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Demonstration of the CDC Worksite Health Scorecard with Jason Lang and Dyann Matson Kaufman


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Demonstration of the CDC Worksite Health Scorecard with Jason Lang and Dyann Matson Kaufman

  1. 1. The CDC Worksite Health ScoreCard:An Organizational Health Assessment Tool Jason E. Lang, MPH, MS Division of Population Health Dyann M. Matson Koffman, DrPH, MPHDivision for Heart Disease and Stroke Prevention Health Promotion Live October 26th, 2012 National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention
  2. 2. The CDC Worksite Health ScoreCard  Why develop the CDC-Health ScoreCard (HSC)?  What is it?  Who should use it?  How was it developed?  How was is validated?  What did we learn?  Next Steps?  How do you use the CDC-HSC?
  3. 3. Why develop the CDC Worksite Health ScoreCard? The United States is facing an unparalleled health epidemic, driven largely by chronic diseases Chronic diseases represent 75 percent of the nation’s $2.2 trillion medical care costs  American businesses’ competitiveness threatened due to lost productivity and unsustainable health care costs A wellness program aimed at keeping employees healthy is a key long term human asset management strategy
  4. 4. Why develop the CDC Worksite Health ScoreCard? Comprehensive worksite health promotion program  Evidence-based individual risk reduction programs  Environmental supports for healthy behaviors  Policy and wellness activities Only 6.9 percent of employers offer a comprehensive worksite health promotion program  Linnan L, et al. Results of the 2004 National Worksite Health Promotion Survey. Am J Public Health 2008;98(8):1. Few validated worksite tools that adequately measure a comprehensive worksite health promotion program
  5. 5. The CDC Worksite Health ScoreCard (HSC)A 100 item tool designed to help employers assess theextent to which they have implemented evidence-basedhealth promotion interventions in their worksites toprevent heart disease, stroke, and related chronicconditions.Available at:
  6. 6. The CDC Worksite Health ScoreCard (HSC)Assesses best practice health promotion interventions(policies, programs, environmental supports)  Organizational supports  High blood pressure  Tobacco control  High cholesterol  Nutrition  Diabetes  Physical activity  Signs and symptoms of  Weight management heart attack and stroke  Stress management  Emergency response to  Depression heart attack and stroke
  7. 7. What does the CDC-HSC look like? ~100 Yes/No Questions
  8. 8. Who can use the CDC-HSC tool? Employers, human resource managers, health benefit managers, health education staff, occupational nurses, medical directors, wellness directors, or others responsible for worksite health promotion to:  Help employees adopt healthy lifestyles  Establish benchmarks and track improvements over time  Integrate efforts with business objectives State health departments can use the tool to:  Assist employers and business coalitions to establish healthier workplaces  Monitor worksite practices  Establish best practice benchmarks and track improvements in worksite health promotion programs over time
  9. 9. How was the CDC-HSC developed?The CDC Division for Heart Disease and Stroke Preventiondeveloped the HSC in collaboration with: Emory University, Institute for Health and Productivity Studies  Dr. Ron Goetzel, Dr. Enid Chung Roemer, and staff Research Triangle Institute CDC’s National Center for Chronic Disease Prevention and Health Promotion Workplace Workgroup An expert panel of federal, state, academic, and private sector representatives
  10. 10. Developing the CDC-HSC Examined existing worksite inventories and resources Identified reliable and valid questions from the Heart Check and Heart Check Lite assessment tools Identified new domains and questions to add from other surveys Pre-tested the tool to help ensure that it was clear, easy to understand, and simple to complete (cognitive test)  9 employers in 2008  9 employers in 2010  70+ worksite health promotion practitioners nationwide in 2010
  11. 11. Developing the CDC-HSC (cont.) Revised the HSC tool based on employer feedback Weighted each question based on level of:  Scientific evidence (1-4)  Impact on intended health behavior (1-3) Summed the scores and adjusted/ assigned value: 1=good, 2=better, and 3=best evidence/impact.  For example, promotion of stair use got a “Strong-4” rating on strength of evidence and a “Large-3” on impact to increase physical activity by more than 3 percentage points. This question gets an adjusted score of 3 for “best evidence/impact”
  12. 12. Developing the CDC-HSC (cont.)Available at: Description of the Rating System How impact scores and weights were assigned How final score was derived for each question Citations and references
  13. 13. HSC Employer Recruitment Recruited employer participants nationwide through  State HDSP Programs,  National Business Coalition on Health  National Safety Council Goal: 30 organizations for each employer size worksite  Very small -- 10-99  Small -- 100-249  Medium -- 250-749  Large -- 750+
  14. 14. How was the CDC-HSC Validated? Field tested the tool for validity, reliability, and feasibility of adopting the tool’s interventions  93 worksites in 2011  24 very small, 13 small, 16 medium, and 40 large Conducted inter-rater reliability and content & face validity  93 employers (2 respondents per site completed online survey)  20 employers (random sample from the 93) participated in telephone interviews  9 employers (random sample from the 93) participated in site visits
  15. 15. What did we learn? Employers like the HSC and reported that most interventions are feasible to adopt There is a linear relationship between employer size and number of interventions in place (215 max score) Average HSC Scores for Study Sample 99 Employer Size 112 Groups Very small: 10–99 129 Small: 100–249 153 Medium: 250–749 129 Large: 750+ 0 50 100 150 200 Very small Small Medium Large All Employers
  16. 16. Next Steps Using HSC as the main organizational assessment tool in CDC National Healthy Worksite Program Submitting peer-reviewed manuscript Developing an online application to use the HSC Continuing Dissemination Developing New Module; available in 2013
  17. 17. New Module Development Three new modules to be tested as part of the CDC National Healthy Worksite Program (NHWP)  Lactation Support - 6 questions  Occupational Health and Safety – 10 questions  Vaccine Preventable Diseases - 6 questions Additional questions on community resources and partnerships (not scored) Testing will follow the same validation procedures as the original modules
  18. 18. Ongoing Dissemination Conferences and Webinars E-blast Listservs  NHWP Constant Contact Targeted Trainings
  19. 19. How Do You Use the CDC-HSC?1. Complete the Health ScoreCard using the instructions (page 8)  Gather a small team of individuals representing different organizational units, e.g., Human Resources, Health Benefits, Occupational Health, Worksite Wellness Committee  Answer “yes” or “no” for each question on the tool.  Answer all questions consistent with practices and programs that are current or have been in place within the last 12 months  If you are a large organization with multiple worksites, complete this tool for each worksite separately
  20. 20. How Do You Use the CDC-HSC? (cont.)2. Tally your score for each topic, e.g., hypertension (page 9)3. Review your scores and use them as a planning tool and to identify potential gaps in your worksite program4. Identify which of your priority strategies are feasible for implementation in the short-term and long-term  Determine which of these strategies are relevant, feasible, and consistent with your organization and employee needs  Identify the highest impact strategies not currently in place at your worksite.  Use this information to develop an Annual Worksite Health Improvement Plan and Budget
  21. 21. Health Improvement Plan Template and Sample
  22. 22. How Do You Use the CDC-HSC? (cont.)5. Consult the Resource Links section6. Contact your State Health Department for technical assistance with your worksite program  index.htm  directory7. Use benchmarking to demonstrate progress over time  Complete the survey annually to document and report progress8. Inform and educate employees and management about the status and progress of your organization’s health promotion program
  23. 23. The CDC Worksite Health ScoreCard
  24. 24.
  25. 25. ResourcesA Purchaser’s Guide to Clinical Preventive Services Developed by CDC, the Agency for Healthcare Research and Quality (AHRQ), and the National Business Group on Health (NBGH) Recommended clinical preventive services for health benefits design Targeted to all health care purchasers (public and private)
  26. 26. ResourcesCDC LEAN Works!
  27. 27. ResourcesTobacco Cessation
  28. 28. Resources Successful Business Strategies to Prevent Heart Disease and Stroke Toolkit Provides information on recommended preventive health benefits and services and worksite health promotion interventions Available at: s/employers_toolkit.htm
  29. 29. Resources National Diabetes Education Program (NDEP) Business Health Strategy Workgroup (BHS) Goals and Partners To increase awareness of the benefits of quality diabetes care among employers, benefits managers and managed care decision makers To provide employers, health plans and employees with tools and information for incorporating diabetes education programs into the workplace To promote the value of investing in prevention
  30. 30. Contact Information Dyann M. Matson Koffman, DrPH, MPH, CHES Health ScientistDivision for Heart Disease and Stroke Prevention Email: Jason E. Lang, MPH, MS Team Lead, Workplace Health Programs Division of Population Health Email:
  31. 31. Thank You!For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: Web: www.cdc.govThe findings and conclusions in this report are those of the authors and do not necessarily represent the officialposition of the Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention