Download - Effective Small Business Wellness (workshop)
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Build it and They Will Come: Launching an Effective Program for Small and Medium Size Companies
FacilitatorDr. Joel B. BennettOrganizational Wellness & Learning Systems
© 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com
2010 WELLNESS SYMPOSIUMStrategies for Companies &Communities to Impact Health in A Changing Economy
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WORKSHOP OUTLINE
• This workshop is designed to create collaborative problem solving for participants around a hypothetical scenario (See Part 4) to create a small business wellness initiative in the community.
• Participants are assigned to tables for diversity of composition (employees, employers, providers, insurers, non-profits).
• The room also has experts from the community available for consultation.• The goal is to identify key elements and strategy needed to launch an
effective community-based wellness initiative that supports small businesses.
• This full-day workshop was conducted at the Houston Wellness Association in January of 2010 with about 30 participants
• This is PART 1 of the slide deck; PART 2 reviews the results of the grant-funded Small Business Wellness Initiative (www.sbwi.org)
• Please contact OWLS at [email protected] if you would like technical assistance or training on how to conduct this workshop and launch an SBWI in your community
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Other Presenters
• Olivia M. Dear, DirectorTexHealth Harris County 3-Share Plan (Harris County Healthcare Alliance)
• Ashly Alberto, Corporate Market Director, Houston Heart Walk, American Heart Association
• Sebabi Leballo, Organizational Development Manager, HCSS, Construction Software & Services
• Daniel Francik , Corporate Ambassador HCSS, Construction Software & Services
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Participants (YOU): Which best describes you?
EMPLOYEES
EMPLOYERS or their representativeA. Very Small Business Owner/Employee-
less than 100 employees (not wellness provider);B. Small Business Owner
100 to 500 employees (not wellness provider)C. Small to Medium
larger than 500 employees (not wellness provider)
PROVIDER (Wellness Practitioner)
INSURERCORPORATE Representative
NON-PROFIT agency
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Each table has good representation?
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Key Elements
LAUNCH
PAD
Workshop Segments
Small BusinessWellness Program
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What we mean by “SMALL” businesses
These data refer to the first quarter of 2004, downloaded from the BLS Quarterly Census of Employment and Wages (QCEW) website http://www.bls.gov/cew/ (accessed June 2005).
26%87%46%11%
1% 24%
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Why Small Business? Top Ten Reasons
1. SBs significantly less likely to do Health Promotion* 2. SBs are 99% of all employers, w/60% of workforce3. Have generated 60% to 80% of net new jobs4. Employ majority of workers in a given community5. Sickness absence impacts work (replacement issues)
6. 1 person has more social modeling (CEO-ripple effect)
7. With less insurance, prevention more important8. Many SBs have positive work culture to leverage9. Entrepreneur/CEOs have humanitarian motives10. Promising practices exist (CDC SWAT study)* Healthy People 2010 targeted 75% businesses to receive wellness, but <50% do so and
some indication this is declining
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More on the Insurance Problem
• The principal barrier to small businesses in Texas offering employer-sponsored health insurance is affordability.
• Recent US Census reports indicate that 1:3 Harris County non-elderly adults are uninsured; almost a quarter of the state’s population.
• Two-thirds of uninsured adults are employed, with 44 percent working at firms that employ less than 25 workers.
• Small business employers who depend on health insurance to attract and retain workers are finding it hard to find cost-effective insurance for their employees.
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Part 1: What are SBs doing?(norms and trends)
SIZE MATTERS
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Society of Human Resource Management 2009 Benefits Survey (% offering benefit)
On-site fitness classes
Health care premium discount for annual HRA
Stress-reduction program
Rewards/bonuses for achieving wellness goals
Health Fairs
Health Screening
Weight Loss
Health & Lifestyle Coaching
Smoking Cessation
Wellness Newsletter/column
On-site vaccinations
Wellness Programs
Wellness Resources/Information
0 10 20 30 40 50 60 70 80 90
2
4
5
14
19
19
21
24
26
27
39
46
60
11
9
11
23
45
39
29
32
39
43
68
58
72
26
14
18
30
68
54
40
43
51
52
84
73
82
Large (500+)
Medium (100-499)
Small (1-99)
3,000 HR managers randomly selected from 250,000—www.shrm.orgISBN 978-1-586-44155-5—SHRM 2009 Employee Benefits Report
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Selected Programs compare with National Survey
On-site fitness classes
Health care premium discount for annual HRA
Stress-reduction program
Rewards/bonuses for achieving wellness goals
Health Fairs
Health Screening
Weight Loss
Health & Lifestyle Coaching
Smoking Cessation
Wellness Newsletter/column
On-site vaccinations
Wellness Programs
Wellness Resources/Information
0 10 20 30 40 50 60 70 80 90
2
4
5
14
19
19
21
24
26
27
39
46
60
11
9
11
23
45
39
29
32
39
43
68
58
72
26
14
18
30
68
54
40
43
51
52
84
73
82
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Five Areas to be Compared
2
5
14
19
21
26
11
11
23
39
29
39
26
18
30
54
40
51
0 10 20 30 40 50 60
On-site fitness classes
Stress-reduction program
Rewards/bonuses for achievingwellness goals
Health Screening
Weight Loss
Smoking Cessation
Large (500+)
Medium (100-499)
Small (1-99)
Note. Gym membership is
30% to 35%, NOsize differences
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2004 national worksite health promotion survey
• Directed by “Healthy People 2010” Initiative• Random telephone survey• Worksites sample (not organizations)• Respondents “directly responsible for health promotion
or wellness” or “in-depth knowledge of these types of programs at the worksite”
• Sample size 730 (60% response rate compares with 19% rate in SHRM survey)
• Over-sampled small businesses (compares with more corporate focus of SHRM survey)
Linnan, L., Bowling, M., Childress, J., Lindsay, G., Blakey, C., Pronk, S., Wieker, S., & Royall, P. (2008). Results of the 2004 national worksite health promotion survey. American Journal of Public Health, 98(1), 1-7.
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Comparing HR with those more familiarHR Personnel (SHRM) Providers (National Survey)
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Focus on Small Businesses (2000, California)
67%
52%48%
46%
SafetyTraining
EmergencyTraining
HazardousMaterial
First Aid
SAFETYPROGRAMS
20% 20%18% 18%
ViolencePrevention
SubstanceAbuse
Prevention
StressManage-
ment
Counseling
BEHAVIORMANAGEMENT
12% 10% 10% 8%
SmokingCessation
CholesterolScreening
PhysicalFitness
Diet orWeight
Manage-ment
PHYSICALHEALTH
McMahan, S. Wells, M., Stokols, D., Phillips, K., Clitheroe, H. C., (2001, Summer). Assessing health promotion programming in small businesses. American Journal of Health Studies (17.4% Response Rate)
1,846 Small Businesses Surveyed (sizes 2-14, 15-99, 100-500)[Los Angeles and Orange counties, California]
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The Smallest of the Small (looking at the smallest businesses across the three surveys)
Smoking Cessation
Weight Manage...
Health Screening
Stress Management
Fitness*
26
21
19
5
2
9
11
21
18
10
9
7
5
9
7
13
7
9
14
9
California (2-14)
California (15-99)
National (50-99)
SHRM (1-99)
For planning, targeting, and marketing small distinctions make a big difference
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So what? There is promise . . .
• Need to pay more attention to the very small (< 50) as these are majority of establishments
• Essential to know who you are talking to:– Human Resources– CEO– Internal Wellness Champion
• Significant variation by industry• Safety may be a lever• Humanitarian outcomes (rather than financial) may be more
important *– Genuine concern for well-being of employees– Improve the quality of their life
• Small businesses can do comprehensive programs* Divine, R. L. (2005). Determinants of small business interest in offering a wellness program to their employees. Health Marketing Quarterly, 22(3), 43-58.
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Part 2
Many Methods are
Available
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Strategy is a critical
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Strategic Elements of the Launch Pad
Individual Health
EnvironmentTeam/Support
CEO/Mgr Engagement
Organization (Policy)
External Support& Community
Integration
© 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com
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IndividualHealth
Environment/Team Support
Organizational (Policy )
CEO Engagement
External SupportCommunityIntegration
Awareness CommunicationActivity CampaignsProgram EffortsBehavior Change
Wellness Culture
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Strategy Matrix for Small Business Wellness Planning
IndividualHealth
Environment/Team Support
Organizational (Policy )
CEO Engagement
External SupportCommunityIntegration
AwarenessCommunication
• HRA• Email • Newsletters
• Posters• Climate survey• Readiness survey
Wellness is written into policy; e.g., no-smoking
Needs assessment with CEO
1. Align with insurance (plan, carrier, broker)
2. Set-up cooperative or local initiative
3. Local agencies• Public health• SBDC• non-profit
4. Local healthcare provider
5. Engage Local wellness biz
6. Community participation (Run for the cure)
ActivityCampaigns
• Walking / pedometer• Weight Loss
• Team activities• Free access to
exercise• Walking club
• Wellness committee• Empower to develop own resources
CEO participates with the team; lead by example
ProgramEfforts
• Coach outreach• e-health • Physician links/SBIRT
• Social marketing• Team wellness• Classes• Social networking
• Incentives• Disincentives• Work-life policy
Annual culture survey part of manager performance
Behavior Change
• Coach follow-up• Evidence based practices
• Reward tie behvior• Design effort-rwrd balance; job strain
Integrate wellness into performance goals
CEO transparency: CEO demonstrates behavior change
Wellness Culture
• Include culture survey with every HRA
Cultural touch-points (see Judd Allen)
• Rituals/calendar• Wellness vision statement• Act on
1. Local CEO roundtable2. Support non-profits3. Host events/fund raisers4. Healthy leadership campaigns
© 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com
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PART 3
SOLUTIONS AND BEST PRACTICES
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Solutions & Best Practices
• START: FIT FRIENDLY (Walking Challenges)• TEXHEALTH HARRIS COUNTY 3-SHARE PLAN
(Accessing Community Healthcare/Insurance)• WORKPLACE WELLNESS
‘LIVE UP TO YOUR FULL POTENTIAL’(HCSS-Heavy Construction Systems Specialists)
• SMALL BUSINESS WELLNESS INITIATIVE(Evidence-Based Health Promotion)
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PART 4
SCENARIO
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Scenario
• Harris County (towns, cities) identified as 1 of 20 areas in the country to receive a Phase I challenge grant (cooperative agreement) for $2 Million
• 8 counties/areas will move to Phase II (10 years; $5M)
• Three years to demonstrate:1. Can match the $2M with private & public monies2. Deliver health promotion to 100 small businesses that have not
received services (industry, diversity, health disparities)50 of these with less than 50; 25 w/51 to 100; 25 w/ 100+
3. Demonstrate Insurers and SB CEO collaboration w/community4. Programs in place for at least 1 year with demonstrable outcomes
in four areas– Behavior change (health improvement)– Environmental and/or culture change– Policy changes are effective– CEO engagement
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References• Barbeau, E., Roelofs, C., Youngstrom, R., Sorensen, G., Stoddard, A., & LaMontagne, A. D. (2004).
Assessment of occupational safety and health programs in small businesses. American Journal of Industrial Medicine, 45, 371-379.
• Brissette, I., Fisher, B., Spicer, D. A., & King, L. (2008). Worksite characteristics and environmental and policy supports for cardiovascular disease prevention in New York State. Preventing Chronic Disease, Public Health, Research, Practice, and Policy, 5(2), 1-12.
• Divine, R. L. (2005). Determinants of small business interest in offering a wellness program to their employees. Health Marketing Quarterly, 22(3), 43-58.
• Eakin, J. M., Cava, M., & Smith, T. F. (2001). From theory to practice: A determinants approach to workplace health promotion in small business. Health Promotion Practice, 2(2), 172-181.
• Linnan, L., Bowling, M., Childress, J., Lindsay, G., Blakey, C., Pronk, S., Wieker, S., & Royall, P. (2008). Results of the 2004 national worksite health promotion survey. American Journal of Public Health, 98(1), 1-7.
• Hunnicutt, D. Big steps for small businesses: The art of implementing a great wellness program in a small business setting. Absolute Advantage, The Workplace Wellness Magazine, 7(2), 3-44.
• McMahan, S., Wells, M., Stokols, D., Phillips, K., & Clitheroe, H.C., Jr. (2001). Assessing health promotion programming in small business. American Journal of Health Studies, 17(3), 120-128.
• McPeck, W., Ryan, M., & Chapman, L. S. (2009). Bringing wellness to the small employer, American Journal of Health Promotion, 23(5), 1-10.
• Society for Human Resource Management (SHRM). (2009). Employee benefits: Examining employee benefits in a fiscally challenging economy. Retrieved INSERT DATE, from www.shrm.org/surveys.