Workplace Wellness Programs Research Articles

Abstract 129: My Unlimited Potential: Multidimensional Workplace Life Style Modification Program Associated With Reduction in Cardiovascular Disease Risk Among Employees With Type 2 Diabetes

Background: Diabetes mellitus is one of the leading conditions resulting in high health costs and lost productivity. In recent year there is a growing interest for managing these chronic conditions through engagement of workplace wellness programs. In this study we examined the short and long term effects of an ongoing multicomponent lifestyle intervention improvement program (My Unlimited Potential (MyUP), among employees of Baptist Health South Florida (BHSF), a large not-for-profit health care system. Method: The present analysis focuses on the efficacy of an intensive lifestyle workplace intervention among individuals presenting with diabetes mellitus. The intervention provided tools to improve physical activity, stress and dietary habits. A multi-disciplinary team made up of an advanced nurse practitioner (ARNP), registered dietician (RD), exercise physiologist (EP), certified diabetic educator (CDE), and registered nurse (RN) met with participants to provide one-on-one counseling and training. Results: The current study assessed 33 (58 years +/- 8.8, 67% female) employees with diabetes mellitus enrolled in the MyUp wellness program who completed baseline, 12-weeks, 6 months and 1 year assessments. Significant short and long term improvements in cardio-metabolic risk factors were observed (Table1). Positive change in distribution of cardiovascular risk factors was noticed at 3, 6 and 12 months (Fig1). Conclusion: These results suggest that a multi component workplace lifestyle modification program results in both short and long term improvement in cardiovascular disease risk among employees with diabetes mellitus. Further large studies are needed to confirm our study findings.

Workplace wellness recognition for optimizing workplace health: a presidential advisory from the American Heart Association.

The workplace is an important setting for promoting cardiovascular health and cardiovascular disease and stroke prevention in the United States. Well-designed, comprehensive workplace wellness programs have the potential to improve cardiovascular health and to reduce mortality, morbidity, and disability resulting from cardiovascular disease and stroke. Nevertheless, widespread implementation of comprehensive workplace wellness programs is lacking, and program composition and quality vary. Several organizations provide worksite wellness recognition programs; however, there is variation in recognition criteria, and they do not specifically focus on cardiovascular disease and stroke prevention. Although there is limited evidence to suggest that company performance on employer health management scorecards is associated with favorable healthcare cost trends, these data are not currently robust, and further evaluation is needed. As a recognized national leader in evidence-based guidelines, care systems, and quality programs, the American Heart Association/American Stroke Association is uniquely positioned and committed to promoting the adoption of comprehensive workplace wellness programs, as well as improving program quality and workforce health outcomes. As part of its commitment to improve the cardiovascular health of all Americans, the American Heart Association/American Stroke Association will promote science-based best practices for comprehensive workplace wellness programs and establish benchmarks for a national workplace wellness recognition program to assist employers in applying the best systems and strategies for optimal programming. The recognition program will integrate identification of a workplace culture of health and achievement of rigorous standards for cardiovascular health based on Life's Simple 7 metrics. In addition, the American Heart Association/American Stroke Association will develop resources that assist employers in meeting these rigorous standards, facilitating access to high-quality comprehensive workplace wellness programs for both employees and dependents, and fostering innovation and additional research.

Workplace Stress Management Interventions and Health Promotion

Employee health and wellness are important for employees, their families, and their organizations. We review the literature on both stress management interventions in organizations and workplace health promotion and wellness programs, from the lens of primary, secondary, and tertiary interventions as well as the framework provided by the job demands–resources model ( Bakker & Demerouti 2007 ). Stress management interventions tend to be ameliorative, often focusing on restoring resources that have been depleted by the work environment, whereas workplace health promotion and wellness programs tend to be more preventive, enhancing job and personal resources for all employees. There appears to be a trend toward incorporating stress management as a component of workplace wellness programs, with these programs taking more of a primary or secondary intervention approach than a tertiary approach. In addition, although organization-level interventions are still relatively rare, there is growing evidence that organizational interventions, especially when combined with individual-level interventions, can be quite effective in promoting a positive, healthy work environment. We conclude the review by offering suggestions for future research and some considerations for the design and evaluation of future interventions.

Fitness of the US workforce.

Fitness matters for the prevention of premature death, chronic diseases, productivity loss, excess medical care costs, loss of income or family earnings, and other social and economic concerns. The workforce may be viewed as a corporate strategic asset, yet its fitness level appears to be relatively low and declining. Over the past half-century, obesity rates have doubled, physical activity levels are below par, and cardiorespiratory fitness often does not meet minimum acceptable job standards. During this time, daily occupational energy expenditure has decreased by more than 100 calories. Employers should consider best practices and design workplace wellness programs accordingly. Particular attention should be paid to human-centered cultures. Research should address ongoing surveillance needs regarding fitness of the US workforce and close gaps in the evidence base for fitness and business-relevant outcomes. Policy priorities should consider the impact of both state and federal regulations, adherence to current regulations that protect and promote worker health, and the introduction of incentives that allow employers to optimize the fitness of their workforce through supportive legislation and organizational policies.

U.S. Chronic Disease Prevention Approaches and Recommendations

Chronic disease (CD) and disability account for nearly half of the U.S. burden of disease. CD-associated risk factors respond to behavior change interventions; yet, evidenced-based approaches in CD prevention are limited. This study describes perceived effective approaches and recommendations for CD prevention in the United States, focusing on seven risk factors: poor diet and adiposity, physical inactivity, tobacco use, mental illness, poor medication adherence, high alcohol consumption, and excess salt intake. Utilizing a step-wise qualitative methodology consisting of one-on-one interviews (n=74) and a consensus building workshop of CD experts (N=24), the following five CD prevention approaches were identified: increase of government policy and regulations, change in the built environment, installment and improvement in workplace wellness programs, higher-value in community-based health initiatives, and use of technology in behavior change adoption. The most actionable and consensual strategies to prevent CDs in the United States were changes in the built environment and a higher-value in community-based health initiatives.

Designing Exercise and Nutrition Programs to Promote Normal Weight Maintenance for Nurses

Living a healthy lifestyle is a constant choice. As a life goal, it is a decision to uphold every moment and is best achieved with support of others. There are a multitude of workplace wellness and healthy lifestyle programs that address achieving and maintaining the goal of normal weight over a lifetime. Fewer such evidence based programs exist and a goal of our hospital is to create a comprehensive wellness program based on evidence. In the context of normal weight maintenance in nurses, this article discusses selected challenges for healthy eating and exercise and nurse fitness programs based on the author and her colleagues experiences with specific obesity research interventions, such as Nurses Living FitTM, that we designed and offered. An exemplar provides details about our wellness programs, which included three annual walk or run events, one full day conference, and a series of multiple exercise, yoga, and nutrition sessions. Our goal was to expose nurses to healthier lifestyle aspects with a primary focus on the optimal balance of exercise and nutrition. Over the years of research, events, and programs, greater than 1,000 people have participated. The conclusion includes implications for education and practice in the hope that our experiences may motive nurses to design exercise and nutrition programs to promote normal weight maintenance in nurses.

Change in well-being amongst participants in a four-month pedometer-based workplace health program.

BackgroundThere is increasing uptake of workplace physical activity programs to prevent chronic disease. While they are frequently evaluated for improvement in biomedical risk factors there has been little evaluation of additional benefits for psychosocial health. We aimed to evaluate whether participation in a four-month, team-based, pedometer-based workplace health program known to improve biomedical risk factors is associated with an improvement in well-being, immediately after the program and eight-months after program completion.MethodsAt baseline (2008), 762 adults (aged 40 ± 10 SD years, 42% male) employed in primarily sedentary occupations and voluntarily enrolled in a physical activity program were recruited from ten Australian worksites. Data was collected at baseline, at the completion of the four-month program and eight-months after program completion. The outcome was the WHO-Five Well-being Index (WHO-5), a self-administered five-item scale that can be dichotomised as ‘poor’ (less than 52%) or ‘positive’ (more than or equal to 52%) well-being.ResultsAt baseline, 75% of participants had positive well-being (mean: 60 ± 19 SD WHO-5 units). On average, well-being improved immediately after the health program (+3.5 units, p < 0.001) and was sustained eight-months later (+3.4 units from baseline, p < 0.001). In the 25% with poor well-being at baseline, 49.5% moved into the positive well-being category immediately after program completion, sustained eight-months later (p < 0.001).ConclusionsClinically relevant immediate and sustained improvements in well-being were observed after participation in the health program. These results suggest that participation in workplace programs, such as the one evaluated here, also has the potential to improve well-being.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-953) contains supplementary material, which is available to authorized users.

Workplace wellness programs: how regulatory flexibility might undermine success.

The Patient Protection and Affordable Care Act revised the law related to workplace wellness programs, which have become part of the nation's broader health strategy. Health-contingent programs are required to be reasonably designed. However, the regulatory requirements are lax and might undermine program efficacy in terms of both health gains and financial return. I propose a method for the government to support a best-practices approach by considering an accreditation or certification process. Additionally I discuss the need for program evaluation and the potential for employers to be subject to litigation if programs are not carefully implemented.

Identification of Healthy Eating and Active Lifestyle Issues through Photo Elicitation.

Effective workplace wellness programs, featuring supports for healthy eating and active lifestyle behaviours, have been found to reduce health risks and the associated economic burdens for individuals, organizations, and their communities. As part of a larger study, the purpose of this research was to engage volunteer participants from a university community to identify healthy eating and active lifestyle barriers and supports. An ethics-approved, action-research design with photo elicitation technique was used to engage employees and students. Data were analyzed using qualitative analysis software. Participants identified barriers and both current and future supports for healthy eating and active lifestyle on campus. These were coded under the sub-themes of food environment, food and nutrition quality, physical environment, physical activity, fitness centre, and awareness/communication. Photo elicitation was determined to be an effective technique to engage participants. Despite many supports, members of the university community still found it difficult to follow healthy eating and active lifestyle behaviours; however, a number of practical future supports were identified. This study also provided valuable insight into the role that dietitians can play in the development of successful wellness programs.

The prevalence and characteristics associated with excessive daytime sleepiness among Australian workers.

To estimate the prevalence of excessive daytime sleepiness (EDS) and its associated factors in a mixed population of employed Australian workers. Study participants (n = 707) were volunteers from various Melbourne workplaces, participating in a workplace physical activity program in 2008. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS), with EDS defined as ESS scores >10. In this population of adult employees (40.0% male; mean age 40.2 ± 10.4 years), prevalence of EDS was 16.0%. Characteristics associated with EDS and higher ESS scores were age, higher body mass index, markers of poorer diet, and markers of poorer mental health. Excessive daytime sleepiness is potentially an important contributor to lower productivity and poorer mental health in the workplace. Our finding suggests that workplace health programs aimed at improving diet and body weight may also help alleviate EDS.

Preventive occupational health interventions in the meat processing industry in upper-middle and high-income countries: a systematic review on their effectiveness.

To investigate the effectiveness of occupational health interventions in the meat processing industry on work and health-related outcomes. A systematic literature review was performed. PubMed, Embase, and The Cochrane Library were searched. Studies were included when they reported on an intervention among employees in the meat processing industry and with outcomes related to work or health. Studies were assessed on risk of bias, and data were synthesized by type of intervention. A total of 13 articles reporting on two randomized controlled trials and nine non-randomized intervention studies were retrieved. Studies were categorized into three topics: ergonomics programs, skin protection, and Q fever vaccination. All studies had high risk of bias. Based on four studies, there was limited evidence for workplace health and safety programs showing reductions in musculoskeletal injury severity, reduction of lost work days, and reduction of costs and claims for several musculoskeletal disorders. There was limited evidence for added rest breaks resulting in improved productivity at the end of a workday and in reductions of perceived discomfort in various body regions at the end of the workday. One study on skin protection showed reductions of eczema prevalence, although evidence was moderate. Based on four studies, there was high-quality evidence for strong effectiveness of Q fever vaccination. This review presents evidence for the effectiveness of a variety of workplace interventions. There was limited evidence for effectiveness of ergonomic interventions, moderate evidence of a skin protection intervention, and strong evidence for Q fever vaccination.

Critical perspectives on wellness.

Workplace wellness programs are written into law as exceptions to otherwise protective antidiscrimination provisions, and the Patient Protection and Affordable Care Act expands employers' ability to treat workers differently based on their health. Rather than assume that wellness programs promote health and save money, here I approach them as legally sanctioned discrimination. What exactly wellness discrimination might look like in practice across many contexts is an open question, but there is good reason to be wary of the power of wellness to create and reproduce hierarchy, to promote homogeneity, narrow-mindedness, and moralism about how to live one's life, and to cover for discrimination based on health, weight, income, age, pregnancy, and disability.

Placing workplace wellness in proper context: value beyond money.

Most companies in the United States now offer some kind of wellness programming to their employees. In 2012, about half of US employers with at least 50 employees and more than 90% with more than 50,000 employees offered a workplace wellness program (1). Employer surveys (eg, the 2011 Automatic Data Processing Survey) suggest that the most often-cited reasons for offering these programs include improved employee health, health care cost control, increased productivity, and absenteeism reduction. Each of these reasons is quantifiable, and their value can be monetized, allowing for a calculation of savings and an estimation of a return on investment (ROI). Yet it isn’t necessarily always about saving money. Dr Risa Lavizzo-Mourey, president and chief executive officer of the Robert Wood Johnson Foundation, notes in a recent online post that companies committed to nurturing a culture of well-being consider broader motivations, including low turnover rates, attraction of top candidates, job satisfaction, and recruitment and retention of workers (2). Each factor was reported as being a more important driver of workplace wellness programs than ROI. There is understandable interest in learning if, and how, workplace wellness programs produce results and generate savings. Publications on the effect of workplace wellness on financial outcomes continue to accumulate (1–5), but instead of producing consistency and clarity, they have introduced doubt and controversy. Systematic reviews and meta-analytic findings indicate that workplace wellness can generate savings (3). However, recent ROI studies indicate that such savings come only from disease management (DM) programs not lifestyle management (LM) programs (1). To gain clarity, 2 issues must be addressed. First, there is a need to standardize the definition of workplace wellness programs so that casual use of what constitutes such programs can be avoided. Second, research approaches should more explicitly recognize that workplace wellness programs generate a range of outcomes, many of them non–health related, that provide substantial value to employers even though they are often not represented in ROI analyses. This essay addresses these 2 issues in the context of a set of best practice program-design principles that allow for properly designed workplace wellness programs to be differentiated from other activities that, although well-intended, may not rise to the level of a bona fide program.

UPMC MyHealth: managing the health and costs of U.S. healthcare workers.

Workplace wellness programs hold promise for managing the health and costs of the U.S. workforce. These programs have not been rigorously tested in healthcare worksites. To evaluate the impact of MyHealth on the health and costs of UPMC healthcare workers. Five-year observational study conducted in 2013 with subgroup analyses and propensity-matched pair comparisons to more accurately interpret program effects. UPMC, an integrated health care delivery and financing system headquartered in Pittsburgh, Pennsylvania. Participants included 13,627 UPMC employees who were continuously enrolled in UPMC-sponsored health insurance during the study period and demonstrated participation in MyHealth by completing a Health Risk Assessment in both 2007 and 2011, as well as 4,448 other healthcare workers employed outside of UPMC who did not participate in the program. A comprehensive wellness, prevention, and chronic disease management program that ties achievement of health and wellness requirements to receipt of an annual credit on participants' health insurance deductible. Health-risk levels, medical, pharmacy, and total healthcare costs, and Healthcare Effectiveness Data and Information Set performance rates for prevention and chronic disease management. Significant improvements in health-risk status and increases in use of preventive and chronic disease management services were observed in the intervention group. Although total healthcare costs increased significantly, reductions in costs were significant for those who moved from higher- to the lowest-risk levels. The contrast differences in costs between reduced- and maintained-risk groups was also significant. Matched pair comparisons provided further evidence of program effects on observed reductions in costs and improvements in prevention, but not improvements in chronic disease management. Incorporating incentivized health management strategies in employer-sponsored health insurance benefit designs can serve as a useful, though not sufficient, tool for managing the health and costs of the U.S. healthcare workforce.

Workplace Safety and Health Programs, Practices, and Conditions in Auto Collision Repair Businesses

This article describes the results of a pre-intervention safety assessment conducted in 49 auto collision repair businesses and owners’ commitments to specific improvements. A 92-item standardized audit tool employed interviews, record reviews, and observations to assess safety and health programs, training, and workplace conditions. Owners were asked to improve at least one-third of incorrect, deficient, or missing (not in compliance with regulations or not meeting best practice) items, of which a majority were critical or highly important for ensuring workplace safety. Two-thirds of all items were present, with the highest fraction related to electrical safety, machine safety, and lockout/tagout. One-half of shops did not have written safety programs and had not conducted recent training. Many had deficiencies in respiratory protection programs and practices. Thirteen businesses with a current or past relationship with a safety consultant had a significantly higher fraction of correct items, in particular related to safety programs, up-to-date training, paint booth and mixing room conditions, electrical safety, and respiratory protection. Owners selected an average of 58% of recommended improvements; they were most likely to select items related to employee Right-to-Know training, emergency exits, fire extinguishers, and respiratory protection. They were least likely to say they would improve written safety programs, stop routine spraying outside the booth, or provide adequate fire protection for spray areas outside the booth. These baseline results suggest that it may be possible to bring about workplace improvements using targeted assistance from occupational health and safety professionals.

Abstract P237: Improved Cardio-metabolic Risk Profile through Targeted Life Style Modification Program

Introduction: Workplace wellness programs are part of the American Heart Association’s (AHA) strategy at improving cardiovascular health. Data suggest that most cost and risk borne by employers is with metabolic syndrome (MS). The current study aimed to ascertain the primary to short-term (12 weeks) efficacy of a lifestyle intervention improvement program (My Unlimited Potential (myUP), among employees of a health care system in improving metabolic status as well as associated degree of vascular inflammation as measured by high sensitivity C-reactive protein (hs-CRP). Methods: The MyUP enrolled high risk individuals with at least 2 of the following cardio-metabolic risk factors, total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30. Improvement in cardio-metabolic risk was assessed by the change in number of metabolic risk components and C-reactive protein (CRP) from baseline to 12 week follow-up. Results: Overall 203 (48±10 years, 78% females) employees were enrolled. The retention of subjects was high with 89% (n=181) of subjects following up at 12 weeks. There were significant changes in the distribution of the number of components of the metabolic syndrome from baseline to 12 weeks follow up, see figure 1. Overall only 25% met criteria for MS at 12 week as compared to 48% at baseline. There were changes in the overall median hsCRP at 12 weeks follow-up compared to baseline, 3.6(1.8-7.9) vs. 4.4(2.0-8.4). We also noticed improvement in median hs-CRP levels across the categories of improving metabolic risk factors. Among individuals who had improvement in 1-2 MS risk factors, the median hsCRP at follow-up compared to baseline was 4.6(2.2-8.8) vs. 5.2(2.7-8.9) p=0.6090 and those with improvements in &gt;2 MS components it was 3.3(2.5-5.3) vs. 5.0(3.5-7.14) p=0.1614. Conclusion: Measurable cardio-metabolic risk reduction was achieved, benefiting participant of a targeted Life style modification intervention program.

Obesity Prevalence by Occupation in Washington State, Behavioral Risk Factor Surveillance System

IntroductionData that estimate the prevalence of and risk factors for worker obesity by occupation are generally unavailable and could inform the prioritization of workplace wellness programs. The aims of this study were to estimate the prevalence of obesity by occupation, examine the association of occupational physical activity and a range of health behaviors with obesity, and identify occupations in which workers are at high risk of obesity in Washington State.MethodsWe conducted descriptive and multivariable analyses among 37,626 employed Washington State respondents using the Behavioral Risk Factor Surveillance System in odd numbered years, from 2003 through 2009. We estimated prevalence and prevalence ratios (PRs) by occupational groups adjusting for demographics, occupational physical activity level, smoking, fruit and vegetable consumption, and leisure-time physical activity (LPTA).ResultsOverall obesity prevalence was 24.6% (95% confidence interval [CI], 24.0–25.1). Workers in protective services were 2.46 (95% CI, 1.72–3.50) times as likely to be obese as workers in health diagnosing occupations. Compared with their counterparts, workers who consumed adequate amounts of fruits and vegetables and had adequate LTPA were significantly less likely to be obese (PR = 0.91; 95% CI, 0.86–0.97 and PR = 0.63; 95% CI, 0.60–0.67, respectively). Workers with physically demanding occupational physical activity had a lower PR of obesity (PR = 0.83; 95% CI, 0.78–0.88) than those with nonphysically demanding occupational physical activity.ConclusionObesity prevalence and health risk behaviors vary substantially by occupation. Employers, policy makers, and health promotion practitioners can use our results to target and prioritize workplace obesity prevention and health behavior promotion programs.

Managing Manifest Diseases, But Not Health Risks, Saved PepsiCo Money Over Seven Years

Workplace wellness programs are increasingly popular. Employers expect them to improve employee health and well-being, lower medical costs, increase productivity, and reduce absenteeism. To test whether such expectations are warranted, we evaluated the cost impact of the lifestyle and disease management components of PepsiCo's wellness program, Healthy Living. We found that seven years of continuous participation in one or both components was associated with an average reduction of $30 in health care cost per member per month. When we looked at each component individually, we found that the disease management component was associated with lower costs and that the lifestyle management component was not. We estimate disease management to reduce health care costs by $136 per member per month, driven by a 29percent reduction in hospital admissions. Workplace wellness programs may reduce health risks, delay or avoid the onset of chronic diseases, and lower health care costs for employees with manifest chronic disease. But employers and policy makers should not take for granted that the lifestyle management component of such programs can reduce health care costs or even lead to net savings.

Education and Experience beyond the Classroom: University Dietetic Students Involvement in a Nutrition-related Workplace Wellness Program

Education and Experience beyond the Classroom: University Dietetic Students Involvement in a Nutrition-related Workplace Wellness Program

Workplace Wellness Programs: Myth or reality?

Workplace Wellness Programs: Myth or reality?