Variety keeps spice in employee program
Same old, same old wellness programs won’t do
Keeping an employee wellness program fresh and new year in and year out is the key to maintaining high levels of participation. That’s the overriding philosophy behind the Good Health Program, a wellness program for employees of the city of Birmingham, AL, administered by the University of Alabama at Birmingham’s (UAB) School of Nursing and the City of Birmingham.
Since the program’s inception in 1985, medical insurance costs have increased more slowly, smoking rates have decreased, and fitness levels have significantly improved, according to Michael T. Weaver, RN, PhD, FAAN, professor of nursing at UAB and director of the nationally recognized program. "As a microcosm of the United States, city employees face the same problems — aging, hypertension, a sedentary lifestyle, obesity. So generally, our programs have nutrition and physical activity components," he notes.
But Weaver and his team recognize how important it is to add novelty to the program. "We do have ongoing programs, but each year we try to introduce new and different things," notes Lynn Artz, MD, MPH, health promotion program planner. "It’s very important to keep approaching employees in different ways."
This year, six new programs were introduced to Good Health participants. They are:
- Weight Watchers
- A program targeting obese workers
- Eat Smart and Win, a nutrition program
- Smoking cessation
- Arthritis prevention and treatment
- A fireman’s cookbook
Each program had its own unique approach to improving health, and each has proved quite effective. The Weight Watchers program, in place for about a year, began with one group and grew to two. "For the first year, city employees lost over 1,000 pounds," reports Debra Brown, MEd, health education coordinator.
The Good Health program pays 50% of costs for all members. And there’s an additional incentive. "If an employee loses 12 pounds in the 15-week session, we give them a $25 gift card to Wal-Mart," says Brown. "If they decide to continue, we will pay 10% of the cost the next time and they will also be eligible for a gift card." Employee response has been very positive, due to the on-site convenience and the incentives.
The obesity program targets employees with stage 2 (body mass index of 35 or higher) and stage 3 (40 or higher) obesity. Invitation letters were sent to potential participants. "We wanted a small group and ended up with 20," says Brown.
A nutritionist was hired for 12 weeks (one-hour sessions twice a week). Participants also met with fitness center staff and began a program at the city’s fitness center. In the beginning, the education component took up most of the hour, with employees free to stay longer and work out. By the end of the 12 weeks the sessions had become mainly exercise.
"We’re now in a follow-up program," says Brown. "We continue to provide the employees with information and act as support. We also encourage them to continue to work out at the center." Not only can they work out free of charge, but they also have staff members assigned as their personal trainers.
How has the program worked? "Some men had great weight loss — there were a number who lost at least 20 pounds — and the women lost on average 10 pounds," Brown reports. "The feedback was tremendous. The employees were impressed we offered this free of charge and that we followed up."
The nutrition contest, a variation on an earlier program, offered employees seven different pledges from which to choose. They were simple and straightforward, like having fewer fat-filled meals or increasing consumption of fruit and vegetables. Participants who kept their pledges for a month were eligible for prize drawings, which included three $50 gift certificates to Bruno’s, a grocery store.
"We promoted the program at our health screening, which was mostly for downtown workers, and close to 500 signed a pledge to make a change," says Artz, who credits the simplicity of the concept. "Sometimes for things to appeal to employees they need to be manageable," she notes. "Asking for just a small change will help participation."
The smoking cessation program targeted employees who had indicated in their annual Health Risk Appraisal (HRA) that they were smokers. They were directed to a booth (the HRA’s were conducted during the annual health fair) where they received additional encouragement to quit. There was a display on a computer program that was offered at a reduced rate, a display of different nicotine products, and a nicotine-dependence quiz. "They were also offered individual and group options for quitting," says Artz. The counseling was available during working hours. "We had a pretty good success rate on short-term cessation," says Artz. "About 75% or so quit for at least a month."
The arthritis program was in collaboration with the Arthritis Foundation. "This was a pilot program to promote early recognition, treatment and prevention — especially repetitive trauma," says Artz. The foundation provided posters, tip sheets, education materials that could be mailed to employees homes, and questionnaires designed to measure how much was learned. They also assessed ergonomic risk factors and met with department heads to plan interventions. "The police department has asked for a special prevention program, and we’re conducting those presentations right now," Artz reports.
And now, something completely different . . .
Perhaps the most creative new intervention is the "Healthy Fire Station Cuisine" cookbook. "I first proposed it because studies show that firemen consume a higher amount of fat at the station than at home," says Artz.
Brown went to more than 30 stations to promote the program, which involved asking the firemen to submit a favorite recipe. "It didn’t have to be low-fat or healthy," Brown notes.
After they were received, however, Dana Kiker, RD, UAB’s Eat Right outreach coordinator, modified the recipes to make them healthier and prepared them and took them to the stations. "I didn’t tell them what I did," she confesses. The firemen tried and rated the recipes. "They all came back as highly recognized and tasting similar or the same as the original recipes," says Kiker.
After the modified recipes were approved, the recipes were sent to a cookbook company, along with nutritional information about the recipes, and the cookbook was produced and sent to each station. Then, the incentive kicked in: The station shift that prepared the most recipes in one month would receive a $250 gift certificate to a local store. The station shift that submitted the best-liked recipe would also get a $250 gift certificate. Six recipes actually tied, so the money was divided equally among them. "The incentives help a lot," notes Weaver, referring to the success of all the new programs. "Also, the support of the supervisors was very important."
"We’ve also learned that printed material only gets you so far," adds Artz. "Usually, you get much higher numbers when you approach employees face to face, and offer incentives."
[For more information, contact: Michael T. Weaver, RN, PhD, FN, UAB School of Nursing, NB104, 1530 Third Ave. S., Birmingham, AL 35294-1210. Telephone: (205) 934-6913. Fax: (205) 975-6142. E-mail: [email protected].]
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