight the idea of completing physical excercise logs, then get a verbal summary of their activity for the week instead.

• Simplify Employee Health and Wellness Program
• If part of your Employee Health and Wellness Program is not working, try making that part less complicated.
• By way of example, if getting follow-up information is not going the way you planned, then make the process to get information easier OR decrease the number of pieces of information that you collect.

• Use lemons to make lemonade
• What do you do when the Employee Health and Wellness Program doesn’t turn out exactly as you planned? Look for what did turn out. Often, the ‘unexpected outcomes’ produce positive results.
• By way of example, one installation’s database to collect sick call data was made obsolete by a regional system. However, the installation database was able to be used in a different way to track vaccination information that improved delivery of care to Employees.
• At another installation, world events halted a new physical training program. Instead, Employee Health and Wellness Program materials were made into a excercise guide.

Take the time to plan Employee Health and Wellness Programs before they are implemented.

Strategic planning enables better use of all your resources. Include all the steps below when you plan a Wellness activity.

• Do your homework – Locate the science and research that support your interventions. Look for similar Employee Health and Wellness Programs that already exist.
• Determine the specific health need(s) - Use these needs to target interventions to problems that are an issue for your population.
• Organize a team – A team is a resource multiplier. Network and build as many partnerships as you can.
• Make a plan, but don’t start completely from scratch. Make a written plan for your Employee Health and Wellness Program. Look for every opportunity to take advantage of resources that already exist. Don’t reinvent the wheel.
• Select a focus - Choose one or two main target areas for Employee Health and Wellness Programs. Address all five stages of change in the target areas rather than trying to hit every possible Wellness topic.
• Determine your resources - What assets do you have? What assets will you need? How can you fill the gaps?
• Get Senior Management support – Think like Senior Management. Communicate the value of Wellness from Senior Management’s perspective.
• Start the activity- Be flexible. Be prepared for unexpected challenges.
• Market the activity - Keep your Employee Health and Wellness Program visible for Senior Management, line and medical personnel, Employee Health and Wellness Program participants, and potential partners and volunteers.
• Collect and analyze outcomes - Outcomes indicate Employee Health and Wellness Program impact. Start with just a few outcomes – you don’t have to collect everything. Remember that it’s never too late to start measuring Employee Health and Wellness Program impact.
• Evaluate, improve and re-evaluate – Use participant feedback and Employee Health and Wellness Program outcomes to determine Employee Health and Wellness Program impact. Identify areas in need of improvement. Use outcomes to determine if expended resources were worth the results.

Why use small steps toward health behavior change?

Small steps give participants immediate feedback on the changes they make towards better health. Measuring these small steps is also an excellent way to collect interim Employee Health and Wellness Program effectiveness information.

Employee Health and Wellness Program small steps make a big difference

Small steps for Employee Health and Wellness Program participants
• Walk to work.
• Use fat free milk instead of whole milk.
• Each day think of two things you are grateful for.
• Do sit-ups while you watch TV.
• Drink water before a meal.
• Take 10 deep breaths to relieve tension.
• Eat half your dessert.
• Skip second helpings and buffets.

Measuring small Employee Health and Wellness Program steps
• Use short pre- and mid-point surveys to ask:
• How many glasses of water do you drink a day?
• How frequently you do eat fast food?
• How frequently do you skip a meal?
• How frequently do you engage in physical activity?
• How many servings of fruits and vegetables do you eat each day?

Use the results to show participants how their health behaviors are changing for the better.

• Ask participants to rate their health status and/or stress levels before and after an intervention.
• Add up individual (or team) steps and mark the progress on a map towards a far away destination.
• Be innovative! Do not rely only on weight loss, BMI, or cholesterol tests as health status progress indicators or health behavior change feedback.

Wise words for taking small Employee Health and Wellness Program steps

• The first wealth is health. (Ralph Waldo Emerson)
• We are what we repeatedly do. (Aristotle)
• The victory is not always to the swift, but to those who keep moving. (CDC)
• There are 1440 minutes in every day…schedule 30 of them for physical activity. (CDC)

Why Employee Health and Wellness Program follow up?

Getting feedback from Employee Health and Wellness Program participants serves two purposes: to obtain information that quantifies a Wellness Program’s impact, and to find ways to improve a Employee Health and Wellness Program.

Building follow up into your Employee Health and Wellness Program

Keep it simple
• Keep follow up to information you absolutely require. A three-question survey is more likely to get a response than one with 20 questions.
• Use email or phone for follow-up. Use personal, AKO, and installation email addresses; use cell phone and unit phone numbers.
• Go to the Employees: go to the unit or somewhere else they will all be gathered (like the APFT test location), and get follow up information there.
• Give participants a stamped envelope addressed to you, with a printed form listing the information you will need.

Keep it structured
• Tell participants right from the beginning that you will be doing follow up after the Employee Health and Wellness Program is finished. Be specific about the information you will collect.
• If you need to do hands-on measurements, find out if participants will be coming back to your location for another reason (like another clinic appointment). Ask them to stop by while they are in the building – or, better yet, go to where they will be.
• Ask participants where they will be the next time you will be collecting information. They may already know their next duty station if they will be PCSing soon.
• Plan ahead for follow up and put it on the schedule. Planning to do follow up “when you have time” usually means follow up will never get done.

Keep it catchy
• Give participants something to go along with the request for information. By way of example, if you send an email to ask for information, send along a yummy recipe or a timely excercise tip.
• Schedule a ‘reunion’ day to collect follow up information. Invite participants to come back and share successes and challenges. Have some (healthy) munchies available.
• Have a silly contest – the team with the most follow up information wins something, like having their photos posted on a prominently-placed bulletin board or an eggplant trophy, or some other fun thing.

Why bother to market your Employee Health and Wellness Programs?
Because of the transient nature of the many staff member populations, you must market your Employee Health and Wellness Programs all the time. Your goal should be to keep your Employee Health and Wellness Programs as visible as possible.

Creative marketing can increase awareness of your Employee Health and Wellness Program for:

• Potential Employee Health and Wellness Program participants
• Senior Management
• Line and medical personnel
• Potential partners and volunteers

Creative Employee Health and Wellness Program marketing ideas

Involve Senior Management in your marketing Employee Health and Wellness Program as frequently as possible.
• By way of example: invite Senior Management to judge a Employee Health and Wellness Program logo contest.

Link your Employee Health and Wellness Programs to national advertising campaigns
• …like the Great American Smokeout and the Dairy Council’s Milk Mustache campaign.

Collaborate closely with personnel in the corporate office.
• Submit articles about your Employee Health and Wellness Programs that coincide with National Health Observances. By way of example: highlight your Asthma Program in May, which is National Asthma Awareness Month.
• Let the corporate office know you can always provide an article to them when they run short on material. (Then make sure you always follow through.)
Word of mouth is the most effective advertisement for your Employee Health and Wellness Program
• Use real staff members in your advertising: enlist the help of successful Employee Health and Wellness Program participants or use Employees and other post personnel for your marketing materials, when possible.
• Start “buzz” by incorporating an element of competition: which ‘team’ had the most steps over the past week? Which department engaged most frequently in physical activity?
Take advantage of technology
• Use post television and radio resources.
• Use email whenever you can.
Don’t just market your Employee Health and Wellness Program to potential participants, but market the opportunities for others to be involved, as well.
• By way of example: does the Red Cross know you can always use a volunteer? Do other departments/clinics know that you can always use personnel with some temporary down time?
Don’t be “old news”
• If you put advertising materials up, be sure to take them down in a timely manner.
• Update marketing logos and themes as appropriate.

What is Employee Health and Wellness Program data?

Employee Health and Wellness Program data is information that is collected about your Employee Health and Wellness Program. All Employee Health and Wellness Programs should include data as an integral part of the Employee Health and Wellness Program plan.

Why should you care about Employee Health and Wellness Program data?

Information tells the Wellness story. Information is the tangible proof of a Wellness Program’s impact.

Building data into Employee Health and Wellness Programs

Why bother with Employee Health and Wellness Program Data?

You need Employee Health and Wellness Program data to:
• Evaluate whether or not your Employee Health and Wellness Program is working.
• Answer the ‘so what?’ about the need for a Employee Health and Wellness Program.
• Offer information to Senior Management about the impact of the Employee Health and Wellness Program.
• Write a budget justification so you can secure Employee Health and Wellness Program resources.
• Use Employee Health and Wellness Program resources efficiently and market your Employee Health and Wellness Program more effectively.

Where to begin collecting Employee Health and Wellness Program data:
• MAKE A PLAN to collect the data: decide what, when, and how information will be collected.
• Determine what information is ALREADY BEING COLLECTED.
o By way of example: use dairy sales information in the dining center to measure the impact of a milk marketing/dairy month campaign.
• Start collecting JUST A FEW small pieces of information. Be innovative!
o By way of example: BMI, APFT scores (before & after), tobacco quit rates

IT’S NEVER TO LATE TO START collecting Employee Health and Wellness Program data.

Innovative Employee Health and Wellness Program data strategies
• Use local college/graduate students to help collect, input, and analyze Employee Health and Wellness Program information.
• If your organization has an internship program, get to know the Internship Director. Take advantage of intern resources – including having the Director and/or interns implement the data collection plan for your Employee Health and Wellness Program.
• Use information to let upper management know about the Employee Health and Wellness Programs affect on the workers.

Present this information at their monthly/quarterly meetings.
• Use innovative follow-up strategies to get information. Phone calls can be effective, but also consider email, mailed surveys with return postage provided, and going to the units in person to collect the information.
• Make data collection ‘fun’ for Employee Health and Wellness Program participants.
o By way of example: use a team approach – the team with the ‘best’ overall results gets some sort of award or recognition.
• ALWAYS relate the impact of your Employee Health and Wellness Program to readiness.

Collaboration and Effective Employee Health and Wellness Programs

Why should you collaborate?

Active, ongoing partnerships and cooperative efforts multiply Employee Health and Wellness Program resources in order to better serve Employees and their families.

How can you build collaboration into a Employee Health and Wellness Program?

Get Ready…
• Brainstorm a list of every potential Wellness partner you can think of. Be innovative!
• Be a politician: introduce yourself to everyone BEFORE you need their help.
• Develop a plan to get Senior Management support from as high up the chain as possible. Make sure to include specific ways that your Employee Health and Wellness Program will impact force readiness.
• Determine how YOU can help your partners (not just what they can do for you).

Be Steady…
• Solicit input from everyone that your Employee Health and Wellness Program will affect. Make a special effort to talk to the staff members closest to Employee Health and Wellness Program implementation (those with “boots on the ground”).
• The most frequently asked questions should be: “What would you suggest?” and “How do you think this would work best?”
• Locate someone who has done the same type of Employee Health and Wellness Program before and ask their advice. (Hint: the Employee Health and Wellness Program has a list of many Wellness POCs.)
• Plan NOW to show Employee Health and Wellness Program effectiveness. Identify who may ALREADY BE COLLECTING information that will show the Employee Health and Wellness Program is working.

Get Set…
• Step back and review your Employee Health and Wellness Program from a potential partner’s point of view.
• Brainstorm questions your collaborators might have, and have the answers ready.
• Be ready to frame your “selling points” in terms that are important to each specific partner.
• Put the Employee Health and Wellness Program benefits in language your collaborators will understand.
• Emphasize to potential partners how this Employee Health and Wellness Program will provide benefit to them.

And Go…
• Build as many partnerships as you can BEFORE you implement a Employee Health and Wellness Program.
• Make your partnerships a two-way street: always let your collaborators know what you can do for them – then follow-up and do what you say you would do.
• Maintain Senior Management support by providing a regular flow of information. Invite Senior Management participation in the Employee Health and Wellness Program and special events whenever possible. (Hint: they make great judges if you have a contest.)
• Offer regular feedback to your collaborators.
• Don’t hog the spotlight: let your collaborators share in the visibility of the Employee Health and Wellness Program.

Employee Health and Wellness Programs at the corporate level are beneficial, right? Wellness statistics clearly show that such Employee Health and Wellness Programs are not only cost-effective to the organization but can assist the staff member in developing a healthier lifestyle. With the rising cost of healthcare, Employee Health and Wellness Programs simply make sense. So where does the problem come in? Let’s examine the topic from both perspectives.

Employee Health and Wellness Programs: The Good

• A sampling of return on investment for Employee Health and Wellness Programs: Bank of America: 600%; General Motors:370%; Pepsico: 300%; Citibank: 465%; and the Washoe County School District leading the pack at a whopping 1,560%. (Campbell,J., Wellness Improvement Experts, www.wellnessimprovementexperts.com, Albuquerque, New Mexico.)
• Companies with Employee Health and Wellness Programs have found a 28 percent reduction in sick leave, a 26 percent reduction in adjunctive health care costs and a 30 percent reduction in disability and workers compensation costs. (Health Affairs, Volume 21, No.2, March, 2002.)
• The Washoe county School District in Northern Nevada found a $15.60 return on investment for every dollar spent due to a 20 percent reduction in rates of absence. (Hardy,A. (2005). At the Top Of The Class. WELCOA’s Absolute Advantage Magazine, 5(1), 14-20.)
• Employee Health and Wellness Programs provide the structure, encouragement, incentives and ongoing support that many individuals need in order to make lifestyle changes.
• Employees also realize returns on their efforts. FiServ, a financial services technology organization, gave workers who filled out a health risk assessment a significant discount on their health insurance premium. (Holland, Kelley, The New York Times, July 22, 2007.)

Employee Health and Wellness Programs: The Bad

The flip side of the argument centers on basic human rights. Do we want/need our employer to tell us to eat our veggies or lose 30 pounds? Some companies are doing just that and at least one lawsuit has resulted because of it.
• Three hundred companies have requested assistance from a national employment and labor law firm to institute more aggressive Employee Health and Wellness Programs.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Clarian Health, based in Indianapolis, Will begin decreasing staff member paychecks by $10.00 for every staff member who has a Body Mass Index (BMI) of greater than 29.9 because not enough workers were utilizing their wellness services.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)
• Scott Rodrigues filed a suit against his prospective employer, Scotts Miracle-Gro, because he believed the organization’s antitobacco use policy violated his civil rights. The organization has a policy against hiring workers who smoke and Mr. Rodrigues’drug screen was positive for nicotine.(Holland, Kelley, The New York Times,July 22,2007.)
• staff member advocates are concerned that health discrimination may not be covered under the Americans with Disabilities Act.(Cornwell, Lisa, Associated Press, Albuquerque Journal, September 10,2007.)

Penalizing workers by hitting them where it hurts the most, in their pocketbook, does not appear to be a favorable approach to molding human behavior.
Such tactics may result in increased resentments and retaliation, primarily in the form of rates of absence and presenteeism (decreased productivity on the job.) Voluntary, incentive-based initiatives, such as the one in the Washoe County School District, can and do produce results. A positive attitude on the part of management along with an opportunity for workers to have a stake in the decision-making may yield the greatest dividends to both employer and staff member.The motivation and resolve needed to change unhealthy lifestyle habits can best be derived from the basic tenets of encouragement, respect and support.

For well over a decade, research has been showing the effectiveness of Employee Health and Wellness Programs. For every dollar spent on Employee Health and Wellness Programs, the returns have been cost savings of between $2.30 and $10.10 in the areas of decreased rates of absence, fewer sick days, decreased WSIB/WCB claims, lowered health and insurance costs, and improvements to staff member performance and productivity.

Statistics do show that Employee Health and Wellness Programs increase staff member morale, improve the ability to attract and retain key staff members, all while having more alert and productive workers. Some Employee Health and Wellness Program return on investment statistics of note:

• Canada Life Insurance reported a return of $3.43 on Employee Health and Wellness Program, and an overall Employee Health and Wellness Program return on investment of $6.85 on each corporate dollar invested on decreased turnover (32.4 percent lower), productivity gains and decreased medical claims,
• DuPont’s Employee Health and Wellness Program pilot sites saw a saving of 11,726 disability days and a return of U.S. $2.05 for every dollar invested by the end of the second year,
• The Canadian government’s Employee Health and Wellness Program return on investment was $1.95-$3.75 per staff member per dollar spent (as reported by Dr. Roy Shephard),
• Municipal workers in Toronto, missed 3.35 fewer days in the first six months of their Employee Health and Wellness Program than workers not enrolled in the program,
• British Columbia Hydro workers enrolled in a Employee Health and Wellness Program had a turnover rate of just 3.5 percent compared with a Organization average of 10.3%,
• Johnson & Johnson estimated an average saving of U.S. $224.66 per staff member per year for the four years examined after the program introduction, with the bulk of the savings being in the third and fourth years,
• Pacific Bell reported that overall rates of absence decreased after implementing a Employee Health and Wellness Program,
• Coca Cola report saving $500 every year per staff member after implementing a Employee Health and Wellness Program, with only 60 percent of their workers participating,
• Coors Brewing Co. reported that for each dollar spent on their Employee Health and Wellness Program they saw a $5.50 return, and the workers who participated decreased their absentee rate by 18%, and
• Prudential Insurance Company reported that the benefits costs for workers participating in their program were $312, as opposed to $574 for non-participants