Mitsubishi LiveHealthier Spring Program · 2018. 10. 13. · Community Intervention Project...
Transcript of Mitsubishi LiveHealthier Spring Program · 2018. 10. 13. · Community Intervention Project...
Community Intervention Project
Mitsubishi LiveHealthier Spring ProgramMay 7, 2013
Jessica Lacontora
ARAMARK Dietetic Internship
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OVERVIEW
The population at the Mitsubishi work site is primarily overweight and reliant on
fast processed foods. Most attribute their reliance on fast food to a busy life. These “on
the go” meals make it easier to work 45 hours a week, shuttle kids to and from activities
and keep up with chores. Today, traditional families include working parents with less
time for food shopping, preparation and sit down meals. According to Shanthy and
Vinyard1 one in four adults eat fast food. Moreover, they found the consumption of fast
food was positively associated with overweight status.
Improved health among workers often results in greater productivity, less sick
days and an overall motivated crew. In order to encourage these results Mitsubishi has
employed a LiveHealthier to provide nutritional assessments, education and counseling.
News letters, private counseling sessions and group programs are offered through out
the year. Mitsubishi employees have the opportunity of cash rewards for healthy
behavior.
Having worksite nutrition counselors like the LiveHealthier coach at Mitsubishi is
an important part of meeting the Healthy People 2020 goals that we have set as
Americans. By making healthy choices more simple for on the go people we can help
turn their lifestyle in the right direction. Worksite settings offer the ability to educate large
groups on the importance of nutritional choices for weight loss and chronic disease
prevention. It is important to provided nutritional education as these employees can
spread their knowledge to family and friends having an even greater overall effect on
the US population.
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NUTRITION ASSESSMENT
Food/Nutrition-Related History (FH):
Food and Beverage Intake (1.2)- Those who participate in LiveHealthier at the
Mitsubishi site have been educated to prepare fresh meals and make better fast food
choices but they report many barriers to living well. Food preferences include WaWa,
Wendy’s, Lean Cuisine, McDonald’s, Pizza, and Applebees. Counseling sessions often
include discussion of poor food choices since the last visit in relation to changes in
schedule, biochemical markers, and weight. Food provided onsite by employer often
includes sandwiches or pizza.
Diet History (2.1)- Diet history is obtained at first visit session for new clients as
this population has often used “fad” or “crash” diets. The population has little regard for
preventing disease and (90%) is more concerned about weight loss.
Behavior/Nutrition Visit Attendance (5.1.2)- Recorded to ensure clients are
reimbursed for their efforts according to LiveHealthier program contract.
Physical Activity History (7.3)- Tracked at each session and most clients have
goals set that they often due not meet in relation to busy schedule.
Anthropometric Measures (AD):
Weight (1.1.2)- Clients self-report weight at each visit which is logged in
Registered Dietitian (RD) notes. Weight status is used in the LiveHealthier Wellness
Score. Compared to the US population the employees of Mitsubishi motors are
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relatively healthy as few are obese and they contain minimal disease risk, however, BMI
>25 in 90% of population.
Biochemical Data, Medical Tests and Procedures(BD):
Glucose (1.5), Blood Pressure & Lipid Profile (1.7)- Labs completed twice
annually for those with history or risk and are provided to LiveHealthier coach for
assessment procedure. The majority of the population has borderline high or elevated
blood pressure and cholesterol. This makes them high risk according to LiveHealthier
and grants them 9 visits with the dietitian. Similarly any patient that smokes is
considered high risk. The rest of staff fall under low or moderate risk and are allowed 4
visits with the dietitian. The population has little regard for preventing disease but is
mostly concerned about weight loss.
Client History (CH):
Personal History Data (1.1), & Medical History (2.1)- LiveHealthier is a worksite
wellness program incorporated into the Mitsubishi health insurance to improve and
maintain the health of onsite employees. Medical history details are obtained at a doctor
visit and provided to RD prior to initial session. An RD is assigned to this facility as the
LiveHealthier coach. Every employee is entitled to health care and offered the
opportunity to participate in LiveHealthier for a cash rebate. LiveHealthier participants
can focus on exercise, nutrition or other wellness topics with the dietitian. Generally the
population tries to find time for healthy activities and care about overall wellness.
Employees are given an hour lunch during which some choose to exercise. There is a
large loop (1/4 mile) of the warehouse that many walk 3-6 times daily.
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Very few members of this population have chronic disease which is likely due to
their age (all <60 years old), education status (all High school graduate or higher) and
socioeconomic status (all have employment). The predominate population culture/
ethnicity is american/caucasian. Gender ratio is equal requiring education for risk on
male and female associated disease states. This population is at low risk for housing
and transportation issues.
Religious beliefs do not play a large roll in the wellness of this population. More
influential problems are lack of time, family issues, and lack of food preparation
education. Access to nutritious food onsite is difficult as most do not pack lunch or store
healthy items onsite. Instead, diets of these individuals rely on less nutrient dense,
affordable convenience, ready-to-eat, processed and fast-foods. For lunch many
employees rely on local fast food options. Onsite, they have a kitchen with refrigerator
and microwave that are rarely used. In the office they have an area to purchase salty
and sweet snack foods at a discount price which employees use often. For this reason,
diets are typically higher in fat, sugar, sodium and are lower in fruits, vegetables, whole
grains and low-fat dairy products. This dietary pattern has led to hypertension, elevated
cholesterol levels and difficulty with weight loss goals.
NUTRITION DIAGNOSIS
Nutrition Problem:
Excessive energy intake (NI-1.5) related to food and nutrition related knowledge deficit
as evidenced by BMI >25 in 90% of population, intake of high caloric density foods
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NUTRITION INTERVENTION
There is strong evidence that this population would benefit from a nutrition
intervention that focuses on making better food choices. Education will focus on
emerging trends such as; quick meal preparation methods, saving money by bringing
lunch, saving time by planning ahead, smart choices when eating out, office exercise
options and portion control.
Nutrition Education (1.5)- Recommended Modification
Nutrition Education (1.4)- Nutrition Relationship to Health/Disease
Healthy People 2020:
Launched in 2010 these ambitious goals for the Nation’s health incorporate ways
to help a diverse group of individuals and organizations. Overarching goals include;
attain high quality longer lives free of preventable disease, achieve healthy equity,
create social and physical environments that promote health for all, and promote quality
of life2,3. These goals can be achieved by encouraging collaboration across
communities, empowering individuals toward making better health decisions and
measuring the impact of prevention strategies.
One of emerging trend goal objectives of Healthy People 2020 that addresses
worksite wellness is under the topic Nutrition and Weight Status.
Goal: Promote health and reduce chronic disease risk thorough the consumption of
healthful diets and achievement and maintenance of healthy body weights.
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Objective (NWS-7): Increase the proportion of worksites that offer nutrition or weight
management classes or counseling.
There is no data available on the percent of worksites that offered nutrition in
2010 however there is data available that shows worksite wellness programs decrease
absenteeism and promote weight loss making the concept more poplar today3,4,5.
Acknowledging the need and importance of support and motivation in combination with
education has promoted corporations to latch onto programs like Livehealthier. Onsite
coaches can help employees make better health decisions and improve preventative
care.
This objective uses SMART criteria being that it is specific to worksite weight loss
programs, results are measurable through polling American companies and asking for
current and retrospective, objective can be attained within 10 years and increasing the
proportion of worksites is realistic as this trend is emerging and backed by positive data.
Give brief overview of education
Lesson Plan:
The Spring Wellness Program will be presented to LiveHealthier participants in
the conference room. The program will focus on making healthy choices simple in
relation to fast food, prepping meals at home, portion control and eating on site. The
program will also address hydration, de-stress ideas, sleep, and office exercise. Those
who participate will be provided with informational hand outs on food, exercise and
disease risk from family history. Healthy beverages will are offered and 2 pedometers
will be given as rewards for participation. (See Template in Appendix B)
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Marketing:
The 4 P’s of marketing were used to promote the event.The program (product)
was developed and planned around the consumers response to a pre-survey. There
was no price associated with the program which increased value of the material. The
location (place) of the presentation was on site for convenience. Finally, the
LiveHealthier staff promoted the event through a variety of channels for 2 weeks prior to
the event. Mitsubishi employees are provided with a Nutritional New letter monthly for
free via email. For April the news letter advertised the event and a flyer was posted
throughout the facility by a LiveHealthier team member. The program flyer was placed
near common doorways and in restrooms in order to reach maximal traffic. (Appendix E)
Resources:
The Mitsubishi conference room reserved contained the overhead projector
necessary for the powerpoint presentation. The Mitsubishi office secretary printed the
required materials provided to her in PDF form by email prior to the presentation. Pens,
beverages and cups were supplied by the presenter. The prizes, 2 pedometers, were
provided by LiveHealthier.
NUTRITION MONITORING & EVALUATION
The pre-survey to access interest and and post-survey for evaluation of the
educational session can be located in Appendix C & D. All participants tried the provided
health beverage (carrot juice) and were engaged in the educational discussion. On the
post survey 100% of participants checked that they learned new information in at least
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two subjects. Also, 100% agreed to bring lunch from home more often. Each post-
survey had a quality lifestyle change listed as a new goal for the employee and all were
pleased with the presentation. Goals and objectives were met for this program and
ideas were formed for programs in the future.
Feedback from the post discussion revealed that it would be beneficial if the
program did not occur on lunch break. People did not want to sit and eat a fast food
lunch during the program for a variety of reasons. Participants suggested that providing
a healthy lunch would get the best turn out from staff. More importantly data needs to be
obtained on health success among the employees that participate so that the stats can
encourage other companies to employ services like LiveHealther. Mitsubishi is just one
site that has started to offer nutrition and weight management since 2010 but if their
success are publicize the US can continue to the proportion of worksites offering
nutritional counseling.
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REFERENCES
1. Bowman, SA and BT Vinyard. Fast food consumption of U.S. adults: impact on
energy and nutrient intakes and overweight status. J Am Coll Nutr. 2004 Apr;23(2):
163-8. Accessed April 17, 2013.
2. Center for Disease Control and Prevention. Worksite Health Promotion. Available at:
http://www.cdc.gov/workplacehealthpromotion/ Accessed April 17, 2013.
3. US Department of Health and Human Services. Health People 2020: Nutrition and
Weight Status. HealthyPeople.gov. Updated March 8, 2013. http://
www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=29 Accessed
May 7th 2013.
4. A. Astrup. Management of obesity at worksites: less work for greater success?
American Journal of Clinical Nutrition. 2013 April; 97 (4); 663-4. Accessed May 7, 2012.
5. VanWormer, JJ., Linde JA., Harnack, LJ., Stovitz, SD., and RW. Jeffery. Weight
change and workplace absenteeims in the HealthWorks study. Obesity facts. 2012; 5(5);
745-52. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23108493 Accessed May 7,
2012.
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Appendix A: Mitsubishi Livehealthier Standards
Health Risk Assessment Review:
• Low Risk Participants have a wellness score that falls in the Very Good or Excellent range
• Moderate Risk Participants have a wellness score that falls in the Good range
• High Risk Participants have a wellness score that falls in the Fair or Poor range.
• PLEASE NOTE: if ANY participant has high blood pressure (systolic pressure over 120 OR diastolic pressure over 80), hyperlipidemia (total cholesterol over 200) or is a current tobacco user, they are automatically HIGH RISK
HRA Review should do the following:
• Identify how many sessions the participant needs to complete (4 for low risk, 9 for moderate or high risk)
• Identify the coaching content area of focus for the participant
• Guide your initial coaching session
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Appendix B: Lesson Plan
Mitsubishi LiveHealthier Lesson Plan:
Target Audience: Men and women enrolled in LifeHealthier program who desire to improve their health status
Duration: 50 minutes: 5 min for sampling of healthy beverages, 25 minute presentation, 5 minute exercise demonstration, 5 minute discussion of family tree and disease risk, 10 minutes for questions/sharing. Goal:
Specific Objectives: 1. By the end of the session through the use of a post-test, clients will be able to identify 1 ways they can LiveHealthier (lifestyle change). S: Specific to clients attending the educational program. M: Results measurable through participant’s responses on post-test. A: Objective to be attained within educational session time. R: Improvement in the commitment to live healthier by incorporating lunch from home, more exercise or better fast food choices T: Achieving the objective by the end of the program session is timely.
2. By the end of the session through the use of a post-test, clients will be able to identify the benefits LiverHealthier objectives as it relates to disease risk.
S: Specific to the clients attending the educational session.M: Results measured through participants responses on post-test.A: Objective to be attained within educational session time.R: It is realistic that clients will be able to relate their individual risk for disease to necessary life style modifications .T: Achieving the objective by the end of the program session is timely.
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Specific Objectives(SMART)
Procedure(State how each specific objective will be met)
Learning Activity
EvaluationMethod
IntroductionIntroduce self to participants and explain the purpose for the program, reason I am presenting, itinerary for the class and welcome them to try samples.
Verbal introduction to presentation
Body of Lesson1. By the end of the session through the use of a post-test, clients will be able to identify 1 ways they can LiveHealthier (lifestyle change).
PPT - Simple Choices1. # of food choices mad in 1
day2. Better fast food choices3. Planning ahead to bring
lunch4. Portion control5. Hydration6. Office Exercise7. De-stress/Better sleep
Verbal education.Educational handouts on exercise, packing lunch. Exercise demonstration
Verbal Q&A Post-testPedometer given as prize for participation
2. By the end of the session through the use of a post-test, clients will be able to identify the benefits LiverHealthier objectives as it relates to disease risk.
Family Tree Homework1. How to fill in tree2. What data is significant3. What to look for and discuss
with MD or RD4. Importance of passing
education onto siblings and kids
5. How disease relates to diet and exercise
Verbal education.Educational handout on family tree.
Verbal Q & APost-test
ConclusionSummarize what was discussed during the educational session. Thank participants for attending.
Verbal conclusion.
Take Questions
Materials List: Audio-visual equipment, beverages, cups, PPT, pencils, paper post tests, handouts (Appendix C-I), reserved conference room, 2 pedometers given as prizes.
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Appendix C: Evaluation Pre
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Appendix D: Evaluation Post
1. Please check all for which you have learned NEW information:
______ Better fast food choices
_____ Office Exercise
______ How to prep meals at home
______ Portion control
______ Preventing Disease
______ How to de-stress
______ Overall living healthier
2. Will your increase the amount of days you bring a heathy lunch from home? If no, please state why.
3. Will you increase your exercise in the office after today? If no, please state why.
4. List any lifestyle changes you plan to make after this program.
5. Overall were you pleased with the presentation?
6. Would you attend another Wellness Program? If no, please state why.
Spring Program Results Survey
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Appendix E: Media Advertisement
Simple Choices Spring Wellness Program
Topics•Good FAST FOOD choices
•QUICK office Exercise
•Meals on the Go with BALANCE
•Portion CONTROL for Overeaters
•Recognizing risk from FAMILY tree
•5-min de-STRESS
•Breaking down BARRIERS
When: April 30, 2013
Where: Upstairs Conference Room
Time: 12:30 to 1:30
Other: Bring lunch, questions
and an open mind. Take home recipes.
Beverage samples will be given.
Questions or Comments?Contact Kristen Hamilton: [email protected]
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Appendix F: Educational Handout Exercise
Office ExerciseName Goal
Office Exercise Date Weather
Page 1
1: Stand instead of sitting
Burn 50 more calories and hour2: Fidget in your chair
Burn 350 more calories a day3: Laugh often, have good posture and breath deep.
Will tighten muscle & relax your mind
4: Desk Push up
Strengthen arms & chest5: Lunge forward and side to side Strengthen lower body
6: Chair Dips
Strengthen triceps & shoulder
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Page 1
7: Chair Squats
Strengthen lower body8: Good Mourning
Stretch for relief of tension
9: Leg Raises
Tightens legs and core
10: Walk the stairs
Activates leg muscles differently
11: Touch your toes
Relive you lower back and hamstrings12: Arm circles and raises
Stretches and strengthens shoulders
Appendix G: Educational Handout Food
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Simple Choices
Recipes Inside
!
Write down some ideas....
Write a shopping list...
Chicken Pita Cut whole wheat pita in half. Toss Grilled chicken with low fat dressing. Fill both sides with spinach, sliced cucumber and chicken.
Add feta cheese and olives for a Greek delight.
Make a Salad
• Watch out for high calorie dressings
• Make it colorful.
• Use left over meats or beans to add protein.
Bean Burrito
In the center of a large whole wheat tortilla combine beans, salsa,
brown rice, pepper jack cheese and fat free sour cream. Wrap in
foil to keep shape.
Easy add in: Avocado, chicken, fish, sauteed vegetables, hot
peppers, fresh cilantro
Brown Bag It
Sandwich-Pick a whole grain wrap, bread or roll • Add shredded chic, roast beef,
tuna, egg salad, PB&J • Add lots of veggies• Top with mustard, or hummus
On the side• Fruit and peanut butter or cheese• Veggies and hummus or LF dip• Snack Bar• Trail Mix• Baked or Soy Chips, pretzels
To Drink• WATER - infuse with fruit & mint • Unsweetened iced tea• Fruit and Veg smoothie• Juice • Mix and Match!
Recipes
Appendix H: Educational Handout Family Tree
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