Communities for Health Launch Event Summary of Proceedings

Communities for Health Launch Event

Summary of Proceedings Thursday, June 4th, 2015

2 | Communities for Health Launch Event | 2015

Introduction

On Thursday, June 4th, 2015 Sodexo, Inc. and the YMCA of Central Florida announced a unique partnership that brings together health service providers, insurance organizations, private enterprise, and public outreach organizations to combat preventable chronic illnesses. The announcement occurred at the Communities for Health launch event at the Dr. Phillips Center for the Performing Arts in Orlando, Florida. Over 200 business and healthcare leaders from across the state attended the event to learn about the Communities for Health initiative and how it differs from what is currently available in the health and wellness marketplace. The initiative represents a 3-year pilot program designed to enhance traditional, and often underutilized, employee wellness programs. Communities for Health uses a personal and coordinated approach that engages employees both at work and at home by providing behavior change support and incentivized rewards, which increases the likelihood of individual success.

The partnership between Sodexo and the YMCA of Central Florida combines the powers of the 18th largest employer in the world with one of the most recognized community wellness organizations in the United States. With such an influential partnership, this pilot program ultimately aims to achieve five specific objectives:

1. Engage individuals to participate in a robust health and wellness program through their employer; by building a network of support, both in the workplace, the community and at home;

2. Leverage community health partners, local and national merchants, and integrated technology systems to support health management and incentive-based rewards for healthy behaviors;

3. Strategically segment the workforce to connect participants to the appropriate evidence-based program, based on risk level and readiness to change;

4. Reduce employee and family health risks by encouraging healthy behaviors that will positively impact performance and reduce healthcare costs; and

5. Leverage healthier behaviors of the employee to change the behaviors of their neighboring community.

Keynote speakers Ann Albright, PhD, RD, Director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC) and Dr. John Armstrong, Florida State Surgeon General and Secretary of the Florida Department of Health, spoke about the importance of the initiative.

Event Summary

The event began with an introduction from Michael Norris, Chief Operating Officer and Market President of Sodexo North America Corporate Services, and John Cardone, Senior Vice President of Health Strategies and Business Development at the YMCA of Central Florida. Cindy Barth, Editor for the Orlando Business Journal, followed with an introduction of the first keynote speaker of the evening, Dr. John Armstrong. Dr. Armstrong highlighted the need for inclusive, positive, and evidence-based wellness initiatives, such as Communities for Health.

Following Dr. Armstrong’s address, Kathy Johnson, Senior Director of Nutrition, Sodexo Health Care, and Kelly Prather, Executive Director of Health Strategies at the YMCA of Central Florida, discussed the Communities for Health initiative in greater detail.

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Communities for Health Central Florida Launch

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Next, a panel discussion took place, in which five panelists answered questions related to the Communities for Health initiative. The five panelists were: • Nebeyou Abebe, Senior Director of Health

& Well-Being, Sodexo North America• Dr. Ann Albright, PhD, RD, Director of the

Division of Diabetes Translation at the CDC• Dr. John Armstrong, MD, FACS, Florida State Surgeon

General and Secretary of the Florida Department of Health• David Lewis, Chief Executive Officer for the

Commercial Division of United Healthcare Florida• Dr. Beth Kollas, Executive Director of Health

Strategies for the YMCA of Central Florida

After the panel discussion, Dr. Ann Albright gave a second keynote address in which she described how Communities for Health greatly aligns with her work at the CDC, which focuses on implementing a comprehensive approach to diabetes prevention and control.

Finally, Michael Norris and John Cardone closed the event with a call to action in which they urged attendees to serve as early adopters of the initiative, so that Communities for Health may ultimately have a lasting impact in the surrounding community.

Overview of the Communities for Health Initiative

The Communities for Health (also referred to as C4H) pilot will include Sodexo employees at Disney and Orlando Health, Sodexo and Rollins employees at Rollins College, and YMCA employees. However, any organization within the Central Florida region can participate in the initiative as long as they cover all program-related expenses.

The 3-year pilot is organized in phases, as it is designed to take a systems-based (integrated) approach to improving health at the population and individual level. This will be accomplished by leveraging evidence-based strategies proven to drive employee engagement and participation, and evidence-based programs proven to prevent the onset of chronic disease and help control existing chronic conditions.

The initiative begins with trained Wellness Champions who encourage fellow co-workers to enroll in the program via a consumer-friendly program website. Upon enrollment, employees opt in to receive customized text messages, starting with an invitation to schedule a diagnostic screening test in order to better understand their personal health status. Based on the results, participants are immediately connected to a lifestyle manager who recommends an appropriate program and serves as their health coach throughout the duration of the program. Once their personal health plans are in place, a series of individualized, text communications are provided to support each employee’s health goals and promote long-term behavior change. In addition to electronic support, employees are directed to the most convenient neighborhood YMCA to access evidence-based chronic disease prevention programs, fitness classes, healthy eating wellness classes, and other activities. Examples of these programs and activities include Sodexo’s Core4™ Programs and the CDC’s National Diabetes Prevention Program. Throughout the program, employees earn reward cards that can be redeemed at hundreds of local and national merchants. The reward and incentives component is designed by the Sodexo Recognition and Reward Services team. Sodexo’s recognition experts believe financial incentives help drive healthy behaviors when there is a community network to support healthy living. The team understands the importance of using incentives strategically in order to ensure effective employee engagement throughout each stage of the program.

Phases of the Communities for Health Pilot

Participants will receive long-term support from multiple sources, including:• Wearable fitness device • Lifestyle coach• Personalized ext messages• Buddy system• Wellness champions at work• Healthy local

merchant access

PHASE PHASE PHASE PHASE

PROGRAM ENROLLMENT

WORKFORCE SEGMENTATION

PROGRAMCONNECTION(S)

LONG-TERMSUPPORT

Trained wellness champions engage their peers and encourage them to participate in the Initiative by signing up via the C4H website.

Participants will be asked to sign up to attend a biometric event at one of the participating Y locations to understand their personal health status.

After they complete their biometric screening, participants will receive an incentive-based reward and will be immediately connected to a Y lifestyle manager who will review their results and enroll them into the appropriate program.


An Initiative of

Reach Employees at Work

Sustain Healthy Living

at Home

Help Employers Track Results

Improved Overall Health and

Performance

24/7/365 Engagement

Sustained Employee and Family

Engagement

in the Community

Peer to Peer Recruitment

One on One Coaching with

Lifestyle ManagerWellness Program

Enrollment

Population Health Management

Strategies

20%

30%

50%

Communities for Health Website

Continue to Reward Healthy Living

Reward Card Fitness Device SDX-Core4YMCA - DiabetesPrevention Program


Sodexo offers three Core4™ programs: Core4™ for Adult Weight Management, Core4™ for Pediatrics, and Core4™ for Diabetes. The programs vary in length, from nine weeks for the Pediatric program to up to 12 months for the Adult Weight Management program. All three programs were developed and are taught by Registered Dietitian Nutritionists (RDNs) using proven evidence-based methods. Through Core4™, participants learn how to improve their eating habits, lifestyle and activity choices. In addition, participants are taught how to maintain their weight loss and lifestyle changes in the long-term.

Core 4TM for Adult Weight Management has been included in several employee wellness programs with significant ROIs. Over 5,000 people have completed the program at 26 sites from New York to Texas. The program has been shown to have statistically significant outcomes: the 3-month program produces an average weight loss of 4%, and the 12-month program produces an average weight loss of 7.6%.

Communities for Health is unique and different because the initiative:

• Uses a peer to peer approach• Uses incentives strategically• Leverages technology• Makes use of a buddy system• Includes triage risk and readiness • Connects employees with local lifestyle coaches• Includes evidenced-based programs

in a community setting

The CDC’s National Diabetes Prevention Program

The CDC-led National Diabetes Prevention Program (DPP) is an evidence-based lifestyle change program for preventing type 2 diabetes. The year-long program helps participants make real lifestyle changes such as eating healthier, including physical activity into their daily lives, and improving problem-solving and coping skills.

• Participants meet with a trained lifestyle coach and a small group of people who are making lifestyle changes to prevent diabetes. Sessions are weekly for 6 months and then monthly for 6 months.

• This proven program can help people with prediabetes and/or at risk for type 2 diabetes make achievable and realistic lifestyle changes and cut their risk of developing type 2 diabetes by 58 percent.

Over 625 organizations offer the program nationally. More organizations are coming on board every day to meet the growing demand for effective programs to help adults prevent or delay type 2 diabetes


Peer to Peer Approach

Many workplace wellness initiatives require that employees report information about their health status to their employer. However, employees may fear discrimination or negative repercussions for less than optimal health, and thus may not feel comfortable disclosing such personal information to their employers.

To combat this issue, the Communities for Health initiative embraces a peer to peer approach in which participants are encouraged to influence and motivate one another. Specifically, certain individuals designated as “Wellness Champions” are tasked with engaging their peers in the program. These Wellness Champions are trained on how to empathetically talk and listen to their peers about health and provide tailored advice to unique health situations.

As Kelly Prather noted,

“We at the YMCA know that peer to peer engagement is powerful. This is a tried and true system that we have lived and breathed by for years and years. By incorporating this approach and having designated Wellness Champions encourage engagement in the program, trust will increase, employees will be more likely to participate, and ultimately a greater proportion of the population will succeed in achieving lasting behavior change.”

Use Incentives Strategically

Sodexo has a team of recognition experts that carefully craft strategic recognition and reward programs based on behavioral economics that help promote behavioral change. Generally, workplace wellness programs invest a significant amount of dollars in participant incentives. Communities for Health partnered with Sodexo’s Recognition and Rewards team to strategically incorporate incentivized rewards into the program, ensuring effective employee engagement throughout each stage. In essence, the incentives incorporate

behavioral economics designed to “nudge” participants to make healthy choices. Through Sodexo’s Recognition and Rewards services, participants have opportunities to earn a reward card or fitness merchandise such as a wearable activity tracker. The reward cards can be redeemed at merchants both on a national and local level which includes YMCA locations in Central Florida. Strategically incentivizing employees based on their engagement and active participation throughout the program helps to improve and maintain healthy learned behaviors and drive achievable outcomes, both as an individual and in the community.

Leverage Technology

Communities for Health incorporates wearable fitness armbands, text messaging, and online resources as key components of the program. Wearable fitness armbands keep participants accountable for their behavior in addition to providing constant awareness of their progress. According to Ted Vickey, an American Council on Exercise board member and former executive director of the White House Athletic Center under the Clinton and Bush administrations, “These devices [wearable fitness sensors] have the ability to be true game changers when it comes to tackling the obesity epidemic.”

Another way the initiative incorporates technology is through the “Text for Health” text messaging program, designed to provide ongoing motivation and engagement for participants. According to the Pew Research Center, 90% of Americans own a cell phone, and nearly two-thirds (64%) own a smartphone – making text messaging an ideal way to reach a large portion of the population. The text messaging platform will also be leveraged to promote available health and wellness resources available at the workplace and in the community.

A 2014 environmental scan conducted by the U.S. Department of Health and Human Services (HHS), Using Health Text Messages to Improve Consumer Health Knowledge, Behaviors, and Outcomes, highlights the effectiveness of text messaging programs. For example, a systematic review of the literature on disease management and prevention services delivered through text messages found evidence to support text messaging as a tool for behavior change in eight of nine studies with sufficient sample sizes.


Lastly, participants can access the Communities for Health website, where helpful resources are available and all of their information is maintained in one central location. By incorporating technology that is enjoyable to use, yet practical, participants will be more likely to remain engaged in the program, regardless of whether they are at work or out in their community.

Buddy System

People are more successful in achieving health and wellness goals when they have a “buddy” to keep them accountable. However, most workplace wellness programs do not incorporate a buddy system; meaning, a program that involves others outside of the workplace (e.g., spouses, significant others, friends). As Kelly Prather states,

“We believe that as part of Communities for Health, participants should be able to work with a buddy who will inspire them and make behavior change along with them. Therefore, the program is going to impact the community as well.” Whether it is a spouse, significant other, neighbor, friend, or anyone else, this initiative not only allows but also encourages others to become involved, and also inspires participants to continue making changes.

Triage Risk and Readiness

Immediately upon enrolling in the Communities for Health program, individuals are triaged for their level of risk and their readiness for change. In other words, Communities for Health is not a “one-size-fits-all” program. Rather, instead of providing the same intervention for all employees, participants are placed in programs that best suit their individual needs.

In the Communities for Health program, there are three levels of risk illustrated in Figure 1 that participants can be triaged into: • Green: This level is for those at a lower risk, defined

as being borderline overweight. These individuals are encouraged to participate in programs like Mindful by Sodexo and the Mindful Mile, which encourage increased physical activity and healthier food choices.

• Yellow: This level is for those at medium or moderate risk, defined as being either pre-diabetic or overweight. These individuals are encouraged to focus on programs that can help them achieve a healthier weight, such as Core4 by Sodexo, the National Diabetes Prevention Program by the YMCA, and the YMCA Lifestyles Management Program.

• Red: This level is for those at high risk, defined as having one or more chronic conditions like diabetes. These individuals are encouraged to participate in programs like Core4 for Diabetes and the YMCA Lifestyles Management Program, which are more intensive for this higher risk group.

Figure 1: Communities for Health Levels of Risk and Corresponding Programs

GREEN - LOW RISK YELLOW - MEDIUM RISK RED - HIGH RISK


This triage system is beneficial for several reasons. As Dr. Albright stated, health interventions:

“…need to be meaningful to people. Participants are not going to engage in a program if it is not relevant to them…it matters that we help people to connect to things that are relevant to them.”

Through the Communities for Health triage system, participants will be directed to evidence-based programs that directly relate to their needs, thus making it more likely that they will be successful in achieving their health and wellness goals.

In addition, this triage system will decrease costs, since the more intensive interventions will be provided only to those who need them. This system allows for greater inclusivity in the program, while ensuring that program funds are used as efficiently as possible to make the greatest impact.

Connect Employees with Lifestyle Coach

Another way that the Communities for Health initiative stands out is through its emphasis on taking advantage of the “teachable moment.” This is the moment in which participants’ attention is highest, occurring at the initial step of the program.

Specifically, as soon as an individual is screened and made aware of his or her risk level, they are connected with lifestyle managers who discuss the employee’s unique risks and opportunities for solutions. It is essential that the appropriate solutions are available to the participants immediately at that moment when they understand their risk level.


Evidence-Based Programs in a Community Setting

Communities for Health incorporates programs that are scientifically proven and evidence-based. It also insists that these evidence-based programs be offered in a community setting. This is because if participants are only engaged while in the workplace, but become disengaged outside of work, the initiative will not be successful.

This is a unique and beneficial aspect of the partnership between Sodexo and the YMCA. Across the country, 85% of U.S. households live within a 5-mile radius of a YMCA. The initiative will utilize these community spaces to deliver programs from organizations like the YMCA and Sodexo. Thus, Communities for Health will be easily replicable, and the program itself will be accessible and affordable for most Americans.

Conclusion

“With nearly 50 percent of adults having one or more chronic health conditions and healthcare costs projected to reach 34 percent of GDP by 2040, we simply cannot afford wellness programs that do not show results. Through our partnership with the YMCA of Central Florida, we are creating a coordinated support system that delivers solutions tailored to individual needs to help families live healthier, happier and more productive lives.”

~ Nebeyou Abebe, Senior Director of Health & Well-Being, Sodexo North America

As Kathy Johnson pointed out, “Only 4% of employees complete a workplace wellness intervention program, but employers spend $8 billion on these initiatives. That means employers achieve only 4% of their organization’s goal!”

96% of employees are not engaged in workplace wellness programs.

When discussing the staggering statistics regarding diabetes in the United States, Dr. Ann Albright noted,

“It is a big deal… if we think we have a problem now, we haven’t seen anything yet. One in 10 Americans have diabetes today, and the CDC predicts that as many as 1 in 3 children born in the U.S. in 2000 will develop diabetes in their lifetime. That is unsustainable – we cannot possibly go in that direction.”

These statistics are unacceptable, and both Sodexo and the YMCA of Central Florida insist that we can do better. In fact, not only can we do better, but we must do better. Something different must be done, and the Communities for Health initiative is committed to answering the call for a unique and feasible solution.


Call to Action

“The work begins today,” said John Cardone. We must not sit idle for another minute and watch as a growing percentage of our population suffers from health and wellness issues related to preventable chronic illnesses.

We hope that you, too, choose to be an early adopter of the Communities for Health initiative, so that we can collectively go on to share the story of wellness and ultimately have a positive, lasting impact on our community at large.

Organizational leaders who want to participate in the pilot can submit an inquiry through the C4H website. Participating organizations will receive quarterly reports that include de-identified, aggregate-level data on their employees. Our program evaluation plan includes both process and outcome metrics, ranging from participation rates to health improvements (e.g., weight loss). Oher interested parties can opt to receive annual reports or participate in webinars.

For more information about Communities for Health,

please visit

www.communitiesforhealth.com

Sharon Bartfield, MS, RDNProject ManagerCommunities for Health Central [email protected]

Communities for Health Launch Event Summary of Proceedings

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