The following wellness article appears in the March/April, 2008 issue of Kentuckiana HealthFitness Magazine

S.T.E.P. by Step:  (Strategies to Empower Productivity)

By Linda Burry, M.Ed.

In the last column, a 5 - S.T.E.P. plan (Strategies To Empower Productivity) was outlined for a successful worksite wellness program initiative. We concentrated on the formation of your wellness committee (or ‘task force’).  

 With roles established, the task force moves on to their next duty that is this issue’s S.T.E.P. topic:  problem identification.   Learning the true uniqueness of your culture is accomplished through what I have termed “Workplace Wellness Audits”.

 Let’s begin with your culture’s demographics:  Do you know the percentage of male-to-female employees?  How many of your employees are full-time vs. part-time; salaried vs. hourly? Do you have more than one shift of workers?  How about the age group distribution in your current workforce, i.e., is your workforce aging?  Is there a distinct ethnicity in your culture?

 Auditing is also imperative in revealing your culture’s unique health issues.  Because of the need for each employee’s medical privacy and health status, health records should be accessed and reviewed only by authorized personnel.  Because of the sensitive nature of this information, a group health data sheet can be developed which will clearly identify your culture’s most prevalent health issues:

Sample Group Health Data Collection, ABC Workforce of 200 Employees*

Health Condition	Number	Percentage
Smoking	65	32.5%
Overweight or obese	52	26.0%
Low back pain	48	24.0%
High Cholesterol	18	9.0%
Muscular pain/ injury	17	8.5%
Pregnancy	15	7.5%

*numbers will be > 200 as employees may have more than one condition simultaneously.

Another method of culture-specific problem identification is accomplished through scrutinizing claims and costs provided by your insurance company (or third-party administrator). Dee Edington, PhD, Professor of Kinesiology, University of Michigan and Director of the Health Management Research Center wants you to know this may take some perseverance on your part, but to remember, you are the one in control here! After all, this is YOUR company data, and you have a right to it.  Strong as it sounds, should you not have success in receiving your data, consider changing carriers.  There are a number of guidelines one needs to follow, but the data must be available. Insurance companies may not have the tools in place to provide you with this data in as timely a manner as you would like.  Most are set up primarily to evaluate and pay claims, so it may take time to work with them.  Realize they’re not used to this type of request, but they are being asked for it more often because of some of the HIPAA regulations. Be persistent and it will pay off!

Once you have received this data, the informative and revealing tables will accurately pinpoint your culture’s most prevalent health issues, with costs for diagnosis and treatment.  Data tables can be classified according to major diagnostic category (MDC) and diagnostic-related group (DRG) or international classification of disease (ICD). 

With this pertinent information in hand, your task force can begin targeting wellness programs that have the most potential impact for reducing the highest and/or most prevalent health care claims and costs.

 Do you have a safety director or risk management department?  These departments are concerned with workers’ compensation claims and data.  Required by law, OSHA 300 and 300A Forms show the incidence and types of injuries resulting from work-related accidents.

Form 300 is used to classify work-related injuries and illnesses and to note the extent and severity of each case.  Incidents involving death, loss of consciousness, days away from work, restricted work activity or job transfer, or medical treatment beyond first aid must be recorded within 7 days of occurrence. Form 300 is used to record specific details about what happened and how it happened.  A summary form (Form 300A), shows the totals for the year in each category. At the end of the year, Form 300A must be posted in a visible location by the coming February, and remain visible thru the end of April so employees are aware of the injuries and illnesses occurring in their workplace.  This information targets potential worksite wellness programs designed to reduce those injuries and accidents within your unique workforce, keeping your employees safe from harm.

Examination of your employees’ everyday “built environment” is yet another viable method for gathering pertinent data as well as insight into environmental conditions to which you might otherwise be oblivious.  Similar to ‘behavior based safety’, a built environment screening requires careful observation and notation of your workers doing their jobs.  Analysis of these reports can well indicate potential safety hazards that exist, that if uncorrected, could lead to injury, or worse.  Safety and wellness must be seen as interconnected.

One commonly used auditing tool for employee health risk identification and subsequent stratification is the Health Risk Appraisal (HRA).  Employees self-report personal health and lifestyle behaviors.  Approximately 50 of these fee-based, commercialized instruments are available in the market today.   Yet before you shell out the big bucks for this assessment tool, it is imperative you learn employees’ receptiveness to this means of collecting data of their health risks.  You may find that even with attractive incentives for participation, hesitation exists in completing a personal health inventory.  Some may be skeptical only authorized personnel will have access to it, so that reassurance needs to be provided.

Self-report HRA’s are convenient tools, enabling collection of large amounts of data in a timely manner.  This alone explains their popularity of use at the work-site. Nonetheless, self-report data are prone to subjective bias with people recording values for such health indicators as height and weight and lifestyle behaviors such as dietary intake and physical activity as more positive than they are.  Not surprisingly, several studies have found overall self-reported weight was lower and self-reported height was higher than measured values.

There is little, if any, investigation directly comparing the accuracy of HRA completed via self-report to physiologic measurement (biometric data collection) in the same people. Whether higher risk employees preferentially chose one type of HRA over the other is not known. Such knowledge would be important to have when designing work-site health promotion programs to optimize participation rates, target the employees in greatest need of these services, and accurately profile the health of the workforce.

Inquire from your culture how they are willing to be measured for their health risk status.   Following through with them in the driver’s seat is imperative for their buy-in.  This will ensure trust, thus providing greater percentages of participation in what is shaping up to be their employee-driven wellness program.  A greater percentage of your culture opting in to your program equates to a more productive, satisfied workforce exhibiting better health, coping skills, morale, physical and mental stamina, concentration, and higher quality of life.   You read this as less absenteeism, presenteeism, turnover, accidents and reduced health care costs.  Either way, a win-win program for everyone.

Sources:

Chenowith, David H., (2007) Worksite Health Promotion, 2nd edition.  Champaign, IL:  Human Kinetics

Marschke, Lisa M;  Allen, George J., et al “Cardiovascular Health Status and Health Risk Assessment Method of Preference among Worksite Employees.”  J Prim Prev.  2006;27(1):67-79.