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- 2. Picture here Toolkit Pilot Project Includes: • Training • Surveys (pre and post) • Contact with a regional contact • At least 6 months • Funds may be available 2
- 3. (MAP) Of regional contacts and pilots 3
- 4. WorkWell Missouri Toolkit Step 1: Purpose Step 2: Getting Started Step 3: Assessing Step 4: Planning Step 5: Implementing Step 6: Evaluating Appendices: Checklists, Samples and Resources http://extension.missouri.edu/hes/workwell/ 4
- 6. What is Worksite Wellness? An ideal healthy worksite has opportunities for employees to: O Be physically active O Eat healthful foods O Live tobacco-free O Reduce stress 6
- 7. Step 1: Purpose Potential benefits to employers: Employee turnover Absent/presenteeism Cost for chronic illness Organizational commitment to health Potential benefits to employees: Productivity, fitness, health and morale Out-of-pocket health care costs Social support within the workplace Safer work environment 7
- 8. Return on Investment O Studies have shown an average of AT LEAST $3.14 in benefits for every dollar spent on worksite wellness programs 8
- 9. Step 2: Getting Started O Gain commitment from stakeholders O Create a wellness committee O Designate a coordinator O Committee meetings Refer to: O Appendix A: Wellness Coordinator Checklist O Appendix G: Samples for Worksite Wellness Committee 9
- 10. Step 3: Assessing O Helps identify where to start O Creates a baseline O Shows existing resources and areas needing improvement O Best if done by committee, not 1 person O Surveys employees to gauge interest O Used as a measure for evaluation 10
- 12. 12
- 13. Step 4: Planning OPrioritize- CDC ScoreCard OSmall successes first OWho will do What by When? OGather feedback 13
- 14. 14
- 15. Environment & Policy Changes Environmen t supports healthy choices Increases the chance for success Helps sustain healthy behaviors 15
- 16. Policy Changes Formal or informal written statements in place to create an environment that promotes: O Healthy habits O Behavioral incentives O Access to resources 16
- 17. Environmental Change O The physical or cultural factors at and nearby the workplace that help protect and enhance employee health 17
- 18. Developing the Content Factors to Consider • Importance • Cost • Time • Commitment • Reach 18
- 19. 19
- 20. 20
- 21. 21
- 22. Employee Readiness to Change • Pre-contemplation -not thinking about changing • Contemplation -beginning to think about changing • Preparation -have tried to change • Action -taking real steps to change -slip is most likely to occur • Maintenance - have changed 22
- 23. Evidence-Based Resources and Interventions O Physical activity O Nutrition and breastfeeding O Mental health O Tobacco cessation 23
- 24. Sample Strategies Low resources • Support PA breaks during the day • Send healthy food messages Medium resources • Promote indoor/outdoor walking paths or maps • Offer healthy food choices at meetings High resources • Provide an on-site exercise facility • Provide incentives for participation in activities 24
- 25. Wellness Objective Example: Goal 1: Our workplace will have healthier food choices for on-site cafeterias and vending machines O Objective 1: By year 1, cost estimates will be gathered from different vendors for the selected foods and ingredients O Objective 2: By year 2, employees will be surveyed on what items they would buy 25
- 26. Communication is Key! Step 5: Implementing OMarket your program -Email, flyers, or announcements at meetings OIf you have staff savvy with marketing, recruit them OWellness Coordinator -Success is linked to time and ability
- 27. Creating Interest and Motivation OTime OAccess OKnowledge and awareness OCost OKey time periods OGoal setting OBuddy system or teams OCampaigns 27
- 28. Incentives Motivation~ incentive items attached to small successes • Achievement awards • Public recognition • Food • Entertainment • Merchandise • Monetary rewards or rebates • Time off 28
- 29. Initiative Launch OShould be fun! OEnergize employees OFit the worksite culture OPromote interventions without demanding attendance 29
- 30. When Implementing: DON’T OBe pushed into a fast startup OFail to act on employee needs and interests OOveruse incentives OJust focus on the high-risk group OForget the fun factor 30
- 31. Step 6: Evaluating How do you know if what you did improved the environment and the bottom line? O Attendance O Sick leave usage O Employee turnover O Morale O Productivity O Health attitudes 31
- 33. Common Challenges OBudget OTime and resources OLack of participant engagement 33
- 35. Thank You to our Partners 35
- 36. Picture here Thank You! Pilots should take Pre-Survey http://extension.missouri.edu/hes/workwell/ Good Luck! Your Regional Contact will be in touch with you. 36
- 37. For More Info: Karla Voss MO Department of Health and Senior Services Jefferson City, MO (573) 751-6197 karla.voss@health.mo.go v Donna Mehrle University of MO Extension Columbia, MO 573-884-0929 mehrled@missouri.edu 37
Editor's Notes
- We appreciate your time and interest in learning more about this topic and helping businesses promote healthier employees. MOCAN worksites Workgroup- been working together to bring you the Workwell mo toolkit. As WW gains in popularity, state agencies are trying to make more resources on this topic, to limit your time commitment.
- Thank You again! For agreeing to help in the pilot project for the newly revised WorkWell MO ToolKit. We hope to collect feedback from businesses who are “piloting” the toolkit before mass dispensing it across the state. We will be asking for the pilot sites’ feedback on the Toolkit in the form of surveys. The pre survey, we need completed shortly after their training next week, the post survey, we will send out after the end of the pilot project. As a RC we expect you to be available to answer questions and assist pilot sites. The length of the pilot project will run for six months. We know many of businesses will not complete the whole toolkit within 6 months, which is ok. But we want to gather feedback and incorporate any changes needed to the final draft of the toolkit without waiting too long. If businesses are interested in receiving a stipend from DHSS, we will be offering $400 to businesses doing this project for either staff time or small incentives, to be approved by DHSS staff. The Pilots are having a very similar training to this next week. 1 hr will be recorded
- This is a map of our pilot project’s reach. We have pilot sites and RCs in several areas across the state to gain insight from a variety of viewpoints.
- MU Ext., DHSS, and the MOCAN worksite workgroup and partners have revised the WW Toolkit which was made in 2009 to encourage worksites to improve employee wellness. Our goal is to guide employers at each step and give resources for programming to decrease a business’ time commitment when doing worksite wellness. We hope the toolkit outlines each step so a wellness coordinator could describe the steps to her committee or be able to promote WW to an employer The toolkit is created for small worksites who have never done worksite wellness but it would also help bigger businesses improve their programs. This toolkit is available on MU Ext’s webpage I’d like to go over each step so you become familiar with the toolkit.
- Some worksites may have already gone through the 1st few steps. Steps 1 & 2 are important for employers who are new to WW. An employer will likely cycle through steps 3-6, continuously re-assessing, planning and evaluating its initiatives.
- Topics covered in worksite wellness generally focus on chronic disease prevention (like heart disease, diabetes, cancer) and target changes that make it easier to be physically active and eat healthy foods. Other topics such as tobacco and stress prevention are great to include. These are the 4 topics that MO decided to make as a priority for employers starting WW. People spend at least 1/3 of their day at work, so it’s important there are healthy choices in the workplace
- The 1st step of the toolkit addresses: Why should my business develop a worksite wellness program? There are benefits to employers and employees, such as: Dec. turnover, dec. absenteeism Presenteeism- is when employees are at work but are not as productive as usual (due to stress, depression, injury, illness) Dec, h. problems usu. Lead to lower h. care costs and improved Productivity, fitness, health and morale An Organizational commitment to health benefits both employers and employees as it is seen as a more attractive place to work and retains quality employees. As health promotion grows in our society, employees are looking for these kinds of benefits from their employer. Again, many of these benefit BOTH employers and employees. A productive, healthier, happier worker is better for everyone. And BOTH want lower h. care costs.
- There are a lot of studies showing different #s on ROI. Most average around $3. You may Expect 3-5 years to see a return. The more $ you put in, the more you get out of your investment. and Changes don’t have to be big. Smaller businesses may not see as drastic monetary differences but should consider the Values Of the Investments like the benefits we just discussed
- The 2nd step of the toolkit describes logistics of buy-in from stakeholders =senior mngt, HR, safety officers, etc. (who hopefully will become your team) This Step describes what a committee and coordinator’s roles/responsibilities are. And how to start these first meetings. The appendices of the Toolkit have lots of helpful tips, checklists, and samples for the wellness coord. And creating a WW committee
- Completing a needs assessment is critical. You need to see where you are before you know where you need to go. Assessments cover a wide range of topics which is why it is helpful that your team completing the assessment be a mixture of folks who know different aspects of the worksite The same people may sit on the wellness committee as you want to complete assess, but it doesn’t have to be. An assessment should only require a few hours commitment vs. meeting monthly as part of the wellness comm. It is important to survey your employees to see what they are interested in participating in so time isn’t wasted hosting events/programs that people won’t show up to. The initial assessment (which is called a baseline) can be compared with a follow-up evaluation several months after the initiative began to show progress. It’s important to think about evaluation (which is Step 6) during Step 3 since they are closely related.
- We recommend the CDC Worksite Health scorecard as the Worksite Assessment. It is a basic benchmarking tool, assessing 16 diff. topics of health comprehensively. It will guide you through the assessment process and help you plan and implement evidence-based initiatives. The ScoreCard is comprised of 125 “yes”/”no” questions which is designed to take about 30 minutes. This can be done on-line and it gives you the flexibility to score multiple locations. After the assessment is done, it will help you prioritize topic areas and give links to suggested activities in these areas.
- employee interest surveys are very important. Looking at the results from these questions will improve understanding of where employees are and help tailor interventions. As an example, if the majority of employees are over 50 years of age and are only moderately active. A graduated walking initiative might be an appropriate physical activity intervention. There are other options for assessment. Sometimes h. insurance co. offer a health risk assess, or HRA, that may help assess the worksite population’s needs. Read more about HRAs in the toolkit. You can also look at workers comp claims, health claims and pharmaceutical use to tailor your programs.
- Once the assessment is completed, there are tools to help you make a plan of action. Use the CDC scorecard to help Prioritize. Think about: What do you want to get out of it: (like., higher morale, fewer injuries)? What could realistically be done in a year or two? What would employees like to see done? Make small changes each year, these seem less overwhelming and get accomplished faster. Be sure to consider time, budget involved, and who is responsible. Report plans to Let others know the situation and how you plan to improve it. Sharing will help build buy-in and support.
- This diagram shows that the more people you reach with a wellness initiative, the less the overall cost. The blue shows the people reached increasing as the cost per person (in green) decreases. When making plans on where to focus wellness efforts, some may have a greater impact than others. Worksite wellness can include many components: • targeting individual changes takes many resources and only affects one person at a time- such as Health screenings • on the interpersonal level, Education through presentations, printed materials and internet resources, reach more people • Initiative interventions, including behavior-change campaigns conducted over a specified time period. This would be the organization or community level • Policy and environmental changes that target everyone have the greatest potential influence.
- many folks assume worksite wellness needs to have lots of scheduled activities. While activities are a great part of it, you get a bigger bang for your buck with larger scale environmental and policy changes. These change the “social culture’’ of your worksite, making healthy the “norm”. So a policy or an enviro that supports healthy choices, inc chances of a person’s success with h. changes, which help sustain the h. beh. (this is a continuous cycle) If the healthy choice is the easy choice (and your boss and co-workers support it), employees are more likely to make healthy decisions and succeed.
- A workplace that supports health is likely to have written policies and an environment that promote health. Health-related policies are formal or informal written statements that are designed to protect or promote employee health. For ex. A lactation policy that provides women time and space to express breast milk Or a tobacco free policy- which could be just indoors or the whole campus Or a policy allowing employees to attend a lunch & learn or workout on work time It’s highly recommended to write supportive policies down as management and supportive staff can change and an unwritten policy would be lost.
- Environmental change refers to the physical or cultural factors around the workplace that help promote healthy habits. Examples include to: Provide a safe and appealing walking environment on facility grounds and in buildings Encourage walking during breaks and lunch breaks Provide clean, safe, and appealing stairwells and promote their use Offer and identify healthy food choices in vending machines, snack bars, and/or cafeterias
- Choosing priorities can be tough. If undecided, For each item from the assessment that needs improvement, ask the following questions: • How important is the item? • How much will it cost? • How much time and effort is needed? • How well does the item match employees’ interests and other relevant data? •How great is the potential reach or how many employees may be affected? Use employee survey results to help answer these questions. Package interventions (if possible) so they fulfill multiple goals.
- If you still can’t decide which intervention gets 1st priority with the CDC Scorecard, The Recommendation Table can help narrow your scope. First, identify possible topic areas to focus on such as PA or nutrition. Then select a specific set of interventions to implement, such as Creating a policy for use of break and lunch time to be active or Installing bike racks to encourage biking to work. then ask the questions that address each interventions’ importance, cost, time, commitment and reach and rank them according to the scale provided.
- Action planning After setting priorities, develop a specific action plan to implement the selected initiative. The action plan would include: • Overall goals and objectives • Specific recommendations on how to implement chosen interventions • Staff, resources and materials needed • Time frame for completion • Evaluation methods
- The action plan can be part of a presentation to share with management to gain buy-in for interventions. This may help convince management that worksite wellness is needed and help get buy-in or even funding, for specific strategies and interventions. This sample shows a 3 month long walking challenge. Recording sheets will be needed in addition to pre/post surveys, pedometers, and organizing team captains.
- The toolkit mentions the Transtheoretical Model also called Stages of Change This is background info to know about the psychology of people when they are trying to make health changes. Most people go through five stages when changing behaviors: • Pre-contemplation- At this stage, people are not thinking about changing their behavior in the near future. • Contemplation- They are beginning to seriously think about changing their behavior in the near future (next six months). • Preparation- At this stage, most people have tried to change their behavior at least once in the past year. They are thinking about trying again within the next month. • Action- People are taking real steps to change their behavior. This is the stage where a slip is most likely to occur. A slip is not a failure, but an important part of the learning and behavior process. You learn from your mistakes. • Maintenance- This stage applies to people who have changed their behavior for more than six months and are maintaining healthy behavior. People can move from one stage to another in order, but they can also move back and forth between the various stages. Reaching the maintenance stage doesn’t mean they aren’t still working hard and could possibly fall back to other stages. Most people may attempt healthy behavior change several times before they succeed. The chance of success increases each time.
- using evidence-based interventions can help a worksite reach its goals and objectives. Evidence-based means it is a program used by others that has been evaluated and proven to be effective. The CDC has resources for all topics included within the ScoreCard. The WW MO Toolkit provides some information on possible interventions to consider for addressing Missouri’s 4 priority topics for worksite wellness. PA, nutrition and BF, mental h, tobacco cess.
- Here are some WW examples. The strategies have been split into low, medium and high resource levels. The levels indicate the relative amount of staff and financial resources needed to implement the intervention. Also consider where the need for change should occur - at the individual, environmental or policy level. Remember there is an average ROI of 3-1. so The more a worksite puts into the program, the more they generally see a return.
- Making goals and objectives that are SMART will increase your committee’s odds of success. SMART means: Specific: • Measurable: • Achievable: • Realistic: • Time-phased: • In this example, a healthy food goal is broken down into smaller increments. Each goal/obj. has explained “Who will do What by When” When changing food choices, it is essential to get employee input. Allowing changes to happen over several years is generally more realistic and less daunting to those in management who will need to approve plans.
- After all that assessing and planning… Finally, we get to the implementing step! Regardless of what intervention is chosen, communication is essential for success. There are many ways to get the word out about interventions: • through company-wide emails, newsletters, wellness champions If you have staff savvy with marketing and promotion, recruit them. Here’s An Ex. of importance of promotion: “1 worksite put [smoking cessation ads] in the break room, but the smokers don’t go in the break room ,they go outside. So nobody saw it.” Get different opinions so you don’t make mistakes like this! Coord- Time to organize interventions is crucial. Consider contracting with an outside party if time is an issue.
- There are many key factors that influence people’s health behaviors. Consider the following list in maintaining participation: Time -People are busy, so the more an organization can blend wellness interventions into existing schedules, the better chances are for success. Example: A walk at lunch, on breaks or during meetings doesn’t take away from existing time Access- How accessible is the intervention? Is it on-site or at a nearby site? Knowledge and awareness- People need to know why they are participating and how to become involved with unfamiliar activities. Cost- Being able to provide no-cost or reduced-cost initiatives will help participation rates. Key time periods- Consider how to motivate employees to get past critical time markers when people tend to drop out or lapse when adopting healthy habits. (usually at 6 weeks and 6 months) Goal setting- Having a goal increases the likelihood people will stick with the initiative Buddy system or teams- make pep feel accountable and keep at it, because each individual has a commitment to something bigger than themselves. Campaigns –are typically competitive events over a specified time frame. You can host something new each year or offer the program at repeated intervals.
- Incentives encourage People who are willing to improve their health if given the right type of interventions and motivations. Some examples are listed While incentives can increase participation, be careful not to overuse them to the extent that they are the main reason for participation. People should want to participate to become healthier, not just for the free stuff. if implementing a health-contingent initiative, It is important that the company understand their responsibilities in complying with government rules. Refer to your toolkit for more info on this.
- The Launch or kickoff should be a fun experience to gain employee’s attention to the program. Some common approaches to launching an initiative include: • Health fair and health screenings. • Employee appreciation events with healthy food taste tests to promote healthy choices. • Ribbon-cutting ceremonies for a new fitness room, wellness lending library, or highlighting any environmental changes. • Walks are also a good way to launch an initiative since they get people together and moving.
- A few don’ts and do’s when implementing. Remember to Start small. Work slowly. Focus on employees’ needs and interests. Encourage people to participate to better themselves, not just get the prize. Target everyone Have fun.
- You have to evaluate to make sure what you’re doing is making a difference. To see if the bottom line was affected, attendance, sick leave usage, and employee turnover can be reviewed before, during and after interventions. These are baselines that should be measured in the assessment phase. Needs assessments and employee feedback and interest surveys can be used before and after wellness interventions to see if environments, practices and opinions changed. If your business is self-insured, you can also review health care usage. It may take several rounds of interventions, if they are small-scale, to begin to see cost savings. It is important to plan evaluation when planning the program. Think about step 6 during steps 3 and 4 of the Toolkit process. The CDC scorecard will also guide you
- Process indicators are simple measures that provide quick feedback on how well new interventions are being accepted by employees. Examples of process measures are: • participation rates • Website hits • Observations or counts (e.g. track number walking at noon), Process indicators do not always have a baseline to use for comparison but can be helpful. Outcome evaluation is more complex and shows the long-term results of new interventions. Outcome evaluation data may need to be collected for multiple years to show impact. Examples of outcome measures are: • Pre/post-test surveys or quizzes (measure changes in attitude, knowledge, current health behavior status), • Number of healthy vending items purchased (arrange with vendor to track sales), • Cafeteria menu options Health indicators as seen from HRAs or h. insurance info Outcome evaluation needs to identify what is being addressed in advance, and have the baseline data for comparison
- There are several common challenges when doing WW Budget - many activities can be planned for free, such as group walks and encouraging staff to bring in healthy snacks for celebrations. When an organization refuses to allocate any funds to a workplace wellness program, it is hard for the program to be successful. Remember ROI Few organizations can afford a fully staffed, highly experienced benefits and wellness department. Leveraging outside experts can help provide direction and knowledge as needed. HR mngr assoc’s and Chambers of Commerce may be a place to look. As well as local h. depts and MU Ext. Time and Resources - A lack of time presents a challenge to many WW organizers and workers who might participate in a program. arrange programs during lunch times or other natural breaks in the day, allowing individuals to participate without missing quite as much work Allow staff to participate in wellness activities on company time. Ex. 1 hour a month. Again, remember ROI Tap into other local programs (such as YMCA’s or P&R) or request free educational resources from USDA, American Heart Association, etc. Lack of participant engagement - To amp up interest, employers must heavily advertise their programs, highlighting the benefits the programs offer. offer incentives. Collect Surveys for feedback. May be a lack of communication. Remember, communication is key!
- The DHSS website has a section for Worksite Wellness – Has a challenge page with ready-made posters and bulletin board displays to print, as well as instructions for challenges and programs that you can use. Including “desk-ercise” videos. displays are provided in power point format and include a list of supplies needed as well as applicable handout links to the particular topic. Displays will easily fit on a 6’ table or can be posted on a bulletin board. This ex. Shows a “added sugar” display
- Describe MOCAN? Contributors on pg. II?
- Before beginning the Toolkit process, please fill out the Pre-Survey provided electronically at this link. We will email this out and remind you if we haven’t received it by the end of next week. Thank you again for helping improve the wellness of your employees and taking the time to give us feedback.
- We will send out our info as well as RCs