Making programs mobile bolsters participation
Duke departmental pilot program nears 100%
Most programs whose average participation rate hovers around 50% would find cause to celebrate, but at the Live for Life program at Duke University and Duke University Medical Center in Durham, NC, the search goes on for still higher levels of employee involvement. In fact, in a recent pilot program, 190 out of 200 employees participated.
What’s the secret of the program’s success? "One of the biggest reasons is that we’ve gotten to be very mobile," explains Julie Joyner, the program’s senior account manager. "Most of our programs are now taken to different buildings; we have a van that travels four days a week. Now, all health risk appraisals (HRAs) are conducted where the employees are." Some of the programs are delivered on-site by program staff, while others are what Joyner calls self-paced. "Employees can participate on-line after work, by phone, or by mail," she explains.
This type of flexibility is essential at Duke, where 20,000 employees are served at more than 400 buildings. Joyner is actually an employee of Johnson & Johnson, of New Brunswick, NJ, which provides the management and many of the components for the program. She is supported by a full-time staff of six, and about 40 contract staff.
A large number of choices
There’s another key element that keeps participation rates so high, says George W. Jackson, MD, Duke’s director of employee occupational health and wellness.
"We have a lot of programs," he says. "Our human resources group has a benefits fair; we have a women’s health fair; this year we’ll be adding a men’s health fair; Duke has a week-long employee appreciation program; and we participate in observations like National Employee Health and Fitness Day. With a lot of events, you can touch lots and lots of people."
In addition, Live for Life offers the following wellness programs:
• Continuous HealthCheck offerings with personalized counseling. Screenings are conducted at the worksite four days a week.
• Physician Summary Report and Health Prescription. With employees’ consent, primary care physicians are sent a summary of important health status and risk measurements.
• Pathways to Change. High-risk intervention programs.
• Injury prevention/reduction programs.
• Special At-Risk employee referral program.
• General health education and health screenings.
• Motivational activities.
• Fitness club.
Getting to the next level
Customization is also a key element. "We have an employee newsletter, and we originally started out with one we bought from a national vendor," says Jackson. "But we felt we would get more mileage out of personalizing it to Duke. Now, each issue [it’s a quarterly publication] we feature an employee or a group that’s done something special, and we include their picture. This helps to bring our message home."
An average participation rate of 49% is impressive enough, but how in the world did Joyner, Jackson, and their team get to the 95%-100% level? "Our greatest success has come when working within a specific department and working with the management of that department," says Joyner. "In some cases, we’ve had 100% participation."
(The program has done more than just generate high attendance; see the box below for a summary of program results.)
| Summary of Live for Life Evaluations | ||
| Risk Category | Outcomes | Estimated Savings |
| High Blood Pressure | 47% of population was reached. Of those, 81% decreased their BP, and 58% were no longer at high risk.
|
$35,300/year ($353 savings per employee X 100 employees) |
| High Cholesterol | 27% of population was reached. Of those, 2/3 decreased their total cholesterol, and 44% were no longer at high risk.
|
$120,000/year ($1,200 savings per employee X 100 employees) |
| Smoking | 35% of smokers were reached. Of those, 25% have not resumed after one year. This surpasses a national average quit rate of ~15% after one year.
|
$83,250/year ($1,110 savings per employee X 75 employees) |
| On-the-Job Injuries | Employees reached through Transition to Fitness return to work more quickly, spend less time on restricted duty, accrue fewer outside referral visits, and show lower medical and workers’ comp costs.
|
$256,200/year ($3,660 savings per employee X 70 employees) |
| _____________________________________________________________________ | ||
Joyner is especially proud of a recent pilot program in which 190 out of 200 employees participated. It involved an engineering and operations group, which was predominantly male. "They were doing a week-long customer service program [customers being the employees in this case], and we asked them to do one wellness activity each day," Joyner recalls. "We called it a boot camp.’ Employees could earn a star each day, and by the end of the week they could rise from buck private to five-star general."
A key to the program’s success was that the request for such a program came from the department’s top management. This was particularly gratifying to Joyner. "A group of us have been working for a couple of years to try to get them excited, and now they’ve come to us," she says. "The department management contacted us about a program, and they got everyone else excited."
"There’s that sense of buy-in — not just from the management group but from the employees — in creating their own program to some degree," adds Jackson. "It’s very clear in the area of behavioral change that it’s important to get people to set expectations that are reasonable. And if we break change down into smaller work units, it gives everyone a much-better opportunity to do better."
Buoyed by the pilot program’s success, the Live for Life team is moving on to a larger group — 800 employees at the Duke Clinical Research Institute.
Once again, it was the management team that requested the program. "Working with management, we put together a steering group that created a plan we felt would excite the employees and increase their desire to participate," says Jackson. "We also came up with incentives we thought were unique for their settings."
The year-long pilot program will be structured as a team health and fitness challenge. Incentives will be offered to the teams each month. A wellness team trophy will go around to the winning team, and individuals with a certain number of points will receive prizes. "We’re getting our [HRA] baseline now," Joyner reports.
Not surprisingly, Jackson and Joyner have their eyes on the future. "We have a whole bunch of things in the planning stage," says Jackson. "We’ve reached the 10-year mark: What can we do differently?"
At the institutionwide level, the team is working hard to create a partnership among all units at Duke that have as part of their overall goals the enhancement of productivity. "We’re creating a task force that includes benefits folks, workers’ comp people, occupational health and wellness, EAP, employee and family programs, and safety people," says Jackson. "We really need to be planning jointly to create a strategy that cuts across all of our units, and make sure we’re all moving in the same direction."
Source
• Julie Joyner, Live for Life, Duke University Medical Center, Employee Occupational Health Services Department of Community and Family Medicine, Duke South, Box 3148, Durham, NC 27710. Telephone: (919) 684-3136. Fax: (919) 681-0555.
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