Tuesday, May 29, 2012

Wellness Program Goals (Draft)

Before we start another wellness campaign, I decided it would be helpful to more formally articulate our goals for our wellness program. As I’ve been participating in wellness discussion outside of ASHA, I’ve noticed a trend toward broadening the focus. I'm wary of getting caught up in dong what’s “hot.” I hope clear goals will help us evaluate what is right for us.

  1. Minimize/reduce the overall percentage of drug costs to treat life-style related conditions. 
  2. Maximize the number of staff and their family members completing screenings that are recommended for their age and gender. 
  3. Maximize staff productivity and minimize sick days taken. 
  4. Help ASHA staff to be more health-conscious consumers. 
  5. Make the N.O. a place where active living is an easier path. 
  6. Enhance the sense of camaraderie and teamwork among ASHA staff. 
I consulted with Rob Mullen, ASHA's National Center for Evidence-Based Practice in Communications Disorders Director, and he pointed out that this is an eclectic mix of distal and intermediate goals. We discussed measurement which poses an interesting challenge -- especially for an organization that is fully insured. We do have access to data from UnitedHealthcare that will help us measure the first two goals (note charts.) We can measure the third goal easily enough if we make it a priority. Measures for goals 4, 5, and 6 could be included in our existing staff survey. I'll be working on collecting additional baseline and comparison data. Then, we can more systematically determine what areas need improvement.

I’d like to follow what ASHA advocates as an association and take an evidence-based approach to what we do. For example, I’ve read some studies recently that suggest being active has a more positive impact on health than losing weight. To the extent the information is available, I'd like to dig in and look for evidence-based behavioral solutions that have been shown to work long-term. I am confident we can still balance this with keeping the program fun and engaging, especially given goal six. 

Many thanks to Rob for his advice and coaching and to Bob Merberg for all of his thought provoking posts on evidence-based wellness. You guys make me think. 

This is all still a work-in-progress and I'm seeking feedback. Please share your thoughts with me.  

Thanks to everyone who provided feedback. I posted the "final" version of our goals here on June 7, 2012

Friday, May 25, 2012

Modernizing Health Care -- Join the discussion on June 12

Mobilize your business for change and learn from other local executives

The highlight of United Healthcare's (UHC) customer forum last year was hearing Dr. Reed Tuckson speak. Dr. Tuckson is the Executive Vice President and Chief of Medical Affairs for UnitedHealth Group. When I was invited to sit on a panel when he is the keynote speaker next month, I jumped at the chance. Dr. Tuckson is a compelling speaker and he's passionate about helping people take better care of themselves. I'm really looking forward to this event on June 12. You can register on the Washington Business Journal site. Hope to see you there.


June 12, 2012 -- Here are my notes from Dr. Tuckson's presentation and the books he recommended

Wednesday, May 23, 2012

Reflections from ASHA’s Biggest Loser -- Guest Post by Mary Raucci

Mary Raucci was the overall winner of our recent 12 week Biggest Loser campaign with an oustanding 13.4% weight loss. Mary generously agreed to share the secrets of her success with you. 

Since winning ASHA’s Biggest Loser competition in April, and losing 30 pounds since I made the commitment to change in January, I receive a lot of questions about how I did it. Here is my advice and observations for anyone struggling with their weight:
This is Mary (left) with her friend, Jenny. Before & After. 
  1. Anyone who says it is easy is lying! Hard work and dedication is the only healthy way to lose weight. Diet pills, potions, and gadgets claiming the pounds will melt off without diet and exercise are not going to do it for you. You have to be ready to make the commitment to yourself to change your diet and exercise habits every day for the rest of your life.
  2. Find an eating plan that works for you. Do not select a fad or deprivation diet. Find something healthy that you can stick with. For example, if you love pasta and rice, don’t swear them off, have them in moderation.
  3. Front-load your calories. Start each day with a healthy breakfast. What worked for me was making a breakfast protein shake with a banana, orange juice, hemp protein powder, wheat grass and spirulina. For lunch I would indulge (with portion control!) my craving for carbs with a sandwich, or a dish with rice or pasta. Most of your calories for the day should be consumed in breakfast and lunch. Dinner should be small, light, healthy and low in calories. If you leave the dinner table feeling stuffed, you ate too much! The reasoning behind front-loading your calorie consumption is you need calories early to fuel your body for the day. Eating the biggest meal a couple hours before bed does not allow you to burn off the calories, and your metabolism slows during sleep so that food is primarily turned to fat.
  4. There is always an occasion to indulge. Doesn’t it seem like it is always someone’s birthday, or there is always something to celebrate? That is the great thing about life! But the bad part is, most of those celebrations are observed by eating and drinking excessively. Until you get close to your weight loss goal, you are going to have to resist indulging. Be social, have a good time, but learn to do it without a plate of food and a glass of alcohol in your hand. You may get questions and pressure from people if you are not partaking, but don’t cave to peer pressure. You are in control of what you eat. 
  5. If you relapse, get right back on track. If you have seconds of your Auntie’s famous apple pie, or raise a glass of champagne too many at a friend’s wedding, don’t beat yourself up. But don’t use a celebration or giving in to your cravings as an excuse to derail your weight loss. Do not think because you went off course one meal, one day, or one vacation, you need to blow off your diet and regroup at a later date. Don’t start your diet again next month or next Monday, start with your next meal!
  6. Make exercise a part of your everyday life. Make a commitment to put your exercise routine first. It is easy to make an excuse day after day as to why we are not exercising—I am too tired, I have errands to run,…isn’t it funny how something seems to crop up every day to prevent us from exercising? Create a weekly routine of exercise at least four days a week, and put it above everything that is not an emergency. It is easy once you are following the routine, but once you break the routine, it is so much harder to start back up!
  7. Find a role model. Find a friend or family member who is at their ideal weight and lives a healthy lifestyle. Spend time with them, and talk about how they do it. Observe how they eat, and try participating in their exercise routine. You can also find a celebrity weight loss role model, but take what you see and hear with a grain of salt! Celebrities often have lots of “help” and may not disclose how they really lost the weight.
  8. Not everyone is going to support your weight loss. You have friends and family who love you just the way you are, and sometimes they may not be ready for a “new you”. This is especially true for those with whom you share the behaviors that got you to your current weight. They may not want you to change your behavior, because they are not ready to change theirs, and they don’t want to be alone! Change is hard, and change makes people uncomfortable. Stick to the commitment you made to yourself, take the positive reinforcement where you find it, and don’t let negativity bring you down. Remember, you are doing this for yourself, not to please everyone else, because if your goal is to please everyone, you will always fall short!

Tuesday, May 8, 2012

Foam Rollers -- A Quick Fix for Aching Muscles

In 2005, Gabrielle Reece interviewed Oakland Athletics pitcher Barry Zito on Fit TV's Insider Training. They showed Barry Zito using a foam roller for recovery and I wanted to give it a try, so I asked my family for a foam roller for Christmas. I was hooked immediately. A few minutes with my foam roller was better than a trip to the chiropractor for relieving an aching back. I used that first foam roller until it was crushed into the shape of a V. I upgraded to a firmer foam roller. Well, not exactly just one, I have one next to my bed, one in the living room, one in the family room, one in my car, one under my desk at the office, and a smaller packable version for travel.

I stocked our exercise room with foam rollers and I have encouraged our instructors to incorporate them in our classes so people know how to use them. In 2010, we held a myofascial release clinic to introduce more staff to foam rolling and other self-massage techniques. It was well attended and well received. I've been meaning to write this post ever since. Matt Hirn, one of the trainers we were working with at the time, even helped me create this little instructional video.  

The benefits of foam rolling include:
  1. Release tight muscles. 
  2. Relieve pain associated with working at a computer for long stretches of time.
  3. Improve circulation which aids in muscle performance and recovery.
  4. Improve the range of motion in your spine.
  5. Reduce the appearance of cellulite. (This last point is somewhat debatable, but it can't hurt to try.)
Some people find foam rolling a little painful initially, but you can easily control the amount of pressure you use. I'd put it in a "hurts so good" category. You use your body weight to roll specific muscles to mimic a deep, gliding massage and pause on any trigger points until they release. Matt will introduce you to a few things you can try to get started, but you can get at most major muscles if you contort yourself into the right position.

There is a lot of additional information available online. I like these posts:

Saturday, May 5, 2012

Eat Like an Athlete -- The Feed Zone Cookbook

On a recent road trip to see our oldest son, Ian, play ball at Ashland University, my husband and I stumbled upon YouTube videos of Allen Lim cooking for Team Garmin during the Tour de France. He was making little rice cakes and potatoes and wrapping them to be easy to eat on the bike. I was intrigued by the portable "real" food. I've never found the gels and bars that endurance athletes typically use very appealing, so I set out to learn a little more about Allen Lim and his work. 

Allen Lim is a sports physiologist who has worked with many professional cyclists. He partnered with chef Biju Thomas to develop The Feed Zone Cookbook. I ordered it mostly because I was fascinated by what I had learned from Allen Lim, but I didn't expect it to be particularly relevant to my level of fitness. My husband and I are training for triathlons, but we're not exactly professional athletes burning 6,000 calories a day.

What a great surprise! For an athlete in training, The Feed Zone is a practical, thoughtful, and (most importantly) useful book that cuts through the hype and focuses on "what works." It has a wonderful introduction that is packed with useful advice; I particularly appreciated the section on food timing broken into pre-workout, workout, post-workout and dinner. 

Here's an example, "After racing or training more than 4 hours, it's critical that you eat at least 4 grams of carbohydrates per kilogram of body weight within 30 minutes of finishing. For exercise lasting less than 2 hours, the goal is 2 grams of carbohydrates per kilogram of body weight... We need to eat immediately after exercise because our muscles are extremely sensitive to insulin during this time. Insulin brings carbohydrate into the muscle, where it can be stored as glycogen. Consequently eating right after exercise helps to better restore muscle glycogen."

The recipes are organized by breakfast, portables, après, dinner and desserts. They're all made with whole foods and can be prepared quickly. Each recipe includes a beautiful photo and the nutritional information. There are lots of 300-400 calorie options and many vegetarian and gluten free choices.
Patrick and I with our son, Ian, at Ashland University

In short, I am a fan. This book is a necessity for anyone training for endurance, but would surely be appreciated by anyone who is trying to eat well and be fit. I wish I would have had this book when our boys were young. Ian would have loved the rice cakes with bacon and eggs in lieu of his standard PB&J between games during a doubleheader. At just under $14, The Feed Zone Cookbook is also a real bargain.