Thursday, April 14, 2011

Our Definition of Wellness

Working on the St. Thomas trip competition prompted us to rethink how we define wellness. We broadened our definition from physical, mental and spiritual health to include four branches -- fitness of body, soundness of mind, sense of purpose, and mindset of sustainability. 

The overlap we've experienced with our Green Team taught of us to think of the importance of sustainability in wellness. The Blue Zones inspired some of my thinking -- especially when it comes to the importance of having a sense of purpose.

ASHA Staff Can Win a Trip to St. Thomas

ASHA's Wellness Advisory Team
Today our Wellness Advisory Team announced our next initiative -- a contest to win a week long trip to St. Thomas. Our very generous and supportive insurance broker, Mark Sager, gave us the trip to use as a prize for our wellness program. 

During a brainstorming session about how we would use the trip, Terry Harris set us down a path to find the best wellness story. Staff that want to compete will set a goal and submit an intention card by the end of this month. In July, they'll submit a reflection statement and a journal that tells their story. The journal can be in any form -- blog, video, photographs, diary, scrapbook, anything someone can think of to convey their journey. An external panel of experts will review the entries and select our winner. 

8452-A Wellness Journey Flier 8.5x11

Tuesday, April 12, 2011

Self Control and the HR Candy Jar

I recently read Switch and it has me thinking about self-control as an exhaustible resource. Today, I read The Battle of the Office Candy Jar in the Wall Street Journal. The gist of the article is that sweets may boost office morale, but sabotage people's attempts to diet or eat healthy. It's not like this thought hasn't crossed my mind before, but thinking about self control as an exhaustible resource sheds a whole new light on this issue. 

We have three candy jars in human resources -- one for dark chocolate, one for milk chocolate, and one for the sugary stuff. We have them because we want people to feel welcome in our space and we want people to have reason to stop by and talk with us. I have always figured it was easy enough for people to resist, but now I'm wondering if it might be a lot harder to resist than I thought for people who are trying to make a healthy change.  In Switch they say, "Change is hard because people wear themselves out." 

Honestly, I'd love to swap the candy for fresh fruit and nuts. We could have 50 servings of fruit delivered from the Fruit Guys for $64 a week, but that's a lot more than what we're spending on candy and it won't last long with 250 people. What are your thoughts?

LOST the Final Chapter

Last week, we concluded the 12 week weight loss program we called Lost. Here are the highlights.

Last year, we had an abundance of enthusiasm and engagement. We never captured that same feeling this year. I talked about some of the things we'd do differently in an earlier post. Although we did not have the success we had last year, there are a few individual stories that will motivate me to try again. Here's one...
I just want both of you to know how pleased I am with the Lost at ASHA program and the wellness coach.  I’ve only had one session with my coach and already I have 3 tangible goals and am very psyched to do well so every week when I check in with her I will be showing progress.  I also want to share with you that as a result of the Lost program, I had a significant drop in my glucose levels and my endocrinologist is giving me another 3 months to get the glucose levels down to where they need to be – and NOT start me on insulin yet.  I sure hope this isn’t TMI – but I want you to know that your work is having a very positive affect on my health and I just want to thank you.

Monday, April 4, 2011

Health Risk Assessment Findings

We recently completed our first real health risk assessment (HRA) with United Healthcare. United offers health risk assessments as part of their Simply Engaged program. They use a tool from the University of Michigan Health Management Research Center. Covered employees and their covered spouses are each offered a $75 gift card as an incentive for completing the assessment. We had 158 people participate -- 56% of eligible staff and 38% of eligible spouses. 

There were no surprises in the information we received about health conditions. We were able ascertain pretty much the same thing by analyzing reports on our prescription drug usage. In the HRA, people reported the following health problems:
  • allergies - 32%
  • high blood pressure -- 22%
  • back pain -- 21%
  • high cholesterol -- 15%
  • arthritis -- 12%
  • depression -- 11%
  • heartburn/acid reflux -- 8%
  • migraine headaches -- 6%
  • diabetes -- 6%
  • heart problems -- 5%
Three preventive health screenings were flagged for low compliance. This information is new to us and we're talking about what we can do to encourage people to take care of these preventive health screenings. Interestingly, there was a high level of compliance with blood pressure, cholesterol, pap tests and mammograms. 
  • tetanus shot -- 53%
  • rectal exam -- 49%
  • colon cancer screening -- 47%
I'm guessing people avoid rectal exams and colonoscopies because they're unpleasant. Years ago we had a doctor come in and talk about what to expect during a colonoscopy and why it's important to have one. He was funny and engaging. We will see if we can have him come in again. 

HRA participants reported they are planning to change the following behaviors during the next six months.
  • increase physical activity -- 85%
  • lose weight -- 70%
  • reduce fat/cholesterol intake -- 57%
  • cope better with stress -- 56%
Our current plans cover the first three behaviors pretty comprehensively. We are discussing what we can do to help people cope better with stress. This article has me thinking in terms of resilience training. 

We will also be assessing how helpful United's Simply Engaged program is to us and if we want to include it in our contract again next year. I know health risk assessments are included in most model wellness programs, but I'm not sure about the ROI. How valuable is what we learned? 

Related Reading: Uncommon Knowledge: The Value of Health Assessment Data

Update September 21, 2011: I'm continuing to evaluate the value of what we learned from the HRAs as we make a decision about whether or not to include Simply Engaged in our contract with United Healthcare next year. Simply Engaged cost an additional one percent of premium.

The one thing that stood out to me that I learned was that 21% of respondents are experiencing back pain. I just thought to look up the prevalence of back pain. According to the Univesity of Missouri-Columbia School of Health Professions, 80% of people experience back pain in their lives -- 20% to 30% at any given time. So, I guess I should have deduced that back pain was an issue without the HRA.

Saturday, April 2, 2011

Incentives and Stigmas

I've spent quite a bit of time thinking about the use of incentives in wellness programs. In the past two days, I've read two posts that have this issue on the forefront of my mind again. Paul Herbert wrote about what he called, The Best Study So Far on Cash vs Non-Cash Reward. The big take-away for me...
"It says that compensation establishes the transactional baseline for a job and that awards create a more social and emotional connection which drives behavior. 
It also tells me that the process – how you give the award – is critical in how the employee assigns value. If you just dump it in with their pay – you stay on the transactional side of the equation and get nothing for the effort. If you separate it out and provide a “moment” where you recognize and reward – with something other than “pay” – you get a much different – and much more effective result."
It's becoming more common for employers to provide premium reductions to employees that meet certain health measures. If employers are expecting these incentives to change behavior, I think they may be disappointed. I actually worry that they’ll be perceived as a penalty and start a rift between fit and unfit staff. If that happens, you could lose any trust and good will you built up with your wellness program. And, then you’ll have little opportunity to really help people make changes that will improve their health. Fran Melmed wrote this thought provoking post, are things going to get ugly? a growing fat stigma.

Some employers, of course, aren't looking at the premium reductions as an incentive. It's logical to charge people that are likely to have high claims more right? We accept this without question when it comes to auto and life insurance. But, what happens to trust and teamwork when these are perceived as fines?

Additional Reading: