WHO Healthy Workplace Model From Strategy to Action
Transcript of WHO Healthy Workplace Model From Strategy to Action
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The WHO Healthy Workplace ModelFrom Strategy to Action
Nico Pronk, Ph.D.HealthPartners andHarvard School of Public Health
Stephanie Pronk, MA Ed Aon-Hewitt
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Agenda
• Introduction to the WHO Healthy Workplace Model
• How to get started
• Individual Health Resources and Psychosocial Work Environment
• Evaluation and Measurement• Open Dialogue
• Concluding Comments
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WHO Healthy Workplace Model
WHO action objectives:1. To devise and implement policy instruments on workers’ health 2. To protect and promote health at the workplace
3. To improve the performance of and access to occupational health services4. To provide and communicate evidence for action and practice5. To incorporate workers’ health into other policies
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WHO Global Model
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4 Avenues of Influence
Structure, air, machinery,furniture, products,
chemicals, materials, andproduction processes in
the workplace
Organizational culture aswell attitudes, values,
beliefs, and daily practicesin the company that affectmental and physical well-
being of employees
The health services,information, resources,opportunities, flexibility,
and other supports tomotivate employees to be
healthy, live a healthy
lifestyle and monitor theirmental and physical health
The activities in which acompany might engage, orexpertise and resources itmight provide to support
the social and physicalwell-being of the
community in which itoperates
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The Process
A model ofcontinuous
improvement•Mobilize workers to invest in
change—
identify needs,values and priority issues
•Form a team to do the work•Assessment and data
collection•Focus and prioritize action
•Develop an implementationplan•Do the work
•See what works and whatdoesn’t
•Improve based on data
•Continue
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The Underlying Principles
Keys to Success•Leadership based on corevalues•Involve workers and theirrepresentatives•Gap analysis (comparativeanalyses)•Learn from others•Sustainability (manage withdata, etc.)•Integration•Adapting to local contextsand needs
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• Practical Application
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Create Focus to Drive Population Health Improvement
80% of totalchronic
illnessesworldwide
By focusing on threemajor risk factors
employers can save anaverage of $700 peremployee per year inhealth care costs and
productivity improvements
Source : 2010 World Economic Forum
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Engaged Employees are Healthy and Productive
Engaged employees:• have healthier habits and are in better health• have lower incidences of chronic health problems• are more likely to be involved in employer sponsored wellness programs
Engaged employees (high vs. low wellbeing):• 46% fewer unhealthy days as a result of physical or mental illness• 39% less likely to be diagnosed with new disease in the next year• 43% less likely to be newly diagnosed with anxiety and depression
Source: Gallup, 2013. Purchasing Power white paper Financial Wellness: Power Behind the Purchase , July 2013.
Employees with strong overall wellbeing are nearly 6X as likely to be engaged to those who are at risk
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Global Framework to Deploy Focus on Health andWellbeing
Using all Spheres of Influence to Create a Healthy and High Performing Workforce
Source: Adapted from 2010 WHO Healthy W orkplace Framework and Model
Incorporateappropriate
activity and health
practices intodaily job functions
Supporting healthpractices outside
of the workenvironment
Making servicesaccessible, easy,meaningful,
confidential andpersonal
Health andwell-being
part of DNA
Wellbeing Categories
Physical
Emotional
Social
Financial
Environment
Career
Community
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Best Practice in Worksite Health Promotion
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Best Practices for Worksite Health Promotion
Best Practice Element 1 Organizational commitment to a healthy culture (mission and
vision) 2 Program connected to company mission, vision and business
objectives3 Adequate resourcing
4 Strategic plan (goals and objectives)
5 Operations work plan
6 Implementation management system
7 Program branding
8 Year-round, comprehensive program communications
9 Human-centered culture
10 Supportive physical work environments and organizational policies
11 Supportive psychosocial work environments and organizationalpolicies
12 Leadership engagement
13 Multi-level leadership
14 Participatory practices
15 Worker involvement and representation
16 Health and wellness committee
17 Assigned program accountability
18 Meaningful and relevant participation incentives
19 Regulatory compliance ( e.g. , HIPAA, GINA, , PPACA, State Law)
20 Measurement and evaluation
21 Analysis and reporting
22 Assessment of health risks with feedback23 Organizational environmental and policy assessment
24 Population triage, segmentation
25 Wellness champions network
26 Easily accessible program options
27 Effective program options (evidence-informed)
28 Targeted outreach
29 Tailored programmatic solutions for individuals
30 Supporting self-care and self-management
31 Integration of programs and vendors (linkages to EAPs, etc.)
32 Continuous improvement model
33 Awareness and education programs
34 Behavior change programs
35 Multiple program delivery options and modalities
36 Multi-level programming
37 Dedicated onsite staff
38 Community connectedness
39 Family involvement
40 Partnership and team oriented (internal and external)
41 Data security
42 Data integrity
43 Data integration
44 Data confidentiality
Source: Pronk NP. Health & Fitness Journal, in press
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Best Practice Governance Structure
C-Suite &Executive
Sponsorship
Management& Site
Leaders
HumanResources,
Facilities,OnsiteServices
Live HealthySite
Coordinators& Teams
Mission/VisionExecutive sponsorshipFinancial commitmentOrganizational, health-related policySet culture, tone, give permission
Program strategy, design, delivery,measurement & evaluationFinancial planningHealth-related policyReinforce culture
Tie to business strategy
Reinforce culture & setclimate Adopt health-relatedpolicyMonitor & communicateprogram performance
The ult imate SocialNetworkers Marketers, logisticalcoordinatorsTrusted resource tocapture feedback; securetestimonialsCapture local-levelparticipant data
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How to Get Started
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Steps in Developing a Successful Program
Discover
Design
Deliver
Determine
1
2
3
4
S t e p s
Data and Information Assessment
Program Strategy and Tactical Plan
Implementation and Engagement
Reporting, Measurement and Outcomes
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Data and Information Assessment Discover1
Analysis Inventory Interviews Survey
TimeFrame
4-5Months
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Multi-Year Strategy/Tactical Plan Design2Time
Frame2-3
Months
Strategy Design TacticalPlanLegal & Financial
Review Business Case
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Results and Outcomes Determine4Time
Frame2-3
Months
VendorReporting
Optimal HealthMetrics Scorecard
SpecialStudies
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Let’s Focus on 2 of the 4 Avenues of Influence
Psychosocial Work
Environment
Individual HealthResources
2
1
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According to Aon Hewitt’s 2013 Health Care Survey outcomes andchallenges are all about changing behavior
Source: Aon Hewitt 2013 Health Care Survey
Desired Outcomes and Major Challenges of Employers
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How Employees View the Challenge of Behavior Change
Source: 2012 Consumer Health Mindset Survey – Aon Hewitt, National Business Group on Health, The Futures Company
Source: The Futures Company, US Monitor, 2012.
Stressed Fun Deprived Willing to ChangeStress causes a significant negativeimpact on at least 1 area of my life
(most often physical health)!64%
…and 5 of 6 top ways to deal withit are sedentary behaviors
I took some positive action basedon HRQ results!
86%
…and 50% think employers shouldreward for positive health
outcomes but money isn’t alwaysthe answer
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Simplicity Facilitates Behavior Change
Select aPrecise
Behavior
Make Sure aTrigger is in
Place
Make theBehavior Easy
to Do
What behavior do
you want tochange?
Translate goalsand outcomesinto behaviors
How can you
make thebehavior easy todo?
Remembersimplicity changesbehavior
What will prompt
the behavior?Some triggers arenatural and someyou will need tocreate
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• Practical Application Individual Health Resources
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WellnessImprove the Health of BSAM Teammates
Awareness
Teammate knows theimportance of being fit(physically, emotionally,
financially) and hasaccess to personalizedinformation/data
Understanding
Ability to translateinformation/data into“what is in it for me”knowledge
Action
Sustained participationin and personalresponsibility for one’s
own health
Today Ideal State
L M d t HighR ti g S l
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Tactical PlanWork Environment Workplace Culture
Considerations
Locations willingness to participate in health & resiliencyenvironment and culture auditsSpeed at which guidelines can be implemented and adhered to
Rationale
According to the 2013 Aon Hewitt Health Care Survey 83% ofemployers believe workplace culture and 79% work environment canhave the greatest influence in impacting worker health and changingbehaviorsTo understand location-specific needs and challenges throughout theday that will influence how health can be incorporated into daily jobfunctionsTo personalize an approach that will meet specific division orlocation needs
R
e c omm
en
d a t i on
s
Incorporating Health into the Work Day and Guidelines
2013 2014 2015 2016Complete a health & resiliencyenvironment and culture audit at allmajor locations and at a samplingof retail locationsGain input from teammates
Perform “a day in the life”visits for key job functionsat operating units of BSAMCreate simple, easy ways toincorporate health into job functionsCreate and implement physicalactivity break guidelines Assessment of worksite food
options
Develop and implement 10minute movement breakbased on job function andtypeCreate and implement guidelines forhealthier food options in vendingmachines and onsite cafeterias
Develop and implement a 3-5 minute stretching andstrengthening programbased on job typeEstablish health food guidelines formeetings and events
Effort
CostEstimate
$$ $$ $ $
Work Environment Workplace Culture
$$$$$$
Low Moderate High
Effort
Cost
Rating Scale
Individual HealthResources
Low Moderate HighRating Scale
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Considerations
Unknown requirements for print and new media campaigns mayimpact costs
Some job functions may find participation challenging
Screening logistics may be challenging
Tactical Plan
R e c omm
en
d a t i on s
Build Awareness and Individual Behavior Change
2013 2014 2015 2016Vendor selectionHealth benefit plan design changesto include personal training andnutritional counseling for all coveredlives
Conduct Health Assessment (HA)Conduct biometric screenings: bloodpressure, fasting glucose, waistcircumference, height, weight, lowHDL cholesterol, triglycerides, steptestEngage at-risk individuals in-person,web and mobile coaching programsPromote comprehensive web portalfor all teammatesImplement physical activitychallenge (e.g., HealthEnhancement Systems Get Fit onRoute 66 )
Conduct Health Assessment (HA)Conduct biometric screenings: bloodpressure, fasting glucose, waistcircumference, height, weight, lowHDL cholesterol, triglycerides, steptest and sit-and-reach testEngage at-risk individuals in-person,web and mobile coaching programsIntroduce traveling lifestyle coach forphysical activity and healthy eatingat locationsImplement healthy eating challenge(e.g., Health Enhancement SystemsColorful Choices)
Conduct Health Assessment (HA)Conduct biometric screenings: bloodpressure, fasting glucose, waistcircumference, height, weight, lowHDL cholesterol, triglycerides, steptest and sit-and-reach testEngage at-risk individuals in-person,web and mobile coaching programsContinue to promote the travelinglifestyle coach for physical activity,healthy eating and weight lossImplement physical activitychallenge (e.g., HealthEnhancement Systems Spring IntoMotion)
Effort
CostEstimate
$$ $$$ $$$ $$$
Individual HealthResources
Rationale
Measuring effectiveness of program requires assessment andbiometric screening
Increases visibility of health across BSAM
Increase awareness of health and taps the competitive nature ofsome departments
$$$$$$
Low Moderate High
Effort
Cost
Rating Scale
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Employer View of Greatest Influence on ChangingBehaviors
83% believeworkplaceculture and
79% workenvironmentcan have the
greatestinfluence inimpacting
worker healthand changing
behavior
Source: Aon Hewitt 2013 Health Care Survey
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A Culture of Health
BusinessPerformance
PersonalValues
Organizational
Values
“A workplace ecology inwhich the dynamicrelationship betweenhuman beings and theirwork environment nurtures
personal andorganizational values thatsupport the achievement of
a person’s best self whilegenerating exceptionalbusiness performance”
Source: Pronk NP. ACSM’s Worksite Health Handbook, 2 nd Ed., 2009
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Environment
Skills(ability)
Motivation(energy)
Employee Engagement
Is it:
• Possible?
• Simple?
• Socially rewarding?
• Financially rewarding?• Personally relevant?
• Organizationally relevant?
• Community connected?
Health
Individual Organizational+
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• Practical Application Psychosocial WorkEnvironment
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Creating Policy and Guidelines
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Creating Policy and Guidelines
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Creating Policy and Guidelines
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Sustainable Engagement
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Measurement and Evaluation
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Workplace Health Evidence of Effectiveness
• Recommendations of selected interventions thatwork from a health improvement perspective
• Health risk assessment with feedback (questionnaire and screening)• Incentives and competitions to reduce tobacco use• Smoke-free policies to reduce tobacco use• Use of decision prompts to increase stair use• Obesity Prevention: Worksite Programs to Control Overweight and
Obesity• Interventions with On-Site, Reduced Cost, Actively Promoted
Vaccinations• Creation Of or Enhanced Access To Places for Physical Activity
Combined with Informational Outreach Activities
Source: www.thecommunityguide.org/worksite/index.html
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ROI Literature Review
Systematic review and meta-analysis
Conclusion: Worksite Health Promotion programs
can generate positive ROI for medical-
and absenteeism-related savings:Medical: 3.27 : 1
Absenteeism: 2.73 : 1
Workplace Health Evidence of Effectiveness
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Value through Design
Companies across a variety of industries reportbenefits:• Lower health care costs• Greater productivity• Higher morale
ROI can be as high as 6:1
Six Essential Pillars for Successful Programs:1. Engaged leadership at multiple levels2. Strategic alignment with the company’s identity and aspirations 3. A design that is broad in scope and high in relevance and
quality4. Broad accessibility5. Internal and external partnerships6. Effective communications
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• Practical Application of Measurement andEvaluation
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Actual Causes of Death in the U.S.
Source: Mokdad, A.H. JAMA 2004;291;1238-1245 [Errata, JAMA 2005;293:293-294].
4 behaviorscause nearly40% of all deathsin the U.S.(year 2000)
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Optimal Lifestyle Metric (OLM)
• Being physically active
• Not smoking/no tobacco use
• Eating 5 fruits and vegetables each day
• Drinking alcohol in moderation
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The Impact of health behavior adherence:The EPIC-Norfolk Prospective Population Study
• 11-Year follow-up of 20,244men and women aged 45-79years
• All-cause mortality adjustedfor age, sex, BMI, social class• The difference between a
health score of 4 and 0 isequivalent to 14 years inchronological age
• Analyses for those with chronicdisease (N=2,057) showedsimilar results
Source: Khaw, et al. PLoS Medicine 2008; 5(1) e12: 0001-0009. www.plosmedicine.org
http://www.plosmedicine.org/http://www.plosmedicine.org/
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Adherence to OLM and New Disease
Source: Pronk NP, et al. Pop Health Manage 2010;13:289-295.
Difference in 2-year incidence of new disease between people who adhere toOLM 0 or 1 and OLM 3 or 4 ( % )
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Adherence to OLM and Productivity Loss
Impact on excess health-related productivity loss
• Absenteeism
• Presenteeism
Based on 33,956 employees (Sample company,assuming $50,000 average salary, expressed asper person per year productivity loss in 2009dollars)
Source: Pronk NP. ACSM’
s Health & Fitness Journal 2012;16(3):39-43.
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Changing Behavior: 3-Year OLM Results
Source: ACSM’
s Worksite Health Handbook, 2 nd Edition, 2009. Chapter 36
93% are very satisfied or satisfied with the programExperience
Tobacco use 37% improvementPhysical activity 58% improvementFruits and vegetables 89% improvementAlcohol use 2% improvement
Health andproductivity
Demonstrated savings and ROI over three yearsMedical $1.3 MProductivity $1.1 MEstimated ROI 2.9:1 M
ROI
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Open Dialogue