CDC Initiative in Worksite Health Promotion Jason E

CDC Initiative in Worksite Health Promotion Jason E. Lang, MPH, MS Team 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 Promotion Division of Population Health

Among Firms Offering Health Benefits, Percentage Offering a Particular Wellness Program to Their Employees, by Firm Size, 2013 Other Wellness Program* 26% 10% Offer at Least One Specified Wellness Program* 99% 76% Class in Nutrition/Healthy Living* 50% 20% Flu Shot or Vaccinations* 87% 53% Employee Assistance Program (EAP)* 79% 22% Weight Loss Programs* 58% 31% Biometric Screening* 55% 26% Lifestyle or Behavioral Coaching* 57% 33% Wellness Newsletter* 47% Web-based Resources for Healthy Living* 47% Smoking Cessation Program* 60% 78% 69% 21% 0% 20% * 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. All Small Firms (3 -199 Workers) 71% 39% Gym Membership Discounts or On-Site Exercise Facilities* All Large Firms (200 or More Workers) 40% 60% 80% 100%

Workplace Health Model Assessment Planning/ Implementation Evaluation Individual Organizational Community (e. g. demographics, health risks, use of services) (e. g. current practices, work environment, infrastructure) (e. g. transportation, food and retail, parks and recreation) Programs Policies Health Benefits (e. g. education and counseling) (e. g. organizational rules) (e. g. insurance, incentives) Worker Productivity Healthcare Costs (e. g. absenteeism, presenteeism) (e. g. quality of care, performance standards) Improved Health Outcomes (e. g. reduced disease and disability) Environmental Support (e. g. access, opportunity, physical/social) 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) Contextual Factors (e. g. company size, company sector, capacity, geography)

Timeline The Purchaser’s Diabetes@Work Guide 1999 2002 2005 Healthier Worksite Initiative 2006 NIOSH Work. Life Initiative Worksite Health Score. Card Workplace Health Toolkit 2010 2011 2012 NHWP NIOSH Total Worker Health Business Cooperative Agreement 2013 Work@Health

CDC Healthier Worksite Initiative http: //www. cdc. gov/hwi • 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

CDC Healthier Worksite Initiative Garden Market

CDC Healthier Worksite Initiative Stair. WELL 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 § § § http: //www. businessgrouphealth. org/preventive 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)

CDC Workplace Tools and Resources

Essential Elements of Integrated Programs Organizational Culture & Leadership 1. 2. 3. Develop a “Human Centered Culture” Demonstrate Leadership Engage Mid-Level Management Program Design 4. 5. 6. Establish Clear Principles Integrate Relevant Systems Eliminate Recognized Occupational Hazards 7. Be Consistent 8. Promote Employee Participation 9. Tailor Programs to the Specific Workplace 10. Consider Incentives and Rewards 11. 12. 13. 14. Find and Use the Right Tools Adjust the Program as Needed Make Sure the Program Lasts Ensure Confidentiality Program Implementation & Resources 15. 16. 17. 18. Be Willing to Start Small & Scale Up Provide Adequate Resources Communicate Strategically Build Accountability into Program Implementation Program Evaluation 19. Measure and Analyze 20. Learn from Experience

The CDC Worksite Health Score. Card (HSC) http: //www. cdc. gov/dhdsp/pubs/docs/HSC_Manual. pdf Assesses best practice health promotion interventions (policies, programs, environmental supports) § § § § Organizational supports Tobacco control Nutrition Lactation support 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 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.

NHWP Training and Assistance Continuum Making the Business Case Relationship between health and performance Impact of worksite health program Key components of a comprehensive worksite health program Module 1 Leadership and Culture Driving senior leadership support Creating a healthy worksite culture Building infrastructure and capacity Module 2 Data Collection Planning & Implementation Program Evaluation Worksite health assessment process Determining program goals and objectives Measuring process and outcomes Types of data to collect Developing detailed worksite health plans Key evaluation metrics Using data for program planning Module 3 Putting assessment and planning into practice Module 4 Module 5

NHWP WH 101 Training Manual http: //www. cdc. gov/nationalhealthyworksite/join/Training-materials. html

Overview § Work@Health. TM is an employer based training program § The Work@Health. TM 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@Health. TM Program Structure § There are two basic ways to get involved: § Work@Health. TM Employer training § Designed to train U. S. employers of all sizes and types how to establish, expand improve science- and practice-based health promotion strategies that will lead to specific, measureable means to reduce chronic disease rates in the workplace. § Work@Health. TM Train-the-Trainer (certified) training § Will provide employers and other participants with the knowledge and tools to train employers using the Work@Health. TM 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 What you receive: § 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.

Benefits to Certified Trainers What you receive: § 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.

Work@Health. TM Program Components § Formal Training § Technical Assistance § Seed Funding Support

Work@Health. TM Training Modalities Employer Training Model Online Seminars, case studies and practical demonstrations delivered through distance-based mechanisms such as webinars. Hands-On Employers 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

Curriculum Continuum Work@Health. TM Technical Assistance Core Training ASSESSMENT Work@Health™ Technical Assistance Learning Community Structured Technical Assistance Organic Technical Assistance PLANNING IMPLEMENTATIO N EVALUATION

2014 Training Dates and Locations BALTIMORE Online – March 16 – April 5 In-person, blended, T 3 – April 8 -10

Work@Health. TM 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 Toolkit www. cdc. gov/whp

CDC Worksite Health Promotion Programs www. cdc. gov/workathealth www. cdc. gov/National. Healthy. Worksite

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/National. Healthy. Worksite 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 Promotion Division of Population Health