Evidence Based Wellness (Helping Human Resources Shop Better)

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Objectives:
+ Distinguish between programs that may be sold well and those that work
+ Identify the common and core elements of effective wellness programs
+ Be able to evaluate whether your current or prospective programs are meeting the standard

This program was presented to HR Professionals at HR SouthWest in October, 2012 (Presenter: Dr. Joel Bennett, learn@organizationalwellness.com)

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  • SLIDE 17
  • Evidence Based Wellness (Helping Human Resources Shop Better)

    1. 1. Evidence-Based Health Promotion Separating the Wheat from the ChaffDr. Joel Bennettlearn@organizationalwellness.comOctober, 2012
    2. 2. • Tremendous growth in workplace wellness programs• Little in the way of evidence-based guidelines for understanding – what works, the why, and the how• This presentation provides the latest research information on – best practice guidelines and – essential elements of effective programs 2
    3. 3. Objectives• Distinguish between programs that may be sold well and those that work• Identify the common and core elements of effective wellness programs• Be able to evaluate whether your current or prospective programs are meeting the standard 3
    4. 4. OutlinePART 1: Evidence & Insights (lots) 4
    5. 5. PART 1: Evidence & Insight 5
    6. 6. (some) factors leading to decisionDoes itwork? Ease of Cost Quality ROI Use
    7. 7. Caveat• This presentation is about “Does it work?”• NOT the other stuff
    8. 8. 5 Insights (preview)1. Your ownership (of any program) is the key to success2. You can “set the bar” on how much evidence you need to help select your wellness program3. You can move from program “selection” to program “crafting”4. System-level stress management is essential5. Your ownership is the key to success (commitment)
    9. 9. INSIGHT # 1Success does not lie in the programs themselves but in the INTERACTION between the internal programmers, the work environment, and the programs. You have to “OWN” the program!GROW FROM WITHIN AND STAY THERE
    10. 10. GROW FROM WITHIN AND STAY THERE
    11. 11. Will it work? (two standards) What evidence Will it work do I need to for me? know if it will work for me?Experience Proof Hearsay ObjectivityMarketing Results
    12. 12. Strategy* Map a Wellness Strategy Assess your needs Ask your employees Start inside Consider a comprehensive/integrated approach Narrow field with accreditation/certification Keep up to date on what works Involve others, collaborate Ask for assurances, guarantees*HR Magazine: (March, 2011; Susan J. Wells)http://www.shrm.org/publications/hrmagazine/editorialcontent/2011/0311/pages/0311wells.aspx
    13. 13. Evidence-based • What does this term mean? • Danger of it being over-used and ill-defined • So, three key questions to ask:? Is there research behind the product/service? ? Was it independent research? ? What is the quality of the research? 13
    14. 14. ? Is there research behind the product/service?  Testimonials: One  Testimonials: Many (independent)  Customer Satisfaction  Expert Panels  Case studiesSetting  Follow-up change in self-reportthe bar  Follow-up change in behavior  Pre-post change  Experimental Design (single study)  Experimental Design (many studies)  Reviews and Meta-analysis
    15. 15. ? Was it independent research?  One internal evaluator, paid for by the company  Internal evaluators, paid for by outside sources  External evaluators, paid for by the company  External evaluators, paid for by outside sources  Non-affiliated research scientists with multiple target sites
    16. 16. ? What is the quality of the research  One case study  Multiple case studies  Observational study (longitudinal)  Correlation analysis  Pre-post (self-report)  Pre-post (behavior)  Pre-post with control group  Randomized clinical trial
    17. 17. INSIGHT # 2Where you set “the bar” for determining “sufficient evidence”is determined by many factors. The key is that you can at least know that there is a bar/standard to set; bring into the purchase conversation. You have to show intelligence! COMMUNICATE YOUR STANDARD
    18. 18. COMMUNICATE YOUR STANDARD
    19. 19. My goal today is synthesis!• Review of evidence-based approaches• Synthesize into core ideas (memory aids)• Five areas to get started or to refresh 1. Walk the talk (Leadership) 2. Love your “sparkplugs” (Advocates) 3. The power of small groups (Teams) 4. Think strategically about wellness (Climate) 5. Keep giving back (Community) 19
    20. 20. Preview Memory Aids
    21. 21. Operational Broad Guidance Broad Specific Evidence-Based Recommendations Benchmarks CriteriaEssential Elements of Effective Workplace Programs and Policies for ImprovingWorker Health and Wellbeing (NIOSH, 2008; DHHS No. 2010-140)List derived by panel of expertsPromising Practices in Employer Health and Productivity Management Efforts:Findings From a Benchmarking Study (Goetzel, Schecter, Ozminkowski et al. 2007)Literature review of 5 best-practice studies, site visits to 9 promising practice employers,interviews with SMEsPromising Practices for the Prevention and Control of Obesity in the Worksite(Archer, Batan, Buchanan, Soler et al., 2011)Synthesis of empirical results from 136 studies, each weighted on the basis of studydesign, quality, and effect size.
    22. 22. Essential Elements of Effective Workplace Programs and Policies for ImprovingWorker Health and Wellbeing (NIOSH, 2008; DHHS No. 2010-140)List derived by panel of expertsNote. Incomplete, list below is example of 20 recommendations.Organizational Program Design Program ImplementationCulture/Leadership ⦁ Establish clear principles ⦁ Be willing to start small⦁ Develop a “Human ⦁ Integrate relevant systems and scale up Centered Culture” ⦁ Eliminate occupational ⦁ Communicate⦁ Demonstrate hazards strategically leadership ⦁ Promote employee ⦁ Build accountability⦁ Engage mid-level participation into program management ⦁ Tailor programs to specific implementation workplace ⦁ Find and use the right tools Broad ⦁ Adjust the program as recommendations needed
    23. 23. Promising Practices in Employer Health and Productivity Management Efforts:Findings From a Benchmarking Study (Goetzel, Schecter, Ozminkowski et al. 2007)Literature review of 5 best-practice studies, site visits to 9 promising practice employers,interviews with SMEsNote. Incomplete, following are from Table 1 (parentheses is # of the 5 best-practice studiesthat showed evidence for the characteristic) • Organizational commitment (all 5) • Identification of wellness champions (3) • Data collection, measurement, reporting, and evaluation (including ROI) (3) • Ongoing program evaluation (3) • Program linked to business objectives (2) • Effective communication (2) • Effective operation plan (2) Benchmarks • Program goals include productivity & morale (2) • Interdisciplinary team focus (2) • Incentives to participate (2) • Effective screening and triage (2) • State-of-the-art interventions (2)
    24. 24. Another Benchmark Example Classic Benchmarking Study (2000)* 1. Align with business strategy 2. Create diverse teams (HR, benefits, safety, legal) 3. Cultivate champion(s) with a sense of purpose 4. Put senior managers/business ops on the team 5. Assure health promotion staff are heavily engaged 6. Emphasize quality-of-life improvement, not just cost cutting 7. Increase importance of evaluation over time 8. Communicate constantly and throughout the organization 9. Show a constant need to improve BY learning from others 10. Have fun *Goetzel, R., Guindon, A., Turshen, I., & Ozminkowski, R. (2001). Health and productivity management. Journal of Environmental & Occupational Medicine, 43(1), 10-17.
    25. 25. Another Benchmark Example Best Practice Score-Card (2010)* Strategic planning (formal plan with objectives) Leadership engagement (senior, champions, policies) Program level management  Program diversity (safety, diet, exercise, occ. health, EAP)  Vendor alignment and coordination  Very good access to program for all workers  Benefits design promotes utilization Programs (risk appraisal, evidence-based lifestyle management)  Engagement methods (engaging communication, incentives) Measurement and evaluation*http://www.the-hero.org Employee Health Management Best Practice Scorecard
    26. 26. Promising Practices for the Prevention and Control of Obesity in the Worksite(Archer, Batan, Buchanan, Soler et al., 2011)Synthesis of empirical results from 136 studies, each weighted on the basis of studydesign, quality, and effect size.Note. List below shows all studies found and those that were deemed of"Greatest Suitability" due to high quality and positive outcomes.• Enhanced access to opportunities for physical activity combined with health education (5 studies, 3 suitable)• Exercise prescriptions alone (14 studies, 10 suitable)• Multi-component educational practices (25 studies, 13 suitable)• Weight loss competitions and incentives (16 studies, 6 suitable)• Behavioral practices with incentives (17 studies, 8 suitable)• Behavioral practices without incentives (47 studies, 26 suitable) Evidence-Based Criteria
    27. 27. Another Evidence-Based Criteria Computer-Delivered Interventions for Health Promotion and Behavioral Risk Reduction: A Meta-Analysis of 75 Randomized Controlled Trials, 1988 – 2007*  CDIs were successful at improving nutrition, reducing tobacco use, reducing substance use, increasing safer sexual behavior, reducing binge/purging behaviors, and promoting general health maintenance  No improvements were observed for physical activity, weight loss, diabetes control, or weight gain/maintenance.  KEY FACTORS:  PLACEBO? Providing individuals with any active intervention content is likely to lead to change.  MOTIVATION MAY WEAKEN: Interventions that had users look at the costs/benefits of quitting an unhealthy behavior or adopting a healthy one were less effective. *http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572996/
    28. 28. Another Evidence-Based Criteria Healthy Workplace Team Awareness Wellness Outreach at Work Coping with Work & Family Stress
    29. 29. INSIGHT # 3There is so much information about “what works” that wecan now re-frame the decision-making from “What should I select?” to “How can I best craft/shape programs based on my needs/costs?” Use evidence-based principles! OWN YOUR OWN CREATIVITY
    30. 30. OWN YOUR OWN CREATIVITY
    31. 31. Another Evidence-Based CriteriaStressManagementEffective Elements(2008 reviews) LaMontagne et al: 30 different interventions Parks & Steelman: 15 different studies Richardson & Rothstein: 36 experimental studies, representing 55 interventionsLamontagne, A. D., Keegel, T., Louie, A. M., Ostry, A., & Lansbergis, P. A. (2007). A Systematic review of the job-stress intervention evaluationliterature, 1990–2005. International Journal of Occupational and Environmental Health, 13, 268–820.Parks, K. M., & Steelman, L. A. (2008). Organizational wellness programs: A meta-analysis. Journal of Occupational Health Psychology, 13, 58–68.Richardson, K. M., & Rothstein, H. R. (2008). Effects of occupational stress management intervention programs: A meta-analysis. Journal ofOccupational Health Psychology,13, 69–93.
    32. 32. INSIGHT # 4It makes no sense to only focus on individual stressmanagement; like teaching someone to fish instead of always feeding them  it pays to help the system to help itself Use multi-level approaches! TREAT THE SYSTEM…PLEASE!
    33. 33. TREAT THE SYSTEM…PLEASE!
    34. 34. Other Noteworthy Resources(to help re-frame)
    35. 35. • Assists employers in identifyinggaps in their health promotionprograms• Helps them prioritize high-impactstrategies for the following healthtopics:• organizational supports,• tobacco control• nutrition• physical activity• weight management• stress management• depression• high blood pressure• high cholesterol• diabetes• signs and symptoms of heartattack and stroke• emergency response to heartattack and stroke.
    36. 36. INSIGHT # 5You can have the greatest technology based on solidevidence-based principles but if you don’t have ownership of the program you may be wasting your time, money, or both. Own programs from the inside out!
    37. 37. Levels of Ownership Burden Compliant Reasoned Motivated Visioning Calling/ Embodied Obligation Obligation Responsibility Cause Passion resistance “have to” “need to” “want to” “We can “We can “We are achieve” change” transforming” Interest Accountability Your Reduced chances Values Greater chances of success Your of success Health We start moving from obligation to ownership when our role is driven by our own values and when we see that our own health and well-being is part of our role.© Organizational Wellness & Learning Systems, 2012.
    38. 38. 39
    39. 39. PART 2: Synthesis
    40. 40. IllnessWellness 41
    41. 41. OWLS Best Practice Thumbnail
    42. 42. OWLS Best Practice ThumbnailoMotivation I o Good Diet & ExerciseoMood & Energy o Role ModelingoSense of Belonging o ParticipationoSense of Engagement o PerformanceoPresenteeism o Communicate Ito Team Spirit We o Biometrics/Programso Culture of Health o Risk appraisal datao Wellness Committee o Culture/climate datao Local “Peer” Climate o Files/Benefits, Incentiveso Connectedness o Communications Its
    43. 43. Tip # 1: Walk the talkUp to 50% of all executives will die of stress-related diseases Employee’s relationships with their boss predicts their future health
    44. 44. Tip # 2: Love your sparkplugsEarly adopters Wellness advocates Champions Change agents
    45. 45. Tip # 2: Love your sparkplugsHunt them down Give them room Engage them Support them Reward them
    46. 46. Tip # 3: Empower groups/committees Formal Committee Informal/Training1. Part of job description2. Diverse3. Promoted well4. Frequent communication5. A strong leader6. Meets regularly7. Continuing education Team AwarenessWELCOA (2007)
    47. 47. Tip # 4: Think strategically about wellnessWhy give workers healthy lifestyle skillsand ignore a “toxic” work environment?You maximize ROI when you attend to climate and  depression  engagement  stressIs it possible that the underlying risks for cardiovascular disease/obesity lie inpsychological and environmental factors? 48
    48. 48. Wellness Work-Life Balance PresenceTeamwork Policy Coping Support
    49. 49. The climate of work units vary in healthRESILIENT RISK Some are healthier than others 50
    50. 50. What factors ‘upper limit’ wellness?RESILIENT Upper Limit Problem RISK Wellness Work-Life Presence Team Policy Coping Support Balance work 51
    51. 51. Tip # 4: Think strategically about wellness REVIEW1 Assess the work climate (level & dimension)2 Include behavioral health (depression)3 Identify your upper limiting factors early on 52
    52. 52. Tip # 5: Keep giving back (community)1 You’re helping families of workers (community)2 Small businesses can band together3 The business itself becomes the role model 53
    53. 53. Tip # 5: Keep giving back/Communitywww.sbwi.org Leadership Sparkplugs Groups Climate
    54. 54. Review Groups/TeamsLeadershipSparkplugs Helping… …families, other businesses, community Climate
    55. 55. Contact Information Dr. Joel BennettOrganizational Wellness & Learning Systems 3321 Collinsworth St. (suite 220) Fort Worth, Texas, 76107 www.organizationalwellness.com (817) 921-4260 56

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