building results through comprehensive programs

7/31/2019 Building Results Through Comprehensive PROGRAMS

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About Laura Linnan, ScDLaura Linnan ScD is Associate Professor and MPH Program Director atthe University of North Carolina. Her work at the UNC Gillings School of Global Public Health includes primary research in the areas of preventionand control of chronic diseases, especially cancer, with a concentration onapplied research e orts in worksites and other community-based settings.

She is also the Director of the Carolina Collaborative for Research on Work and Health (CCRWH).

Dr. Linnan earned her doctorate from Harvard University’s School of Public Health and servedfor six years as a research associate faculty member at Brown University. She has a jointappointment at the Lineberger Comprehensive Cancer Center and is a Research Fellow at theUNC Center for Health Promotion and Disease Prevention, where she also serves as SeniorAdvisor to the Evaluation Core. She has authored more than 70 scienti c articles and was akey contributor to the 2008 publication, Results of the 2004 National Worksite Health PromotionSurvey in the American Journal of Public Health.

An Expert Interview With

Laura Linnan

About David HunnicuttSince his arrival at WELCOA in 1995, David Hunnicutt has interviewedhundreds of the most in uential business and health leaders in America.Known for his ability to make complex issues easier to understand, Davidhas a proven track record of asking the right questions and getting straightanswers. As a result of his e orts, David’s expert interviews have been

widely-published and read by workplace wellness practitioners across the country.David Hunnicutt can be reached at [email protected] .


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W E L C O A N E W S & V I E W S

I n this exclusive WELCOA interview, Dr. Laura Linnan, a nationally-recognized public health expert shares with us the status of

workplace wellness programs and the impact that they are having onemployees and American businesses.

In 2004, Dr. Linnan and her colleagues conducted a national worksitehealth promotion survey by examining a cross-section of worksite wellness programs. Results showed that only 7% of worksites o ered comprehensive or results-oriented wellness programs—indicating animportant need to increase the number, quality and types of programso ered across the nation.

Te following insightful interview highlights the resources you can use toimplement and evaluate your comprehensive worksite wellness programsto keep them aimed at improving employee health and cost reduction.

David Hunnicutt: Please tell us a little about your work with the 2004National Worksite Survey and what it evaluated?

Laura Linnan: Well, rst, I would just like to say that it was an honor and a privilege to be part of the National Worksite Survey in 2004. Te team includedindividuals from the Partnership for Prevention, the CDC, and leaders in diseaseprevention, health promotion and national health statistics. Te 2004 survey was about a ve-year process, and part of that process involved reviewing similar

surveys and research that dated back almost 20 years.

We wanted to monitor how things are going on a national level. So, this survey established benchmarks that linked to the Healthy People 2010 and now Healthy People 2020 National Objectives. Te survey allowed us to monitor how we’redoing with worksite health promotion in relation to those objectives. It enabled usto not only compare results over previous surveys, but it also allowed us to look atsome new, important areas.

I think surveys like this at the national level are extremely important.Tey provide monitoring functions that help us see progress on speci cbenchmarks over time. Te survey allowed us to determine the impact andoutcomes of wellness programs, from the perspective of the employer.

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DH: In your 2004 study, you revealed some compelling data regardingactivity-centered versus results-oriented programs. Can you add somecommentary on that discovery?

LL:Te 2004 survey was the rst time that we actually asked about comprehensprogramming as opposed to just activity-speci c programming. When it camecomprehensive programs, we established an ambitious goal of 75 percent—we wanted to see 75 percent of the workforce o er comprehensive programming.Unfortunately, the survey revealed that only seven percent of employers areactually o ering a comprehensive program.

o be honest, I wasn’t that surprised at the number. I think there’s a lot of interein health promotion, which is obviously a good thing. Employers are getting thmessage that it’s important to think about employee health. However, I think thsurvey really showed us that we need to go beyond what I would consider “sprand pray” approaches. What I mean by that is that there are several programs w

goodwill and good intentions, but these programs tend to be narrow in scopeand can’t conclusively answer the critical questions: Can we improve employehealth? Can we in uence the nancial health of an organization? Can we helpreduce health care costs? So, I think we need to get beyond the single-activity approach and think more about comprehensive programming. Tis is the kind oprogramming that will have a positive, long-term impact on employee health.

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I think we need to get beyond the single-activity approach and think more about

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DH: In your 2004 study, what were some o the other surprising and, inyour opinion, compelling fndings?

LL:A number of things jumped out. For one, we con rmed something wesuspected, which was that employers tend to look to their insurers for help withtheir programming. About half of the employers who responded said they reliedon their insurers for help with their programming. Tat was an important nding.Going forward, I think it’s critical to develop strategic partnerships with healthinsurers in such a way that we’re all focused on comprehensive programs.

Secondly, we wanted to look at how the work environment can be mobilized tosupport health. We learned that the physical environment plays a large role insupporting employee health. For example, o ering onsite tness facilities is a great way to promote and support health. About half of our employers with more than750 employees had a tness center onsite, which is an enormous percentage whenyou think about it. If we can get people using those facilities at these worksites,that would be tremendous.

On the ip side, we discovered that most of the smaller worksites don’t have thesekinds of facilities. Of course, that doesn’t mean small employers can’t create a supportive, healthy work environment. Tere are opportunities for creating a morehealth-supportive environment in all worksites. Simple options include creating a measured walking distance around the worksite or in the surrounding community. You can also focus on the foods that are o ered in your cafeteria and/or vending machines. Are healthy food choices labeled? Are special promotions o ered? Are there healthy catering options you can leverage? We know that when healthy

food options are available it can make a tremendous di erence. So, it’s criticalto leverage partnerships and mobilize the physical environment to supportgood health.

Te survey also con rmed something else we suspected, which was that smaller worksites continue to have less programs, policies and environmental support forhealth. We cannot ignore that data any longer. We found that employers with 750employees or more are very, very di erent than those who have 750 employeesor less. Sadly, I think we learned that small employers have a lot less happening in terms of health promotion. Tere’s lots of room for improvement there. So,as these small businesses try to create e ective, comprehensive health promotionprograms, they need to consider new approaches, new models and new ways to



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create healthier work environments. I do want to mention that small employershave some great opportunities and advantages. For example, policy change in large organization often takes years to implement. Yet, policy change in a smal work environment can happen rather quickly, as there are usually only a few laand decision makers involved in the process. So, by sharing some evidence-bapolicies that have been proven to help support healthy workplaces, we can helpsmaller businesses create an almost immediate impact on that work environme

DH: I you could o er up any salient advice or recommendations orbusiness leaders and workplace wellness practitioners, based onthe fndings o your national survey and other related pro essionalexperiences, what would you tell them?

LL:Number one is: don’t settle for the ‘spray and pray’ approach. Developsome key partnerships so you can be more strategic in your wellness programs Additionally, focus on more than just programming. Tink about the physical ansocial environment of the workplace. Tink about policies that are already in plaor could be in place to help support the health of your workers. Tink beyond just wellness—think about integrated approaches. For example, try partnering with your employee assistance program. After all, a great portion of the illnessand health care costs we face today are linked to stress and mental health. So,if you can build a strong partnership between your health programs and yourorganization’s employee assistance program, I think that will go a long way. We just at the tip of the iceberg on that. I think we can do a lot more.

I think practitioners also need to focus on really engaging their employees. Inour 2004 survey, employers cited lack of employee interest as the key barrierfor o ering wellness programs. However, in all of the surveys I’ve done—andI’ve done hundreds—employees always indicate that they are interested in thes

programs. So, there’s de nitely a ‘disconnect’ there. It tells me that we need todo a better job of engaging employees. We need to ensure that the programs,services, policies and environmental changes we o er are truly responsive to wemployees are interested in. I don’t think we’ve done a good job with that at alSo, I’m a big advocate of things like employee wellness committees. Tey engaemployees and allow them to get involved in the programs and to take ownershof them. Getting employees involved—employees at all levels, not just managbut also line supervisors and those on the front lines—is really key.

6

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Keep in mind that employees love hearinggood news. They like hearing that theworkforce is getting healthier. They likehearing the success stories.

Additionally, we cannot ignore the importance of marketing these programs. If people don’t know they exist, they’re not going to participate and take advantageof them. And don’t forget that employees can help with the marketing. If they’repart of these wellness committees, they’ll do a great job getting the word out.

We also need to do a better job with evaluation. I think strategic planning for wellness should include mechanisms that allow you to track your progress. Youneed to ask your employees: Is this working? You need to provide some front-endbenchmarking that shows where you were and where you are now. Keep in mindthat employees love hearing good news. Tey like hearing that the workforce isgetting healthier. Tey like hearing the success stories. Moreover, this creates a culture shift and a positive, healthy environment where employees like to work. When employees know that their employer cares about their health and well-being, it creates a culture shift, and that is just an amazing thing when you see ithappen.

Lastly, when I think about strategic planning for wellness, my goal is to seethe entire organization take on a new feel. I like to see organizations that aresupportive of health, and that create a work environment and culture thatencourages and embraces health. It’s not a stick approach; it’s a carrot approach.It’s an approach that fully involves employees in the change process. Te goodnews is that our data is showing us the way— showing us the benchmarks andhow to get there. So, we really need to keep monitoring this, and keep doing goodresearch that will help build the evidence-based programming and culture shiftsthat truly make a di erence.

DH: It seems like we’ve got a long way to go when it comes too ering comprehensive workplace wellness programs in businessand industry. How long do you think it will take us to get there,

and are you optimistic about the journey?

LL:I’m an eternal optimist, so I’m convinced we’ll get there. I think it’s hard toapply a strict timetable on when we will see a move from sevento 75 percent. It’s not going to happen overnight. However,I believe that there are things happening in the larger socialcontext of our country that are going to help us. Weneed some political will here. It can’t just be on anemployer-by-employer basis. While we certainly need

National Worksite Health

Survey Results Are Available

Dr. Laura Linnan and her col-

leagues conducted the 2004 Na-

tional Worksite Health PromotionSurvey, by examining a national

cross-section o worksite wellness

programs. Results showed only

6.9% o worksites ofered compre-

hensive programs—indicating an

important need to increase thenumber, quality and types o pro-grams ofered across the nation.

Read The Full Results At:http://ajph.aphapublications.org/cgi/ reprint/98/8/1503.pdf


http://ajph.aphapublications.org/cgi/reprint/98/8/1503.pdf








Even Small Worksites Can Create SupportiveEnvironments… There are opportunities or creating a more health-supportive environmentin all worksites. Simple options include creating a measured walkingdistance around the worksite or in the surrounding community. You canalso ocus on the oods that are ofered in your ca eteria and/or vendingmachines. Are healthy ood choices labeled? Are special promotions ofered?Are there healthy catering options you can leverage? P E 5

Maximize Your Programs… Think about policies that are already in place or could be in place to helpsupport the health o your workers. Think beyond just wellness—think abouintegrated approaches. For example, try partnering with your employeeassistance program. A ter all, a great portion o the illnesses and health carecosts we ace today are linked to stress and mental health. P E 6

Make Opportunities For Employees To et Involved…I’m a big advocate o things like employee wellness committees. Theyengage employees and allow them to get involved in the programs and totake ownership o them. Getting employees involved—employees at alllevels, not just managers, but also line supervisors and those on the rontlines—is really key. P E 6

Surveys nd Evaluations re Key… The good news is that our data is showing us the way—showing us thebenchmarks and how to get there. So, we really need to keep monitoringthis, and keep doing good research that will help build the evidence-based

programming and culture shi ts that truly make a diference. P E 7

Support For Wellness On National Level…I think it’s hard to apply a strict timetable on when will we see [results-orientedprograms] move rom seven to 75 percent. It’s not going to happen overnight.However, I believe that there are things happening in the larger social contexto our country that are going to help us. We need some political will here. Itcan’t just be on an employer-by-employer basis. P E 7

from Laura Linn

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employers to take ownership and get on board, we also need some support in thelarger political, social and economic environment. When I think about health carereform and what’s out there and what we can expect with some of the new initiatives, I am optimistic. I think we’ve got some new e orts underway at the national level that we’ve never had the infrastructure or funding for in the past. For example, there’s an opportunity for creating regularmonitoring of worksite health promotion programs. I’m happy to say thatthe CDC and the O ce for Disease Prevention and Health Promotionare working together to instill this regular monitoring. Tat’s one small,but important step.

Secondly, we need to think about some incentives for employers when they o er comprehensive programs. In the new health carereform initiative, there are various incentives built in for employersto o er these programs. So, if they stick, I think we’re in luck because having some incentive for employers to o er will be great. I alsothink employees themselves need incentives. Tere are evidence-basede orts that support the whole issue of incentives. For example, if you do a health risk appraisal and you provide appropriate feedback, there’s evidence

that that(awareness, or feedback) actually stimulates some health behaviorchange among employees. So, why not incent that? Get insurers to makethat (what?) available either free or at very low cost. We need incentives at thenational level, we need employers to get on board, and we need employees torealize that it’s in their own best interest. Employees in particular need to know that being healthy is in their own best interest and the interest of their family.Moreover, being healthy is in the interest of keeping jobs and maybe evencreating jobs.

So, the idea of an incentive structure for worksite wellness programs can helppromote and support healthy behavior change. I think that should help accelerate

the process of moving us beyond the seven percent mark. I think the incentives will help us take this on as a business strategy as well as a personal strategy. I don’tthink you can have one without the other. I think employers need to be on board.I think employees need to be on board. We need to be working together on thisand not be polarized by it.



Employees in particular need toknow that being healthy is in theirown best interest and the interestof their family.

about Madeline Jahn, mo

Madeline Jahn is the CommunicAssociate for the Wellness C

America. Her role is to coordinate the developmpublications and pool existing resources for WEbers, serving the mission of health promotion thketing and planning support. She has a Master’Organizational Leadership from the College ofFor questions about this publication, or to obtainfor reprinting, please contact Maddy atmjahn@welcoa







mailto:[email protected]

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