Monday, August 30, 2010

Cardio and Diabetes Screening Results

On August 19, we offered two screenings to our staff -- Cardio CRP and A1c. Cardio CRP is a blood test that is clinically used to assess reltaive risk of cardiovascular disease (CVD) as well as assess risk of a recurrent cardiovascular event in patients with coronary heart disease (CHD.) A1c is a blood test that checks the amount of sugar (glucose) bound to hemoglobin. It is used to diagnose diabetes as well as check the long-term control of blood glucose levels in people with diabetes.

Lifeworks Strategies conducted the screenings for us. 59 employees (24%) participated in the screenings. All participating employees will receive a letter with educational materials and their results. Any employees who had an abnormal result will receive a phone call from a physician's assistant at Lifework Strategies who will offer coaching and next steps. People that have an abnormal A!c result will also be referred to the diabetes education program that we are kicking off next month.

Cyndi Fales prepared this report that describes the tests in more detail and shows our aggregate results. As you can see, a lot of peope fell outside the normal range.

ASHA A1C CRP Aggregate Report Aug 2010

Thursday, August 26, 2010

Staffing Continuity, Flu Shots and Workplace Wellness

I was asked by LifeWork Strategies to sit on a Flu Panel on September 2 with a nurse and a doctor from Adventist HealthCare. They've asked me to help send the message that flu shots are most effective when offered as part of a comprehensive wellness program. I hope you'll join us.

A recent study indicated that obesity is a risk factor for severe illness from the flu and, of course, the obesity rates are climbing. The CDC released a report earlier this month that said more adults are obese -- an additional 2.4 million. The report includes a statement from Dr. William Dietz that is particularly relevant to workplace wellness.

“Obesity is a complex problem that requires both personal and community action,” said William Dietz, M.D., Ph.D., director of the CDC’s Division of Nutrition, Physical Activity and Obesity. “People in all communities should be able to make healthy choices, but in order to make those choices, there must be healthy choices to make. We need to change our communities into places where healthy eating and active living are the easiest path.”

Working on our workplace wellness program is largely fun -- exercise classes, educational programs, and campaigns to inject some enthusiasm. However, it's also important to plan for the not fun -- events like a pandemic.

Last year with the threat of a flu pandemic looming large, we finally finished developing a staffing continuity plan. ASHA had a business continuity plan that was designed to help us respond to localized threats -- fires, bombs, riots, earthquakes and hurricanes -- that affect infrastructure already in place. We decided we needed to compliment that plan with a staffing continuity plan that protects employees and their ability to conduct business during a sustained crisis like a pandemic. (In all honesty, I don't understand why staffing continuity is not part of business continuity, but that's not my area of expertise.)

We started the process with a lot of questions. We expected that our members would understand a short term delay of service in the event of an emergency, but how would that change if we needed to seriously limit services if a large percentage of the staff was unable to come into the office over an extended period of time? What services would we want to maintain at a minimum? Do we have adequate cross training in those functions? Could the staff meet those needs even if they weren’t physically present in the N.O.? Are there things that ASHA can do to minimize the number of staff exposed to an illness or limit the spread of an illness between staff? What information needs to be shared with staff in the event of a pandemic?

We did our best to answer these questions in the plan below.

ASHA Staffing Continuity Plan FINAL

Update: September 2, 2010

Here are the slides from the event. I learned that if we could vaccinate 92% of our staff we could basically stop the spread of the flu within our workplace. We're no where near that number now, but at least we have a goal.

Update: October 4, 2010

Interesting post in the Your Health at Work Blog from Harvard Business Review -- Flu Vaccination Programs and the Bottom Line. The article states that a recent study from the University of Pittsburgh showed employee vaccinations programs save anywhere from $15 to $1,494 per worker depending on the type of the business and the severity of the flu.

Monday, August 2, 2010

Redesigning Our Body Fat Reports - Guest Post by Cyndi Fales and Diana Levin

After our Eat Like an Athlete session with Kristin Wood, I stopped by Max Muscle to check out their body fat machine. Max Muscle uses a Futurex machine. I don't know that it's much more accurate than the Omron machine Lifework Strategies is using with us, but Kristin provided a much more comprehensive report. I liked that it showed essential fat, reserve fat, and excess fat. (I think it's important to remember that not all fat is bad.) I also think it's more encouraging for people to focus on eliminating just the excess fat. Kristin also gave me my BMR and how many calories I probably burn each day. I've used other apps that gave me a much lower number. This one seems more realistic (or maybe I just like it because it's higher ;-)

This experience prompted me to ask Cyndi Fales our partner at Lifework Strategies to help us redesign the reports we give to our staff. Below is a description from Cyndi and Diana Levin, the intern we share, about how they developed our new report.

We'll be using the new report for the first time on Wednesday, August 4. We created it as a pdf file, so that we could share it with others. If you use it, please pass along your feedback to help us hone the tool. (Many thanks to Emerald Ong for sharing her graphic design skills.)

Body Composition for PRINT

BMI and Body fat are two common methods of determining obesity. But what do these numbers really tell us? BMI tells us if we are X inches tall, we should weigh a certain amount, above said amount would be considered overweight or obese. BMI does not take into account age, gender, athletic build, etc. As a result, it doesn't provide the best picture of body composition. It is, however, a simple and inexpensive method of calculating possible health risks.

There are many ways to test body fat: underwater weighing, bioelectrical impedance, skinfold, Futrex, etc. Each method has it pros and cons, but any of these methods will give you a ratio of fat to lean muscle. What we have learned is that the percentage of body fat readings from these tests tells us a lot more than just how fat or lean we are! Our bodies have essential fat (required for normal bodily function), reserve fat (additional fat that doesn't cause medical risk), and excess fat (extra fat that increases medical risk). After reviewing some exercise physiology and nutrition texts, as well as, various online resources, we discovered that we can determine essential, reserve, and excess fat from our body fat percentage using a few equations.

Based on our research, essential fat is a constant percentage for men and women. However, various materials suggested different percentages for essential fat, which means that the numbers are up for debate. We aired on the side of caution by going with The American Council on Exercise’s numbers which went up to 13% versus other resources claiming as low as 9% for females. If a female’s essential fat is too low, they lose their menstrual cycle. Therefore, sticking to 13% is a safer bet. For men, we saw essential fat recommendations between 2-6%. Reserve fat is the amount of fat above essential that does not exceed the recommended total body fat range. Finally, with the essential and reserve fat known, the difference between these two weights and your total fat weight is how much excess fat you have.

Some body fat equipment may give you the breakdown of the fats, but it is just using simple calculations to determine the weights. As mentioned before, we did come across some varying information. For example, there are many different recommendations for percentages of essential fat. Some sources break down their recommendations by sex, gender, and even athletic level. As a result, there is room for discussion and debate with all the calculations. All in all, the calculation can give a great ball park figure of excess body fat and where there is room for improvement. We think reviewing the equation helps to show that not all fat is bad fat. Our body needs fat to function properly, and this equation can show if someone does not have enough of that essential fat.

Update: It's August 4, 2010 and people are lining up to get their new body composition reports.