unit 2 wellness concepts programs & practices
DESCRIPTION
Lecture on what is wellness.TRANSCRIPT
Wellness Concepts, Programs, & Practices 2011
Lona Sandon, MEd, RD, LD
The function of protecting and developing health must rank even above that of restoring it when it is impaired.
—Hippocrates
Objectives
Define the terms wellness and health promotion.
Restate reasons for implementing wellness and health promotion program.
Explain how wellness and health promotion programs improve health and reduce health care costs.
Review examples of health promotion and wellness initiatives.
Discuss best practices in wellness programming.
View Video
The effects of health care costs on U.S. businesses
http://www.cdc.gov/leanworks/index.html
Discussion Starter
What do you think a dietitian who works in wellness/health promotion does?
What does health mean to you?
What determines health?
Biology Lifestyle
Working/living/social conditions
Community conditions
Background conditions
Sex, race, age, hereditary factors
Physical activity, diet, hobbies, leisure time, use of any type of drugs, safety practices, medical self-care, stress management
Housing, education, occupation, income, employment status, social networks, socioeconomic status, race/ethnic health disparities
Climate, geography, water supply, availability of hospitals, clinics, medical services, social services, industries, government structure, grocery stores, recreation, transportation
Nutrition policy, minimum wage, cultural beliefs, values, & attitudes, advertising, media messages, food distribution systems
Table 1-1, Boyle & Holben, 2010
Match the Definition
A. Wellness
B. Health Promotion
___ Includes positive emotions, relationships, physical & mental traits, engagement, & satisfaction
___ Intends to reduce or control risk factors for disease by empowering people to take control of their health
A
B
What is Wellness?
“Wellness is an active process through which people become aware of, and make choices toward, a more successful existence.” - National Wellness Institute (NWI)
http://www.nationalwellness.org/index.php?id_tier=2&id_c=26
6 Dimensions of Wellness
Developed by Dr. Bill Hettler, NWI
Physical
Spiritual
Inte
llectu
al
Soci
al
Occ
upati
onal
Em
otio
nal
http://www.nationalwellness.org/index.php?id_tier=2&id_c=25
What is health promotion?
Health Promotion – process of enabling people to increase control over, and to improve their health
Typically focused on reducing, eliminating or controlling health risk factors
Health Promotion …
Dynamic balance of: physical,
emotional, social, spiritual, & intellectual health
O’Donnell MP. Definition of health promotion 2.0: embracing passion, enhancing motivation, recognizing dynamic balance, and creating opportunities. Am J Health
Promot. 2009 Sept-Oct;24(1):iv.
Health Promotion…
Motivates & supports lifestyle toward optimal health using health education & behavior change theory
Am J Health Promot. 2009 Sept-Oct;24(1):iv.
American Journal of Health Promotion
Physical Fitness. Nutrition. Medical self-care. Control of substance abuse.
Emotional Care for emotional crisis. Stress Management
Social Communities. Families. Friends
Intellectual
Educational. Achievement. Career development
Spiritual Love. Hope. Charity.http://www.healthpromotionjournal.com/
HP Occurs at All Levels
Boyle & Holben, 2010 p. 9 Fig. 1-2
Current Health Care Systems Individual is responsible
for their own prevention Downstream health care
system Majority $ are spent on
curative care Designed to respond to
crisis intervention Are people’s
expectations of a cure to high?
Why do we need health promotion?
Advances in the 20th century = people living longer with chronic disease
Progress is now trending in the wrong direction
Health disparities due to race, income, geography are significant
Rising obesity in youths
Why do we need health promotion?
Self-induced chronic disease
Struggling public health infrastructure
Rising cost of health care/insurance
Concern with access to care
Leading Causes of Death in U.S.
Nutrition & lifestyle related 1 Heart disease - $318 B 2 Some cancers - $89 B 3 Stroke 5 Diabetes - $116 B 9 Kidney disease
Key risk factors: obesity ($61 B), physical inactivity, smoking, poor diet
CDC http://www.cdc.gov/chronicdisease/overview/index.htm
Health Statistics
7 out of 10 deaths due to chronic disease
133 million have at least 1 chronic disease
Arthritis most common cause of disability
Diabetes leading cause of kidney failure, amputations, & blindness
> 1/3 adults do not exercise regularly CDC
http://www.cdc.gov/chronicdisease/overview/index.htm
Health Statistics
< 25% eat enough fruit/veggies 1 in 5 smoke Avg. medical costs $7000/person/yr
(2006 estimate) 75% of health care $ spent on
chronic disease
CDC http://www.cdc.gov/chronicdisease/overview/index.htm
Healthy People 2020 - DHHS
Nations health improvement agenda Vision, mission, & goals
http://www.healthypeople.gov/2020/about/default.aspx
Align goals/objectives with nutrition program planning
Fell short of meeting 2010 goals
http://www.healthypeople.gov/2020/default.aspx
Healthy People 2010/2020
Improved but didnot meet goal.
Healthy People 2010
Base
line
1988
-94
2010
obj
ectiv
e0
102030405060
HP 2010 obj.: 60% healthy weight
Perc
en
t of
Pop
ula
tion
Base
line
1988
-94
Curen
t est
imat
e (o
besity
)
2010
Obj
ectiv
e0
10
20
30
HP 2010 obj: 15% obesity
Perc
en
t o f
Pop
ula
tion
Healthy People 2020 Goals
1. Eliminate preventable disease, disability, injury, & premature death
2. Achieve health equity, eliminate disparities, & improve health in all groups
3. Create social & physical environments that promote good health for all
4. Promote healthy development & healthy behaviors across every stage of life
Boyle & Holben, 2010 p. 16
Match the Definition
A. Primary Prevention
B. Secondary Prevention
C. Tertiary Prevention
____ treatment to prevent further complications
____ awareness & environmental/policy influence on health
____ screening & reducing risk
A
B
C
Showing a group of teenagers how to eat healthier using the MyPlate web site is what level of prevention?
A. PrimaryB. SecondaryC. Tertiary
Power of Prevention
3 elements Health promotion (10) Early detection (20) Management of
existing disease (30)
Power of Prevention
Quitting smoking ’s CVD risk by ½ in 1 yr. & ’s death from lung cancer risk by ½ in 10 yr.
5-7% in weight can prevent or delay type 2 diabetes
in BP & total Chol ’s CVD risk
Power of Prevention in the Workplace
Adults spend most their time at work
Most chronic illness develops during the working years, 20-40 yrs.
Employers can control the environment & policies that promote health
Healthier workers = Improved
productivity Less absenteeism Lower health care
costs Improved morale &
loyalty
Methods of Health Promotion:
Enhance awareness Increase motivation Build skills Create opportunities &
environments that make positive health practices the easiest choice
O’Donnell MP. Definition of health promotion 2.0: embracing passion, enhancing motivation, recognizing dynamic balance, and creating opportunities. Am J Health
Promot. 2009 Sept-Oct;24(1):iv.
Health screenings/HRA’s
Smoking cessation Health fairs* Brown-bag seminars* Weight loss programs* Fitness programs Nutrition
assessments* Injury prevention
Poster boards* Health Newsletters* Healthy cooking
demos/taste tests* Stress reduction
programs Individual
counseling* Vending/cafeteria
policies*
Examples of HP Activities
* Expertise of RD importantWhat is
the problem with
most o
f these
types of stra
tegies?
Motivators to Participate in HP
Concerns for one’s health
Monetary incentives Free to participate During work hours Social interaction Reduced insurance
premiums Health provider
recommended Competition Leadership support
Barriers to Participate in HP
Lack of time Cost Competing
interests/programs Kids got soccer
practice Lack of interest Lack of support
from friends, family, co-workers, leadership
Best Practices in Workplace HP Leadership buy-in Identify a leader Determine interest
& assess needs Health
screenings/HRA’s Physical activity
incentive campaigns
Lunch-n-learns Wellness library Quarterly wellness
newsletter Health policies Leverage
community resources
Hunnicutt, D. Big steps for small businesses. Absolute Advantage, 7(3);2-48, 2008. Wellness Council of America www.welcoa.org
CDC’s LEANWorks!
Leading Employees to Activity & Nutrition
View Dr. William Dietz video http://www.cdc.gov/leanworks/why/in
dex.html
Workplace obesity prevention initiative
Case studies: http://www.cdc.gov/leanworks/why/casestudies.html
CDC’s LEANWorks!
Obesity – Impacts productivity Increases employer health care costs Increases absenteeism Strong association with chronic disease
CHIP Wellness Program
Coronary Health Improvement Project
” affordable, lifestyle enrichment program designed to reduce disease risk factors through the adoption of better health habits and appropriate lifestyle modifications”http://www.chiphealth.com/index.php
CHIP Wellness Program
Goals are to lower: blood cholesterol, triglycerides, blood sugar levels, & high blood pressure by reducing excess
weight, enhancing daily exercise, & improving dietary choices
And to eliminate smoking
CHIP Wellness Program
Components Health risk assessment Lifestyle Education program▪ four times a week for four weeks, or▪ three times a week for five weeks, or▪ twice a week for eight weeks
Train the trainer approach▪ Implements video lessons
http://www.chiphealth.com/about_chip/course_content.php
Washoe County School District Mission Statement
http://www.washoe.k12.nv.us/staff/wellness-program/about-contact
Framework – HP 2010 goals & Healthier US initiatives
Create environments that: Increase awareness Promote positive lifestyles Lower disease risk Improve quality of life
Washoe County School District
Incentive driven: $40 per mos. Good Health Incentive
Contribution paid by all employees Price is lowered potentially to $0 if:▪ Employees participate in screening - $30▪ No health problems found - $0 ▪ Found at risk & participate in education
programs 91-93% participation rates!!!http://www.washoecountyschools.org/staff/wellness-program
Washoe County School District
Variety of activities Picture gallery
http://www.washoecountyschools.org/staff/wellness-program
Oregon.gov
Wellness at Work Toolkithttps://
dwp1.dhs.oregon.gov/WellnessAtWork/
Call To Action
Harness collective power of Communities Health care professionals Volunteer groups Government agencies Academic institutions
http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf
Call To Action – Key Areas
Well-being – help people take charge of their health School education Workplace wellness Faith-based communities Community based lifestyle interventions
http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf
Call To Action – Key Areas
Policy promotion Environmental
changes that support healthy living – mixed use communities
Public transportation Fresh fruit & veggie
access in all neighborhoods
Phys ed requirements in schools
http://www.cdc.gov/chronicdisease/pdf/2009-Power-of-Prevention.pdf
Call To Action – Key Areas Health equity
Target social determinants of health▪ Race, ethnicity, income,
education Equitable access to
health screenings Coverage for
prevention Access to healthy food
Research translation Communicate
effectively what we know works
Design and test effective strategies
Spread the word quickly
Call To Action – Key Areas
Workforce development State funded chronic
disease prevention program workforce
Community prevention & self-management programs
Worksite wellness program
Call To Action – Key Areas
What is the RD’s Role?
Assess, develop, implement,manage programs
Evaluate effectiveness
Act as Health & Wellness coach
Needs Assessment
Plan
ImplementMonitor
Evaluation
Summary
Wellness & health promotion aim to improve quality of life & reduce disease risk
Health is more than just biology and individual choices
Wellness programs lower health care costs
RD’s do more than tell people what to eat – program planning & implementation
Breslow’s 7 (2004) Keys for HP
No smoking Moderate alcohol or none Regular exercise Regular sleep Regular meals Moderate weight Eat breakfast
Healey & Zimmerman, Jr., 2010