Worksite Wellness Evaluation: Basic Strategies for Worksites of All Sizes w David Chenoweth

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Worksite Wellness Evaluation: Basic Strategies for Worksites of All Sizes w David Chenoweth

  1. 1. Worksite  Wellness  Evalua0on:  Basic  Strategies  for  Worksites  of  All  Sizes   David  Chenoweth,  Ph.D.,  FAWHP   HPlive.org   Webinar   March  15,  2013  
  2. 2. Well-­‐planned  Evalua0ons  Can  be  a  Decisive   and  Strategic  Advantage        Assess  quality  of  resources  (personnel,            equipment,  facili>es,  etc.)      Determine  level  of  impact        Allocate  your  budget  propor>onately      Establish  external  benchmarking      Guide  strategic  planning  
  3. 3. A  growing  impetus  for  evalua0on…   Alcohol Health & Benefits Abuse Structured “Wellness” Productivity Recreational Enhancement Treatment Safety Exercise Programming ManagementHorseback rides, Occupational “Business Strategy” Employeegyms, swimming, • Hershey Assistance Safety & Health •PepsiCo • Quaker Oatsetc. Foods Programs Act •NASA • Union Pacific•Pullman • Kimberly-Clark • Steelcase • Sentry Ins. • First Chicago Bank•NCR 1890 1930 1950 1970 1980 1990 2000 2015
  4. 4. Purpose  of  Evalua.on…        “Evalua>on  is  not  research;    it  is  not  done  to  prove  or  disprove  anything;     it  is  done  to  improve  something...”   Research   Evalua>on   “Careful  or  diligent  search”   “Determine  or  affix  the  value  of”   “Studious  inquiry  or  examina9on”   “Determine  the  significance,   worth,  or  condi9on…”  
  5. 5. The  Seven  Benchmarks  1.  Capturing  Senior  Level  Support  2.  Crea>ng  Cohesive  Teams  3.  Collec0ng  Data  4.  CraRing  an  Opera>ng  Plan  5.  Choosing  Appropriate   Interven>ons  6.  Crea>ng  Suppor>ve   Environments  7.  Carefully  Evalua0ng  Outcomes   Courtesy  of  Wellness  Council  of  America  (WELCOA).  
  6. 6.  Perceived  Values  vs.  Actual  Performance…   WELCOA  Faculty  &   Well  Workplace  Checklist   Ranked  Diff.   %  Criteria  @  B-­‐ Webinar    Part.  (480+)   (3,800+)   Benchmarks  vs.   mark  Status   Rank   “Benchmarks”   “Norms”   Norms    (>4  of  5)   1st   Wellness  Opera>ng  Plan   Choosing  App  Inter.   +5   85%   2nd   Sr.  Level  Support   Wellness  Teams   +1   88%   3rd   Evalua0ng  Outcomes   Sr.  Level  Support   +4   100%   4th   Crea>ng  Wellness  Team   Healthy  Environ.   -­‐2   50%   5th   Choosing  Appropriate   Collec>ng  Data   -­‐4   58%   Interven>ons   6th   Crea>ng  Healthy   Well.  Opert’g  Plan   -­‐2   55%   Environment   7th   Collec0ng  Data   Evalua0ng  Outcomes   -­‐2   38%  Source:  Chenoweth,  D.  and  HunnicuM,  D.  WELCOA’s  Benchmark  Survey,  2013.  
  7. 7. Crea.ng  a  data-­‐driven  evalua.on…   1.  Capturing  Senior  Level  Support   2.  Crea>ng  Cohesive  Teams   3.  Collec0ng  Data   4.  CraRing  an  Opera>ng  Plan   5.  Choosing  Appropriate  Interven>ons   6.  Crea>ng  Suppor>ve  Environments   7.  Carefully  Evalua0ng  Outcomes  
  8. 8. Building  a  prac0cal,  results-­‐oriented  [3-­‐0ered]  evalua0on…   Health   Management   “Financial   Outcome”   “Impact”   “Process”   8  
  9. 9. Insert  slide  of  Eval’n  book   Financial   Process   Impact   outcome   Chenoweth  &  Associates,  Inc.   9  
  10. 10. Transi.oning….from  Process  to  Impact  to  Outcome…  is  a  JOURNEY….that  takes  .me…  
  11. 11. The  essence  of  “tailoring”  an  evalua.on  around  your   wellness  interven.on…   Process   Impact   $  Outcome  
  12. 12. “Financial     Outcome”   “Impact”   Appraising  the      Risk  factor  status   monetary  value  to        Behavior     wellness-­‐generated   “Process”      Health  care  usage   impacts    Produc>vity     Assessing  par9cipant   sa9sfac9on  with  instructor/coach,   facility,  program  quality,  etc.  Jan.                                                  July                                            December                    July      
  13. 13. “Financial     Outcome”   “Impact”   “Process”   Business     Quan0ty   Performance     -­‐ -­‐  -­‐  -­‐  -­‐  -­‐  -­‐  -­‐  -­‐  -­‐   Financial     Quality     Accountability  Jan.                                                                      July                                                                December                  July          
  14. 14. “Process”   Do  employees  like  and  respect   the  wellness  program,  etc.?     Par>cipa>on     Par>cipants’  sa>sfac>on  with:    -­‐  program  content    -­‐  delivery    -­‐  feedback  Jan.                                                                              July                                          December                              July        
  15. 15. “Process”  Evalua.on   [Qualita.ve]   •    Employees’  sa.sfac.on  with  program  content,  delivery,   availability,  facili.es,  instructors,  policies,  etc.   When  using  HRA  and  self-­‐report    tools,  use  non-­‐biased  statements    and  a   quan9ta9ve  index   Please  indicate  your  opinion     with  a  check  mark  on  the  following  scale:     “Level  of  customer  service  provided  by  wellness  staff”   [  -­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐]   Very                          High                    Moderate                  Low                          Very   High                                                                                                                                                              Low   (5)                          (4)                              (3)                    (2)            (1)  
  16. 16. “Impact”      Risk  factor  status      Behaviors      Health  care  usage      Produc>vity     “Process”  Jan.                                                                                          July                                                                                    December                          
  17. 17. Tools/techniques  for  assessing  IMPACT…     Employee  health  records     Environmental  audit     Culture  audit     Employee  focus  groups     Health  risk  assessment  (HRA)     Biometric  screening     Produc0vity  survey     Medical  care  claim-­‐cost  data     Visual  observa0on   CAUTION:  No  single  technique  is  a  sufficient  stand-­‐alone  diagnos0c  tool   17  
  18. 18. Conduc.ng  an  IMPACT  evalua.on…   1)  Select  key  variables  to  measure  (i.e.,   par9cipa9on,  risk  factor  status,  health  care   usage,  worksite  accidents,  etc.)   2)  Iden9fy  your  target  popula9on   3)  Prepare  a  format  to  record  and  format  data   4)  Collect  data  via  screening,  health  risk   appraisal,  etc.   5)  Analyze  data  at  designated  intervals  
  19. 19. Preparing  a  format  to  record  and  analyze  IMPACTS…   “IMPACT” " Baseline 02" 03 " 04 " 0 5" Variable" 01 " March" July" Oct.! Dec." Jan."Blood"pressure"Absences" Visits to OHN"Low backinjuries"Productivity"
  20. 20. Recording and analyzing impact data…   Impact" Baseline 02" 01 to 02" 03 " 01 to 03 " Variable " 01 [Jan.] " [March] " % Change " [Oct.] % Change" !Blood" 134/90 " 130/89 " -2.3"pressure"Absences" 5/100" 4.8" -4.0%" 4.5" -10%"On-site 348" 346" -1%" 321" -7.8%"clinic visits"Low back 3/100" 2.9" -3.5%" 2.8" -6.7%"injuries"Productivity" 78" 79" +1.3%" 83" 6.4%"
  21. 21. A  sample  IMPACT  variable…    “Rate  the  availability  of  healthy  vending  machine  items:”    Very  Good                      Good                  Neutral                                  Poor                                Very  Poor                5                4                3            2            1    
  22. 22. “Financial     Outcome”   Appraising  the     “Impact”   monetary  value  of     wellness-­‐generated   impacts  Jan.                                                                          July                                                              December                                        July      
  23. 23. …the  real  value  proposi0on…  conver0ng  human  [health  capital  into  business  capital…      Work  performance      Revenue  genera0on      Compe00ve  edge   23  
  24. 24. Transi0oning  from  IMPACT  to  $  OUTCOME…   Impact  (Non-­‐financial)  Values   $  Financial  Outcomes      BMI  decrease      Blood  pressure  decrease      Physical  ac>vity  increased      Self-­‐confidence  improved      Perceived  performance  higher      Fewer  workers’  comp  claims      Fewer  Rx  drug  claims      Fewer  medical  claims   2 4
  25. 25. Ostbye,  T.  et  al.  Arch  Intern  Med  2007;167:766-­‐773.   25  
  26. 26. When possible, build on today’s standards…(e.g., specificity)… Source:  Chenoweth  &  Associates,  Inc.;  North  Carolina  League  of  Municipali9es,  Raleigh,  NC,  2010.  
  27. 27. Medical  care  cost  per  risk  factor    Source:  Chenoweth,  D.  Promo.ng  Employee  Well-­‐Being:  Wellness  Strategies  to  Improve  Health,  Performance  and  the  Bo_om  Line.  SHRM  Founda9on’s  Effec9ve  Prac9ce  Guidelines  Series.  June  2011.  [www.shrm.org/founda9on]  
  28. 28. Risk Condition Absenteeism Presenteeism TotalDiabetes mellitus 4.94% 18.26% 23.20%Depression 2.61% 14.51% 17.12%Alcohol abuse 5.00% 4.78% 9.78%Obesity 1.40% 8.30% 9.70%High cholesterol 3.14% 4.91% 8.05%Smoking 2.84% 4.78% 7.62%High stress 3.08% 4.45% 7.53%Arthritis 2.36% 4.90% 7.26%High blood pressure 0.37% 5.70% 6.07%Asthma 4.80% 1.20% 6.00%Migraine 3.96% 1.99% 5.95%Physical inactivity .28% 4.59% 4.87% 28  Source:  Chenoweth,  D.  2011.  Ibid.  
  29. 29. Recommended  resource…   Full  Report:   www.shrm.org/founda9on/ products/documents/ 6-­‐11%20Promo9ng %20well%20being%20EPG-­‐ %20Finalpdf   Execu9ve  Summary:   www.shrm.org/about/ founda9on/products/ documents/wellness/%20Exec %20Briefing-­‐Final.pdf   Chenoweth  &  Associates,  Inc.   29  
  30. 30. Calcula0ng  the  Cost  of  Lost  Produc0vity  Per  Risk  Factor     “A”    mul9plied  by    “D”  [BxC]    mul9plied  by  “  E  “      =        “F”   Risk  Factor   (A)  %   (B)  #   (C)   (D)  #  At-­‐risk   (E)  Median   (F)  Lost   Workload   Employees   Prevalence   employees   Annual   prod.  cost   Lost   Compens’n   Alcohol  abuse   Arthri0s   .0726   500   .26   130   $50,000   $471,900   Asthma   Depression   Diabetes   High  cholest.   Hypertension   Migraine   Obesity   Phy.  inac>vity   Stress   30  
  31. 31. Building  a  credible  evalua0on  approach  …   Process   Impact   $  Financial   Outcome   Chenoweth  &  Associates,  Inc.   31  
  32. 32. CAUTION!  What  are  the  key  prerequisites  for   construc0ng  a  credible  evalua0on?     Suitable  and  suppor0ve  poli0cal  environment     Programs  –  well  established     Sufficient  par0cipa0on     Data  tracking:  pre  vs.  post     Evaluator’s  competence  and  objec0vity   Chenoweth  &  Associates,  Inc.   32  
  33. 33. Enhancing  the  quality  of  evalua.on   by  establishing  goals  that  are…     compa0ble  with  stakeholders’  needs  and  values     measurable:  variables  that  can  physically  be  measured     quan0fiable:  a  value  (#,  %,  $)  can  be  assigned  to  a  variable     focused  on  an  interven>on  that  has  been  opera0ng  long                  enough  to  legi>mately  generate  an  impact     realis0cally  achievable  (e.g.,  wellness  interven>on  is  likely  to                          make  a  posi>ve  impact)   Chenoweth  &  Associates,  Inc.   33  
  34. 34. Wellness  Strategies  and  Impact  Timeframes   Impact  on   Impact  on  Employee   Impact  on  Employee   Organiza>on’s  Health  Wellness  Interven>on   Health  Status   Produc>vity   Costs  Biometric  Screening   12-­‐18  months   Not  well  established   NWE   (NWE)  Condi0on  mgmt   6-­‐12  months   6-­‐12  months   12-­‐18  months  (asthma,  arthri0s,  diabetes,  etc.)  Drug-­‐tes0ng     3-­‐6  months   3-­‐6  months   6-­‐12  months  EAP     12-­‐18  months   12-­‐18  months   >24  months  Ergonomics   3-­‐6  months   3-­‐6  months   NWE  Financial  incen0ves   6-­‐12  months   NWE   NWE  Flex-­‐0me  work   3-­‐6  months   3-­‐6  months   6-­‐12  months  schedule  Health  Risk   NWE   NWE   NWE  Assessment  (HRA)  Low  back  health   6-­‐12  months  Chenoweth  &  Associates,  onths   6-­‐12  m Inc.   12-­‐18  months   34  
  35. 35. Wellness  Strategies  and  Impact  Timeframes   Impact  on   Impact  on  Employee   Impact  on  Employee   Organiza>on’s  Health  Wellness  Interven>on   Health  Status   Produc>vity   Costs  Medical  self-­‐care   3-­‐6  months   6-­‐12  months   12-­‐18  months  Mental  health/ 3-­‐6  months   3-­‐6    months   12-­‐18  months  depression  mgmt.  Non-­‐financial   NWE   NWE   NWE  incen0ves    Nutri0on     3-­‐6  months   6-­‐12  months   12-­‐18  months  Physical  ac0vity   3-­‐6  months   6-­‐12  months   12-­‐18  months  Smoking  cessa0on   3-­‐6  months   6-­‐12  months   36-­‐48  months  Stress  management   3-­‐6  months   3-­‐6  months   6-­‐12  months  Tobacco  free  worksite   3-­‐6  months   3-­‐6  months   6-­‐12  months  Weight  management   6-­‐12  months   12-­‐18  months   NWE   Chenoweth  &  Associates,  Inc.   35  
  36. 36. Identifying and acquiring key data for evaluation… Occupational Health andWork/life Safety (Accidents/ Demographics Productivity Injuries) Management Medical Ergonomics claims Health risk status Absenteeism/presenteeism (HRA/Screening) 36  
  37. 37. Designing  a  prac.cal  plan  for  evalua.ng…   Scope  &   Evalua>on   Evalua>on   Evalua>on   Timeframe   Specificity   Goals   Design   Resources  What   -­‐  are  we   -­‐  do  we  want  to   -­‐  design  is   -­‐  types  of   -­‐  Is    an   evalua9ng:   generate:   appropriate:   resources  are   appropriate      program?      internal      non-­‐exp?   needed?   9meframe?      policy?   assessment?      quasi  exp?      benchmark?      incen9ve?      proposal  for   expanding?  Why   -­‐  are  we   evalua9ng?  How   -­‐  can  we  best   use  each   resource?  Who   -­‐  is  the  target   -­‐  is  most   popula9on?   qualified  to  use   each  resource?  Where   -­‐  is  the  evalua9on   -­‐  can  we  obtain   conducted?   resources?  When   -­‐  is  the  best  9me?   Chenoweth  &  Associates,  Inc.   37  
  38. 38. Iden0fying  WHAT  you  are  going  to  evaluate…   Wellness   Enviro-­‐   Program   Health  Plan   Policies   Cultural   Incen>ves  Health  coaching   CDHP  focus   Smoke  free,  drug   Healthy  work   Health  insurance   with  incen>ves   free,  safety   semng/clean/safe   premium  discount   Fitness  center   Waived  co-­‐pays   Healthy  food   Accessible,   Fitness  center  subsidy   for  main.  Rx   op>ons   aorac>ve  stairways   drugs  Women’s  weekly   Medical  self-­‐ Lacta>on   Healthy  food   Flexible  spending   health  series   care  included   op>ons   account  (FSA)     Lunch  ‘n  Learn   Flex-­‐>me  and   Ergonomically-­‐   Health  reimbursement   telecommu>ng   enhanced   account  (HRA)     worksta>on   Walking  club   38  
  39. 39. Programs,  policies,  and  incen0ve  op0ons…   Physical  Ac>vity   Nutri>on   Informa>on/Educa>on   Other  Stairway  signage   Lunch  ‘n  learns   E-­‐mail  daily  >ps   On-­‐site  medical  clinic  Low  impact  walking   On-­‐line  webinars   Bull.  Boards  in  high   Health  Kiosk  with  b.p.   density  areas   cuff,  scales,  etc.  Walking  trails     Color-­‐coded  healthy   Medical  self-­‐care   Quiet  room   vending  items   booklets  Exercise  equip.  in  break   Healthy  potluck  with   On-­‐site  library   5  minute  on-­‐>me  area   recipe  exchange   stretching  Stretch  breaks   Gradually  phase  in   Hlth  mags  in  bathroom   Days  off  for  excellent   healthy  vend.  items   stalls   aoendance    Fit  ctr.  $  subsidies   Fruits/veggies  @  mtgs.   Health  column  in  co.   Establish  smoke-­‐free   newsleoer   worksite  At-­‐work  showers  and   Subsidize  healthier   Lacta>on  suites  for  lockers   cafeteria  food   nursing  employees  Dept.  compe>>ons    “Nutri-­‐>ps”  on  café/ break  tables   39  
  40. 40. Environmental  enhancements  to  boost  more   physical  ac0vity…   Before   ARer  
  41. 41. Environmental  [physical  environment]   enhancements…   –  Vending  op9ons   –  Workout/fitness  space   –  Cafeteria   –  Hea9ng/cooling/ven9la9on   –  Ergonomic/Safety   –  Well  lit  areas   –  Smoke-­‐free  
  42. 42. Tailoring  the  scope  of  an  evalua0on…      Process            -­‐  par>cipa>on            -­‐  like/dislike  change      Impact              -­‐  #  of  steps/day              -­‐  #  mins.  exercise/day              -­‐  body  mass  index  (BMI)              -­‐  #  of  health  care  claims              -­‐  perceived  produc>vity      Financial  outcome              -­‐  Health  care  cost$  
  43. 43. In  a  small  worksite…   PCL  Construc>on  –  Denver,  CO   “Keys  to  Wellness”      Provides  healthy  snacks  in  vending  machines      Fitness  center  subsidies      “Ping-­‐pong”  tables      Local  5K  runs      H1N1  and  flu  vaccina>ons      Annual  on-­‐site  health  screenings      Doesn’t  use  “program”  as  this  creates  a  percep>on            that  healthy  ac>vi>es  are  separate  from  the            company’s  normal  business  prac>ces.     Courtesy  of  PCL  Construc9on,  Inc.   43  
  44. 44. Aligning  wellness  (programs,  policies,  and  incen0ves)  within    a  feasible  evalua0on  plan…   PCL  Construc>on  –  Denver,  CO   “Keys  to  Wellness”   Strategy   “Process”   “Impact”   “$  Outcome”   Healthy  vending  snacks   √   √   Fitness  center  subsidy   √   √   √√   “Ping  Pong”   √   H1N1  vaccina9ons   √   √   √√   On-­‐site  hlth  screenings   √   √  √√  Compare  medical  care  claims  and  cost  among  par.cipants  vs.  non-­‐par.cipants.   44  
  45. 45. Sample  tools/techniques  used  for  evalua0on…   Strategy   “Process”   “Impact”   “Financial   (volume  indicators)   (changes)   Outcome”  Healthy  vending  snacks   √   √   (Item  counts)   (HRA,  BMI   scr’g)    Fitness  center  subsidy   √   √   √√   (Par>cipa>on)   (HRA,  biometric   (Annual  claims   scr’g)   data)  H1N1  vaccina9ons   √   √   √√   (Par>cipa>on)   (Aoendance,   (Annual  influenza   flu  claims)   claim  &  cost  data)  On-­‐site  hlth  screenings   √   √   (Par>cipa>on)   (HRA  health   status)  √√  Compare  medical  care  claims  and  cost  among  par.cipants  vs.  non-­‐par.cipants.   45  
  46. 46. In  a  mid-­‐size  worksite…   Syngenta  Crop  Protec0on      Healthy  snacks  in  vending  machines      Fitness  center  subsidy      On-­‐site  Medical  Clinic      Weight  Watchers™  on-­‐site  program      Annual  on-­‐site  health  screenings   Courtesy  of  Judy  Garreo,  COHN.  Syngenta  Crop  Protec>on,  Greensboro,  NC   46  
  47. 47. Syngenta  Crop  Protec.on   Strategy   “Process”   “Impact”   “Financial   (volume  indicators)   (change)   Outcome”  Healthy  vending  snacks   √   √   (Item  counts)   (HRA,  BMI  scr’g)  Fitness  center  subsidy   √   √   √√   (Par>cipa>on)   (HRA,  biometric  scr’g)  On-­‐site  Medical  Clinic   √   √   √√   (U>liza>on)   (HRA,  health  records,   (Annual  claim   #  of  medical  claims)   costs)  Weight  Watchers™   √   √   √√   (Par>cipa>on)   (HRA,  biometric  scr’g)    (Pre  vs.  Post   claim  costs)  On-­‐site  health  scr’ning   √   √   (Par>cipa>on)   (HRA  health  status)  √√  Compare  medical  care  claims  and  cost  among  par.cipants  vs.  non-­‐par.cipants.   47  
  48. 48. In  a  large  worksite…   Bap0st  Health  South  Florida…     “Wellness  Advantage”  award-­‐winning  program     Eight  on-­‐site  fitness  centers  with              2x  annual  open  houses     Classes:  boot  camp,  urban  training,  walking  and      circuit  training     Bi-­‐annual  wellness  fairs  with  free  screenings     $3  Wellness  Meals  (<600  calories  &  <30%  fat)                -­‐    the  fastest-­‐selling  items!  >  Disease  management  program  =  posi>ve  ROI   Courtesy  of  Bap0st  Health  South  Florida   48  
  49. 49. “Process”   “Impact”   Strategy   (volume  indicators)   (changes)   “$  Outcome”  On-­‐site  fitness  centers   √   √   √√   (Par0cipa0on)   (HRA  status  &   (Annual  medical   biometric  scr’g)   claim  costs)  Classes   √   √   (Par0cipa0on)   (HRA  status)  Wellness  Fair   √   (Par0cipa0on)  Wellness  Meals   √   √   (#  Meals  sold)   (HRA  health   status  indicators)  Disability  management   √   √   √+   (Par0cipa0on)     (RTW,   (Disability-­‐ Produc0vity   specific  claim   indicators)   costs)  √√  Compare  medical  care  claims  and  cost  among  par.cipants  vs.  non-­‐par.cipants.  √+  Track  medical  care  and  Rx  drug  use  and  costs  at  quarterly  intervals.   49  
  50. 50. Tips  for  Enhancing  your  Evalua.on…      Establish  a  clearly  delineated  goal  or  vision  for                  doing  an  evalua>on      Allocate  at  least  5%  -­‐  10%  of  your  budget  for  evalua>on      Iden>fy  key  stakeholders  and  tailor  the  evalua0on                  to  their  needs  and  values      Have  a  realis0c  expecta0on  of  what  an  evalua>on  can  produce      Select  only  variables  that  you  can  reasonably  track      Assess  data  sources  and  types  of  data  that  are  available                    before  pumng  an  evalua>on  into  ac>on      Give  the  interven>on  >me  to  make  a  genuine  impact      Once    essen>al  resources  (e.g.,  personnel,  equipment,                    facili>es,  etc.)  are  iden>fied,  conduct  a  beta  trial  (test  run)                  to  iden>fy/resolve  any  barriers    Source:  Chenoweth,  D.  “Decision  Points  Around  Evalua9on.”  AWHP’s  Worksite  Health,    Summer  2001,  8-­‐14.   50  
  51. 51. Crea0ng  synergism  for  building  successful  evalua0ons  today…tomorrow…and  the  future…   PROCESS   Environment   Programs   Evalua0on   IMPACT  Worksite  Infrastructure   Policies   $  OUTCOME   Incen0ves   51  
  52. 52. Thank  You!   David  Chenoweth,  Ph.D.   Chenoweth  &  Associates,  Inc.   128  St.  Andrews  Circle   New  Bern,  NC    28562-­‐2907   252-­‐636-­‐3241  EconohealthROI™   www.chenoassociates.com   dave@chenoassociates.com   PRFCA™   CorpWellROI™   52  

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