The opinions expressed in this presentation are those of the speaker. The International Society and International Foundation disclaim responsibility for views expressed and statements made by the program speakers.

Why Workplace Health is as Important as PE,

Recess and School Lunch

Kristy Clark, MPHWellness Account Executive

Parker, Smith & FeekSeattle, Washington

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Agenda

• What schools and worksites have in common that contribute to public health?

• Compare influences to health• Policy Individual Choice

• What worksites can do– See what some employers have done to gain traction

in health promotion– What has the most influence on behavior

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What do schools and worksites have in common regarding public health?

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Social Ecological Model:

*Damis, Brian. A Holistic Approach to Environmental Public Health. National Environmental Health Promotion Network. // September 21, 2011

Use to enable employees and students to take an active role in their health, Targeting Behavior at the Organizational Level

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Worksite

• Americans work an average of 34.5 hours per week, spending 6.8-10 hours a day at their place of work.

• 55% of the population gets health insurance through their employer

• Employer pays 87% of cost• Costs are rising unsustainably• Influence prevalent social norms

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Schools

• Structured environment where students spend large amount time

• Eat meals• Opportunity for physical activity• Teachers and curriculum

influence knowledge• Create social norms

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Public Health Problem

• Obesity trends, Diabetes, Chronic stress

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Why it’s Important

Workplace SchoolsHealth and Safety Health and SafetyProductivity Build foundation for learningAccess to care Access to careAttraction and Retention RetentionEconomy

- Health care 19% of GDP Our Future

– Healthcare and Economy

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Organizational Development Theory

• System-wide process of applying behavioral science knowledge for:– Planned change and development of strategies– Design components– Processes driving organizational effectiveness

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Where to focus change:

• Meet people where they are: – If healthy, keep that

way. – If can lose weight, help

them.– If have chronic disease,

help with management.

Inner and Outer Determinants

Existence of Wellness

Plan

Intentionto

exercise

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Analyze Current State of WellnessStrategy How/Who IndicatorsUnderstand EmployeeClaim costs

Risk stratum • Quarterly healthcare expense report• Quarterly Rx utilization• High $ individual claims

Understand employeerisks

HRA • Aggregated results• Target problem areas

Understand existing environment

Policy and environmental assessment

Employee interest survey • Incentives to increase response rate

Understand Utilization of Existing wellness benefits

Increased Participation:• Smoking cessation programs• Enrollment at health clubs

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Develop Program to Address Environment, Benefits, Risks and Behaviors

Strategy How/Who Indicators

Align benefit structure with health objectives Expert input

Incentivize preventive

Review insurance plan for:Prevention Disease management

Develop new incentives Interest survey HRA, Achievement awards

% Participation

Plan for policy and environmental changes

Comprehensive Campus Wellness Committee

Showers, physical activity facilities, on-site food, bike racks, lighting

Ensure protection of vulnerable employees and security of data

Human Resources

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Evaluating the Program

• Data results from measurement• Participation rates• Satisfaction surveys• Policy/environmental change tracking • Overall healthcare claims spending• Determine measurement of quality

– Can you trust the data?

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Wellness Well-Being Engagement and Culture

Wellness Evolution

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More Comprehensive, new set of standards:1. Health2. Meaning3. Safety4. Connection5. Achievement6. Growth7. Resiliency

Implementing Changes/Focus Areas

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School Safety

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U.S. Education

• Young people faced with a variety of challenges on a daily basis. – Small changes can outsize difference

• Chronic stress—not left at the door– taken to work and school

• Schools are inconsistent with PE, recess and school lunch– Yet data indicates active students learn better

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What Some Schools are Doing

• Epiphany School—Seattle, Washington• Naperville High School—Illinois• Yale—Newtown, Connecticut

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Heart Adventure Course

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Results

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Exercise

• Beat Stress• Lift Mood• Sharpen Intellect• Function Better

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Establish Life Long Behaviors/Habits

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Naperville, Cardio Room

• 17 percent improvement for zero hour PE vs.10 % for those not.

• Schedule hardest classes after PE • Teaches:

– Fitness instead of sports– Lessons will serve for life– Skills– Sense of fun and awareness of how bodies work– Hooked on moving

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Naperville, Cardio Room

• Exercise stimulates neuro growth• Best in world on science test, ahead of

Singapore. • “Gym teachers create the brain cells,

teachers fill them.”• Virginia tech study did not improve test scores

after cutting gym.

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College

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Parker Smith & Feek

• Parker Smith & Feek• Koop Award Winners• Cleveland Clinic

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Wellness Components at PSF

1. Medical Outcomes

Earn Dollars for 2019Medical HRA/HSA Accounts

2.Activity-basedprograms

Earn Gift Card and Days Off in 2019

3. Tobacco$25 Surcharge for tobacco useon Medical Premiums 2018

2018

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Introduced New Vendor

What we liked:• Broad panel blood draw (no finger stick)

– Can take to your physician; do not have to repeat– Expanded panel to include PSA, A1C

• Easily understood Health score 0-100 scale • 2019 Incentives will reward progress, not perfection • Personalized reporting • Challenges - fewer, different • Earn points and rewards• Will manage Reasonable Alternative (appeals) process

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Objective, Easy to Understand Scoring

• Developed and reviewed by a panel of physicians

• Designed to reward health improvement across all risk levels

• Detailed, personalized report highlighting risk level

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Activity Incentives

Wellness Portal• Provides the ability to

plan, track, and manage participation:– Individual and Team Challenges– Lifestyle Rewards– Volunteering– Participation in Fitness Events– Device Integration

• Pair your activity tracker

Intention for these challenges to promote health or culture

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Claims Results

Costs have remained relatively flat,Wellness participation rates have ranged from 60-78%

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What Some Workplaces are Doing

• Parker Smith & Feek• Koop Award Winners• Cleveland Clinic

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Charles Everett Koop Award

• American Pediatric Surgeon and Public Health Administrator

• 13th Surgeon General of United States, served under Ronald Reagan

• Honored by award in his name promoting employer achievement in improving population health cost effectively

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• Reduce need and demand for medical services• Share objectives of Healthy People’s workplace

health promotion targets• Prove net health care and/or productivity cost

reductions as a result of improving population health.

Koop Award Criteria

BEHAVIOR CHANGE + RISK REDUCTION + COST SAVINGS= KOOP NATIONAL HEALTH AWARD

JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.

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Koop Award Industries

Health careIndustrialFinancialTechnologyUtillitiesMaterialsEnergyConsumer

JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.

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C. Everett Koop National Health Awards

• 1-4 winners a year• Initially invested $10,000 equally among 15

companies• Programs in place for at least 3 years• If acquired, removed from portfolio

JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.

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Value

• Koop Award winners outpaced S&P 500– Tracked 14 year period (2000-2014)– S&P Results

325% appreciation (compared to market 105%) 2.35/1.0

– Many companies are realizing that workers health extends beyond individual choices. Polices, programs, and practices at organizations can influence health.

JOEM. Volume 58, Number 1 // January 2016, Ron Z. Goetzel, Raymond Fabius, et al.

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What Some Workplaces are Doing

• Cleveland Clinic– Cleveland, Ohio

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Components of Clinic Program

• Cost and travel barriers removed with convenient and free access to fitness centers

• Premium Incentive

• Sign up deadlines and participation requirements

Employee Premium Level DiscountGOLD – Meet the health goals 30%SILVER – Participate, but do not meet goals 15% Bronze – Choose not to take part None

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Categories to Earn Premium Incentive

– Shape Up and GoHealthy Coordinated Care

– Hypertension – Diabetes – Hyperlipidemia – Asthma– Weight Management – Current Tobacco Use

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Current Status

• Participation: 16,621 Bronze,5,600 Silver, 11,000 Gold

• Of employees identified with chronic conditions, 57% enrolled in Coordinated Care Programs

• 2012 cost avoidance Employee Health Plan of $15 million • Costs leveling or decreasing for those enrolled in Healthy

Choice, rest of participants continue to increase• Spouses eligible to enroll in 2014, increasing impact

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Lessons Learned

• Clinic uniquely poised as provider and payer • Workplace wellness proved effective at

improving outcomes • Quality Measurement helped focus on specifics

to change• Even with reduced barriers, incentives and

efficient processes, Ultimately behavior change is up to the individual.

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What has the most influence on behavior?

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Influencers for Behavior Change

• If you can’t go “all in” with wellness, provide some of these features (AMSO)

Michael O’Donnell, Health Promotion in the Workplace 5th Edition, 2017

Awareness

Motivation

Skills

Opportunity 40%

30%

5%

25%

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Outcomes

Short-term results Increased knowledge and awareness

Intermediate results

Revised attitudes, perceptions, and beliefs

Long-term results Changed behaviors, actions and norms

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2018 Employer Priorities

First year that reducing health care costs is not #1 in employer priority 1. Increase employee

engagement2. Increase employee retention3. Reducing healthcare costs

Source: 2017 Virgin Pulse survey

Individual Results

Business Results

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Quality of life improvesHealth care utilization is reduced

Wellbeing behaviors

Outcomes

Benefits Impact and Performance

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Key Takeaways

• Implications of providing health literacy and a culture of health at work and school

• Understanding the landscape of workplaces in targeting behavior and accessing health care

• Learn some practical places to start; You do not need to be “all in” with wellness to impact lives

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Thank You

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