HRA Follow-Up Involves Intervention And Monitoring, Survey Finds

The majority of wellness professionals involved in the administration of health risk assessments (HRA’s) follow up on the HRA results, according to the results of a workplace wellness management survey conducted by Wellness Program Management Advisor and Wellness Junction.

Almost 71 percent of survey respondents said they follow up on the HRAs while almost 16 percent do not perform follow-up services, according to the findings.

However, almost 57 percent of the wellness professionals respondenting to the survey intervene immediately and refer employees with serious health problems to physicians, emergency facilities and other care providers, the survey discovered.

Referral Process

Methods of referral to health professionals include onsite and offsite procedures, wellness managers said.

“At the time cholesterol and blood pressure are measured, a doctor’s referral is given to the employee, if needed,” said a provider of wellness services. “We follow up after two weeks to see if these employees actually did see their doctors.”

Others make direct contact with the physician to whom an employee is referred.

“If we refer an employee to a primary care physician (PCP), we mail the PCP a postcard and ask them to send it back if the employee has been seen,” explained a program coordinator. “We do the same thing with our outpatient wellness programs.”

High Risk Situations

Situations involving employees found to be in a high risk status usually prompt immediate action, according to the study.

“Employees determined to be at high risk for cardiovascular events or cancer are referred to their PCPs with a copy of our findings,” said a wellness program director. “Depending on how acute the risks are, we may even call the PCP in the patient’s presence and refer from that moment.”

HIPAA

“With the HIPAA guidelines, we have the participant read and sign an informed consent form that gives us permission to send copies [of the HRA findings] to their PCP and discuss their personal data with designated medical personnel,” a program manager explained.

“If the participant needs referral to outpatient wellness programming, the person is furnished with the name and phone number of the appropriate contact,” the manager continued. “But whatever the process, we are extremely mindful of confidentiality and privacy. There are times when we might even be overly cautious, but this is a very important and emerging area of concern.”

Resources

Wellness professionals primarily rely on the following resources for HRA referrals, the study revealed:

* Onsite nurse care managers.

* Health management summaries that explain aggregate results from HRA responses.

* Onsite medical departments that consist of physicians, nurses and wellness professionals.

* Contact lists of health insurance plan member physicians.

* Telephone counseling.

* In-person health education/behavioral change counseling.

Monitoring Success

Along with intervention comes the monitoring of success rates, and survey respondents track the HRA success rates in a variety of ways.

The use of employee participation and feedback was cited by most respondents, along with:

* Clinical test results.

* Lifestyle questionnaires.

* Onsite education.

* Administration of HRAs on a yearly basis to compare and monitor improvements in employee health status.

* Annual health management summaries that detail aggregate results from HRA responses (the results also are used to evaluate various company wellness programs).

* HRA updates performed at six-month and 12-month intervals.

* Comparison of HRA results to employee use of sick time, workman’s compensation claims, general health claims data and company HMO utilization.

* Baseline health screenings.

* Tracking the percent of employees identified as “at risk” for a serious health condition, along with the percentage who accept and follow through with subsequent referrals for further medical evaluation or care.

* Quarterly reports that measure increases in participation.

* Executive summary reports compiled before and after HRA administration.

* Estimation of cost savings from employees who have lowered their health risks by improving personal health, such as weight reduction, lowering blood pressure, and cholesterol and reduction of tobacco use.

* Sharing of experiences and personal success stories in wellness department newsletters.

“We can’t discriminate based on outcomes, so we monitor compliance,” noted a wellness program coordinator.

“For instance, if you are told to lose weight, we require that you attend eight sessions of Weight Watchers, for which the company pays,” the coordinator said. “But we don’t require that you actually lose the weight. Compliance is all we can legitimately require.”

Source: Workplace Wellness Management Leadership Survey conducted online at http://www.WellnessJunction.com

Tapping Into Your Resources: Cafeteria Personnel

Experts in the workplace wellness and health promotion field often encourage managers to aggressively integrate themselves throughout organizational departments.

This integration serves two purposes. It creates unique opportunities for the wellness department to influence employees’ quality of life at a systemic level. As interdepartmental relationships grow, the wellness staff will gain access to previously untapped resources.

One natural target of opportunity is on-site snack bars and cafeterias. While enhancing the healthfulness of food options is an obvious goal, serving line customers are particularly receptive to nutrition information. Being able to rely on dining facility personnel to answer simple questions and appropriately refer customers with more complex needs is an invaluable asset to the health promotion manager.

Dining facility personnel underestimate the impact they have on their customers’ health. All you need is to provide a little nurturing, a little education, a few resources and some motivation.

Step One: Overcoming Fear

A seven-month study reported in the Journal of the American Dietetic Association demonstrated that when a comprehensive marketing campaign preceded lowering fat and sodium content in food choices in the Kansas Farm Bureau and Affiliated Service employee cafeteria, no significant differences in sales data were observed. Study authors concluded that “customers in worksite cafeterias may be more willing to tolerate changes in flavor attributes when modified entrees are marketed as ‘healthful’ and nutrition information is available.”

It is important for wellness managers to arm themselves with such studies. Dining facility managers are often concerned that modifying food choices to make them healthier may affect the flavor, and thus, their sales. Work with the dining facility staff to develop a comprehensive marketing campaign. This is important for program success and will go a long way to calm any fears.

Step Two: Training

Evaluate the existing nutrition training of dining facility personnel. Offer to conduct a series of nutrition/healthy eating inservices to address any deficit areas in their education. Provide videotapes and other learning tools that can be used during staff breaks. If the budget allows, offer to bring in a nutritionist/dietitian periodically to advise staff, review menus, etc.

In addition to formal inservices, make a practice of providing frequent nutrition quick tips to the staff (at least weekly, if not daily). The “tips” can be included during staff meetings, in an e-mail, or in the form of a poster or flyer. Besides nutrition and food preparation information, include inservices and tips on where to refer customers for more advanced nutrition counseling or other information.

Step Three: Motivation and Reward

As the inservice training gets underway, initiate an ongoing dining facility staff competition. The purpose of this competition is to reward dining facility personnel who learn key information provided in the inservices and training material.

Periodically, a “planted” customer going through the serving line at mealtime asks a nutrition-related question randomly of a server. The question should be challenging and appropriate to real-world customer questions and nutrition decisions facing the server.

If the dining facility staff member correctly answers the question, a wellness staff member or other designated official (discreetly standing nearby) comes forward, publicly congratulates the server and gives him/her an incentive award or prize.

If the dining facility staff member cannot answer the question, avoid embarrassing the server. The “planted” customer quietly hands him/her a card with the question and correct answer, then moves on through the line without comment.

Step Four: Recognition

Once the dining facility education program has been completed, offer the cafeteria and snack bar personnel the opportunity to take a voluntary nutrition test. If they successfully pass the test, provide them with a designation that sets them above the other line servers as a basic nutrition counselor. Give them a pin and certificate that reflects this title. For instance: “Certified by your Health Promotion Office as a ‘Cafeteria Nutrition Counselor.’” Discuss with the department chief making this certification a factor for pay raises or promotions.

Promote the dining facility staff’s cooperation and new expertise in nutritional counseling to the customers. Encourage employees to visit the cafeteria or snack bar and ask questions.

More Ideas

The following suggestions are pulled from the “5-A-Day Worksite Implementation Guide.” The entire guide can be downloaded from the American Cancer Society’s Web site: http://www.cancer.org/docroot/COM/content/div_OH/COM_11_2x_5ADay.asp?sitearea=COM (Click on “For Your Worksite” once you reach this page). A variety of nutrition and promotion material supporting this program is available free of charge.

Ask the cafeteria to sponsor cooking demonstrations. This can include cleaning, peeling and chopping fruits and vegetables, as well as various cooking techniques (e.g., stir-fry, steaming, microwaving). Provide participants with the opportunity to sample some of the prepared foods. Focus demonstrations on individual skill-building. Provide tip sheets and recipes from the cooking demonstration to reinforce the observed skill.

Cafeteria Labeling Program

Point-of-Purchase Promotion

Frequency Card Program

Offer discounts, such as three-for-two specials, by adding more fruits and vegetables to menu offerings.

Offer fruit and vegetable serving lines or pre-packaged ready-to-go fruits and vegetables.

Post a comparison of caloric and other nutrition information between junk food and fruits and vegetables.

Address: American Dietetic Association, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995; (800) 877-1600, www.eatright.org.

 The purpose is to influence the consumer at the point of choice. It conveys messages and suggests simple steps that can be taken to increase one’s consumption of healthy food options at a meal eaten in the cafeteria. Some point-of-purchase promotions provide cues that encourage the purchase of fruits and vegetables outside the workplace as well as tips for cooking methods.

Point-of-purchase promotions could include: static cling stickers, floor mats, posters, balloons, flyers, free-standing signs, etc.

Such programs identify foods meeting the 5-A-Day (or other healthy choice) criteria with an identifiable logo and keep the message in front of employees by providing reminders about healthy choices. More importantly, the labeling program will provide a quick and easy way for employees to identify foods that meet 5-A-Day or other nutrition criteria.

– Increase the frequency of healthy food choices by rewarding frequent fruit and vegetable buyers with a free serving of fruit or vegetable after a certain number of servings have been purchased. – –  

Point-of-Purchase Promotion – The purpose is to influence the consumer at the point of choice. It conveys messages and suggests simple steps that can be taken to increase one’s consumption of healthy food options at a meal eaten in the cafeteria. Some point-of-purchase promotions provide cues that encourage the purchase of fruits and vegetables outside the workplace as well as tips for cooking methods. Point-of-purchase promotions could include: static cling stickers, floor mats, posters, balloons, flyers, free-standing signs, etc.

Frequency Card Program – Increase the frequency of healthy food choices by rewarding frequent fruit and vegetable buyers with a free serving of fruit or vegetable after a certain number of servings have been purchased.

Offer discounts, such as three-for-two specials, by adding more fruits and vegetables to menu offerings.

Offer fruit and vegetable serving lines or pre-packaged ready-to-go fruits and vegetables.

Post a comparison of caloric and other nutrition information between junk food and fruits and vegetables.

Address: American Dietetic Association, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995; (800) 877-1600, www.eatright.org.

Wellness Managers and Issues Surrounding Return on Investment (ROI)

Return on investment or the ROI of a wellness and health promotion topic is always a key concern for wellness managers – proving the ROI of their programs to senior management.

The topic comes up every year on our Wellness Management Leadership Survey.It also has been the subject of numerous discussions on our Wellness Manager Discussion Group.

We have written about the ROI of workplace wellness in Wellness Program Management Advisor and some 17 articles written on the subject have been posted on WellnessJunction.com

Over on the Wellness Manager Discussion Group you can search on the term ROI over all the messages posted by the members and you’ll find more than 250 posts. Many of the messages have valuable information on this topic and on cost savings.

Just go to our Group home page on Yahoo. http://finance.groups.yahoo.com/group/WellnessManager

On the left hand navigation column click on Messages. Use the Search box:

Likewise, on WellnessJunction.com just use the Search box for articles on ROI and cost savings, etc. http://www.wellnessjunction.com

Understanding Audience Is Key To Incentive Program Success, Say Wellness Professionals

The key to designing a strong wellness incentive program is about “knowing your audience,” wellness management professionals said, according to the results of a workplace wellness management survey conducted by Wellness Program Management Advisor and WellnessJunction.com.

“I believe incentives can work, but you need to ‘know your audience,’” said an operations manager of a corporation responsible for the health promotion program, which offered incentives ranging from T-shirts, to drawings for iPods or airline tickets. “Providing them with a generic incentive doesn’t always motivate them. If you offer them ‘things’ that they don’t need or want, you won’t see any effect.”

And despite the trend in offering cash-based incentives (67.8 percent), the manager said that incentives do not have to be extravagant. “I’ve seen people be motivated by just receiving stickers on a hanging cut-out just because the reward is visible to others they work with.”

Another respondent also said she believes that incentives cannot be implemented blindly to employees.

“Incentives should be strategically given. If an incentive is always expected with little effort, it does not have the same impact overall,” said Paola Ball, fitness and wellness manager at an education institution focused on employee wellness. “Moreover, it is important for people to be driven by their own commitment as a result of the successful marketing of a wellness program and through encouragement by other staff members.”

“This promotes community and support for long- term behavior change,” Ball continued. “I havefound that some of the most successful programs have been those that do not put the emphasis on the prize, rather the emphasis is placed on congratulating participants for their commitment to wellness and their own health. Fun is also an essential component to a wellness program. If activities are looked at as a ‘fun thing to do’ instead of an imposed behavior change, people are more willing to sign up and try new things.”

Another survey respondent suggested that programs should urge the employees to see their self-improvements as the ongoing incentive.

“In my experience, people are initially motivated by the incentives and later excited and encouraged by the changes they see in themselves,” said Shelly Beall, a self-employed wellness professional.

The Wellness Management Leadership survey on incentives for participation in wellness programs was conducted online among wellness professionals and subscribers to Wellness Program Management Adviser, The Wellness Junction Professional Update and members of the Wellness Managers Professional Discussion Group.

Source: Wellness Program Management Advisor www.wellnessjunction.com

www.healthresourcesonline.com/wellness/18nl.htm

 

 

 

 

 

Wellness Executives Say 2008 Better Than Previous Year For Programs

The majority of wellness professionals thought last year was a better year for their programs, according to the Workplace Wellness Management Leadership Survey conducted by the Wellness Program Management Advisor in conjunction with WellnessJunction.com.

Executives were asked whether 2008 was a better year for their programs than the previous year 75.4 percent said it was and only 15.8 percent said it was not.

Maureen Barte, assistant coordinator of the Health and Wellness Institute at the Washington Hospital, agreed 2008 was a better year and added “this is year four of our employee wellness program and the employees are becoming more accustomed to stopping into our offices and joining different programs that are always on-going.”

Another executive said it was a better year “because the outcome measures are becoming more sophisticated and we are planning for expansion.”

A manager of organizational health and well-being said there was “a lot more support and recognition by executives of the importance of health and productivity.”

For Jason J. Paul of the LifeCore Group, 2008 was also better. He said, “many companies are learning that taking a one-time health analysis does not really create any long-term change.”

Another executive said in 2008 “the [wellness] program was all inclusive. Meaning we ensured consistency throughout the organization’s 17 regional locations. Each site has a wellness coordinator with monthly wellness team steering committee meetings and support.

“The company also dedicated significant budget dollars to support the program. Incentives are being used to gain participation.”

Daniel M. Moriarty, human resources manager for Jewish Geriatric Services Inc., said “By engaging the employees we were able to provide programs that they had an actual interest in and felt some ownership in the programs.”

For Gary Morriston, director of human resources at the Howard Training Center, 2008 was better. “United Healthcare/PacificCare became our health benefits carriers and brought an excellent wellness template that we are able to implement on a low budget but with high impact.”

Another respondent said, “By tying our benefits/wellness together, we realized where we needed to drive our programing going forward into 2009. We had a plan instead of scattered efforts at guessing what was working and what was not.”

Not all respondents agreed. For one executive it was not a better year because of the “administration’s emphasis on online programs which are less effective/interactive than traditional classes. [It is] harder to measure outcomes [and we] don’t have the secondary gain of team building and support in the work environment.”

A paricipant also thought 2008 was a worse year and put the blame on less money and more turnover. “Wellness is not at the forefront of our worries, or at least it doesn’t seem to be.”

“Fewer employees participated in our free wellness screening,” said an executive who felt that 2008 was not a better year.

**************************************************

Was 2008 better than the previous tear for your wellness program?

Yes – 75.4 percent

No – 15.8 percent

Unanswered – 8.8 percent

Source: Wellness Professional Salary and Benefit Survey 2008, Wellness Program Management Advisor.

**************************************************

Source: Wellness management Leadership Survey, Wellness Program Management Advisor, and Wellness Junction Professional Update www.wellnessjunction.com