CDC Initiative in Worksite Health Promotion

Jason E. Lang, MPH, MSTeam Lead, Workplace Health Programs

National Center for Chronic Disease Prevention and Health Promotion

ACSM/IAWHP Executive Summit April 1, 2014

National Center for Chronic Disease Prevention and Health PromotionDivision of Population Health

Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, 2013

* Estimate is statistically different between All Small Firms and All Large Firms within category (p<.05).

NOTE: Biometric screening is a health examination that measures an employee's risk factors

SOURCE: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2013.

Gym Membership Discounts orOn-Site Exercise Facilities*

Smoking Cessation Program*

Web-based Resources for Healthy Living*

Wellness Newsletter*

Lifestyle or Behavioral Coaching*

Biometric Screening*

Weight Loss Programs*

Employee Assistance Program (EAP)*

Flu Shot or Vaccinations*

Class in Nutrition/Healthy Living*

Offer at Least One Specified Wellness Program*

Other Wellness Program*

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

21%

39%

47%

47%

33%

26%

31%

22%

53%

20%

76%

10%

69%

71%

78%

60%

57%

55%

58%

79%

87%

50%

99%

26%

All Large Firms (200 or More Work-ers)

All Small Firms (3-199 Workers)

Assessment

Planning/Implementation

Evaluation

Individual(e.g. demographics, health

risks, use of services)

Organizational(e.g. current practices, work environment, infrastructure)

Community(e.g. transportation, food and retail, parks and recreation)

Contextual Factors(e.g. company size, company sector, capacity, geography)

Programs(e.g. education and counseling)

Policies(e.g. organizational

rules)

Health Benefits(e.g. insurance,

incentives)

Environmental Support

(e.g. access, opportunity,

physical/social)

WorkerProductivity

(e.g. absenteeism, presenteeism)

HealthcareCosts

(e.g. quality of care, performance standards)

Improved Health Outcomes

(e.g. reduced disease and disability)

Organizational Change“Culture of Health”

(e.g. morale, recruitment/retention, alignment of health and business

objectives)

Workplace Governance(e.g. leadership support, dedicated resources, health improvement plan, staffing, partners/vendors, communications, informatics)

Workplace Health Model

Timeline

1999 2013

NHWP Work@Health

Diabetes@Work

2011

Business Cooperative Agreement

2002

Healthier Worksite Initiative

2006

The Purchaser’s Guide

2005

NIOSH WorkLife Initiative

NIOSH Total Worker Health

2010

Workplace Health Toolkit

2012

Worksite Health

ScoreCard

CDC Healthier Worksite Initiative

• Goals– For worksite health promotion to

become a part of CDC culture– Increase “healthy days” among

CDC employees• Strategies

– Formative research– Collaboration– Physical Environment

modifications– Policy modifications

http://www.cdc.gov/hwi

CDC Healthier Worksite InitiativeGarden Market

CDC Healthier Worksite InitiativeStairWELL to Better Health

Project

Before After

CDC Healthier Worksite Initiative

Food at Meetings Guidance

Tobacco Free Campus

• Significant policy change in 2005• Completely smoke free

campuses, indoors and out• Collaboration of health

promotion, clinical, EAP staff and “quit-lines”

• Personal quit plan, free nicotine replacement

• Support for multiple quit attempts

• Link annually with the Great American Smokeout®

Building Diverse Partnerships

A Purchaser’s Guide to Clinical Preventive Services: Moving Science

into Action

NBGH product developed with CDC and AHRQ

Recommended clinical preventive services for health benefits design

Comprehensive: 46 conditions, 50% address chronic diseases

Targeted to all health care purchasers (public and private)

Written with contract language (Summary Plan Description – SPD)http://www.businessgrouphealth.org/preventive

CDC Workplace Tools and Resources

Organizational Culture & Leadership

1. Develop a “Human Centered Culture”

2. Demonstrate Leadership3. Engage Mid-Level Management

Program Design4. Establish Clear Principles5. Integrate Relevant Systems6. Eliminate Recognized

Occupational Hazards7. Be Consistent8. Promote Employee Participation9. Tailor Programs to the Specific

Workplace10. Consider Incentives and

Rewards

11. Find and Use the Right Tools12. Adjust the Program as Needed13. Make Sure the Program Lasts14. Ensure Confidentiality

Program Implementation & Resources

15. Be Willing to Start Small & Scale Up

16. Provide Adequate Resources17. Communicate Strategically18. Build Accountability into Program

Implementation

Program Evaluation19. Measure and Analyze20. Learn from Experience

Essential Elements of Integrated Programs

The CDC Worksite Health ScoreCard (HSC)

Organizational supports Tobacco control Nutrition Lactation support Physical activity Weight management Stress management Depression

http://www.cdc.gov/dhdsp/pubs/docs/HSC_Manual.pdf

Assesses best practice health promotion interventions (policies, programs, environmental supports)

High blood pressure High cholesterol Diabetes Signs and symptoms of heart

attack and stroke Emergency response to heart

attack and stroke Occupational Safety and Health Vaccine-Preventable diseases Community resources

The National Healthy Worksite Program (NHWP) is designed to assist employers in implementing science and practice-based prevention and health promotion strategies that will lead to specific, measureable health outcomes to reduce chronic disease rates. The NHWP seeks to promote good health through prevention, reduce chronic illness and disability, and improve productivity outcomes that contribute to employers’ competitiveness.

Module 4 Module 5

NHWP Training and Assistance Continuum

Driving senior leadership supportCreating a healthy worksite cultureBuilding infrastructure and capacity

Making the Business Case

Leadership and Culture

Data Collection

Planning & Implementation

Program Evaluation

Module 1 Module 2 Module 3

Relationship between health and performance

Impact of worksite health program

Key components of a compre-hensive worksitehealth program

Worksite healthassessment process

Types of data to collect

Using data for program planning

Determining program goals and objectives

Developing detailed worksite health plans

Putting assessment and planning into practice

Measuring process and outcomes

Key evaluation metrics

NHWP WH 101 Training Manualhttp://www.cdc.gov/nationalhealthyworksite/join/Training-

materials.html

Overview Work@HealthTM is an employer based training

program The Work@HealthTM Program will build employer

knowledge and skill as well as capacity to implement, grow and sustain effective workplace health promotion and protection strategies.

Accelerate the adoption of science-based worksite health programs nationwide.

Help to identify, develop, and share best practice models for comprehensive worksite health program training.

Work@HealthTM Program Structure

There are two basic ways to get involved: Work@HealthTM Employer training

Designed to train U.S. employers of all sizes and types how to establish, expand and improve science- and practice-based health promotion strategies that will lead to specific, measureable means to reduce chronic disease rates in the workplace.

Work@HealthTM Train-the-Trainer (certified) training Will provide employers and other participants with the

knowledge and tools to train employers using the Work@HealthTM curricula how to promote good health in their workplaces to prevent or reduce chronic illness and disability, thereby improving productivity and the competitiveness of employers participating in this training program.

Benefits to Employers

Professional training at no cost to the participant. Complete organizational health and safety assessment to define

existing needs. Expert technical assistance and consultation. Seed funding up to $5,000. Opportunity to network with peers. Participation recognition.

What you receive:

Benefits to Certified Trainers

Professional training at no cost to the participant. Enhanced knowledge and skills necessary to deliver.

comprehensive workplace health training. Enhanced skill at using integrated social media and

professional training tools. Seed funding up to $2,500. Expansion of professional network. Certificate of achievement.

What you receive:

Work@HealthTM Program Components

Formal Training Technical

Assistance Seed Funding

Support

Work@HealthTM Training ModalitiesEmployer Training Model

OnlineSeminars, case

studies and practical

demonstrations delivered through

distance-based mechanisms such

as webinars.

Hands-OnEmployers participate

in in-person interactive workshops that provide content through a variety of

approaches, including lectures and case

studies.

Blended Involves a

combination of distance-based or e-learning (online model) and in-

person classroom sessions

(hands-on model).

Employer Curricula

Core Elements

Work@HealthTM Technical Assistance

ASSESSMENT

PLANNING

EVALUATION

IMPLEMENTATION

Cu

rric

ulu

m C

on

tin

uu

m

Organic Technical Assistance

Structured Technical Assistance

Core Training

Work@Health™ Technical Assistance Learning Community

2014 Training Dates and Locations

BALTIMOREOnline – March 16 – April 5In-person, blended, T3 – April 8-10

Work@HealthTM Program Evaluation

Overall program will be conducted through quantitative and qualitative data applying the RE-AIM framework to assess: The comparative effectiveness of the four models in

reaching and engaging employers and long-term sustainability.

The effect of the training on employers’ learning and self-efficacy in applying knowledge and skills gained through training.

The resulting actions taken by employers to set up science-based workplace health programs, policies, practices, and environmental supports.

Information will be disseminated through manuscripts, case studies, and success stories.

Additional Benefits

• A complete health and safety assessment of their organization

• Technical assistance and community support resources over 12 months

• Seed funding to help take action– Up to $5,000 for employers to implement interventions– Up to $2,500 for trainers to train others

• On-going networking opportunities

Visit The TWH™ Website: http://www.cdc.gov/niosh/TWH/

CDC Workplace Health Promotion Toolkitwww.cdc.gov/whp

CDC Worksite Health Promotion Programs

www.cdc.gov/NationalHealthyWorksite

www.cdc.gov/workathealth

Thank You

For more information please contact Centers for Disease Control and Prevention

E-mail: jlang@cdc.gov Web: http://www.cdc.gov/workplacehealthpromotion http://www.cdc.gov/NationalHealthyWorksite http://www.cdc.gov/workathealth

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

National Center for Chronic Disease Prevention and Health PromotionDivision of Population Health