6 Take Home Points from the Art & Science of Health Promotion Conference


1)  It’s not ALL about ROI.

When the field of Worksite Health Promotion became popular some 40 years ago there were no studies claiming ROI for investment in employee health.  Leading companies decided to invest in wellness programs because it was the right thing to do.  It only makes sense, right?  Healthy employees are better employees.  They are productive, happier, less stressed, less absent and, of course, they cost less.

Somewhere along the line companies started showing a positive ROI for health promotion programs.  Yes, it makes sense if employees are healthier they will cost less.  And yes, there are hundreds of studies to prove this point.  Lately, however, there have been some reports claiming that there is actually no ROI associated with wellness programs.

For one, that simply isn’t true.  Those of us in the field know that well-designed programs achieve great financial ROI.  But that simply isn’t the point and it’s not the only reason we should be investing in employee health.  In the rest of the world, where often times paying for health insurance isn’t a responsibility of the company but rather the government, wellness programs still exists. Why? Because of all the other value associated with having a wellness program: recruitment, retention, productivity, reduced absenteeism, and morale to name a few.

A new term came up several times at the conference and I think it may stick.  VOI: Value on Investment.  I can’t think of a better value on investment than improved health.

2)  Less finger pricks, more purpose.  

Dr. Victor Strecher delivered a powerfully motivating opening keynote focusing on finding one’s purpose in life.  It was quite refreshing to hear a well known industry researcher take a step back from the numbers and focus on individuals.  This is a field, after all, that focuses on improving the lives of people.  And the research tells us that there are three things that, more than any other factors, lead to behavior change: autonomy, mastery, and purpose.  Autonomy: the feeling of being self-directed.  Mastery: the feeling of self-efficacy.  Purpose: the feeling of living a meaningful life.

As it turns out, people feeling a sense of purpose is fairly important.  Does your organization focus on allowing employees to feel a sense of purpose?  Does your wellness program address these needs?  Health Risk Assessments and Biometric screenings may seem important, but so is an individual feeling like they have a sense of purpose.

3)  Incentives do not work.

The secret is out: incentives don’t work.  At least not in producing long-term behavior change, which is often times what they are used for as part of wellness programs.  If you pay someone $100 to fill out an HRA, are they likely to comply? Sure.  Will they show up to a weight loss class?  Maybe.  Will they lose weight and keep it off?  No.

The research is very clear on this subject.  For simple tasks (filling out a quick survey) incentives are great, they work quite well actually.  One problem in this scenario, however, is the underlying message you are sending is that “this is not something you should want to do on your own volition and that is why I am bribing you to do it.”  When goals become more complex (and changing one’s behavior towards a healthier lifestyle is very, very complex) incentives, at best, will not improve your chances and, at worst, make them worse.  That’s right, incentives for long term behavior change do not work, and it’s well documented.  This was echoed by expert after expert at the conference and I’m not sure why incentives are still so pervasive throughout health promotion programs.

4)  Culture is key.

If incentives don’t change behavior, what does?  Well, the term “culture of health” has been thrown around quite a bit for several years but that doesn’t mean anyone actually has a clue what that means or what it looks like.  One thing that was repeated many times over the week was that it’s not even worth trying to change behavior if you don’t have a healthy, supportive environment.  I’m not prepared to take it that far, although, I do agree culture is a very important component to a successful wellness program.  Can you really provide nutrition education and allow employees access to unhealthy vending machine and cafeteria options at the same time?  It’s certainly worth a long look at whether or not your organization’s culture is supporting healthy choices.

5)  The more things change, the more they stay the same.

We would like to think that wellness programs have evolved quite a bit over the years.  But we heard from many experts who have been in the field for a long time that they largely remain the same, at least in their format.  Generally, an organization starts with all its employees (let’s say 1000).  They assess those employees in some manner.   Maybe half of them complete the assessment so we are down to 500 now.  Then we target the highest risk employees with interventions thinking that they are driving the cost (maybe 20% of the 500, or 100 employees).  Of those 100 employees maybe half of them will take part in the interventions we are offering and before we know it we have engaged 50 employees out of 1000.

Sure the assessments and interventions have changed over time, but this model really has not.  And it’s about time it does.

6)  The future is bright.

This field is full of bright minds and great companies really looking to improve health.  There is no shortage of truly passionate people in the field and the conference saw its largest attendance in history this year.

Dr. Don Powell and his 35+ years of experience weighed in on the topic “Future Trends in Health Promotion” and he presented some thought-provoking ideas.

To highlight a few:

1)      HRA’s and screenings will decline.   We should be doing wellness with our employees, not to them.  Additionally, we already know the risk factors of a population before we assess them.  The data is readily available.

2)      More emphasis on stress management.  Most employees report that they experience increased levels of stress in their lives and the most common source is work.  In order for organizations to successfully manage health, they must manage stress.

3)      Personalized Self Care.  Self care programs will become tailored in the way that other health programs have.  When you enter symptoms into a program that software will have your family history and health record to help draw conclusions.

4)      “Fit for Hire” certificates.  There will be a governing body to award and monitor health status across employers.  If you were deemed “fit” at your former job you can use that status to help gain employment at a new company.

5)      Wellness will become Well-being. The focus of well-being will become more holistic include physical, emotional, social, spiritual, and financial health.

Five ways to promote your self-care guide

Here are five tips to improve the likelihood that employees will use a self-care guide instead of high-tailing it to the doctor or ER:

1. Distribute a guide annually.

You move, and it ends up in a box you never unpack. You use it and then misplace it. You never remember to bring it home from work and your family never has the chance to take advantage of it. Or it just blends into the scenery on your bookshelf.

Distributing a new guide every year is an easy way to send a regular message about the importance of self-care and wise consumerism. It’s a little bit like getting a new toothbrush every time you go to the dentist.

And most self-care guides are updated and medically reviewed annually, so employees have access to the latest and most accurate health information available.

2. Include medical self-care in your newsletter.

Whether your newsletter is online or in-hand, it is really easy to tie-in medical self-care — and a reminder about using the book.

Here’s an example from our latest HealthyLife Newsletter:

With a friendly reminder bar at the bottom: “Many topics like the one of this page are contained in a medical self-care guide … If you have a self-care guide, use it whenever you are unsure about what to do for symptoms and health issues you are experiencing.”

3. Hang posters and flyers.

Here’s one we recently developed.

Do you know what to do? I don’t. True story — I looked it up in my self-care guide just because I was curious.

Make sure you change it up often (every 2-3 weeks) to keep your message fresh! And you don’t have to stop at posters — stick up a fridge magnet in the office kitchen, pass out postcards, or send a regular self-care email.

4. Host a workshop.

Help employees make better use of their self-care guide, and they’ll be more likely to use it. It may seem self-explanatory, but the density of information, the flow-chart format and the variety of recommendations for action — what’s the difference between “See a doctor” and “Call a doctor”? — can be intimidating for some. Do an in-person lunch-and-learn, conduct a webinar, or distribute a how-to video.

5. Remember that promotion is a process, not a one-time event.

Don’t make the mistake of doing one self-care quiz with a cash incentive and calling it a day. It’s an ongoing effort. The good news is that the more people use their self-care guides,

- The more you will save on health care costs.

- The higher your return on invesment.

- The healthier your employees will be.

So don’t be daunted! Jump in!

How do you promote your self-care program to your employees?


How to win upper management support for your wellness program

Are you ready to bring wellness to the table? 

1. Show some numbers.

Do your research and get some data together that supports the cost savings of wellness programs.  Our data tends to show an ROI of about $3 for every $1 invested in a program, but recent data suggests that as health care costs escalate, those returns could climb even higher. A self-care program alone can help employees reduce costly doctor and ER visits (averaging over $200 / $700 per visit, respectively) — a significant relief to your health care costs.

Start with this Harvard Business Review study on the hard return of employee wellness programs — some of the most recent and comprehensive hard financial data available. (Harvard shows a $6 to $1 ROI for wellness programs, by the way.)

And our Medical Self-Care Savings white paper shares in-depth results of several independent studies on our self-care guides.

2. Emphasize strategy.

Your company has short-term and long-term strategic priorities in place, as well as core values that guide decisions at the executive level. Do you know what those priorities and core values are?

If not, it’s worth finding out. Why?

Because wellness can be a business strategy. Just ask our friends at the LinkedIn group Wellness is a Business Strategy.

How can a wellness program help your business meet its strategic goals? How does wellness reflect your organization’s values? Answer those questions and you are well on your way to success at the executive table.

3. Find a champion.

Odds are there is at least one person in your organization’s upper ranks who already values wellness. You know the type: hits the gym during lunch, sits on an exercise ball instead of a desk chair, uses the office microwave to steam veggies for lunch, just got back from a yoga retreat, has an enviously healthy snack stash, or bikes to work.

That’s a partnership you can’t pass up. Talk to that person about your interest in starting a wellness and see if (s)he’s on board. Find an advocate for wellness on the executive level, and you’ll have someone to persuade fellow members of the c-suite to get behind your plan. It’s like having a seat at the table.

4. Start small.

Maybe you’ve been dreaming about a wellness program with all the bells and whistles: mobile biometric screening trucks, expensive incentives, a full-fledged fitness center with state-of-the-art equipment and flat-screen TVs, a huge online portal with an exhaustive library of information.

A wellness manager can dream, right? But if you know that your budget is the primary eyebrow-raiser for upper management, don’t despair. An effective, comprehensive wellness program can cost as little as $15 or $20 per employee.

The basics of a low-budget wellness program might include:

  • Health risk assessment to determine population risks
  • Self-care book
  • Telephonic health coaching for lifestyle change programs like weight loss and smoking cessation
  • Monthly wellness newsletter
  • Online resources: A learning center, e-book, customized nutrition plan, or wellness challenge
  • Promotional materials
  • Supplemental health education materials (brochures, self-care kits, screening magnets)

We have loads more ideas for promoting wellness on a shoestring budget here.

5. Pilot your program.

If your executive team is still skeptical, consider piloting a program to a sample population. Keep it simple and low-cost, give it 9 months to produce results, and then do a thorough evaluation on how much you spent vs. how much you saved. You can offer a limited sign-up phase for interested employees and then do a random lottery if you have too many registrants.

If your program was successful — if it improved health, reduced costs, and met your goals and the goals of your organization — you’ll have a much easier time convincing upper management to support a company-wide wellness program.

Good luck!

Cooking: Does it work … at work?

By Ginny (ginger chicken Uploaded by Partyzan_XXI)                        via Wikimedia Commons

At AIPM, we know that a healthy diet is a huge component of overall health and well-being. We’re also a small business. Our office kitchen does quadruple-duty as a coat room, a stock closet, and a copy center. Making it easier for employees to eat well during the work day is a topic that’s close to our hearts.

So yesterday, we were excited to discuss Cooking & Company (a project of Jamie Oliver’s Food Revolution) and other experiments for better food at work.

The gist? What if companies offer their employees:

  • Take-home kits for fresh, healthy, home-cooked meals, with fully prepped ingredients and a recipe — e.g., vegetable fajitas?
  • Cooking classes, led by local chefs or personal cooking consultants?
  • “Pop-up” community cooking events, like a singles night, wine tasting, or make-your-own-omelet breakfast stations?
  • A communal kitchen/cooking space at the office where employees can cook and eat together?

Are you thinking: Do we have the space? Who has a budget for this stuff? Will my boss sign-off? Fire hazards?

Yeah, we were thinking that too. But go ahead and download the free toolkit, and read it with an open mind. It includes plenty of flexible planning ideas to help you scale. Maybe you can:

  • Take advantage of a cooking class at an off-site community center?
  • Use designated employee break time (lunch seems natural)?
  • Instead of paying for a full-flight cooking program (or total office kitchen rehab!), subsidize take-home meal kits to offer to employees at an affordable price?

It was helpful for me to realize that this is about more than offering healthy options for your employees.

It’s about engagement.

Not just watching a cooking demonstration: actual, hands-on cooking. Not just grabbing  the least-unhealthy option in the vending machine: actively preparing a healthy meal with your co-workers, and building skills that employees can bring home to their families.

What do you think? How do you handle food at work? Would any of these Cooking & Company experiments work at your workplace? What have you tried to help employees make healthy, nutritious choices?

Does your wellness program reach young employees?

That’s because:
  • Young adults can stay on their parents’ health insurance until they are 26 years old
  • It’s easier and less expensive to buy insurance through the exchange if employer does not offer insurance coverage

Some consulting firms estimate that 7.5 million adults age 19-26 have or will gain insurance through HCR.

But it remains to be seen if young people will:

  • Use insurance for regular preventive care
  • Develop a relationship with a primary care physician or use pharmacy clinics or walk-in urgent care instead
  • Practice wise health care consumerism — since about a third of them have been uninsured since they graduated from college

If your wellness program doesn’t currently serve the needs of your younger employees — or if you’re not sure whether or not it does — this is a great opportunity to get them involved, educated, and more engaged in their health.

But why? Aren’t they pretty much healthy, anyway?

1. Yes, but they still have health risks

Young people are healthier on average than your older employees and less likely to suffer from high cholesterol, hypertension, heart disease and other chronic conditions.

But there’s still plenty of room for improvement — and you have a unique opportunity to stop bad habits and health problems before they become damaging and costly. Problems like:

  • Smoking
  • Heavy drinking
  • Stress management
  • Anxiety, depression and other mental health issues
  • Weight management
  • Nutrition
  • Sedentary habits

I can think of a dozen other examples and I bet you can too. Are they educated about nutrition and smart grocery shopping or do they subsist on frozen pizza and take-out? Do they protect their skin from sun damage or hit the tanning bed regularly? Do they buckle their seat belt when driving or wear a helmet when riding their bicycle?

2. You can manage the spectrum

In general, health risks flow from low to high. So do health care costs.

Low-risk employees, as younger employees tend to be, won’t stay low-risk forever.

  • As many as 10-20% of low-risk employees will move to a higher risk category in a year
  • The best worksite wellness programs address both high-risk and low-risk employees

Make it a strategic priority to keep healthy people healthy.

3. Include young employees in your wellness efforts

The best way to get young employees involved in workplace wellness efforts might be just inviting them to be involved.

Do your young employees have a seat at the table?

  • Do you have a young employee on your wellness committee?
  • Do you take their opinions and suggestions seriously?

What do they want in a wellness program?

  • Yoga classes? Healthier cafeteria food? A smartphone app instead of a self-care book?
  • Longer breaks so they can go to the gym? Bike racks?
  • Clearer and more accessible information about how their insurance plan works and what it covers? (This is a big one, especially for the first-time insured)
  • What incentives would make them more likely to participate?

How’s your current program working for them?

  • Do they use it?
  • What do they like? What do they dislike? What did they not even know you offered?
  • Don’t make assumptions: Just because you offer new technology channels or social networking features doesn’t mean your younger employees are using it.

You won’t know unless you ask. Send out a survey, recruit a young employee wellness summit, or just drop by to chat.

Once you have a program in place, don’t forget to check in periodically and ask how your program is going and how it can be improved!

5 Ways to Engage Participants in Your Wellness Program

Employee HealthAn employee wellness program is only as effective as it is engaging. Getting employees to actually participate within your wellness program is the first step you’ll need to take towards fostering a healthier workplace atmosphere overall. Here are five ways that you can move towards employee engagement and a successful wellness program.

1. Create Reasonable Goals

Not everyone is going to be able to lose 20 pounds by summer, but everyone can take a walk for five minutes a day. Creating reasonable goals will encourage your employees and make them feel more confident and in charge of their health.

2. Get Your Management on Board

A wellness program that is supported by upper management will be more effective overall. A company’s culture is always driven by those on top. Upper management can also get excited about being a positive role model for their employees.

3. Create a Supportive Culture

Training for a marathon is going to be a lot harder with a bunch of unhealthy snacks cluttering up the break room. When you diet on your own, you need to remove all temptation. The same goes for an employee wellness program. Promoting health throughout the office is a good way to ensure that the system works.

4. Use Incentives Appropriately

While it may seem a little direct, bribery works. Creating rewards and prizes for those that commit to your wellness program is a fantastic way to get more employees involved. The prizes can be as simple as a plaque on the wall or as involved as a day of paid time off. Prizes don’t have to be expensive to make it fun.

5. Listen to Advice

Often, there may be a direct and simple reason why employees aren’t engaged in your existing wellness program. Listening to suggestions and even actively seeking them out can be the best way to discover the incentives that will work and the reasons why the existing system is faltering. Keeping an open mind about employee suggestions can often lead you down avenues you never considered.

When engaging employees in a wellness program it’s important to remember that the goal isn’t only health. A wellness program is also designed to get employees to work together and foster a sense of teamwork.

Affordable Care Act and Tobacco Surcharges: What You Need to Know

The average smoker costs an additional $4,260 per year in direct medical costs and lost productivity according to the CDC.  In an effort to reduce tobacco use and the additional costs related to tobacco use, many insurance companies and employers implement a surcharge to users of tobacco.

What is a surcharge?


A tobacco surcharge is an increase in the premium amount paid by users of tobacco. The surcharge can also be referred to as a tobacco premium or premium differential.

How much is the surcharge?

Current federal law allows health insurance plans and companies to charge tobacco users an additional 20%.

Beginning January 1, 2014 health insurance plans and employers will be able to charge up to 50% more.

Will every state implement a surcharge?

Some states have made it illegal for insurance companies to implement a surcharge. Those states include: California, Connecticut, Massachusetts, New Jersey, New York, Rhode Island, Vermont, and Washington D.C.  Employers in these states may still opt to implement a surcharge.

Who is considered to be a “tobacco user?”

A tobacco user is defined as anyone who uses any tobacco product including cigarettes, cigars, chewing tobacco, snuff, pipe tobacco, or hookah, four times per week for the last six months.

What else do I need to know?

Health insurance plans and employers who implement a surcharge are required to offer a reasonable alternative for tobacco users.  If a tobacco user participates in the reasonable alternative program, they will not have to pay the surcharge.  In this case a reasonable alternative is a comprehensive tobacco cessation program.

What should I look for in a tobacco cessation program?

The ultimate goal of the surcharge is to alleviate the country of one of its largest public health concerns. The program you offer is of the utmost importance. You should look for a program from a trusted provider with a long history of success and flexible program options.  The program should provide:

1)      Structure and a proven methodology for quitting.

2)      Telephonic or in-person counseling

3)      Nicotine replacement therapy, either over the counter (patch or gum) or prescription.

The Smokeless® program has helped over 1 million people quit, and stay tobacco free, using the comprehensive approach recommended by the American Lung Association. Learn more about the smokeless program by clicking here.

If Food Were Health Care

Wee all know that health care costs have risen at rates beyond comprehension.  We constantly hear numbers thrown around as to what health care is costing,  but it’s impossible to imagine what a billion dollars really looks like.  Let’s take a look at the increase from another angle,  possibly making it easier to digest ;)

If food prices had risen at medical inflation rates since the 1930’s:

1 dozen eggs $  92.97
1 pound apples $  14.18
1 pound sugar $  15.87
1 roll toilet tissue $  28.05
1 dozen oranges $  125.08
1 pound butter $  108.32
1 pound bananas $  18.60
1 pound bacon $  141.99
1 pound beef shoulder $  50.52
1 pound of coffee $  74.40
10 item total $669.98

Source: American Institute for Preventive Medicine, 2013

10 Tips to Enhance Your Wellness Program

American Institute for Preventive Medicine developed a very handy guide called “Wellness On a Shoestring: Over 350 No or Low Cost Activities and Resources to Enhance your Wellness Program.”  They offer it for $34 on the website, which at that price is a steal.  But, they’ve taken 10 of the activities and offer them in this free toolkit.  Go ahead, download it and share the link with all your friends! Download the toolkit here! Free Wellness Toolkit

What lessons can health promotion take from USA Today?

It’s ubiquitous.

You might not buy a copy of USA Today at the newsstand, subscribe for home delivery, or seek out its content on the web, but you’ve probably thumbed through countless issues of the paper in your life.

Why? Well, USA Today is all over the place. It’s dropped at the door of your hotel room in the morning. It’s free at the airport. Whenever you’re in motion, it satisfies your need to sit down and read the news — from wherever you are.

The tip: Are your wellness communications everywhere? In the stairwells? The break room? Even bathroom stalls can be a great place to deliver your message to an, er, captive audience.

It’s intuitive and simple.

Stories on the front page of USA Today take up only the front page — no skipping to page A4 mid-sentence. On the front page of each section you’ll find one-line blurbs that tell you what’s inside.  Articles tend to be short and easy-to-read, sometimes with bullet-point summaries of key take-aways.

USA Today gets lampooned a lot for being the McDonald’s of print newspapers, but we think there’s a big difference between simple and simplistic. Sure, readers won’t want to turn to USA Today for in-depth analysis of the latest Congressional policy fight. But for those looking for a quick overview of the news of the day, stocks, and maybe a recap of the game they missed last night, USA Today delivers.

The tip: Know your audience and deliver the information they need in a format they can read and digest over continental breakfast at the hotel. What’s the most concise, engaging way to deliver the information your employees need?

It’s attractive.

USA Today is color-coded for ease of navigation — blue for News, red for Sports, green for Money. You know that, even if you’re not conscious of it. And years before “infographic” became a buzz word, USA Today placed an eye-catching daily chart on its front page for a snapshot of pertinent data.

The tip: Is your communication well-designed? It’s easy to overlook this step, especially in small firms where budgets are crunched. But by paying attention to clean, clear, and colorful presentation of information, your can send a message in barely more than the blink of an eye.

There’s something for everyone.

One of my favorite lunchtime hobbies in college was sitting with friends from all over the country and reading the nation’s news blurbs to each other, sharing the latest from each others’ home states and quirky headlines from across the country. And with a national weather report, you can be prepared for whatever the winds bring, wherever you are.

It’s no small feat that USA Today can be broadly appealing while remaining relevant and personal. The reading level is appropriate, the amount of information is just right, and there’s something useful for pretty much everyone in the country.

How can you make your wellness efforts just as efficient, timely, and useful?