evidence based wellness (helping human resources shop better)
DESCRIPTION
Objectives: + Distinguish between programs that may be sold well and those that work + Identify the common and core elements of effective wellness programs + Be able to evaluate whether your current or prospective programs are meeting the standardThis program was presented to HR Professionals at HR SouthWest in October, 2012 (Presenter: Dr. Joel Bennett, [email protected])TRANSCRIPT
Evidence-Based Health PromotionSeparating the Wheat from the Chaff
Dr. Joel [email protected], 2012
• Tremendous growth in workplace wellness programs
• Little in the way of evidence-based guidelines for understanding – what works, the why, and the how
• This presentation provides the latest research information on – best practice guidelines and – essential elements of effective programs
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Objectives
• Distinguish between programs that may be sold well and those that work
• Identify the common and core elements of effective wellness programs
• Be able to evaluate whether your current or prospective programs are meeting the standard
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Outline
PART 1: Evidence & Insights (lots)
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PART 1: Evidence & Insight
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Ease of Use
Cost Quality ROI
Does it work?
(some) factors leading to decision
Caveat• This presentation is about “Does it work?”• NOT the other stuff
5 Insights (preview)
1. Your ownership (of any program) is the key to success
2. You can “set the bar” on how much evidence you need to help select your wellness program
3. You can move from program “selection” to program “crafting”
4. System-level stress management is essential5. Your ownership is the key to success
(commitment)
Success does not lie in the programs themselves but in the INTERACTION between the internal
programmers, the work environment, and the programs. You have to “OWN” the program!
INSIGHT # 1
GROW FROM WITHIN AND STAY THERE
GROW FROM WITHIN AND STAY THERE
Will it work? (two standards)
Will it work for me?
What evidence do I need to know if it will work for me?
Hearsay
Marketing
Proof
Objectivity
Experience
Results
Strategy*
*HR Magazine: (March, 2011; Susan J. Wells)http://www.shrm.org/publications/hrmagazine/editorialcontent/2011/0311/pages/0311wells.aspx
Map a Wellness Strategy Assess your needs
Ask your employees
Start inside
Consider a comprehensive/integrated approach
Narrow field with accreditation/certification
Keep up to date on what works
Involve others, collaborate
Ask for assurances, guarantees
Evidence-based
Is there research behind the product/service??Was it independent research??What is the quality of the research??
• What does this term mean? • Danger of it being over-used and ill-defined• So, three key questions to ask:
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Is there research behind the product/service?? Testimonials: One Testimonials: Many (independent) Customer Satisfaction Expert Panels Case studies Follow-up change in self-report Follow-up change in behavior Pre-post change Experimental Design (single study) Experimental Design (many studies) Reviews and Meta-analysis
Settingthe bar
One internal evaluator, paid for by the company
Internal evaluators, paid for by outside sources
External evaluators, paid for by the company
External evaluators, paid for by outside sources
Non-affiliated research scientists with multiple target sites
Was it independent research??
One case study Multiple case studies Observational study (longitudinal) Correlation analysis Pre-post (self-report) Pre-post (behavior) Pre-post with control group Randomized clinical trial
What is the quality of the research?
Where you set “the bar” for determining “sufficient evidence” is determined by many factors. The key is that you can at least
know that there is a bar/standard to set; bring into the purchase conversation. You have to show intelligence!
INSIGHT # 2
COMMUNICATE YOUR STANDARD
COMMUNICATE YOUR STANDARD
My goal today is synthesis!
• Review of evidence-based approaches• Synthesize into core ideas (memory aids)• Five areas to get started or to refresh
1. Walk the talk (Leadership)2. Love your “sparkplugs” (Advocates)3. The power of small groups (Teams)4. Think strategically about wellness (Climate)5. Keep giving back (Community)
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Preview Memory Aids
Broad Recommendations
Specific Benchmarks
Evidence-Based Criteria
OperationalGuidance
Broad
Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing (NIOSH, 2008; DHHS No. 2010-140)List derived by panel of experts
Promising Practices in Employer Health and Productivity Management Efforts: Findings From a Benchmarking Study (Goetzel, Schecter, Ozminkowski et al. 2007)Literature review of 5 best-practice studies, site visits to 9 promising practice employers, interviews with SMEs
Promising Practices for the Prevention and Control of Obesity in the Worksite (Archer, Batan, Buchanan, Soler et al., 2011)Synthesis of empirical results from 136 studies, each weighted on the basis of study design, quality, and effect size.
Organizational Culture/Leadership⦁ Develop a “Human
Centered Culture”⦁ Demonstrate
leadership⦁ Engage mid-level
management
Program Design⦁ Establish clear principles⦁ Integrate relevant systems⦁ Eliminate occupational
hazards⦁ Promote employee
participation⦁ Tailor programs to specific
workplace⦁ Find and use the right tools⦁ Adjust the program as
needed
Program Implementation⦁ Be willing to start small
and scale up⦁ Communicate
strategically⦁ Build accountability
into program implementation
Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing (NIOSH, 2008; DHHS No. 2010-140)
List derived by panel of expertsNote. Incomplete, list below is example of 20 recommendations.
Broad recommendations
Promising Practices in Employer Health and Productivity Management Efforts: Findings From a Benchmarking Study (Goetzel, Schecter, Ozminkowski et al. 2007)Literature review of 5 best-practice studies, site visits to 9 promising practice employers, interviews with SMEsNote. Incomplete, following are from Table 1 (parentheses is # of the 5 best-practice studies that showed evidence for the characteristic)
Benchmarks
•Organizational commitment (all 5)•Identification of wellness champions (3)•Data collection, measurement, reporting, and evaluation (including ROI) (3)•Ongoing program evaluation (3)•Program linked to business objectives (2)•Effective communication (2)•Effective operation plan (2)•Program goals include productivity & morale (2)•Interdisciplinary team focus (2)•Incentives to participate (2)•Effective screening and triage (2)•State-of-the-art interventions (2)
Classic Benchmarking Study (2000)*
1. Align with business strategy2. Create diverse teams (HR, benefits, safety, legal)3. Cultivate champion(s) with a sense of purpose4. Put senior managers/business ops on the team5. Assure health promotion staff are heavily engaged
*Goetzel, R., Guindon, A., Turshen, I., & Ozminkowski, R. (2001). Health and productivity management. Journal of Environmental & Occupational Medicine, 43(1), 10-17.
6. Emphasize quality-of-life improvement, not just cost cutting 7. Increase importance of evaluation over time 8. Communicate constantly and throughout the organization9. Show a constant need to improve BY learning from others10. Have fun
Another Benchmark Example
Best Practice Score-Card (2010)*
Strategic planning (formal plan with objectives) Leadership engagement (senior, champions, policies) Program level management
Programs (risk appraisal, evidence-based lifestyle management) Engagement methods (engaging communication, incentives) Measurement and evaluation
Employee Health Management Best Practice Scorecard*http://www.the-hero.org
Program diversity (safety, diet, exercise, occ. health, EAP)
Vendor alignment and coordination
Very good access to program for all workers
Benefits design promotes utilization
Another Benchmark Example
Promising Practices for the Prevention and Control of Obesity in the Worksite (Archer, Batan, Buchanan, Soler et al., 2011)Synthesis of empirical results from 136 studies, each weighted on the basis of study design, quality, and effect size.
Evidence-Based Criteria
Note. List below shows all studies found and those that were deemed of "Greatest Suitability" due to high quality and positive outcomes.
•Enhanced access to opportunities for physical activity combinedwith health education (5 studies, 3 suitable)•Exercise prescriptions alone (14 studies, 10 suitable)•Multi-component educational practices (25 studies, 13 suitable)•Weight loss competitions and incentives (16 studies, 6 suitable)•Behavioral practices with incentives (17 studies, 8 suitable)•Behavioral practices without incentives (47 studies, 26 suitable)
Computer-Delivered Interventions for Health Promotion and Behavioral Risk Reduction: A Meta-Analysis of 75 Randomized Controlled Trials, 1988 – 2007*
CDIs were successful at improving nutrition, reducing tobacco use, reducing substance use, increasing safer sexual behavior, reducing binge/purging behaviors, and promoting general health maintenance
No improvements were observed for physical activity, weight loss, diabetes control, or weight gain/maintenance.
KEY FACTORS: PLACEBO? Providing individuals with any active
intervention content is likely to lead to change. MOTIVATION MAY WEAKEN: Interventions that
had users look at the costs/benefits of quitting an unhealthy behavior or adopting a healthy one were less effective.
Another Evidence-Based Criteria
*http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572996/
Another Evidence-Based Criteria
Healthy Workplace
Team Awareness
Wellness Outreach at Work
Coping with Work &Family Stress
There is so much information about “what works” that we can now re-frame the decision-making from “What should I
select?” to “How can I best craft/shape programs based on my needs/costs?”
Use evidence-based principles!
INSIGHT # 3
OWN YOUR OWN CREATIVITY
OWN YOUR OWN CREATIVITY
Another Evidence-Based Criteria
Stress ManagementEffective Elements(2008 reviews)
Parks, K. M., & Steelman, L. A. (2008). Organizational wellness programs: A meta-analysis. Journal of Occupational Health Psychology, 13, 58–68.Richardson, K. M., & Rothstein, H. R. (2008). Effects of occupational stress management intervention programs: A meta-analysis. Journal of Occupational Health Psychology,13, 69–93.
LaMontagne et al:30 different interventions
Parks & Steelman:15 different studies
Richardson & Rothstein:36 experimental studies, representing 55 interventions
Lamontagne, A. D., Keegel, T., Louie, A. M., Ostry, A., & Lansbergis, P. A. (2007). A Systematic review of the job-stress intervention evaluation literature, 1990–2005. International Journal of Occupational and Environmental Health, 13, 268–820.
It makes no sense to only focus on individual stress management; like teaching someone to fish instead of always
feeding them it pays to help the system to help itself
Use multi-level approaches!
INSIGHT # 4
TREAT THE SYSTEM…PLEASE!
TREAT THE SYSTEM…PLEASE!
Other NoteworthyResources
(to help re-frame)
• Assists employers in identifying gaps in their health promotion programs• Helps them prioritize high-impact strategies for the following health topics:
• organizational supports,• tobacco control• nutrition• physical activity• weight management• stress management• depression• high blood pressure• high cholesterol• diabetes• signs and symptoms of heart attack and stroke• emergency response to heart attack and stroke.
You can have the greatest technology based on solid evidence-based principles but if you don’t have ownership
of the program you may be wasting your time, money, or both.
Own programs from the inside out!
INSIGHT # 5
Burden Compliant Obligation
Reasoned Obligation
MotivatedResponsibility
Visioning Calling/Cause
EmbodiedPassion
resistance “have to” “need to” “want to” “We can achieve”
“We can change”
“We are transforming”
Your Health
Your Values
Levels of Ownership
Greater chancesof success
Reduced chances of success
We start moving from obligation to ownership when our role is driven by our own values and when we see that our own health and well-being is part of our role.
© Organizational Wellness & Learning Systems, 2012.
AccountabilityInterest
HRM39
PART 2: Synthesis
Illness
Wellness
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OWLS Best Practice Thumbnail
OWLS Best Practice Thumbnail
oMotivationoMood & EnergyoSense of BelongingoSense of EngagementoPresenteeism
We
Its
I
It
oGood Diet & ExerciseoRole ModelingoParticipationoPerformanceoCommunicate
oTeam SpiritoCulture of Healtho Wellness CommitteeoLocal “Peer” ClimateoConnectedness
o Biometrics/ProgramsoRisk appraisal dataoCulture/climate dataoFiles/Benefits, IncentivesoCommunications
Belonging Participation
Culture/climate
Communications
Tip # 1: Walk the talk
Up to 50% of all executives will die of stress-related diseases
Employee’s relationships with their boss predicts their future health
Tip # 2: Love your sparkplugs
Early adopters Wellness advocates Champions Change agents
Tip # 2: Love your sparkplugs
Hunt them down
Engage them
Support them
Reward them
www.prevtools.com
Give them room
Tip # 3: Empower groups/committees
Formal Committee
1.Part of job description2.Diverse3.Promoted well4.Frequent communication5.A strong leader6.Meets regularly7.Continuing education
WELCOA (2007)
Informal/Training
TeamAwareness
Tip # 4: Think strategically about wellness
Why give workers healthy lifestyle skills and ignore a “toxic” work environment?
Is it possible that the underlying risks for cardiovascular disease/obesity lie in
psychological and environmental factors?
You maximize ROI when you attend to climate and depression engagement stress
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Presence
Teamwork Policy
Support
Work-LifeBalance
Coping
Wellness
RISK
RESILIENT
The climate of work units vary in health
Some are healthier than others
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PolicyTeamwork
SupportWork-LifeBalance
Wellness Presence Coping
RISK
RESILIENT
Upper Limit Problem
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What factors ‘upper limit’ wellness?
Tip # 4: Think strategically about wellness
Assess the work climate (level & dimension)
Include behavioral health (depression)
Identify your upper limiting factors early on
1
2
3
REVIEW
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Tip # 5: Keep giving back (community)
You’re helping families of workers (community)
Small businesses can band together
The business itself becomes the role model
1
2
3
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Tip # 5: Keep giving back/Community
www.sbwi.orgLeadership Sparkplugs Groups Climate
Review
Groups/TeamsLeadership
Sparkplugs
Climate
Helping… …families,other businesses,community
Contact Information
Dr. Joel BennettOrganizational Wellness & Learning Systems
3321 Collinsworth St. (suite 220)Fort Worth, Texas, 76107
www.organizationalwellness.com(817) 921-4260
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