William B. Baun, EPD, CWP, FAWHP

Wellness Officer, MD Anderson Cancer Center

President, National Wellness Institute

wbaun@mdandeson.org/

Worksite Wellness: A

Business Sustainability

Strategy

William B. Baun, EPD, FAWHP

Wellness Officer

wbaun@mdanderson.org

williambaun.blogspot.com

USA Workforce growing older,

sicker, and fatter

Older worker:

• More experienced,

knowledgeable,

reliable, and loyal

• Less likely to suffer

injury, but takes

longer to return to

work

High cost of chronic disease across

healthcare system

• 7 in 10 deaths

• ¼ with chronic disease

significant limitations

• 1960s 1.8% kids, 2011

43% kids

• 1 in 3 adults obese, 1 in

5 kids obese

• Kids with chronic

disease change families

Healthcare spending is unsustainable

To Both

Businesses

Individuals/

Families

The State of Working America

• In recent decades our economy has failed to increase the living standards of typical American workers at a pace matching the country’s overall economic growth

• USA has highest per person

healthcare cost of industrialized world and ranked 37th of 91 countries, $1 out of $7 spent on medical goods or services

• 1% of population account for 30% of costs and 5% account for 70%

• Employers health benefits cover more than 3/5 nonelderly

• Healthcare spending by 2015 predicted at $4T, 20% GDP, per capita $12,320

• Productivity losses related to personal or family health problems estimated at $225.8b or $1,685 PEPY

• Four modifiable health risk behaviors—lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption—are responsible for much of the illness, suffering, and early death related to chronic diseases

Healthy Workplace 2010 & Beyond (PFP 2009)

America’s State of Health

• 32.5% eating 2 or more fruits per day / CDC goal of 75%

• 35.7% of American adults are obese, (400,000+ deaths),

• 68.8% of adults overweight or obese and 31.8% of children / adolescents

• Race-ethnicity, gender, age, geographic region, and socioeconomic status disparities exits relative to body weight

• Physical inactivity ranges from 10.1-43% in U.S. counties

• 60% of American adults not regularly active, and 25% not active at all

• 19.3% adults are tobacco users / 1 in 5 deaths tobacco related (443,000 deaths, 50,000 second hand smoke)

• 26.3% eating 3 or more vegetables per day / CDC goal of 50%

Health and Human Services / Center for Disease Control (2012)

• Baby boomers working longer

• Work week expanding average 47 hours

• Technology revolution = sedentary lifestyles

• Stress levels increasing, disconnected from healthcare

• Wellness linked to health, quality of life, and productivity

• Cost savings

Why Worksite

Wellness?

What’s Driving Interest in

Worksite Wellness in Tampa?

Turn to your partner

on your right and

come up with the top

5 reasons worksite

wellness is growing in

Tampa.

Rand Report Summary: A Review of the U.S. Workplace Wellness Market

http://www.rand.org/content/dam/rand/pubs/research_reports

/RR200/RR254/RAND_RR254.sum.pdf

• Workplace wellness programs emerged as a common employer-sponsored benefit / 50+

employers ½ have programs, but impact rarely formally evaluated

• Lifestyle management interventions can reduce risk factors, are sustainable over time and

clinical meaningful

• Reason to believe reduction in medical costs would materialize, judging by program cost

data after 5-program years, programs cost-neutral

• CULTURE, ENGAGEMENT, and leadership all important to program success and use of

incentives tied to health standards still not understood, tobacco dis-incentives growing

Opportunities for Future Research

• Long term impact

• Design features that work on individual and organizational level

• Study broad range of outcomes and contextual factors that modify impact

• Comprehensive evaluation of intended and unintended effects of incentives

“You see culture in the way the furniture is arranged, what people brag about, what they are rewarded for doing and what they wear.” Whitmore (2008) SHRM “…corporate culture is no longer the relevant topic, I think the relevant topic is macro culture (where different nationalities and occupations play out), and micro cultures where you have problems in the operating room and in teamwork because you have people of different occupations and cultures that all interplay.” Edward Schein (2011) Forbes

…..organizational factors that promote healthy lifestyle choices have been collectively referred to as culture of health. Aldana, HERO (2012)

…..health, employee well-being and organizational success are inextricably linked aligning leadership, benefits, policies, incentives, programs and environmental supports to reduce barriers to active engagement and sustainability of healthy lifestyles across the healthcare continuum. Baun, Workset (2009)

Culture of safety is one in which employee behavior is guided by safety procedures, norms, and supports that encourage a safe working environment.

Safety behaviors are incorporated into the vision and goals of leadership.

Climate Culture

Monday vs. Friday Gives Mon permission to be miserable

Attitude or mood of the group Personality of the group

Provides state of mind Provides a way of thinking

Flexible, easy to change Takes many years to evolve

Based on perceptions Based on values and beliefs

Feel it when you come in the door Always there even on bad days

The way we feel around here The way we get things done around here

First step to improvement Determines if improvement is possible

It’s in your head It’s in your head, heart, and a part of “us”

Modified Gruenert (2008)

-Perceived as a business asset -Recognized as having a big & important impact to the success of the organization -Leadership participation & encouragement

-Build a business case for senior management -Illustrate the value proposition to the organization -Pitch a comprehensive program -Build unit level management champions

Culture of Health

“Ultimately, a company needs to engage people at all levels of the organization to drive a culture of health forward.”

Catherine Baase, MD Dow Chemical Health Director Employee Benefit News (2012)

Top Down ↓

Bottom Up↑

• Develop a sense of urgency • Honor the strengths of your existing

culture • Focus on a few critical shifts in

behavior norms • Integrate formal and information

interventions • Match strategy and culture • Measure and monitor cultural

evolution

Katzenbach, et. at. (2012)

Young Adult Adult Pre-Retirement Family

Healthy

At Risk

High Risk No Chronic disease

Disease MGT Eligible

Chronic Disease

Turn to your partner on

your left and discuss

the models you are

using to reach /

engage the different

groups of individuals

on the continuum of

health?

• Evidenced based

models

• Joint consensus

statements

• Government funded

white papers

• Research initiatives

documenting

components

• Business reviews

Promising Practices – Dr. Ron Goetzel,

nationally recognized & widely published expert in worksite

wellness ROI

Director of Emory University Institute of

Health and Productivity Studies, Vice

President of Truven Health Analytics

• Wellness culture built on trust not

fear, focused on responsibility, and

accountability

• Multilevel leadership

• Integrated, targeted, relevant, and

accessible programs

• Healthy choice the easy choice

• Strategic communications

• Internal and community

partnerships

• Appropriate use of incentives

• Metrics aligned with business

goals

Six Essential Hard Return Pillars Regardless of Organizations Size

• Multilevel Leadership

• Alignment

• Scope, Relevance, and Quality

• Accessibility

• Partnerships

• Communications

“We manage what we measure.”

Are you measuring things that have high value in your wellness

programs?

Harvard Business Review, December 2010 Berry, Mirabito, Baun

“What is going to free,

fuel, and inspire this

person to bring the best

of him or herself to work

every day, most

sustainably?”

Tony Schwartz, HBR 2013

Do you want productive

healthy employees? Treat

them like adults!

A culture of trust not

fear, focused on self

responsibility and

accountability

Tony Schwarz HBR

Blog (2012)

“what’s required now

is something called

sustainable

engagement….that

fully energizes

employees by

promoting their

physical, emotional,

social, mental and

spiritual well-being

that gives an added

capacity for focus

and a strong sense

of purpose.”

Engagement

more than

participation!

Career Well-being – liking what you do each day

Social Well-being – having strong relationship and

love in your life

Financial Well-being – effectively managing your

economic life to reduce stress and increase security

Physical Well-being – having good health and

enough energy to get things done on a daily basis

Community Well-being – the sense of engagement

and involvement you have with where you live

Engagement: The Key to Overall

Well-being

“Engaged participants

attend programs because

they are intent on

improving their health and

are excited about

contributing positive

energy and productivity to

their companies, families,

and communities.”

Terry & Anderson (2011)

Engagement Metrics aligned with

business goals Leadership support

Champ network

Environmental / policy supports

Social and partnership supports

Health benefit design

Appropriate financial metrics

Participation and satisfaction

Engagement and improvement

Wellness culture sustainability

Worksite wellness needs you to drive higher wellness engagement!

Four E’s of Worksite Wellness Success: Engage, Enable, Educate, Empower

William B. Baun, EPD, CWP, FAWHP Wellness Officer MD Anderson Cancer Center

President National Wellness Institute

Engagement Stories

Driven by

values,

thinking,

attitudes,

and

motivation

Journey of Worksite Wellness

Engagement

Power of culture

Behavior change strategies

Degrees of engagement

Collaborations

Innovations

Social media

Change agents

Engagement – connect / commit

Head + Heart = Heightened

Connections / Commitment

Engagement

Spiritual Occupational

Is

expressed

and

measured

in terms

of feelings

and

behaviors

National Wellness

Institute

Wellness Model

Wellness Touchstones Lead to engagement

Be Well

Engagement Pyramid Different mindset leads to different actions…..

Pass It On

Own It

Practice

Maybe a Baby Step

Considering

No Interest /

Opposed

Modified from

Rosenblatt

(2010)

Leveraging

Sustained Engagement

Four E’s that Drive Wellness Programming Success

Engagement – opportunities that connect and commit

employees both intellectually (head) and emotionally (heart),

and grow heightened levels of wellness ownership, self-

responsibility, accountability

Enable – providing the means and opportunities to be well,

and make it possible, practical, or easy to make healthy

choices and maintain healthy habits

Educate – the learning processes designed, developed, and

implemented to increase wellness knowledge, skill, attitudes,

and commitment

Empower – open individuals to the wisdom, experience, and

motivation they possess

#1 - Enabling Factors Help Build a

Strong Foundation

•Availability of resources

• Accessibility of services

• Supportive policies

• Multilevel Leadership

Support

Availability of Resources Environmental Audit

• Availability of nutritious foods in vending machines and

cafeterias

• Availability of employee break rooms to store and prepare

nutritious foods from home

• Availability of tobacco-free areas

• "Walkability" of the work place

• Availability of fitness centers, shower facilities, multi-purpose

paths, and bicycle racks, that support physical activity

• Availability of lactation rooms

• Availability of quiet places / rooms

CDC (2011) Healthier

Worksite Initiative

Accessibility of Services Convenience matters…..

Appropriate screenings Parenting classes

Appropriate immunizations Cooking classes

Tobacco cessation Personal training

Weight management Coach counseling

Nutrition Quiet rooms

Stress management Eldercare

Relaxation Massage therapy

Meditation Swimming pool

Fitness center Healthy vending machines

Walking path / trail Healthy cafeterias

Legal assistance Aerobic classes

Bike racks Pilates classes

Showers & towels Yoga classes

Dressing rooms Spinning classes

Lactation rooms Walk / run / bike clubs

Blood pressure machines Prenatal classes

Work Life Employee Assistance

Supportive Policies • Tobacco

• Paid time off to attend employee development / wellness training

• Worksite wellness committee

• Program champs or ambassadors

• Use of Employee Assistance Program

• Vending machine

• Catering & food service

• Physical activity

• Participation in community-sponsored, company supported events

• Working Mother / lactation room use

• Flexible work hours / arrangements

• Commuting / biking

• Employee discounts, subsidies

• Childcare / eldercare\

• New moms & dads

#2 - Educate It’s all about multiple touch points that

facilitate adult learning …..

Learning – acquisition of new knowledge, skills, attitudes,

and commitments

Group based learning Lunch-n-learn activities

Individual learning Health fairs

OJT Mini health fairs

Distance learning Mentors

Technology assisted learning Wellness portals

Self-study Health risk assessments

Guided learning Work related training

Interactive learning

Coach counseling

Point of purchase information

World café

Problem solving activities

Educational Program Development

Outline

• Class / workshop title

• Short description of class

• Length of class

• Maximum number of students

• Suggested class frequency

Educational

Objectives

Content

(Topics)

Time Frame Presenter Teaching / Learning

Strategy

Group discussion

Small group discussion

Facilitated lead

Lecture

Buddy / partner work

Etc…..

• Best day of the week

• Best time to offer

• Classroom set up

• Special equipment

Wellness Education Opportunities What’s hot and what’s not…..

4F Heart Health Plan 21 Ways to Manage Stress

12 Great Foods Boosting Energy Beating Stress

Cooking Light Relax….Take a Breath

Reading Food Labels Creating a Positive Mindset

Kicking Cholesterol with Diet Getting a Good Night Sleep

Mindful Eating Healthy Aging

Portion Distortion Meditation Matters

Snack Attacks Walking Meditation

What = 100 Calories Smart Goals

Whole Grains The Calming Function of Water

Boosting Your Metabolism Put Yourself First

Finding your Fitness Personality Eat This Not That

Minutes a Day to a Healthy Back The Art of Reframing

Office Stretch and Tone Anger Hot Stones

The Basics of Stretching Put the Breaks on Stress

The Do’s and Don’t of Exercise The Joy Diet

Walking for the Health It Stand Tall

Getting Ahead by Getting Started Clear Your Mind of Can’t

Calming the Mind Stop the Clock

The Science of Meditation Attitude the Difference Maker

Fit2Run Unlocking Wisdom Through Journaling

Yoga4U Wellness Leadership

#3 - Empowerment

happens when

employees begin

taking small steps to

be well…..

What starts those

steps?

What Drives Empowerment?

Inspiration

Education

Revelation

Motivation

Multiple Touchstones

Program Calendar Strategizes Empowerment

J F M A M J J A S O N D J F M A M J

Awareness Motivation - Engagement

Behavior Change

Environmental Support

Worksite Wellness Empowerment Is all about passing it on…..

Self

Peer

Friends

Family

Neighborhood

Community

City / Organization

We don’t do wellness alone

Many successful

wellness steps and

accomplishments are

nudged through

relationships.....

Nudges are gradual,

intentional positive

interactions of

encouragement

to BE WELL

N

U

D

G

E

Notice

Understand

Decide

Guide

Encourage

Bennett (2011) OWLS

Wellness Social Networking Maximizes Community Engagement

Community: a place , feeling,

relationships, common characteristics

Community Mapping: boundaries,

potential building blocks of people and/or

other resources, collaborations,

integrations

CDC (2011) Community

Engagement

Leveraging

Sustained Engagement

Four E’s that Drive Wellness Programming Success

Engagement – opportunities that connect and commit

employees both intellectually (head) and emotionally (heart),

and grow heightened levels of wellness ownership, self-

responsibility, accountability

Educate – the learning processes designed, developed, and

implemented to increase wellness knowledge, skill, attitudes,

and commitment

Enable – providing the means and opportunities to be well,

and make it possible, practical, or easy to make healthy

choices and maintain healthy habits

Empower – open individuals to the wisdom, experience, and

motivation they possess

What will you do to better leverage the 4e’s of

worksite wellness success?