Objectives: + Distinguish between programs that may be sold well and those that work + Identify the common and core elements of effective wellness programs + Be able to evaluate whether your current or prospective programs are meeting the standard This program was presented to HR Professionals at HR SouthWest in October, 2012 (Presenter: Dr. Joel Bennett, learn@organizationalwellness.com)

1. Evidence-Based Health Promotion
Separating the Wheat from the Chaff
Dr. Joel Bennett
learn@organizationalwellness.com
October, 2012

2. • Tremendous growth in workplace wellness
programs
• Little in the way of evidence-based guidelines
for understanding
– what works, the why, and the how
• This presentation provides the latest research
information on
– best practice guidelines and
– essential elements of effective programs
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3. Objectives
• Distinguish between programs that may
be sold well and those that work
• Identify the common and core elements
of effective wellness programs
• Be able to evaluate whether your
current or prospective programs are
meeting the standard
3

4. Outline
PART 1: Evidence & Insights (lots)
4

5. PART 1: Evidence & Insight
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6. (some) factors leading to decision
Does it
work?
Ease of
Cost Quality ROI
Use

7. Caveat
• This presentation is about “Does it work?”
• NOT the other stuff

8. 5 Insights (preview)
1. Your ownership (of any program) is the key to
success
2. You can “set the bar” on how much evidence
you need to help select your wellness program
3. You can move from program “selection” to
program “crafting”
4. System-level stress management is essential
5. Your ownership is the key to success
(commitment)

9. INSIGHT # 1
Success does not lie in the programs themselves but
in the INTERACTION between the internal
programmers, the work
environment, and the programs.
You have to “OWN” the program!
GROW FROM WITHIN AND STAY THERE

10. GROW FROM WITHIN AND STAY THERE

11. Will it work? (two standards)
What evidence
Will it work do I need to
for me? know if it will
work for me?
Experience Proof
Hearsay Objectivity
Marketing Results

12. Strategy*
Map a Wellness Strategy
Assess your needs
Ask your employees
Start inside
Consider a comprehensive/integrated approach
Narrow field with accreditation/certification
Keep up to date on what works
Involve others, collaborate
Ask for assurances, guarantees
*HR Magazine: (March, 2011; Susan J. Wells)
http://www.shrm.org/publications/hrmagazine/editorialcontent/2011/0311/pages/0311wells.aspx

13. Evidence-based
• What does this term mean?
• Danger of it being over-used and ill-defined
• So, three key questions to ask:
? Is there research behind the product/service?
? Was it independent research?
? What is the quality of the research?
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14. ? Is there research behind the product/service?
 Testimonials: One
 Testimonials: Many (independent)
 Customer Satisfaction
 Expert Panels
 Case studies
Setting  Follow-up change in self-report
the bar
 Follow-up change in behavior
 Pre-post change
 Experimental Design (single study)
 Experimental Design (many studies)
 Reviews and Meta-analysis

15. ? Was it independent research?
 One internal evaluator, paid for by the
company
 Internal evaluators, paid for by outside
sources
 External evaluators, paid for by the
company
 External evaluators, paid for by
outside sources
 Non-affiliated research scientists with
multiple target sites

16. ? What is the quality of the research
 One case study
 Multiple case studies
 Observational study (longitudinal)
 Correlation analysis
 Pre-post (self-report)
 Pre-post (behavior)
 Pre-post with control group
 Randomized clinical trial

17. INSIGHT # 2
Where you set “the bar” for determining “sufficient evidence”
is determined by many factors. The key is that you can at least
know that there is a bar/standard to set;
bring into the purchase conversation.
You have to show intelligence!
COMMUNICATE YOUR STANDARD

18. COMMUNICATE YOUR STANDARD

19. My goal today is synthesis!
• Review of evidence-based approaches
• Synthesize into core ideas (memory aids)
• Five areas to get started or to refresh
1. Walk the talk (Leadership)
2. Love your “sparkplugs” (Advocates)
3. The power of small groups (Teams)
4. Think strategically about wellness (Climate)
5. Keep giving back (Community)
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20. Preview Memory Aids

21. Operational
Broad
Guidance
Broad Specific Evidence-Based
Recommendations Benchmarks Criteria
Essential Elements of Effective Workplace Programs and Policies for Improving
Worker Health and Wellbeing (NIOSH, 2008; DHHS No. 2010-140)
List derived by panel of experts
Promising Practices in Employer Health and Productivity Management Efforts:
Findings From a Benchmarking Study (Goetzel, Schecter, Ozminkowski et al. 2007)
Literature review of 5 best-practice studies, site visits to 9 promising practice employers,
interviews with SMEs
Promising Practices for the Prevention and Control of Obesity in the Worksite
(Archer, Batan, Buchanan, Soler et al., 2011)
Synthesis of empirical results from 136 studies, each weighted on the basis of study
design, quality, and effect size.

22. Essential Elements of Effective Workplace Programs and Policies for Improving
Worker Health and Wellbeing (NIOSH, 2008; DHHS No. 2010-140)
List derived by panel of experts
Note. Incomplete, list below is example of 20 recommendations.
Organizational Program Design Program Implementation
Culture/Leadership ⦁ Establish clear principles ⦁ Be willing to start small
⦁ Develop a “Human ⦁ Integrate relevant systems and scale up
Centered Culture” ⦁ Eliminate occupational ⦁ Communicate
⦁ Demonstrate hazards strategically
leadership ⦁ Promote employee ⦁ Build accountability
⦁ Engage mid-level participation into program
management ⦁ Tailor programs to specific implementation
workplace
⦁ Find and use the right tools Broad
⦁ Adjust the program as recommendations
needed

23. Promising Practices in Employer Health and Productivity Management Efforts:
Findings From a Benchmarking Study (Goetzel, Schecter, Ozminkowski et al. 2007)
Literature review of 5 best-practice studies, site visits to 9 promising practice employers,
interviews with SMEs
Note. Incomplete, following are from Table 1 (parentheses is # of the 5 best-practice studies
that showed evidence for the characteristic)
• Organizational commitment (all 5)
• Identification of wellness champions (3)
• Data collection, measurement, reporting, and evaluation
(including ROI) (3)
• Ongoing program evaluation (3)
• Program linked to business objectives (2)
• Effective communication (2)
• Effective operation plan (2) Benchmarks
• Program goals include productivity & morale (2)
• Interdisciplinary team focus (2)
• Incentives to participate (2)
• Effective screening and triage (2)
• State-of-the-art interventions (2)

24. Another Benchmark Example
Classic Benchmarking Study (2000)*
1. Align with business strategy
2. Create diverse teams (HR, benefits, safety, legal)
3. Cultivate champion(s) with a sense of purpose
4. Put senior managers/business ops on the team
5. Assure health promotion staff are heavily engaged
6. Emphasize quality-of-life improvement, not just cost cutting
7. Increase importance of evaluation over time
8. Communicate constantly and throughout the organization
9. Show a constant need to improve BY learning from others
10. Have fun
*Goetzel, R., Guindon, A., Turshen, I., & Ozminkowski, R. (2001). Health and productivity
management. Journal of Environmental & Occupational Medicine, 43(1), 10-17.

25. Another Benchmark Example
Best Practice Score-Card (2010)*
 Strategic planning (formal plan with objectives)
 Leadership engagement (senior, champions, policies)
 Program level management
 Program diversity (safety, diet, exercise, occ. health, EAP)
 Vendor alignment and coordination
 Very good access to program for all workers
 Benefits design promotes utilization
 Programs (risk appraisal, evidence-based lifestyle management) 
 Engagement methods (engaging communication, incentives)
 Measurement and evaluation
*http://www.the-hero.org Employee Health Management Best Practice Scorecard

26. Promising Practices for the Prevention and Control of Obesity in the Worksite
(Archer, Batan, Buchanan, Soler et al., 2011)
Synthesis of empirical results from 136 studies, each weighted on the basis of study
design, quality, and effect size.
Note. List below shows all studies found and those that were deemed of
"Greatest Suitability" due to high quality and positive outcomes.
• Enhanced access to opportunities for physical activity combined
with health education (5 studies, 3 suitable)
• Exercise prescriptions alone (14 studies, 10 suitable)
• Multi-component educational practices (25 studies, 13 suitable)
• Weight loss competitions and incentives (16 studies, 6 suitable)
• Behavioral practices with incentives (17 studies, 8 suitable)
• Behavioral practices without incentives (47 studies, 26 suitable)
Evidence-Based
Criteria

27. Another Evidence-Based Criteria
Computer-Delivered Interventions for Health Promotion and
Behavioral Risk Reduction:
A Meta-Analysis of 75 Randomized Controlled Trials, 1988 – 2007*
 CDIs were successful at improving nutrition, reducing
tobacco use, reducing substance use, increasing safer
sexual behavior, reducing binge/purging behaviors,
and promoting general health maintenance
 No improvements were observed for physical
activity, weight loss, diabetes control, or weight
gain/maintenance.
 KEY FACTORS:
 PLACEBO? Providing individuals with any active
intervention content is likely to lead to change.
 MOTIVATION MAY WEAKEN: Interventions that
had users look at the costs/benefits of quitting an
unhealthy behavior or adopting a healthy one
were less effective.
*http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572996/

28. Another Evidence-Based Criteria
Healthy Workplace
Team Awareness
Wellness Outreach
at Work
Coping with Work &
Family Stress

29. INSIGHT # 3
There is so much information about “what works” that we
can now re-frame the decision-making from “What should I
select?” to “How can I best craft/shape
programs based on my needs/costs?”
Use evidence-based principles!
OWN YOUR OWN CREATIVITY

30. OWN YOUR OWN CREATIVITY

31. Another Evidence-Based Criteria
Stress
Management
Effective Elements
(2008 reviews)
LaMontagne et al:
30 different
interventions
Parks & Steelman:
15 different studies
Richardson & Rothstein:
36 experimental
studies, representing 55
interventions
Lamontagne, A. D., Keegel, T., Louie, A. M., Ostry, A., & Lansbergis, P. A. (2007). A Systematic review of the job-stress intervention evaluation
literature, 1990–2005. International Journal of Occupational and Environmental Health, 13, 268–820.
Parks, K. M., & Steelman, L. A. (2008). Organizational wellness programs: A meta-analysis. Journal of Occupational Health Psychology, 13, 58–68.
Richardson, K. M., & Rothstein, H. R. (2008). Effects of occupational stress management intervention programs: A meta-analysis. Journal of
Occupational Health Psychology,13, 69–93.

32. INSIGHT # 4
It makes no sense to only focus on individual stress
management; like teaching someone to fish instead of always
feeding them  it pays to help the
system to help itself
Use multi-level approaches!
TREAT THE SYSTEM…PLEASE!

33. TREAT THE SYSTEM…PLEASE!

34. Other Noteworthy
Resources
(to help re-frame)

35. • Assists employers in identifying
gaps in their health promotion
programs
• Helps them prioritize high-impact
strategies for the following health
topics:
• organizational supports,
• tobacco control
• nutrition
• 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.

37. INSIGHT # 5
You can have the greatest technology based on solid
evidence-based principles but if you don’t have ownership
of the program you may be wasting your
time, money, or both.
Own programs from the inside out!

38. Levels of Ownership
Burden Compliant Reasoned Motivated Visioning Calling/ Embodied
Obligation Obligation Responsibility Cause Passion
resistance “have to” “need to” “want to” “We can “We can “We are
achieve” change” transforming”
Interest Accountability
Your
Reduced chances Values Greater chances
of success Your of success
Health
We start moving from obligation to ownership when our role is driven by our own values
and when we see that our own health and well-being is part of our role.
© Organizational Wellness & Learning Systems, 2012.

39. 39

40. PART 2: Synthesis

41. Illness
Wellness
41

42. OWLS Best Practice Thumbnail

43. OWLS Best Practice Thumbnail
oMotivation I o Good Diet & Exercise
oMood & Energy o Role Modeling
oSense of Belonging o Participation
oSense of Engagement o Performance
oPresenteeism o Communicate It
o Team Spirit We o Biometrics/Programs
o Culture of Health o Risk appraisal data
o Wellness Committee o Culture/climate data
o Local “Peer” Climate o Files/Benefits, Incentives
o Connectedness o Communications Its

44. Tip # 1: Walk the talk
Up to 50% of all executives will die of stress-
related diseases
Employee’s relationships with their boss
predicts their future health

45. Tip # 2: Love your sparkplugs
Early adopters
Wellness advocates
Champions
Change agents

46. Tip # 2: Love your sparkplugs
Hunt them down Give them room
Engage them
Support them
Reward them

47. Tip # 3: Empower groups/committees
Formal Committee Informal/Training
1. Part of job description
2. Diverse
3. Promoted well
4. Frequent communication
5. A strong leader
6. Meets regularly
7. Continuing education
Team
Awareness
WELCOA (2007)

48. Tip # 4: Think strategically about wellness
Why give workers healthy lifestyle skills
and ignore a “toxic” work environment?
You maximize ROI when you attend to climate
and  depression  engagement  stress
Is it possible that the underlying risks for
cardiovascular disease/obesity lie in
psychological and environmental factors?
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49. Wellness
Work-Life
Balance
Presence
Teamwork Policy
Coping Support

50. The climate of work units vary in health
RESILIENT
RISK
Some are healthier than others
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51. What factors ‘upper limit’ wellness?
RESILIENT
Upper Limit
Problem
RISK
Wellness Work-Life Presence Team Policy Coping Support
Balance work
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52. Tip # 4: Think strategically about wellness
REVIEW
1 Assess the work climate (level & dimension)
2 Include behavioral health (depression)
3 Identify your upper limiting factors early on
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53. Tip # 5: Keep giving back (community)
1 You’re helping families of workers (community)
2 Small businesses can band together
3 The business itself becomes the role model
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54. Tip # 5: Keep giving back/Community
www.sbwi.org
Leadership Sparkplugs Groups Climate

55. Review
Groups/Teams
Leadership
Sparkplugs
Helping…
…families,
other businesses,
community
Climate

56. Contact Information
Dr. Joel Bennett
Organizational Wellness & Learning Systems
3321 Collinsworth St. (suite 220)
Fort Worth, Texas, 76107
www.organizationalwellness.com
(817) 921-4260
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