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Workplace_Wellness_Toolkit

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									                                                                            15 Public Square, Suite 101
                                                                               Wilkes-Barre, PA 18701
                                                                                  570-408-1630 Phone
                                                                                     570-408-1633 Fax
                                                                                   info@stepspalc.org
                                                                                    www.stepspalc.org



To the worksites of Luzerne County, Pennsylvania:
Why should worksites encourage employees to adopt a healthier lifestyle?

Every year, U.S. businesses spend billions of dollars on the health of their employees for
diseases that are impacted by obesity and inactivity such as heart disease, hypertension, and
diabetes. In fact, most premature deaths are linked to personal behaviors. For employers,
poor employee health equates to lower productivity, lower morale, and higher insurance
claims. Employees with multiple risk factors such as high blood pressure, sedentary lifestyle
and smoking are more likely to be your high-cost employees in terms of healthcare use,
absenteeism, disability and overall productivity. Thus healthy employees, especially those
with healthy families are likely to incur lower medical costs and be more productive.

Since most adults spend half or more of their waking hours at work, employers have a great
opportunity to affect the health of the community and offset the rising costs of health care
that ultimately affects their bottom line. Research continues to show a return on investment
to employers when they invest money in the health of their employees through
comprehensive health promotion programs. Additionally, worksite health promotion
programs continue to gain popularity as an outstanding recruitment and retention tool to
attract and maintain high quality employees who are healthier and more productive.

Steps To A HealthierPA Luzerne County is part of a national health promotion and disease
prevention initiative to help all Americans live longer, better and healthier lives by helping to
reduce the burden of asthma, diabetes and obesity while addressing physical inactivity, poor
nutrition and tobacco use and exposure. The Steps To A HealthierPA Luzerne County
Initiative’s Workplace Action Team members have organized this Workplace Wellness
Toolkit for worksites to gain resources and program ideas to begin or add to current
worksite wellness initiatives. It is meant to be a blueprint for a successful comprehensive
worksite wellness program.

We encourage you to turn the page and take your next Steps toward a healthier workplace.




             Employees are your most valuable asset!
Steps to a Healthier Workforce, Luzerne County                          Joseph Makarewicz
                                                                        Chief Operating Officer
                                                                        Executive Vice President


       Developing and sustaining a healthy workforce is a critical element to an
organizations success. If not already in place, the first step is to create a well rounded
wellness program that is designed around a network of smaller, relevant health related
programs that inspire and motivate individuals to attain a healthier, more vital, safe and
secure way of living.

        Steps to a Healthier Workforce, Luzerne County provides the essential building blocks
required to implement a focused and proven workplace wellness initiative. As you will see in
the enclosed CD, this information is designed to help you plan, implement and evaluate a
resourceful and comprehensive worksite wellness program. Through this program, your
organization will gain the necessary tools to develop a wellness program that will not only
keep your employees healthy, but help to combat increasing healthcare costs, reduce
absenteeism, increase productivity, and improve morale.

        This unique CD provides information and incentives on how to address tobacco
cessation, how to develop a healthier workplace environment, steps to manage stress, and
how to develop healthy eating habits. The worksite toolkit is geared toward improving the
overall wellness of your biggest asset – your employees. It also reinforces the fact that
wellness programs do not have to be complicated or expensive to be effective.

        I challenge you and your colleagues to take these Steps to a Healthier
Workforce. This comprehensive program is a wonderful opportunity to see firsthand how
healthier and happier employees provide a positive impact to your company's bottom line.


Joseph Makarewicz




Offset Paper Mfrs.Inc.   Berryville Graphics, Inc.
101 Memorial Highway     25 Jack Enders Blvd
P.O. Box N               P.O. Box 272
Dallas, PA 18612         Berryville, VA 22611
(570) 674-9401           (540) 955-9242
FAX (570) 675-8714       FAX (540) 955-2633
www.bvg.opm-books.com
                                                Workplace Wellness Success Stories




Health insurance expenses are the fastest growing cost component for employers. Money
spent on wellness programs is money well spent. At Offset Paperback Mfrs., our wellness
program is a long-term investment in a healthier, happier and more productive workforce.
Our comprehensive Wellness Program has helped our employees and their families adopt
healthier habits which in turn have decreased our employee absenteeism, reduced our
medical claims and improved our employee productivity, recruitment and retention.
“Workplace wellness programs can make the most of your greatest asset, your employees.”




To contact Offset Paperback Manufactures for more detailed information, see:
www.opm.com




Caterpillar is a national corporation that has grown to be one of the largest makers of
construction and mining equipment, diesel and natural gas engines in the world. The goals
of Caterpillar’s Healthy Balance Program include: motivate positive change in modifiable
health risk behaviors; reduce health risks; improve long-term health status; promote self-
efficacy and informed decision-making; reduce healthcare and related costs; and achieve
exceptional participation via strong incentives.

Caterpillar predicts that the Healthy Balance Program will lead to long term savings of $700
million by 2015. To date, the program has reduced the aggregate health risk score by 6% for
the “low-risk” population and 14% for “high risk” subjects. This decline in aggregated risk
represents improvement in major risk factors: physical activity, cigarette smoking, stress, fat
and fiber consumption, etc. Participants who completed the high-risk program reduced their
doctor office visits by 17% and hospital days by 28%.

To contact Caterpillar for more detailed information, see: www.caterpillar.com
Worksite Wellness Kit                                            Table of Contents




                                 Table of Contents

                           Acknowledgements

                           Introduction:
                                • Executive Summary
                                • Making the Case
                                • Steps to Get Started

                               Section 1: Assessment

                               Section 2: Health Education

                               Section 3: Physical Activity

                               Section 4: Healthful Eating

                               Section 5: Worksite Environment


                           Appendix A: Smoke-free Environment

                           Appendix B: Stress Management

                           Appendix C: Liability

                           Appendix D: National Health Observances




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                        Acknowledgements




Acknowledgements
Steps To A HealthierPA Luzerne County would like to thank the following individuals and organizations
for their time and energy in preparing the Worksite Resource Kit.

Betty Jane Ahearn of                                              Susan Kennedy of
Blue Cross of Northeastern Pennsylvania                           Wilkes-Barre City Health Department

Jane Ashton of                                                    Frank Lawler of
Greater Wilkes-Barre Chamber of Commerce                          RejuvenEssence Wellness Spa

Peter Balsamo of                                                  Lyndsay Nybeck of
Luzerne County Community College                                  East Stroudsburg University

Michelle Bernotsky of                                             Rebecca McCaffrey of
Pennsylvania Department of Health                                 Luzerne County Community College

Owen Costello of                                                  Joanne Namey of
Keystone State Games                                              Pennsylvania Department of Health

Christine Donnolo of                                              Laura Novakowski of
Luzerne County Community College                                  Positive Power Strategies, Inc.

Diane Frain of                                                    Conrad Schintz of
WNEP-TV                                                           Geisinger Wyoming Valley Medical Center

Paul Ginter of                                                    Jeanette Stefanick of
Wilkes-Barre City Health Department                               Pennsylvania Department of Health

Mary Ellen Hogan-Balliet of                                       Linda Tirpak of
Greater Wilkes-Barre YMCA                                         Blue Cross of Northeastern Pennsylvania


We gratefully acknowledge the contributions of Melissa Rehrig, MPH, CHES who has assisted with the
development of this toolkit.

Updated August 2008 acknowledgement to Lauren Zehnder and Katherine Dotter Marywood Dietetic Interns

We would also like to thank the Colorado Physical Activity and Nutrition Program of the Colorado Department of
Public Health and Environment, for the approval to use their Worksite Resource Kit as a template for this resource
toolkit. For access to their toolkit see link below.
         http://www.cdphe.state.co.us/pp/COPAN/resourcekits/WorksiteWEllnessResourceKit.pdf

Organizational and editing contributions by: Midge Berfield RN, MSN, Steps To A HealthierPA Luzerne County
Nurse Consultant.

        Disclaimer: All efforts were made to obtain accurate and complete information for this toolkit. Any inaccuracies or
        omissions are unintentional. Steps To A HealthierPA Luzerne County welcomes comments/suggestions on changes or
        additions. Please contact Steps To A HealthierPA Luzerne County @ 570-408-1630 or info@stepspalc.org.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                   Introduction


                                          Executive Summary

Blueprint for success
Creating a blueprint for a healthy work environment can be a very complex process. However, the
process can be simplified by understanding the overall problem, outlining good goals and objectives,
understanding available resources, and implementing proven strategies and resources available to
worksites in order to help employees lead healthier lifestyles. It is intended to be a guide, on the path
to your worksite’s road to increased health and productivity.

Alarming trends1
   ♦ Healthcare costs are rising at 4 times the rate of inflation and are now consuming 50% of corporate
      profits.
   ♦ In 2004, the per-capita cost of health care was $6,040, which will increase to $11,046 per person by the
      year 2014.
   ♦ Preventable illness makes up ~ 70% of the burden of illness and associated costs.

How worksites can get started
     Gain commitment from stakeholders such as senior management, human resources managers, safety
     officers, staff members, etc.
     Assess the needs of your worksite.
     Create a wellness council or team that involves a good cross-section representation of your
     organization.
     Set goals and objectives, and prioritize them.
     Develop an action plan with appropriate strategies to address specified goals.
     Implement the plan.
     Monitor progress and make necessary changes.
     Evaluate the outcomes.
     Continue to revise the plan to maintain a healthy environment for all employees.

What worksites can do
      Conduct awareness activities surrounding National Health Observances, such as National Employee
      Health and Fitness Month in May or National Nutrition Month in March.
      Offer health education seminars and workshops.
      Conduct health screenings.
      Provide wellness and other self-help information through print or electronic means.
      Coordinate special events such as Bike to Work Day.
      Administer incentive programs for improvement of health and fitness behaviors.
      Offer employees a health risk assessment/appraisal.

How to use the Worksite Resource Kit
      This kit is divided into five sections: Assessment, Health Education, Physical Activity, Healthful Eating,
      and Worksite Environment.
      Within each section are corresponding action steps. Within accompanying CD are the specific action
      steps with additional information and resources on how to implement each action step.
      Once your worksite wellness team has determined priorities, goals and objectives, use this kit and CD
      to select the specific action steps you wish to implement at your worksite.

1
    COPAN’s Worksite Fact Sheet located at http://www.cdphe.state.co.us/pp/COPAN/worksite/COPANWorksiteFactSheet.pdf



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                  Introduction

   Introduction: Making the Case

   The following points help support why businesses should make workplace wellness a
   priority, as well as tools/resources that can be useful when negotiating for workplace
   wellness programming:

            •   Physical Inactivity cost Luzerne County businesses over $ 322 million dollars in
                2004 which equates to about $ 1,360 per person. (Physical Inactivity Cost
                Calculator, www.activelivingleadership.org).

            •   If as few as 5% of the inactive individuals in Luzerne County became physically
                active, it could save an estimated $ 16 million per year (significantly reducing the
                costs of medical care, worker’s compensation and lost productivity). (Physical
                Inactivity Cost Calculator, www.activelivingleadership.org).

            •   Inactivity costs between $670-1,125 per person, per year (Economic Costs of
                Obesity and Inactivity, Medicine and Science in Sports and Exercise, 1999).

            •   The total cost of obesity to U.S. companies is estimated at $13 billion per year
                (Prevention Makes Common Cents: Estimated Economic Costs of Obesity to
                U.S. Business, Department of Health and Human Services, 2003).

            •   Costs due to poor nutrition and physical inactivity are being shouldered by both
                private and public employers in the form of lost productivity and health insurance.
                (Steps To A Healthier Salinas).

            •   Each health risk an employee has equates to a 2.4% loss in on-the-job
                productivity. 2

            •   Large employers spent over $8,000 per employee on health in 2004. 2

            •   Health insurance premiums have been increasing faster than overall inflation and
                workers earnings since 1999. 2

            •   Presenteeism may account for 18% to 60% of employee costs. World Health
                Organization data from the Health and Workforce Questionnaire 2005 show that
                presenteeism costs may account for 74% of total costs. 2

            •   Recent surveys of local businesses sponsored by Steps To A HealthierPA
                Luzerne County have shown that there is an overall belief system that healthier
                employees have lower health insurance costs, lending credibility to the financial
                importance of businesses focusing on the “health” issue. For more information
                about the surveys contact Steps To A HealthierPA Luzerne County @ 570-408-
                1630 or at info@stepspalc.org.
      2
          Ryung Suh, MD, MPP, MPH An Aging Workforce: Health-Related Productivity and the Economic Value of Health
          Promotion for Medscape, Highlights of the American Occupational Health Conference August 25, 2006.


Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                Introduction
          •   Employer Health Coalition, Business and Health Institute provide the following
              estimated annual costs associated with these chronic conditions in the
              workplace;

                           Chronic Condition                      Annual Cost
                              Depression                           $ 880,152
                             Hypertension                          $ 520,884
                                Asthma                             $ 275,808
                               Diabetes                            $ 187,200
                             Heart Disease                         $ 148,512


          •  Refer to report: The Economic Costs of Physical Inactivity, Obesity, and
             Overweight in California Adults: Heath Care, Workers’ Compensation, and Lost
             Productivity
             This topline report by the California Department of Health Services, examines the
             link between physical inactivity, obesity, and overweight as it relates to heath
             care, workers’ compensation, and lost productivity. The findings highlight the
             rapid increase in costs related to physical inactivity, obesity, and overweight
             among California adults and identify the potential for significant cost savings. For
             topline report see
             http://www.cdph.ca.gov/PROGRAMS/CPNS/Pages/WorksiteResearchEvaluation
          .aspx

          •   The following are helpful tools to use when trying to make a case for workplace
              wellness initiatives;
                     Stanford Presenteeism Scale
                     American Productivity Audit
                     Work Productivity and Activity Impairment Questionnaire
                     Work Limitation Questionnaire as part of a Health Risk Appraisal
                     Absence Multipliers (tool to evaluate costs of absenteeism). Mean
                     absence multiplier is 1.61. Median absence multiplier is 1.28.

          •   Components to measure the impact of health and productivity programs include;
                   Medical costs (from health plans, health service Utilization Reviews and
                   Health Risk Appraisals),
                   Lost time data (from ST, LT disability, family and medical leave, and sick
                   leave),
                   HR and payroll data (time reporting, employee surveys, performance
                   appraisals and turnover data),
                   Worker’s Comp and safety data (from OSHA reporting, drug testing and
                   claims data),
                   Productivity metrics (from staffing, self-reported presenteeism metrics,
                   Per-employee financial measures, and
                   Business data (from customer satisfaction, production data, quality metrics
                   and revenue/cost information).



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                 Introduction
          •   Key elements to workforce productivity and performance include; Absence
              management, Human capital management and Quality Improvements (QI’s) in
              product or service.
          •   Health and Productivity Toolkit published by the American College of
              Occupational and Environmental Medicine (ACOEM) recommends these 6
              factors be considered when designing health programs and benefits
                  1. One’s own time and money matter more to the individuals than someone
                     else’s.
                  2. Nothing is free
                  3. What gets paid gets done
                  4. Incentives and disincentives always exist, influencing the general direction
                     of behavior.
                  5. There is a reason the term “rational” has the word “ration” in it.
                  6. Employment is a human capital marketplace


          •   Helpful Organizations:

                    American College of Occupational and Environmental Medicine (ACOEM)
                    www.acoem.com,
                    Institute of Health and Productivity Management (IHPM) www.iphm.org,
                    Integrated Benefits Institute www.ibiweb.org,
                    The Health as Human Capital Foundation www.hhcfoundation.org,
                    Disease Management Association of America (program evaluation guide)
                    www.dmaa.org,
                    Partnership for Prevention www.prevent.org (Healthy Workforce 2010
                    Sourcebook, http://health.gov/healthypeople or 800-3674725.
                    Business Group on Health with the CDC and AHRQ, “Purchaser’s Guide
                    to Clinical Preventive Services: Moving Science into Coverage”
                    www.businessgrouphealth.org/prevention/purchasers/
                    Center’s for Disease Control and Prevention-Healthier Worksite Initiative
                    www.cdc.gov/hwi


          •   Helpful Cost Calculators:

              Alcohol Misuse
              George Washington University Alcohol Treatment ROI Calculator,
              http://www.alcoholcostcalculator.org/roi/

              Diabetes
              Diabetes at Work, Conducting a Diabetes Assessment. General Assessment Tool.
              http://www.diabetesatwork.org/diabetesatwork/GettingStarted/AssessmentTool_General.cfm

              Obesity and Physical Activity
              American Cancer Society ROI Calculator for Obesity and Physical Activity,
              http://www.acsworkplacesolutions.com/obesitycalculator.asp


Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                           Introduction
             Magellan Health Services Obesity Cost Calculator
             http://www.magellanassist.com/customer/services/obesitycost/default.asp

             Tobacco
             American Cancer Society ROI Calculator for Tobacco,
             http://www.acsworkplacesolutions.com/tobaccocalculator.asp

             America’s Health Insurance Plans (AHIP) and Center for Health Research, Kaiser
             Permanente Tobacco ROI calculator,
             http://www.businesscaseroi.org/roi/default.aspx

             Free & Clear Employer and Health Plan ROI Calculator for Tobacco,
             http://www.freeclear.com/case_for_cessation/econ_impact.aspx?nav_section=2#




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                    Introduction


   Introduction: Steps to Get Your Worksite Started
   Planning a worksite health promotion program can be a rewarding experience for company
   leaders and other employees. Whether a business decides to develop a comprehensive
   worksite health promotion program all at once or begin with a few ongoing health promotion
   activities, it will be helpful to use a planning process. This will help to ensure the success of
   any health promotion program regardless of the number of employees.

      1. Establish a Planning Committee
          The committee should include potential program participants, individuals who may
          have a role in program implementation or evaluation, individuals familiar with
          budgeting, a person responsible for contracting with outside vendors, and someone to
          represent management.

          The planning committee serves several functions.
                1. An employee driven committee encourages “buy-in” from both
                   management and potential program participants.
                2. The committee will help assure that the program is responsive to the needs
                   of all potential participants.
                3. The committee will be responsible for carrying out or overseeing the rest of
                   the steps in the planning process.

      2. Assess the Interests and Needs of Leaders and Employees
          Businesses of all sizes will want to address the questions below. The Assessment
          Chapter in the toolkit provides examples of assessment tools that answer these
          questions and are appropriate for small or large businesses. The assessment may
          address the following questions:
                 Are managers willing to take part in the program and encourage others to do
                 so?
                 What do they see as the benefits of the program for employees and the
                 organization?
                 What kinds of activities are they willing to allow?
                 What is the level of employee interest in various types of health promotion
                 activities, the most convenient times and places to schedule activities, and/or
                 suggested organizational changes to promote a more healthful work
                 environment?

          Assessment also includes a health risk appraisal (HRA) to determine current
          employee disease risks, learn the level of interest in changing unhealthy behaviors
          and collect baseline data that can later be used to help evaluate the program. The
          planning committee may wish to periodically assess how well the organization is doing
          to support healthy behaviors on and off the job. Repeating the same survey over
          several years can help program planners evaluate the impact of specific organizational
          changes. It can also keep management interested in ongoing health promotion
          activities.



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                Introduction


      3. Develop Goal and Objectives to Design Programs
          Based on the results from the employee interest survey and the Health Risk Appraisal
          surveys the committee should discuss who will do what, when, and how in regards to
          designing the programs to be implemented.

      4. Implement a Program/Template
          Program implementation involves putting the plan into action. It may necessitate
          making arrangements with health promotion vendors, recruiting speakers, negotiating
          with health plans or health clubs, scheduling health promotion activities and more.
          Below are some steps in implementing wellness programs.
              • Plan a Kickoff event
                          Order healthy snacks or have a brown bag lunch
                          Arrange for speakers
                          Choose location
                          Prepare materials such as log sheets/books, instruction sheets
              • Determine how long you will collect data using logs sheets, on-line forms, etc.
              • Hold a Kickoff Event
                          Create a fun, festive atmosphere (balloons, decorations)
                          Provide participants with details of program log sheets, contests, or
                          events
                          Provide participants with a list of upcoming physical activity events
              • Provide weekly reminders to increase steps and decrease calories using email,
                 newsletters, or posted signs in and around the worksite
              • Ask participants to share ideas and stories through the company newsletter
              • Consider holding a “halfway there” event at 6-7 weeks
                           Give prizes for progress to date
                           Recognize individuals or groups
                           Set up opportunity for sharing
          Remember, this is only the beginning. Starting with simple fun activities will lead to
          more progress than trying to do everything at once. Keep your messages and goals
          small and attainable. Keep moving forward with new ideas to constantly refresh your
          program.

      5. Determine Success/Reassess
          Periodically review a program to determine its efficiency and effectiveness. A good
          program evaluation looks at information to learn both how well the program is working
          (program measures) and whether or not it is achieving expected results (outcome
          measures). Program costs and outcomes can also be compared. Occasional
          modifications based on these reviews can ensure that a program is following a course
          that leads to success.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                   Section 1




             Section 1: Assessment
             Different assessment tools can provide different types of important
             information. Therefore, a worksite wellness program may benefit
             most from using each of the following types of assessments.

             Types of Assessments:

                    1. Worksite Wellness Individual Interest Survey (Sample Provided)

                    2. Organizational Health Survey (Sample Provided)

                    3. Health Risk Appraisal (HRA)

                    4. Assessment Resources




Steps To A Healthier Workforce in Luzerne County
Worksite Resource Kit                                                                            Section 1




1
     Worksite Wellness Individual Interest Survey



Why: Since worksite wellness programs are for employees, it’s a good idea to find out from
     them what approaches have the greatest chance of success. A simple survey made up
     of 10 or 12 questions can provide valuable information.


How:
       Discover how employees want to receive program information (i.e. electronically,
       strategically-placed, bulletin boards, memos, etc.)
       Discover what health components (health education, physical activity, healthful eating)
       are they most interested in addressing and how.
       Find out what types of groups might employees be most inclined to join (e.g. walking,
       biking, weight-loss, nutrition, etc.)
       Discover which employees have expertise that may be useful to the program

       A sample survey has been included in this section for your use. Feel free to use
       as is, modify it for your purposes or just review it for ideas to create your own
       survey.




Steps to a Healthier Workforce in Luzerne County
Worksite Resource Kit                                                                                                         Sample Interest Survey


                             Worksite Wellness Individual Interest Survey
                                                                             (Sample)

           Large businesses may prefer to do this, or similar, surveys by computer to reduce data entry and analysis time.
         Businesses with few employees can easily compile the information by hand.
            This short survey is designed to get a feel for where employee interests lie, while at the same time giving employees
         a chance to better understand the concept of a wellness program. All responses will be kept anonymous.
            Select one number for each question:
                   4 = Very likely
                   3 = Somewhat likely
                   2 = Not very likely
                   1 = Not at all likely


1. I buy heart-healthy snacks when they are available (for example, pretzels, cereals,                                        4     3      2      1
    yogurt, one percent or skim milk, fresh fruit, 100 percent juice, raisins or other dried fruit.
    NOT candy, chips, pastry, etc.).

2. If I had a five-minute break I would use it for a personal activity like stretching, yoga or                               4     3      2      1
   a walk if there were a place to do it.

3. 1 would eat fruit if available at our staff meetings.                                                                      4     3      2      1

4. I would participate in group activities encouraging healthy eating or physical activity if                                 4     3      2      1
    they were offered to staff.

5. I am satisfied with my current state of health.                                                                            4     3      2      1

6. I make time for 30 minutes of physical activity most days of the week.                                                     4     3      2      1

7. I don't think about health when deciding what to eat.                                                                      4     3      2      1

8. It's hard for me to get as much exercise as I should.                                                                      4     3      2      1

9. I try to look for healthier foods, but usually eat whatever is available.                                                  4     3      2      1

10. I don't know what is meant by "worksite wellness."                                                                        4     3      2      1

11. Healthier people are more productive at work.                                                                             4     3      3      1

12. Paying attention to healthy eating and exercising is a lot of trouble.                                                    4     3      2      1

13. I know what it takes to lead a healthy lifestyle.                                                                         4     3      2      1

14. Whether or not to live a healthy lifestyle is completely up to the individual.                                            4     3      2      1


          Additional comments are welcome. Please write them on a separate sheet of paper. If you want to know more
          about this program and how you can help, please contact your supervisor.


                                            Source: Tompkins County, New York, Worksite Wellness Program Working Well Works




                                                                                  1
Worksite Resource Kit                                                                      Section 1




2
     Organizational Health Survey



Why: The organizational surveys are geared to obtain information on your organization’s
environment indicators from both managers and the general workforce.


How:
  ♦ The surveys are comprised of questions that reveal the extent to which opportunities
     exists in the workplace to pursue and maintain a healthy lifestyle.


       A sample survey has been provided in this section.




Steps to a Healthier Workforce in Luzerne County
                   Work-Site Organizational Health Survey
                                          (Sample Health Survey)

Name of Work Group: _____________________________________________________

Address: ___________________________City:_________________State:____Zip:____

Name of Respondent: __________________________Title/Function: _______________

Phone Number: (_ _ _) _ _ _ - _ _ _ _                  Email: _________________________________


Physical Activity
What types of facilities or resources does your organization provide for employees to engage in physical
activity? Please tell us if your organization offers the following resources by placing an “X” in the “Yes”
or “No” box.
                                                                                                Yes      No
  1. Does your worksite have a place for employees to go for a walk? ....………………
         a. If yes, can employees walk:                  Indoors ……………………………
                                                         Outdoors ………………………….

        b. If yes, is this place: (“X” all that apply)     Well Lit …………………………...
                                                           Safe from traffic, cars & machinery
                                                           Secure from intruders …………….
                                                           Well ventilated ……………………
                                                           Attractive …………………………

  2.   Does your organization have organized physical activities for employees?... ……..

  3.   Does your organization have access to physical activity facilities for employees?...
       (such as basketball courts, walking trails)

  4.   Does your organization have access to an indoor exercise facility?.... ......................
             a. If yes, what equipment does it provide: (“X” all that apply)
                                                     Bikes, stair climbers, treadmills ….
                                                     Running track ……………………
                                                     Swimming pool …………………..
                                                     Strength training equipment ……...
                                                     Other _______________________

              b.   When is the exercise facility open? (“X” all that apply) ……………….
                                                       Before work hours ………………..
                                                       After work hours ………………….
                                                       During work hours ………………..

              c.   Is the facility free or discounted to employees? ………………………...

              d.   Can family members of employees use the facility? …………………...
Worksite Resource Kit                                                                                                                        Sample Health Survey

        5.   Does your organization subsidize memberships to off-site physical activity                                                         Yes    No
             facilities?..................................................................................................................

        6.   Does your organization have stairs that employees can use for physical activity?...

        7.   Does your organization provide any incentives or rewards to employees who are
             physically active? …………………………………………………………………..

        8.   Does your organization offer a health plan which provides discounts for health
             club membership? ………………………………………………………………….



      Nutrition
        9.   Can employees in your organization obtain food or snacks at the workplace?
             If No, please skip to question #12. ……………………………………………….

        10. Where are the foods or snacks offered? (“X” all that apply)
                                                          Break room or company kitchen….
                                                          Canteen truck/snack bar…………..
                                                          Vending machines………………...
                                                          Caterer…………………………….
                                                          Other: (describe)…………………..


        11. If your organization has vending machines, what types of food are available
            through the machines? (“X” all that apply)
                                                         Candy, chips, or cookies…………..
                                                         Soda……………………………….
                                                         Pretzels……………………………
                                                         Fresh vegetables…………………..
                                                         Salads……………………………...
                                                         100% fruit juice…………………...
                                                         Fresh fruit…………………………
                                                         Dried fruit…………………………
                                                         Granola bars or trail mix………….
                                                         Yogurt…………………………….
                                                         1% or skim milk…………………..
                                                         Water……………………………...

        12. Can your employees obtain any of the following foods in the work place?
            (“X” all that apply)
                                                         Fresh fruit…………………………
                                                         100% fruit juice…………………..
                                                         Cooked vegetables………………..
                                                         Fresh salads……………………….
                                                         Fat free or low fat salad dressing.....
                                                         1% or skim milk…………………..
                                                         Fat free or low fat yogurt………….

        13. Does your organization have written policies or guidelines to ensure that fruit,
            vegetables and salad are offered at catered meetings?.... …………………………...

        14. Does your organization have a place where employees can refrigerate and heat
            meals?.... …………………………………………………………………………….




                                                                                    2
Worksite Resource Kit                                                                                           Sample Health Survey

                                                                                                                   Yes    No

        15. Does your organization offer nutrition education programs to your employees?...

        16. Does your organization offer weight control programs?........................................

        17. Does your organization offer reimbursement or discounts for dietary counseling,
            whether through health insurance or direct subsidy?..............................................




      Smoking
        18. Does your organization have a written smoke-free environment policy?.. ..………..
            If No, go to 22.

        19. Are employees who violate the policy penalized in any way?... …………………...

        20. Where is smoking prohibited (“X” all that apply)
                                                         In offices ………………………….
                                                         Throughout the office building …...
                                                         Throughout the grounds.………….
                                                         In company vehicles ……………...

        21. Where is smoking permitted? (“X” all the apply)
                                                         In offices ………………………….
                                                         In designated areas of buildings…..
                                                         Outside of office buildings…...…...
                                                         In company vehicles ……………...

        22. Do you offer programs to help employees quit smoking? ……………………….

        23. Does your organization offer reimbursement or discounts to employees who enroll
            in programs to quit smoking, whether through health insurance or direct subsidy?...



      Other Health Programs
        24. In the past 12 months, has your organization offered employees any health
            education classes, workshops, lectures or special events?.... ……………………….

        25. In the past 12 months, has your company offered any of the following health
            screening services? (“X” all that apply)
                                                          Blood pressure screening …………
                                                          Cholesterol screening …………….
                                                          Blood sugar screening ……………
                                                          Other: (describe):______________




                                                                    3
Worksite Resource Kit                                                                                                                         Sample Health Survey

                                                                                                                                                 Yes    No
        26. Are your employees allowed to use paid work time to participate in health-related
            activities?....................................................................................................................

                  a. If Yes, is this for:                                            Activities at work? ………………..
                                                                                     Time off to participate elsewhere?..

                  b. If Yes, in which activities are employees allowed to use paid work time for
                  participation? (“X” all that apply)
                                                                Blood pressure screening ………….…….
                                                                Cholesterol screening ………………
                                                                Blood sugar screening ……………….
                                                                Nutrition classes …………………..
                                                                Physical activity …………………..
                                                                Classes to quit smoking ……………
                                                                Weight control programs ………….
                                                                Stress management ……...…………

        27. Does your organization have a written flextime policy? …………...……………….

        28. Does your organization participate in an Employee Assistance Program?...................

        29. In the past 12 months, has your organization solicited feedback from employees
            on the types of health programs and services that would be beneficial to them?...

        30. Does your organization have a budget for colleague health promotions? .................

        31. Is there a designated person, group or committee within your organization who
            Is responsible for employee health promotion? ......................................................

        32. Does your organization offer family leave for employees to care for sick family
            members?......................................................................................................................

      About Your Organization
        33. How would you describe the attitude of your organization’s leadership toward the
            promotion of health among your colleagues?..................
                                                                         Strongly supportive...........
                                                                         Somewhat supportive........
                                                                         Neutral attitude..................
                                                                         Not very supportive...........
                                                                         Not at all supportive...........
        34. Which of the following statements best describes your organization’s health
            insurance benefit?
                  a. We do not offer health insurance to employees.........................................

                        b.     We offer a health insurance plan,
                               but do not contribute a % of the premium.................................................

                        c.     We offer a health insurance plan,
                               and contribute a % of the premium...........................................................




                                                                                    4
Worksite Resource Kit                                                                                            Sample Health Survey

                                                                                                                      Yes   No
        35. How many employees work in your business?
            (include full and part time employees)........................   Fewer than 50......................
                                                                             50 to 249.............................
                                                                             250 or more........................



        36. What % of your employees are women?                  Percent: _______________

        37. What % of your employees are disabled?              Percent: ________________

        38. What % of your employees are:                        Percent: ________________Full-time

                                                                 Percent: ________________Part-time

                                                                 Percent: ________________Satellite/offsite employees



                                                                                                                      Yes   No
        39. Does your organization work more than one shift per day?.........................................
            If Yes, do employees on all shifts have equal access to the following resources?
            (“X” all that apply)
                                                  Physical activity programs.............................
                                                  Fresh fruits, vegetables, low fat foods...........
                                                  Health screenings...........................................
                                                  Nutrition education programs........................
                                                  Weight loss programs....................................
                                                  Tobacco cessation programs..........................



             Thank you very much for participating.
             Source: Massachusetts Cardiovascular Program




                                                                  5
Worksite Resource Kit                                                                          Section 1




3
     Health Risk Assessment (HRA)



Why: The health risk assessment is central to health promotion programs. It can help
companies of all sizes identify their workforce’s problems and establish targets for improvement.


How:
  ♦   Using the HRA, you can discover risk levels, determine appropriate interventions and
     measure results.
   ♦ HRAs help employees manage their health care and allow companies to control their
     health care costs.
   ♦ Assessment tools can accurately measure risk levels and can proactively channel
     individuals to appropriate, cost-effective interventions are valuable for a company.
   ♦ It is important to contact local health insurance companies and inquire what tools they
     use for HRA.


   Three basic building blocks for health risk assessments
                       1. Questionnaire
                       2. Risk Calculation
                       3. Educational Message or Reports

   The resource section provides links for more information about Health Risk
   Assessment tools.

              http://www.hcrewards.com/news/pdf/the_right_hra.pdf




Steps to a Healthier Workforce in Luzerne County
Worksite Resource Kit                                                                            Section 1


Section 1: Website resource descriptions
Alcohol Misuse: http://alcoholcostcalculator.org/roi
This resource is provided by George Washington University, use this Return on Investment (ROI)
Calculator to learn what your business can save in healthcare costs when employees have access to a
treatment approach known as screening and brief intervention. In addition to saving on healthcare
costs, treatment reduces absenteeism and improves employee productivity.

American Cancer Society: http://acsworkplacesolutions.com/obesitycalculator.asp
                             http://acsworkplacesolutions.com/tobaccocalculator.asp
This ROI Calculator evaluates the Return on Investment for the institution of a physical activity or
smoking cessation programs in your company. This national organization provides Return on
Investment (ROI) Calculators.

American Health Insurance Plans (AHIP): http://www.businesscaseroi.org/roi/default.aspx
This site presents the business case for smoking cessation. The information is designed primarily for
use by health insurance plans. However employers, purchasers, and health benefits managers can
also gain valuable insight into the economic advantages of a range of smoking cessation programs.

Centers for Disease Control and Prevention: http://www.cdc.gov/hwi
Healthier Worksite Initiative website that includes a worksite health promotion resource toolkit with cost
calculators, sample tools, and a multitude of helpful resources and links. Website developed to be a
comprehensive one-stop shop for planners of workforce health promotion.

Cornell University Institute for PolicyResearch:
http://vivo.cornell.edu/pslengr/entity?home=11&id=11478
Health and Productivity research centering on the relationship between employees’ health and well-
being and their work-related productivity.

Diabetes At Work: http://www.diabetesatwork.org
This website can help businesses and managed care companies to assess the impact of diabetes in
the workplace.

Free & Clear Employer and Health Plan: http://www.freeclear.com/quit-for-life/
                                            http://www.freeclear.com/quit-for-life/calculator.aspx
Free & Clear’s tobacco cost exposure calculator illustrates both your current tobacco-related medical
costs and the savings you can expect should you implement the Free & Clear® Quit For Life™
Program. The assumptions in this calculator are based on peer reviewed research from unbiased
national leaders such as the Centers for Disease Control and Prevention (CDC).

Fitness on the Job:
http://www.fitnessonthejob.com
Fitness solutions for business; organization located locally in NEPA. Provides fitness programming
matched to an organization’s goals, budget and space.

Harvard Center for Cancer Prevention: http://www.yourdiseaserisk.harvard.edu/
A source where you can find out your risk of developing five of the most important diseases in the
United States (cancer, diabetes, heart disease, osteoporosis, and stroke) and get personalized tips for
preventing them.


Steps to a Healthier Workforce in Luzerne County
Worksite Resource Kit                                                                           Section 1

Healthier Days Program: http://www.healthierdays.com/
This Program was developed and is managed by HealthcareData.com, LLC. Healthier Days is a
managed and measured wellness program that helps people improve their overall health through
exercise, weight loss, eating healthy foods, smoking cessation, and other special programs.

Heart Check: http://www.health.state.ny.us/nysdoh/heart/healthy/heartcheck.pdf
A survey tool from NY Department of Health that helps employers’ measure opportunities for physical
activity, healthy eating, and tobacco prevention.

Institute of Health and Productivity Management: www.ihpm.org
The Institute for Health and Productivity Management is a nonprofit corporation that promotes the
relationship of employee health to workplace productivity.

Luzerne County Community College – Center for Business Solutions
http://www.luzerne.edu/workforce/main.jsp
LCCC is a regional leader in business and industry training and performance improvement, offering
quality programming either at employer location or on campus. The Center for Business Solutions also
assists regional employers with preparation of grant applications, consultation, and problem-solving.
Contact Director David Sawicki, M.B.A, 1-800-377-LCCC ext. 663; dsawicki@luzerne.edu

Magellan Health Services: http://www.magellanassist.com/customer/services/obesitycost/default.asp
Magellan's Obesity Cost Calculator estimates incremental medical and pharmacy expense associated
with overweight and obese individuals. The Employer module includes costs associated with lost
productivity.

Michigan Health Tools: http://mihealthtools.org/work/
Provides assessment tools in designing healthy environments at work

National Business Group on Health: www.wbgh.com/prevention/prev.cfm
Employer’s Guide to Health Improvement and Preventives Services available as well as information
that translates evidence-based research into practical strategies and solutions.

National Committee for Quality Assurance (NCQA): http://www.ncqa.org/
This organization provides a Quality Dividend Calculator tool that is simple to use to generate projected
cost savings in offering employees worksite wellness programs.

Thomson Medstat: www.medstat.com
Information and assistance is available to help businesses identify and manage the chronic diseases of
their workforce.

Wellness Councils of American: http://www.welcoa.org/freeresources/index.php?category=11
From Welcoa; several different surveys that employers can administer in assessing employees interest
of wellness programs.




Steps to a Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                      Section 2




             Section 2: Health Education
             Promote social support interventions and/or health education
             activities in the workplace.

             Action Steps:

                    1. Offer regular health education presentations on various
                       physical activity, nutrition, and wellness-related topics.
                          Cost= $; Time=

                    2. Provide health education information through newsletters,
                       publications, websites, email, libraries, and other company
                       communications.
                          Cost= $; Time=

                    3. Conduct preventive wellness screenings for blood pressure, body
                       composition, blood cholesterol, and diabetes.
                          Cost= $$$; Time=

                    4. Provide confidential health risk appraisals.
                          Cost= $$; Time=

                    5. Host a health fair.
                          Cost= $; Time=

                    6. Provide healthy cooking demonstrations with taste tests.
                          Cost= $$; Time=

                    7. Start employee activity clubs (e.g., walking, bicycling).
                          Cost= $; Time=

                    8. Offer on-Site weight management/maintenance programs at a
                       convenient time for employees.
                          Cost= $$$; Time=

                    9. Offer health literacy education information through publications,
                       newsletters, websites, and factsheets.
                          Cost= $; Time=
             Key:
                        Cost =                     Time =
                        $    = Minimum                  = Minimum
                        $$ = Moderate                   = Moderate
                        $$$ = Maximum                   = Maximum




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 2




1
     Offer regular health education presentations on various activities,
     nutrition, and wellness-related topics.

Why: Providing health and wellness information to employees at the workplace demonstrates an
organization’s concern for the well-being of its employees. The information they gain from health
education seminars may empower employees to take better care of their health, start a habit, or
become a better consumer. This, in turn, may assist the organization to positively impact such things
as health care costs, absenteeism, and productivity.

How:
       Understand your employee demographics such as gender, age, insurance coverage,
       overweight population, smoking population, etc.
       Conduct an employee interest survey to collect information on the topics that would be of most
       interest to staff and to determine the best time of day for health education seminars.
       Sample topics: Physical activity, healthful eating, stress management, heart health, etc.
       Select the best time of day for a presentation and consider offering it at multiple times. For
       traditional work schedules, the lunch hour is often a popular time. However for employees with
       shift work, it may be beneficial to offer the presentation at various times throughout each shift.
       In addition, you may want to videotape the presentation and make it available for those who
       were not able to attend.
       Select the length of the seminar according to your organization’s needs. Seminars most
       commonly last one hour (approximately 45 Minutes of presentation and 15 minutes for
       questions), but can vary according to the environment.
       Once a topic has been selected, contact local organizations that can provide speakers on the
       topic. Specify the date (s) and time (s).
       Promote the seminars through all marketing media available such as e-mail, flyers, and meeting
       announcements.
       Consider encouraging employees to pre-register if materials are needed.
       Offering snacks or a door prize often will increase participation.
       Develop an evaluation or request that the presenter provide you with an evaluation that can be
       given out to attendees.

Resources:
Contact the following organizations to inquire about low or no-cost speakers:
      American Cancer Society: www.cancer.org
      American Diabetes Association: www.diabetes.org
      American Heart Association: www.americanheart.org
      American Lung Association: www.lungusa.org
      Pennsylvania Dietetic Association: www.eatrightpa.org
      Penn State Cooperative Extension, Luzerne County: http://luzerne.extension.psu.edu/

Other organizations to consider for speakers:
       Employee assistance providers
       Fitness organizations
       Health departments
       Hospitals
       Nonprofit organizations
       Recreation centers/YMCAs



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                         Section 2




2
    Provide health education information through newsletters,
    publications, websites, email, libraries, and other company
    communications

Why: Providing health education information to employees is one way to encourage them to make
positive lifestyle changes and responsible health care decisions.

How:
       Provide information in newsletters. Subscribe to pre-written health and wellness newsletters or
       create your own.
       Start a health education library of books, magazines, newsletters and/or videos.
       Include bookmarks or brochures in paycheck envelopes.
       Send weekly or monthly tips through email.
       Offer internet access stations for employees who do not have individual access.

    Be sure to consider the following when determining the information to provide:
      Budget
      Company culture
      Company demographics
      Employee interest
      Target audience

Resources:
      American Cancer Society Workplace Outreach: www.acsworkplace.org
      Because We Care newsletter
      Berkeley Wellness Letter: www.berkeleywellness.com
      Center for Science in the Public Interest: www.cspinet.org
       Nutrition Action newsletter
      Harvard Health Publications: www.health.harvard.edu
      Hope Health: www.hopehealth.com
      National Institutes of Health: www.nih.gov
      Oakstone Wellness Publishing: www.oakstonewellness.com
      Tufts University Health and Nutrition Letter: www.healthletter.tufts.edu
      Wellness Councils of America: www.welcoa.org




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 2




3
     Conduct preventive wellness screenings for blood pressure, body
     composition, blood cholesterol, and diabetes.

Why: Health screenings help identify risk of serious illness. Preventive wellness screenings provide
measurements or evaluations of certain “biomarkers” that indicate a person’s degree of risk for specific
diseases. Many preventable diseases and the “biomarkers” are interrelated. For example, an
individual with excess body fat is also at risk for high blood pressure and cardiovascular disease.

Inconvenience and cost are barriers that often prevent people from getting routine health screenings.
When offered at work, these screenings are very convenient and cost-effective. Early identification of
risk can often prevent the development of more serious health issues. When serious risk is identified,
early intervention will lead to better outcomes.

How:
       Offer health screenings as part of a health fair.
       Host periodic screening events as an alternative to full health fairs.
       Host a Health Fair or encourage employees to attend a Health Fair in their community.
       Offer different wellness screenings each month along with an educational program on that
       specific topic. This allows people to focus on different topics and reinforces wellness and
       prevention throughout the year. For example, during February, American Heart Month, offer
       cholesterol and blood pressure screenings.
       Many companies pay for part or all of the screenings for their employees. Other companies do
       not have this option, but can still offer convenient, lower-cost worksite screenings.
       Screening/wellness companies should be able to offer reasonable rates for their services on a
       cash (no insurance) basis.

Preventive Wellness Screenings
A variety of health screenings are easy to offer in the workplace. Listed below are some of the most
common screens for cardiovascular disease, diabetes, osteoporosis, and cancer.
        A1c: People who have been diagnosed with diabetes should ideally have this test four times a
        year. A1c level is a good measure of a person’s average blood glucose level over the previous
        two to three months, which indicates his or her glucose control. It is not used to diagnose
        diabetes.
        Blood composition or body fat: Measuring the percentage of body fat and lean muscle mass
        is a better indicator of health than weight alone. Two people weighing exactly the same could
        have very different percentages of fat and muscle. Several different methods can be used to
        measure body composition: underwater weighing (expensive and requires special equipment),
        and bioelectrical impedance (easy to use, requires handheld or standing equipment).
        Body mass index (BMI): Body mass index is the measurement of choice for many physicians
        and researchers studying obesity. Body mass index uses a mathematical formula that takes
        into account both a person’s height and weight. Body mass index equals a person’s weight in
        kilograms divided by height in meters squared (BMI=kg/m²). Body mass index, rather than
        scale weight, is a more accurate assessment of an individual’s risk for obesity.
        Waist to Hip Ratio (WHR): WHR is the ratio of your waist circumference to your hip
        circumference by the hip circumference. WHR is a measurement tool that looks at the
        proportion of fat stored on your waist, and hips and buttocks.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                        Section 2

      Bone density: Bone density screenings measure a person’s risk for osteoporosis. Portable
      screening devices use sonogram technology to measure the bone density of the heel.
      Measurements of the heel have about an 85 percent correlation with the hip. The test is quick
      and painless. More than 28 million Americans have osteoporosis. One of every two women
      and one of every eight men over age 50 will break a bone due to osteoporosis.
      Compressive chemistry screen: This blood test usually includes 30 different tests that
      measure cholesterol levels, thyroid function, liver function, and various enzyme levels.
      Glucose levels: This test measures the amount of a simple sugar called glucose in the blood.
      High levels of blood glucose indicate risk for diabetes. An estimated 16 million people in the
      United States have diabetes; and about one-third of them have not been diagnosed.
      Lipid profile (also called a cholesterol check): This blood test measures total cholesterol, LDL
      (bad cholesterol), HDL (good cholesterol), triglycerides (a form of fat carried in the blood
      stream), and provides a coronary risk ratio that indicates a person’s risk of coronary heart
      disease.
      PSA screening for prostate disease: This blood test measures a protein made by the
      prostate gland. Elevated PSA levels may indicate prostate cancer cells or other non-cancerous
      prostate conditions. The American Cancer Society recommends PSA testing every year for
      men over age 50, or age 40, if they have prostate cancer in the family.
      Push-up test: This test measures an individual’s level of muscular endurance.
      Rockport one-mile walk test: This test measures an individual’s level of aerobic fitness.
      Sit-and-reach test: This test measures an individual’s range of motion or flexibility.
      Stoke screening: This screening identifies problems with vascular circulation. Using Doppler
      ultrasound technology, problems such as blockages of the carotid arteries, aneurysm of the
      aorta, and circulation problems of the legs, can be identified before symptoms occur.

Resources:
      American College of Sports Medicine: www.acsm.org
      HEALTHBREAK, Inc.: www.healthbreakinc.com
      Life-Span Wellness: www.lindyspharmacy.com/wellness.htm
      Med-Well, Inc.: www.medwellinc.com

   Other organizations to consider for screenings:
      Health departments/agencies
      Hospitals
      Insurance providers
      Recreation Centers/YMCAs
      Screening/wellness companies




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                           Section 2


    Provide confidential health risk appraisals.
4
   Why: A Health Risk Appraisal is a technique for determining the presence of disease and
   estimation the risk that someone with certain characteristics will develop disease within a given time
   span. The three components of a Health Risk Appraisal are: 1) questionnaire, 2) risk calculation,
   and 3) educational reports.

   Health Risk Appraisals:
          Are easy to use.
          Are popular with clients and may increase participation in health promotion programs.
          Provide a systematic approach to organizing preventive health information and tend to
          emphasize modifiable risk factors.
          May provide data on stages of change for behavioral risk factors.
          Provide group data that summarize major health problems and risk factors.
          May increase motivation to make positive behavior changes, when integrated into a broader
          health promotion program.

   Limitations of the Health Risk Appraisal:
           It does not diagnose disease.
           It does not provide a complete medical history, nor is it a substitute for a medical exam.
           It is not a predictor of an individual’s medical future, chances of death, or most likely cause
           of death.
           It is not an assessment of social or environmental risk factor.
           It is not a health promotion program in itself.

   How:
   On average, a Health Risk Appraisal cost $15 - $50 per employee.

   Computer-based appraisals
         Most cost-efficient
         Most popular
         Require a computer-literate population
   Pen and paper appraisals
         Staff intensive
         Take longer for feedback

   Resources:
         HEALTHBREAK, Inc.: www.healthbreakinc.com
         Institute for Health and Productivity Management: www.ihpm.org
         Johnson and Johnson Health Care Systems: www.jjhcshealth-fitness.com
         May Clinic Health Management Resources: www.mayoclinichmr.org
         Med-Well, Inc.: www.medwellinc.com
         Occupational Health Strategies: www.healthyself.org/handbook1.htm
           Handbook of Health Assessment Tools
          StayWell: www.staywell.com
          Summex Corporation: www.summex.com
          Wellsource: www.wellsource.com
          http://www.hcrewards.com/news/pdf/the_right_hra.pdf



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                         Section 2




5
    Host a health fair.


   Why: Corporate health fairs are an effective way to provide valuable health information and
   screening services to large numbers of employees in a convenient “one-stop shop” format.

   How: There are several ways to plan a health fair. Some companies may chose to host their own
   health fair for employees. With either option, planning follows some basic steps.

   Establishing a Health Fair Planning Committee is the first step to a successful event. This
   committee should include a cross section of employees interested in healthy living and willing to
   commit time to the planning process. This committee may do the following tasks:

          Select a date and location
          Create goals and objectives
          Develop a budget
          Contact vendors or exhibitors
          Create a theme
          Market the event
          Solicit volunteers to help with the event
          Create evaluations for both vendors and participants
          Analyze the evaluations
          Submit a post-event report to management

   Health fairs should complement the workplace environment and provide services in a convenient
   manner for employees. No matter the size of the event, offering some services on-site encourages
   employees to examine their lifestyle and health. Simply increasing awareness of health issues may
   be the greatest benefit of the event.

   Resources:
   ♦ Wellness Councils of America:
      http://infopoint.electricpulp.com/blueprints/healthfairs/index.html
        5 Elements of a Successful Health Fair

   Other organizations to consider for health fairs:
      Health departments/agencies
      Hospitals
      Insurance providers
      Recreation Centers/YMCAs
      Screening/wellness companies




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                            Section 2




6
    Provide healthy cooking demonstrations with taste test.


   Why: Cooking demonstrations at the worksite make a great lunchtime seminar or health fair
   attraction. Demonstrations can be tailored to fit a variety of settings and time limitations. Seeing
   and tasting foods prepared quickly and easily can provide people the incentive they need to get
   creative in the kitchen.

   How:
          Host a one-hour cooking demonstration over the lunch hour or as part of a health fair.
          Create a theme for your demonstration such as “meals in minutes”, “bone up for good
          health”, “take nutrition to heart” or “healthy holidays”.
          Invite a chef to participate in cooking demonstrations or health fairs.
          Consider cold recipes if adequate equipment is not accessible.
          Start a video lending library of cooking videos.
          Offer a cooking class that includes a demonstration, hands-on participation, and sampling.

   Resources:
         American Heart Association: www.americanheart.org
          Cooking for Life program: 303.369.5433
          Pennsylvania Dietetic Association: www.eatrightpa.org
          Penn State Cooperative Extension, Luzerne County: http://luzerne.extension.psu.edu/


      Other resources to consider:
         Cooking schools
         Cooking videos
         Food section or cooking class calendars in local and statewide newspapers
         Insurance providers
         University culinary departments




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                           Section 2




7
     Start employee activity clubs (e.g., walking, bicycling).


Why: Employee activity clubs encourage employees with similar interests to interact in an environment
outside of the workplace. Activity clubs help foster camaraderie, improve physical fitness, reduce
stress, and build self-esteem.

How: These clubs can be formally or informally organized, depending on the company’s resources.
They can be initiated or coordinated by either interested employees, wellness committees, or through
onsite fitness center or wellness staff.

Here are some guidelines for the activity club coordinator to follow:
       Obtain support and permission from your organization’s management, often human resources.
       Request any necessary budget for the program.
       Check with your legal department for possible liability issues with the activity club. The
       American College of Sports Medicine resource listed below has sample liability forms and a
       health history Par-Q (Physical Activity Readiness Questionnaire) that participants may need to
       sign.
       Send out an interest advertisement that follows company communication policies.
       Establish a meeting time and location for the activity.
       Advertise the activity club via the intranet, company newsletter, email, or flyers in high traffic
       locations.

Examples of activity clubs:
      Basketball
      Bicycling
      Hall walking/Walking Wednesdays
      Softball
      Running
      Volleyball

Resources:
      American College of Sports Medicine: www.acsm.org
      Shape Up PA: http://www.keystonegames.com/shapeuppa.htm
      Wyoming Valley Wellness Trails Partnership: http://www.wvwellnesstrails.org/index.html




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                       Section 2




8
    Offer on-site weight management/maintenance programs at a
    convenient time for employees.

Why: Ongoing programs, such as weight management classes, provide the support and motivation
employees need to facilitate lasting behavior change.

How:
       Conduct an employee survey to determine interest in such a program and best day of the week
       and time of day to host it.
       Determine which program you want to offer. Research your options and take into consideration
       program reputation, class content, instructor credentials, cost, etc.
       Offer an on-site program before work, over the lunch hour, or after work.
       Consider subsidizing the program so that the employer and employee each pay half of the class
       registration.
       In smaller communities where programs might not be available, invite a registered dietitian or
       exercise physiologist to speak about nutrition and physical activity.

Resources:
      American Cancer Society: www.cancer.org
      American Heart Association: www.americanheart.org
       Slim for Life, Cooking for Life, Active for Life programs: 303.369.5433
       Choose to Move Program: www.choosetomove.org
       Pennsylvania Dietetic Association: www.eatrightpa.org
       Think Light! : www.thinklight.com




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                    Section 2




9
    Health Literacy



      Health literacy is the degree to which individuals have the capacity to obtain, process,
      and understand basic health information and services needed to make appropriate
      health decisions.
                                                -Healthy People 2010, Health Communication Terminology

                                      Health Literacy Affects People’s Ability to:
                Navigate the healthcare system, including filling out complex forms and locating providers and
                services.
                Share personal information, such as health history with providers.
                Engage in self-care and chronic-disease management.
                Understand mathematical concepts such as probability and risk.

      Source: DePArtment of Health

      • Websites for Worksites

      Institute of Medicine http://www.iom.edu/
      The Institute of Medicine website provides independent, objective, evidence-based advice to
      policymakers, health professionals, the private sector, and the public.

      Healthfinder® http://www.healthfinder.gov/
      A Federal website for consumers that offers reliable health information. It finds the best
      government and nonprofit health and human services on the Internet.

      AskMe3™http://www.npsf.org/askme3/
      This site focuses on the critical aspect of clear communication between patients and health care
      providers; includes the 3 most important questions you should ask your health care provider.

      2003 National Assessment of Adult Literacy (NAAL)
      http://nces.ed.gov/pubsearch/pubsinfo.asp?pubid=2006470
      A website which provides national education statistics including NAAL which measures the
      English literacy of adults.

      National Institute for Literacy (NIFL) http://www.nifl.gov/nifl/facts/facts.html
      This website provides NIFL Literacy Fact Sheets which include statistics pulled from more than
      50 research studies based on literacy analysis.

      New Zealand Literacy Portal http://www.nzliteracyportal.org.nz/Health+Literacy/
      A website designed to provide a knowledge base of adult literacy information. Contributed by both
      New Zealand and international organizations it provides a rich source of information for all people
      interested in adult literacy.

      Centre for Literacy Canada
      http://www.centreforliteracy.qc.ca/publications/lacmf/vol17no2/vol17no2.pdf
      This site provides detailed findings from the Health Literacy Project at the McGill University
      Health Centre. Connects literacy to media and technology in schools, community, and the
      workplace.


Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                     Section 2


Section 2: Website resource descriptions
American Cancer Society (ACS): www.cancer.org
This site provides information about different types of cancer, prevention, and treatment options. The American
Cancer Society dietary guidelines and common questions about cancer and diet are covered.

American Cancer Society Workplace Outreach: www.acsworkplace.com
This site provides information on sample worksite wellness policies, tools for starting w wellness program, and
information for company employees on being active, quitting tobacco, staying sun smart, and being aware. There
are also recipes, resources, and Meeting Well guidelines under the “eat smart” link.

American College of Sports Medicine (ACSM): www.acsm.org
The American College of Sports Medicine advances and integrates scientific research to provide educational and
practical applications of exercise science and sports medicine. This site contains health and fitness information
on aerobic activity, strength training, and stretching.

American Diabetes Association (ADA): www.diabetes.org
This site has two home pages, one for professionals and one for laypersons, which provide a comprehensive
resource on diabetes.

American Dietetic Association (ADA): www.eatright.org
The American Dietetic Association is an organization of registered dietitians. This site offers information on food
and nutrition, as well as upcoming conferences and events. You may also access registered dietitians in your
area using this site.

American Heart Association (AHA): www.americanheart.org
The American Heart Association is a national voluntary health agency whose mission is to reduce death and
disability from cardiovascular disease and stroke. Information on health, physical activity, nutrition, and
overweight/obesity can be found on this site.

American Lung Association (ALA): www.lungusa.org
The American Lung Association is a national organization whose mission is to prevent lung disease and promote
lung health. See also ALA of Pennsylvania @ www.lunginfo.org

Berkeley Wellness Letter: www.berkeleywellness.com
The Berkeley Wellness Letter was rated #1 by US News & World Report, The Baltimore Sun, Money Magazine,
and the Washington Post for its “brisk” and “reasoned” coverage of health issues.

Centers for Disease Control and Prevention (CDC)/Overweight and Obesity:
http://www.cdc.gov/nccdphp/dnpa/obesity/
This site provides information and statistics on obesity, as well as a Resource Guide for Nutrition and Physical
Activity Interventions to Prevent Obesity and Other Chronic Diseases.
http://www.cdc.gov/nccdphp/dnpa/healthyweight/
A website that provides information about achieving and maintaining a healthy weight as part of an ongoing
lifestyle change.

Center for Science in the Public Interest: www.cspinet.org
Order the Nutrition Action Newsletter on this site.

Pennsylvania Department of Health Physical Activity and Nutrition Program:
http://www.dsf.health.state.pa.us/health/cwp/view.asp?a=186&q=237142
This site has the Pennsylvania Physical Activity and Nutrition State Plan, which includes strategies for improving
nutrition and physical activity in schools, worksites, and communities.


Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                      Section 2

Pennsylvania Dietetic Association (PDA): www.eatrightpa.org
The Pennsylvania Dietetic Association, a chapter of the American Dietetic Association, is the advocate of the
dietetics profession serving the public through the promotion of optimal nutrition, health and well being. The
organization has nearly 3400 members throughout the Commonwealth of Pennsylvania.

Harvard Health Publications: www.health.harvard.edu
A range of health issues are discussed in the various publications offered on this site. Articles are comprehensive
yet clearly written and provide careful explanations of medical terminology.

Hope Health: www.hopehealth.com
Order newsletters, brochures, calendars, and pamphlets on this site. Articles include information on general
health, nutrition, physical activity, and more.

HEALTHBREAK, Inc.: www.healthbreakinc.com
HEALTHBREAK, Inc. is a health promotion company that provides consulting, wellness program management,
and fitness center management services.

Institute for Health and Productivity Management: www.ihpm.org
The Institute for Health and Productivity Management is a nonprofit corporation that promotes the relationship of
employee health to workplace productivity.

Employment Law Information Network
http://www.elinfonet.com/blog/index/workplace_wellness/Establish_on-
site_fitness_rooms_or_exercise_facilities/
Employment Law Information Network offers a variety of services from health risk appraisals to full scale fitness
center management. Many resources can be found on this site.

Life-Span Wellness: www.lindyspharmacy.com/wellness.htm
This site includes information on preventive screening services offered by Life-Span Wellness. It also includes an
extensive health library with information on health conditions, body systems, vitamins, minerals, herbs, and
homeopathy.

Mayo Clinic: www.mayoclinic.org
The Mayo Clinic is a nonprofit organization that provides patient care through integrated clinical practice,
education, and research.

Med-Well, Inc.: www.medwellinc.com
The Med-Well Corporate Wellness Program offers a variety of services including seminars, on-site health fairs,
blood chemistry profiles, remote online access health risk appraisals, and more.

National Institutes of Health (NIH): www.nih.gov
This site provides health information on a variety of topics including nutrition and physical activity.

Oakstone Wellness Publishing: www.oakstonewellness.com
The Top Health newsletter can be offered in print format, in Spanish, and customized with a company’s logo.
Topics include physical activity, anger management, stress relief, and smoking cessation.

Occupational Health Strategies: www.healthyself.org/handbook1.htm
Occupational Health Strategies publishes the Handbook of Health Assessment Tools, a resource to assist health
professionals in selecting and implementing health assessment tools.

Penn State Cooperative Extension, Luzerne County: http://luzerne.extension.psu.edu/
Penn State Cooperative Extension, Luzerne County provides local residents with research based information
through educational programs, publications and events.



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                      Section 2

Shape Up PA: http://www.keystonegames.com/shapeuppa.htm
Shape Up PA, a program of the Keystone State Games, is a health and wellness program whose goal is to
encourage Pennsylvanians to develop nutritional eating habits and increase physical activity through teamwork
and friendly competition in effort to combat the state’s growing obesity problem.

StayWell: www.staywell.com
The StayWell companies provide publications, educational materials, training programs, and web-based services
to assist health care professionals in reaching consumers.

Steps To A Healthier Luzerne County:
http://www.stepstoahealthierluzernecounty.org/
Steps To A Healthier Luzerne County is established to help area residents live longer, better, healthier lives by
reaching them where they live, work and go to school.

Summex Corporation: https://www.summex.com/
This site offers a variety of Health Risk Appraisals and other population health risk management tools for
worksites.

Think Light: www.thinklight.com
Think Light! Is a weight management/healthy eating program. This low-cost kit includes a variety of educational
materials, recipes, menus, and meal planning ideas.

Tufts University Health and Nutrition Letter: www.healthletter.tufts.edu
This Tufts University publication includes reliable health and nutrition information based substantially from the
research and expertise of Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy.

Wellness Councils of America: www.welcoa.org
This nonprofit membership organization promotes healthier lifestyles through health initiatives at the worksite and
serves as a national clearinghouse and information center on worksite wellness.

Wellsource: www.wellsource.com
This site includes a number of resources for worksite wellness programs including an Online Wellness Center,
Coronary Risk Profile Online, disease management tools, and WellAssured® Guides.

Wyoming Valley Wellness Trails Partnership: http://www.wvwellnesstrails.org/index.html
The Wyoming Valley Wellness Trails Partnership is a collaboration to promote active living in our Pennsylvania
community.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                             Section 3




             Section 3: Physical Activity
             Explore opportunities for increased physical activity.

             Action Steps:

                    1. Support physical activity breaks during the workday, such as
                       stretching or walking.
                          Cost= $; Time=

                    2. Implement incentive-based programs to encourage physical activity,
                       such as pedometer walking challenges.
                          Cost= $$; Time=

                    3. Host “walk-and-talk” meetings.
                          Cost= $; Time=

                    4. Post motivational signs at elevators and escalators to encourage stair
                       usage.
                          Cost= $; Time=

                    5. Offer flexible work hours to allow for physical activity during the day.
                          Cost= $; Time=

                    6. Support recreation leagues and other physical activity events (on-site
                       or in the community)
                          Cost= $; Time=

                    7. Offer on-site fitness opportunities, such as group classes or personal
                       training.
                          Cost= $$$; Time=

                    8. Provide incentives for participation in physical activity and/or weight
                       management/maintenance activities.
                          Cost= $$; Time=

                    9. Explore discounted memberships at local health clubs, recreation
                       centers, or YMCA’s.
                          Cost= $$; Time=

             Key:
                        Cost =                     Time =
                        $    = Minimum                  = Minimum
                        $$ = Moderate                   = Moderate
                        $$$ = Maximum                   = Maximum




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                             Section 3




1
     Support physical activity breaks during the workday, such as
     stretching or walking.

Why: Stretch breaks, also known as active breaks, micro breaks or mini breaks, will help reduce
muscle tension caused when muscles remain static or fixed in one position for too long. When
remaining static, muscles fatigue more easily, circulation decreases, you become uncomfortable, and
tasks become more difficult. Stretching can help relieve discomfort due to repetitive movements,
awkward postures, and excessive force.

Repetitive Strain Injury occurs from repeated physical movements, doing damage to tendons, nerves,
muscles, and other soft body tissues. Occupations ranging from meatpackers to musicians have
characteristic Repetitive Strain Injuries that can result from the typical move they make. The rise of
computer use and flat, light-touch keyboards that permit high speed typing have resulted in an epidemic
of injuries of the hands, arms, and shoulders.

Four factors are associated with the development of Repetitive Strain Injury:
       Force
       Posture
       Repetition
       Insufficient rest

The human body has great recuperative powers, given the opportunity to repair itself. Regular
incorporation of stretch breaks throughout the day not only helps to avoid Repetitive Strain Injury, but
may help improve alertness and decrease fatigue.


How:
       Stretch breaks can be self-initiated or formally led by an instructor.
       Employees can schedule their own breaks in Outlook software or by email calendar.
       Software is available that will automatically notify you when it’s time for a break and will lead you
       through some exercises.
       Hang posters of stretching exercises on the walls for people without Internet access.
       Incentive programs can also be incorporated.

Instructor led-format:
        Include stretching, strength exercises, walking, or relaxation techniques in instructor-led
        activities.
        Keep sessions to 5-15 minutes in length.
        Offer stretch breaks 2-3 times per week depending on managerial approval.

The program design is intended to be:
       Convenient: instructor goes to the worksite area and usually uses a conference room.
       Flexible: days and times are set up to accommodate employee work schedules.
       Adaptable: customized sessions are provided for each group; i.e. stretching vs. walking vs.
       relaxation tapes vs. strength exercises with or without prop use vs. mini massage or a
       combination of all of the above.
       Informational: discussions regarding health awareness including self-care, nutrition, physical
       activity, stress management, safety, etc.



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                            Section 3

Use resources within the corporation for design and implementation. Resources can include:
       Physical therapy
       Massage therapy
       Risk management
       Safety and ergonomics

Assessment methods for workday physical activities:
      Attendance
      Evaluations (participants and managers)
      Workers’ compensation claims
      Initial assessment (flexibility, blood pressure, etc.) can be taken with a follow-up to determine
      program effectiveness.

Resources:
      Park Nicollet: www.healthsource.org
      Take A Break posters and Two-sided laminated cards featuring stretching and strengthening
      Exercises
      Power Pause: www.possibility.com/PowerPause/
      Yoga Everywhere: http://yogaeverywhere.com/home.html




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                           Section 3




2
     Implement incentive-based programs to encourage physical activity,
     such as pedometer walking challenges.


Why: Research shows that incentive-based programs help employees to maintain positive change.
Encouraging employees to add physical activity to their day can help them make permanent lifestyle
changes.


How: Depending on a company’s budget, an incentive-based program can be small or large. Program
planners should consider that employees with all levels of physical fitness will be participating and that
prizes may be offered for different levels of effort. Prizes can be awarded to all those who successfully
complete the program or on a raffle basis.

A sample program might consist of a 12-week walking challenge in which employees wear a
pedometer, track steps, and get prizes for most steps per day, week, or month. Another option would
be to have employees keep track of their physical activity on a score card or tracking sheet.
Employees would then get “points” for participating in various types of physical activities (walking,
dancing, swimming, biking, gardening, strength training, stretching, etc.).

For more information on a sample incentive-based program
Sample incentives:
      Gift certificates to sporting goods stores, health food stores, or a massage therapist
      Company “Dollars” to use towards benefits such as flex spending or annual leave
      Water bottles
      Pedometers
      T-shirts
      Workout bags
      Lunch bags
      Cookbooks
      Workout journals

Resources:
      Fitness on the Job: http://www.fitnessonthejob.com
      Health Enhancement Systems: www.hesonline.com
      National Association for Health and Fitness: www.physicalfitness.org/nehf.html
      Shape Up PA: http://www.keystonegames.com/shapeuppa.htm
      Wellness Councils of America: www.welcoa.org
      Wyoming Valley Wellness Trails Partnership: http://www.wvwellnesstrails.org/index.html




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 3




3
     Host “walk-and-talk” meetings.


Why: The 1996 Surgeon General’s Report on Physical Activity and Health reported for the first time
that small bouts of physical activity accumulates towards the daily goal of 30 minutes of moderate
intensity physical activity. Physical activity has been shown to improve a person’s mood, decrease
stress and depression, and increase creativity.

How: When planning a meeting with a small number of participants, suggest a walking meeting. Be
sure to ask meeting participants if this works for them, and keep in mind that not all meetings are
appropriate to do this. When the agenda is mostly talking, not writing, and there are only a few
attendees, consider a “walk-and-talk” meeting.

Pick a location to meet and then “walk-and-talk”. Suggestions for walking locations include:
        Hallways
        Around the building
        Outside the building
        Around parking lots
        Nearby parks or walking trails
        Other safe locations close to the worksite

Resources:
      Centers for Disease Control and Prevention: www.cdc.gov/nccdphp/sgr/sgr.htm
      1996 Surgeon General’s Report on Physical Activity and Health




Steps To A Healthier Workforce in Luzerne County
   Worksite Wellness Kit                                                                             Section 3


        Post motivational signs at elevators and escalators to encourage
   4    stair usage.


   Why: Taking the stairs regularly is a promising intervention for increasing physical activity. Deciding
   between using the stairs and using an elevator or escalator is a lifestyle choice that often occurs daily.
   Using the stairs requires little or no additional cost because the building codes require stairs.

   How: Posting motivational signs at points-of-decision around a building is important in encouraging
   people to use the stairs. However, messages and artwork that are motivating to one audience may be
   a turn off to another, which is why it is important to test them with members of your audience first.
   Whether the messages are inspirational, factual, health-related, or humorous, find out what motivates
   your audience and tailor your messages and artwork accordingly.

          Put the signs next to the elevator buttons at eye-level or in a place where elevator and escalator
          users will easily see them as they approach.
          Vary the messages from time to time to keep people reading and interested.
          Post the first sign at all elevator sites for a week or two. Periodically post new signs.
          Consider doing a survey before posting the signs to find out how often people use the stairs.


Resources:
         Centers for Disease Control and Prevention:
         www.cdc.gov/nccdphp/dnpa/stairwell.index.htm
          StairWELL to Better Health Project




   Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                       Section 3




5
     Offer flexible work hours to allow for physical activity during the day.


Why: Your corporate physical activity strategy needs to reflect and compliment your corporate plan-
matching you goals, objectives, needs, and resources.

Employees who do physical activity on a regular basis make up a more fit and healthy workforce. The
benefit is having a workforce that is more efficient and loses fewer days from illness and stress.
Individuals improve their self-esteem, increase their personal satisfaction, have less psychological
stress, can relax more easily, and show greater mental alertness.

Having flexible work hours allows employees to participate in specific physical activities before work,
during the lunch hour, or during the work day.

How:
        Assist management in developing a corporate policy statement supporting flexible work hours
        and distribute it to all managers and staff.
        Define supervisory responsibilities in the policy for approving work hour flexibility for physical
        activity while maintaining staff coverage and workflow.
        Offer flexible working hours allowing people to arrive at work a little later or leave a little earlier
        to help them add physical activity to their day
        Provide and maintain male and female locker rooms that will support employees in midday
        physical activity. Lockers rooms could include showers, hair dryers, towels, etc.


Resources:
Sample policy for providing rental lockers:
(Ideas for defining a policy for providing employee lockers should include rental fees and locker sizes.)

Lockers may be rented for a quarter and include a combination lock; no outside locks will be allowed. Belongings
must be removed from rental lockers by the last week of each quarter. Belongings must be removed from rental
lockers by the last week of each quarter. Belongings left in the locker and/or locker room after the end of the
rental period will be put into Lost and Found for a period of two weeks. If not claimed in that time, they will be
donated to local charitable organizations.

Sample policy statement from former Utah Governor Mike Leavitt:

“I urge you and your employees to attend the Healthy Utah Lifestyle Assessment and Wellness Connection
workshops…I would like to remind you that worksite health promotion programs can increase employee morale,
decrease absenteeism, lower medical utilization rates and, most importantly, increase our employees’ chances of
living healthy and productive lives…In order to encourage maximum employee participation resources, I will
support these programs by approving three hours release time for participating employees. I also urge you to
support additional health promotion programs in your departments throughout the year.”




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                            Section 3




6
     Support recreation leagues and other physical activity events (on-
     site or in the community).

Why: When a company sponsors outside sports competitions, it feeds employees’ desire to play the
game and win. At the same time, the company provides a way for employees to manage stress or
frustration in a non-threatening environment and gives them opportunities to win that they may not have
in their jobs.


How:
Recreation League
        Sponsorship of outside sports leagues may be the company’s best route since the least amount
        of organizational support is required. Local city and county organizations run leagues for a
        variety of activities such as softball, bowling, tennis, volleyball, etc. Usually the company can
        pay a team fee, as well as individual fees. Coworkers get together outside the business at least
        once a week for physical activity and team building.

Activities/Events
        Host a golf league or day tournament, in which employees, their families, customers, and
        suppliers can participate. Designate a schedule and place for the league. Participants pay their
        own course fees or co-pay depending on budget allotted. The company can provide the prizes.
        Everybody benefits from this program. The company gets advertising and publicity, and
        participants have some relaxing fun.
        Recognize National Employee Health and Fitness Day by sponsoring an event such as a 5K fun
        run/walk. This event can be held at lunch with a course mapped out and a few scheduled
        activities, such as a raffle for participant, a pre-stretch, or a post-stretch. The local newspaper
        and/or radio station could be invited to cover the event.
        Sponsor a team in a benefit day race. A group of coworkers can all participate at their level of
        ability. The event sponsors encourage team participation and provide team prizes and
        incentives.


Resources:
      Active: www.active.org
      American Cancer Society: www.cancer.org
      American Diabetes Association: www.diabetes.org
      American Heart Association: www.americanheart.org
      Pennsylvania Recreation and Park Society: www.prps.org
      National Association for Health and Fitness: www.physicalfitness.org/nehf.html
      Wyoming Valley Wellness Trails Partnership: http://www.wvwellnesstrails.org/index.html




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                Section 3




7
     Offer on-site fitness opportunities, such as group classes or
     personal training.

Why: The benefits of on-site fitness opportunities include:
      Increased employee satisfaction and health
      Informal building of company networks
      Increased employee engagement and energy
      Building of positive company culture
      Potential reduction in overall healthcare costs
      Potential reduction in employee absences

On-site fitness opportunities can include:
       Group fitness classes led by an instructor
       Group fitness classes following a fitness video
       Dedicated room with fitness basics such as stretching mats, exercise balls, small hand weights,
       exercise videos, a TV, VCR or DVD player, etc.
       On-site shower facilities


How:
NOTE: It is strongly recommended that you read the following book before creating any on-site fitness
opportunities: ACSM’s Health/Fitness Facility Standards & Guidelines, Second Ed., American College
of Sports Medicine, 1992
        Survey employee population to ascertain desired videos and/or classes.
        Work with employer to find an appropriate existing space such as a conference or meeting
        room.
        Partner with a local health club for fitness class ideas and for qualified instructors. See
        Appendix C for more detailed information on instructor credentials.
        Purchase TV, VCR or DVD player, and fitness videos.
        Research potential liability issues.
           o Contract your employer’s legal department regarding participant waivers, necessary
               insurance, and any other liability concerns.
           o See Appendix C for more detailed information on liability issues.
       Provide shower facilities for employees who want to bicycle/run to work or exercise over the
       lunch hour.
       Provide bike racks or other bike storage facilities.


Resources:
      American Council on Exercise: www.acefitness.com
      Ball Dynamics: www.balldynamics.com
      Collage video: www.collagevideo.com
      Fitness Wholesale: www.fwonline.com
      Human Kinetics: www.humankinetics.com
       Health Fitness Management, A Comprehensive Resource for Managing and Operating
       Programs and Facilities, by William C. Granthan/Robert W. Patton/Tracy D. Your/Mitchel L. Winick,
      1989.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                             Section 3




8
     Provide incentives for participation in physical activity and/or
     weight management/maintenance activities.

Why: Most wellness programs are designed to change a health behavior such as increasing physical
activity or losing weight. Health behavior is difficult to change, and therefore, wellness program
coordinators must recognize that people often need external motivators and reasons to change.
Incentives generate interest in the wellness program, offer rewards for changed behavior, and promote
the company’s belief in and commitment to wellness.

Incentives are useful and effective because of their direct impact on the universal human need for
personal recognition and reward. An incentive is “an anticipated positive or desirable reward designed
to influence the performance of an individual or group.” By reinforcing behaviors and rewarding results,
successful program outcomes can be achieved. Among other things, incentives can be expected to: 1)
increase program participation and completion rates, 2) provide a purpose for participants to make
health behavior changes, and 3) improve long-term adherence to a behavior.

How: In order for an incentive to be effective, the participant needs to find it desirable and worth the
effort. Finding out what incentives motivate your participants can be accomplished in many ways
including preference surveys, focus groups, structured interviews, pilot testing different incentives with
small groups, or just randomly asking key people what they think.

Experts recommend that incentives be kept as small as possible while achieving program goals. Small
but effective incentives are always more cost-effective. Smaller external incentives are more likely to
help individuals internalize their new behaviors and maintain them over the long term without ongoing
external rewards. The bottom line is that participation rates will increase if an incentive is offered.

Types of incentives can be categorized as follows:
      Achievement awards. Verbal praise and a pat on the back are motivational to some, but a
      token of recognition of achievement may offer more. A colorful certificate to congratulate an
      employee for achieving a health-related goal is one example.
      Public recognition. Most people love to see their names in print. Publish the names of
      wellness program participants in your employee newsletter. This will honor the employees who
      have attempted to make positive lifestyle changes and can motivate others to do the same.
      Merchandise. Award a t-shirt, canvas bag, cap, or an AM/FM radio to participants who sign up
      and/or complete a program. Your company logo may be imprinted on these items as well.
      Monetary rewards. Offer an employee $10 for completing a wellness program. Discount
      health insurance premiums for participants. Reimburse employees for attending a health-
      related educational training seminar.
      Food. Offer beverages and healthy snacks to employees who participate in on-site wellness
      programs. Use gift certificates to a local restaurant as door prizes.
      Entertainment. Hold a drawing for movie tickets, sporting events tickets, or fitness store gift
      certificates for participants of wellness programs.
      Time off. Allow employees to take an extended lunch break or a half-day of leave for
      completing a long-term, company-sponsored wellness program.

Resources:
      Summex Corporation: www.summex.com
        Using Wellness Incentives-Positive Tools for Healthy Lifestyles




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                         Section 3




9
     Explore discounted memberships at local health clubs, recreation
     centers, or YMCAs.

Why: Discounted memberships encourage employees to start regular physical fitness programs,
allowing them to save money. By participation, they can build outside relationships with co-workers,
relieve stress, and get rewarded for maintaining a good level of physical fitness.

Discounted memberships are also a good alternative to creating an on-site fitness facility.

How:
       Contact individual health clubs (commercial fitness centers, fee-based, nonprofit agency fitness
       centers, and hospital-affiliated fitness/wellness centers) to inquire about corporate rate
       packages.
       Evaluate which clubs participate in company discounts and offer the best programs and
       amenities.
       Try to find a program that extends the discount to family members.
       Provide the human resources department with all of the information.
       Create a menu of fitness centers for employees to use as a resource.
       Promote the program/discount to employees.

Resources:
      Luzerne County Parks and Recreation:
      http://www.luzernecounty.org/living/recreational_resources
      Pennsylvania Recreation and Parks Society: www.prps.org


Other Resources:
       Local YMCA’s: www.ymca.net
       Health Clubs/Fitness Centers




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                           Section 3


Section 3: Website resource descriptions
Active: www.active.com
This site provides a calendar of events including individual and team sports and park and community events in
every state.

American Cancer Society (ACS): www.cancer.org
This site provides information about different types of cancer, prevention, and treatment options. The American
Cancer Society dietary guidelines and common questions about cancer and diet are covered.

American Council on Exercise (ACE): www.acefitness.org
The nonprofit fitness certification and education provider is widely recognized as “America’s Authority on Fitness.”
The American Council on Exercise continually sets standards and protects the public against unqualified fitness
professionals and unsafe or ineffective fitness products, programs, and trends.

American College of Sports Medicine (ACSM): www.acsm.org
The American College of Sports Medicine advances and integrates scientific research to provide educational and
practical applications of exercise science and sports medicine. This site contains health and fitness information
on aerobic activity, strength training, and stretching.

American Diabetes Association (ADA): www.diabetes.org
This site has two home pages, one for professionals and one for laypersons, which provide a comprehensive
resource on diabetes.

American Heart Association (AHA): www.americanheart.org
The American Heart Association is a national voluntary health agency whose mission is to reduce death and
disability from cardiovascular disease and stroke. Information on health, physical activity, nutrition, and
overweight/obesity can be found on this site.

Ball Dynamics: www.balldynamics.com
This site provides information on using exercise balls and on on-line catalog for ordering FitBall Products,
exercise bands, workout videos, and more.

Centers for Disease Control and Prevention:
http://www.cdc.gov/nccdphp/dnpa/hwi/toolkits/stairwell/index.htm Stair WELL to Better Health Project
www.cdc.gov/nccdphp/sgr/sgr.htm 1996 Surgeon General’s Report on Physical Activity and Health

Collage Video: www.collagevideo.com
This site sells videos for all types of physical activity including aerobic fitness, strength training, stretching, yoga,
Pilates, intervals, etc.

Fitness on the Job: http://www.fitnessonthejob.com
Fitness solutions for business; organization located locally in NEPA. Provides fitness programming matched to
an organization’s goals, budget and space.

Fitness Wholesale: www.fwonline.com
This site sells a variety of fitness equipment including books, music, videos, posters, hand weights, tubing,
exercise bands, fitness balls, stretching mats, and more.
Health Enhancement Systems: http://www.hesonline.com/
This site provides information on health promotion programming, and incentive-based programs including 10K A
Day and Colorful Choices.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                       Section 3

Human Kinetics: www.humankinetics.com
Human Kinetics produces textbooks, consumer books, software, videos, journals, and distance education for
teachers, coaches, researchers, sports participants, and fitness enthusiasts.

Luzerne County Parks and Recreation: http://www.luzernecounty.org/living/recreational_resources
Provides area information on state parks, hiking, golf, skiing and other recreation activities offered in and around
Luzerne County.

Moving into Action: Promoting Heart-Healthy and Stroke-Free Communities, CDC:
http://www.cdc.gov/dhdsp/library/moving_into_action/order.htm
Series of action items to help governors, state legislators, local officials, employers, and health care leaders
promote heart-healthy and stroke-free communities.

National Association for Health and Fitness: www.physicalfitness.org/nehf.html
This site describes the benefits for employers and employees in beginning worksite wellness initiatives. It also
provides information on National Employee Health and Fitness Month and programs available for worksites
including Let’s Get Physical 2003 and Make Your Move!

Park Nicollet: http://www.parknicollet.com/healthsource/index.cfm
This site sells a variety of health publications as well as worksite services such as consultation, fitness center
management, and health risk assessments.

Pennsylvania Recreation and Parks Society: www.prps.org
The Pennsylvania Recreation and Park Society (PRPS), founded in 1935, is the principal organization promoting
quality recreation and park opportunities for all citizens of the Commonwealth through education, training,
technical assistance and other support to local, county, state and federal recreation and park providers.

Power Pause: www.possibility.com/PowerPause/index.html
For $10 a month, this site will automatically prompt you to take a stretch break. The program also leads you
through a variety of stretches.

Promoting Physical Activity: A Guide for Community Action, CDC:
http://www.cdc.gov/nccdphp/dnpa/pahand.htm
A guide to promote physical activity with target populations in environments in which people live and work.

Summex Corporation: www.summex.com/
This site offers a variety of Health Risk Appraisals and other population health risk management tools for
worksites.

Wellness Councils of America: www.welcoa.org
This nonprofit membership organization promotes healthier lifestyles through health initiatives at the worksite and
serves as a national clearinghouse and information center on worksite wellness.

Wyoming Valley Wellness Trails Partnership: http://www.wvwellnesstrails.org/index.html
The Wyoming Valley Wellness Trails Partnership is a collaboration to promote active living in our Pennsylvania
community. “A New You” resource guide for physical activity in Luzerne County and Keystone Active Zone
Passport Campaign.

YMCA: www.ymca.net
The largest not-for-profit community service organization in America, working to meet the health and human
service needs of 20.2 million men, women and children in 10,000 communities in the United States.

Yoga Everywhere: http://yogaeverywhere.com
This site provides a variety of information on yoga including yoga exercises, teachings, teaching directory,
vacations, merchandise, and more.



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 4




             Section 4: Healthful Eating
             Explore opportunities for healthful eating.

             Action Steps:

                    1. Offer appealing, low-cost, healthful food options, such as fruits and
                       vegetables, juices, and low-fat dairy products on-site such as; in
                       vending machines, snack bars, break rooms, and/or cafeterias.
                          Cost= $; Time=

                    2. Promote the adoption of Fruits & Veggies-More MattersTM concepts in
                       catering/cafeteria policies.
                          Cost= $; Time=

                    3. Offer healthful food alternatives at meetings, company functions, and
                       health education events.
                          Cost= $; Time=

                    4. Post motivational signs about Fruits & Veggies-More MattersTM ,
                       nutrition, and healthful eating in the cafeteria.
                          Cost= $; Time=

                    5. Make water available throughout the day.
                          Cost= $; Time=

                    6. Provide protected time and dedicated space away from the work area
                       for breaks and lunch.
                          Cost= $$; Time=

                    7. Make refrigerators available for employees’ food storage.
                          Cost= $$; Time=

                    8. Provide incentives for participation in nutrition and/or weight
                       management/maintenance activities.
                          Cost= $$$; Time=


             Key:
                        Cost =                     Time =
                        $    = Minimum                  = Minimum
                        $$ = Moderate                   = Moderate
                        $$$ = Maximum                   = Maximum




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 4

     Offer appealing, low-cost, healthful food options, such as fruits and

1    vegetables, juices, and low-fat dairy products on-site such as; in
     vending machines, snack bars, break rooms, and/or cafeterias.

Why: Offering appealing, low-cost, healthful food options at the worksite is one way to promote
healthful eating to employees. Vending machines are a quick and convenient way for employees to
purchase these types of food. If cafeterias or snack bars are not available, vending machines may be
the only option for employees to purchase foods and beverages.

How: Here is one example of how to get healthful food options at the worksite.
  Step 1: Identify employee representative (s) to assess the need and interest in changing vending
  machine offerings.
  Step 2: Conduct a vending machine inventory asking employees to determine their interest in
  having healthful foods available in machines. Identify preferences for vending machine items such
  as fruits, vegetables, milk, water, energy bars, pretzels, etc.
  Step 3: Identify worksite staff that deal with vending companies. Identify the date of the vending
  machine contract renewal and schedule your plans to initiate changes with vending machine
  companies several months in advance of this renewal date.
  Step 4: Meet with a vendor representative to:
                                                           TM
               Explain the Fruits & Veggies-More Matters campaign (i.e. focus on environmental
               changes at work to facilitate dietary change); share the program guidelines.
               Share the results of the survey that support employees’ desire for healthful food options
               with the vendor.
               Provide the vending company with suggestions for healthful food choices and determine
               which are appropriate to include.
               Seek permission from the vendor to label fruit and vegetable products with nutrition
               information on the vending machine.
               Explore opportunities for reducing the cost of healthful food options.

    Step 5: Recruit employee representatives to publicize and promote the healthful changes in
    vending options.
              Post signs near the vending machines encouraging the purchase of new products; place
              labels on the machines that indicate healthful choices and provide nutrition education.
              Continue to publicize the offerings; monitor and maintain labels and signs; and track
              sales of healthful food items.

Another option to make fruits and vegetables more readily available would be to create a Garden
Market or partner with local farmer(s) to hold a farmer’s market on-site.

Resources:
      Healthy Vending: www.healthyvending.com
      Produce for Better Health: http://www.pbhfoundation.org or
      www.fruitsandveggiesmorematters.org
      Working Well Works: www.tompkinsco.org/wellness/worksite/
      CDC’s Healthier Worksite Initiative- Nutritious Eating Toolkits and Garden Market:
      http://www.cdc.gov/nccdphp/dnpa/hwi/toolkits/index.htm
      & http://www.cdc.gov/nccdphp/dnpa/hwi/toolkits/gardenmarket/index.htm




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                            Section 4




2
     Promote the adoption of Fruits & Veggies-More MattersTM in
     catering/cafeteria policies.


Why: Nutrition experts currently recommend that Americans eat, 2-6 cups of fruits and vegetables a
day. Americans should include fruits and vegetables with a spectrum of colors: red, yellow/orange,
blue/purple, white, and green, since they contain a variety of healthful antioxidants. Diets that are high
in vitamins A and C and fiber may reduce risk of chronic diseases. Fruits and vegetables are rich
sources of these nutrients. People who eat more than 2 cups of fruits and vegetables daily have half
the risk of developing cancer as those who eat less than 2 cups per day. Thirty-five percent of all
cancer deaths may be related to poor dietary habits.
                                                                            TM
How: Here are some ways to promote the Fruits & Veggies-More Matters campaign:
                                                 TM
     Promote Fruits & Veggies-More Matters           month/week in September.
     Host an employee health fair and include information on fruits and vegetables.
     Involve cafeterias and vending companies in promoting fruits and vegetables.
     Give Farmers’ Market coupons as employee recognition awards.
     Hold cooking demonstrations using fruits and vegetables.
                                             TM
     Write Fruits & Veggies-More Matters         articles for your corporate newsletter.
                                                                                      TM
     Solicit articles, recipes, and events related to Fruits & Veggies-More Matters      from employees
     for your newsletter.
     Develop policies on having fruits or vegetables served at all worksite meetings where food is
     offered.

Resources:
      About Produce: www.aboutproduce.com
      American Cancer Society: www.cancer.org
      Penn State Cooperative Extension, Luzerne County: http://luzerne.extension.psu.edu/
      Pennsylvania Dietetic Association: http://www.eatrightpa.org
      National Cancer Institute: http://www.cancer.gov
      Produce for Better Health: http://www.pbhfoundation.org or
      www.fruitsandveggiesmorematters.org




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                         Section 4


                Fruits & Veggies-More MattersTM in the Workplace
Bag Lunch

      Add vegetables such as spinach, tomatoes or peppers to your sandwich.
      Add a piece of fruit to your lunch. Carry soft fruit in a plastic container to prevent squishing.
      Have sliced vegetables instead of chips. Keep a container of vegetables ready to go on the top
      shelf of your refrigerator or buy pre-cut veggies.
      Bring leftover salad or cooked vegetables and dress lightly with salad dressing

Cafeteria or Restaurant

      Have a bowl of vegetable or bean soup with your meal.
      Pile up those vegetables at the salad bar.
      Choose entrees with vegetables at the salad bar.
      Ask if you can replace French fries or breads with salad, tomato slices, or a vegetable side dish.
      Top off your pizza with lots of healthful fruits and vegetables.

Fast Food Restaurant

      Choose a restaurant that has a salad bar or serves other fruits and vegetables.
      Ask for orange juice instead of soda pop.
      Replace French fries with a baked potato, salad, corn on the cob, coleslaw, or beans.
      Have some fruit or juice when you return to work.

Snacks

      Eat trail mix loaded with dried fruit.
      Try a V8 drink.
      Have some pre-cut vegetables or fruit and dip.
      Eat a piece of fruit, the original grab-and-go food.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                            Section 4




3
     Offer healthful food alternatives at meetings, company functions,
     and health education events.

Why: By offering healthful food choices at company meetings and functions, employees have
increased opportunities for making healthy food choices at work that, in turn, benefit their health. Also,
offering healthy food choices and alternatives at company functions shows employees that their
employer cares about their health and well-being.

How: Here is a list of suggestions for healthful meals and snacks:

Breakfast meetings
      Fruit and/or 100 percent fruit juices
      Whole grain cereal and low-fat milk
      Low-fat yogurt
      Whole grain bagels and reduced-fat cream cheese
      Whole grain English muffins

Lunch Meetings
      Baked chicken with vegetables and brown rice
      Pasta with vegetables
      Box lunches: sandwiches with fruit
      Veggie pizza
      Vegetable soups
      Green salads
      Bean and veggie burritos
      Lean meats

Afternoon or mid-morning meetings
       Fruit: apples, oranges, grapes, raisins, 100 percent juice
       Sliced vegetables with low-fat dip or hummus
       Low-fat milk or yogurt
       Pretzels
       Nuts, trail mixes
       Baked tortilla chips with salsa
       Reduced-fat crackers, graham crackers, animal crackers
       Air-popped popcorn

Resources:
      American Cancer Society: www.cancer.org
       Meeting Well: A Tool for Planning Healthy Meetings and Events
       Healthy Eating and Active Living in Northern British Columbia: http://healbc.ca/work.htm
       Prevention Institute: www.preventioninstitute.org/CHI Workplace.html
       University of Minnesota School of Public Health:
       www.ahc.umn.edu/ahc content/colleges/SPH/index.cfm
       Guidelines for Offering Healthy Foods at Meetings, Seminars, and Catered Events
       Working Well Works: www.tompkinsco.org/wellness/worksite/




Steps To A Healthier Workforce in Luzerne County
   Worksite Wellness Kit                                                                        Section 4


        Post motivational signs about Fruits & Veggies-More MattersTM,
   4    nutrition, and healthful eating in the cafeteria.


   Why: Motivational signs can act as both a reminder and decision prompt when posted in a cafeteria.
   Encouraging healthful eating near the point-of-purchase of foods can influence decisions. Signage
   posted in various locations presents reminders for on and off-site eating habits. Good nutrition has
   been linked to improved heath and increased energy.

   How:
          Motivational signs can be posted in a variety of places. Unconventional locations usually have
          more impact. Examples are trash cans, walls, ceilings, vending machines, and restroom doors.
          Don’t limit your signage to the cafeteria. Post signs in other places such as break rooms,
          hallways, elevators, restrooms, etc.
          Posters are not the only possibility. Try making table tents, window signs, flyers, or hanging
          displays. Laminating the information helps to keep it in good shape longer. Depending on the
          size/type, framing or mounting on foam core also lengthens the life of the sign and adds to the
          professionalism of the message.

Resources:
         CDC’s Fruits and Veggies Matter Campaign: www.fruitsandveggiesmatter.gov
         Fitness Wholesale: www.fwonline.com/charts.htm
         Produce for Better Health: www.pbhcatalog.com or www.fruitsandveggiesmorematters.org
         Project Lean: www.californiaprojectlean.org/popups/pdfs/lowfatposter.pdf
         United States Department of Agriculture/Center for Nutrition Policy and Promotion:
         www.usda.gov/cnpp/
          Food Guide Pyramid and Dietary Guidelines




   Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                             Section 4




5
     Make water available throughout the day.


Why: Drinking water is essential for keeping your body functioning normally and preventing
dehydration. Water, one of the most important and often overlooked nutrients, plays many roles in
body processes. Water regulates body temperature, transports nutrients to cells, carries waste
products away, helps cushion joints, protects, organs and tissues, and helps in weight loss efforts.

Dehydration, the loss of body water, can have a detrimental effect. Dehydration can begin as thirst, but
can quickly progress to effects such as fatigue, headache, dizziness, weakness, and delirium, and in
the worst case, even death. It is always important to drink water regularly. It’s even more important
when being physically active.

Water is a great alternative to soda and high-calorie beverages that offer little nutritional value. Many
vending machines in the workplace are fully stocked with soda and sugar-filled beverages. Providing
water at company functions and making it more available and visible to employees may help them
choose water more often.

How:
       Educate employees about the importance of water and hydration through the company
       newsletter, emails, and posters/table tents in the cafeteria or around the building.
       Incorporate the message of drinking more water into existing health and fitness programs
       offered in the worksite. Encourage employees to set goals to drink more water along with other
       health and fitness goals.
       Make water available through water fountains and water coolers in break rooms, hallways, and
       lobbies. If budgetary constraints do not allow for purchase of water, initiate a program to get
       employees to contribute a small monthly donation that would fund bottled drinking water.
       Serve bottled water or water from pitchers at staff meetings as an alternative to coffee and
       soda. Try adding lemons and/or limes; toss in some fresh mint leaves; or mix in a bit of orange
       juice to add variety.
       Make water available in vending machines. Discuss with the vending representative the
       potential for adding water to the beverage inventory.

Resources:
      MEDLINEplus: www.nlm.nih.gov/medlineplus/ency/article/000982.htm
       Preventing Dehydration




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                           Section 4




6
     Provide protected time and dedicated space away from the work
     area for breaks and lunch.

Why/How: Having protected time and space for breaks and lunch helps employees to get away and
re-energize before coming back to work. Pennsylvania employers are required to provide break
periods of at least 30 minutes for minors ages 14 through 17 who work five or more consecutive hours.
Employers are not required to give breaks for employees 18 and over. If your employer allows breaks,
and they last less than 20 minutes, you must be paid for the break. If your employer allows meal
periods, the employer is not required to pay you for your meal period if you do not work during your
meal period and it lasts more than 20 minutes. A collective bargaining agreement may also govern this
issue.

The following is an example of a flextime policy that organizations can implement in order to achieve
protected time for employees to pursue a healthy lifestyle.

Sample flextime policy:
“Employees can adjust their working hours in a flexible manner within a two-week period. The two
timesheets for the pay period must total 80 hours. The additional hours above the 40 hours can be on
either the first or second timesheet. Employees shall post their hours either as positive or negative to
specific accounts.”

Why/Dedicated space: This worksite initiative is well worth it. Consider specifically identifying a break
room and lunch center which reflects healthy lifestyles, personal expression, and encourages “active
breaks”. The defined space-away from the intensity of the work environment-will provide a better,
healthier and more meaningful experience for everyone. Workers will welcome breaks and lunch
periods because the space is so pleasant.

How/Dedicated space: Employees and management can work together to define a policy and assure
its distribution to all employees.

Resources:
      Pennsylvania Department of Labor and Industry:
      http://www.dli.state.pa.us/landi/cwp/view.asp?A=142&Q=61106




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 4




7
     Make refrigerators available for employees’ food storage.


Why: Increasing opportunities for employees to store food safely at work may help them make smart
food choices and save money. Simple modifications such as installing refrigerators in break rooms
allow employees to bring perishable foods such as fruit, yogurt, low-fat milk, and brown bag lunches to
work. Creating space in cabinets and on countertops in break rooms or workrooms also makes it
easier for employees to bring non-perishable foods to work.

How:
        Assess the worksite environment. Determine where it is possible to increase food storage
        space. Identify closet spaces that could house a refrigerator, if no break room exists.
        Arrange a meeting with management and the facilities department to discuss purchasing a
        refrigerator if needed. Research opportunities to allocate funds from other projects or programs
        to cover the cost.
        Find protected spaces for employee food storage such as closets with old filing cabinets that
        could be cleaned and reorganized allowing for extra space.
        Encourage employees to store healthy food choices, such as fruit bowls, in visible locations
        with a great deal of foot traffic, like the top of a filing cabinet or in a corner cubicle.
        Initiate a healthy snack program and enlist the help of a wellness committee or motivated
        employees to administer the program. Individual serving sizes of healthy food choices are non-
        perishable lunches and snacks such a peanut butter on whole grain bread, canned or dried
        fruit, and vegetable juice.
        Organize a lunch club where employees are assigned a specific day or week to make brown
        bag lunches for the group.
        Consider providing insulated lunch bags for employees to keep foods cold throughout the day.

Resources:
      Pennsylvania Department of Health: http://www.dsf.health.state.pa.us/health/site/default.asp
      Penn State Cooperative Extension, Luzerne County: http://luzerne.extension.psu.edu/
      Fight BAC!: www.fightbac.org
      Working Well Works: www.tompkinsco.org/wellness/worksite/




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                             Section 4




8
     Provide incentives for participation in nutrition and/or weight
     management/maintenance activities.

Why: Most wellness programs are designed to change a health behavior such as increasing
consumption of fruits and vegetables or losing weight. Health behavior is difficult to change, and
therefore, wellness program coordinators must recognize that people often need external motivators
and reasons to change. Incentives generate interest in the wellness program, offer rewards for
changed behavior, and promote the company’s belief in and commitment to wellness.

Incentives are useful and effective because of their direct impact on the universal human need for
personal recognition and reward. An incentive may be defined as an anticipated positive or desirable
reward that influences individual or group performance. By reinforcing behaviors and rewarding results,
successful program outcomes can be achieved. Among other things, incentives can be expected to: 1)
increase program participation and completion rates, 2) provide a purpose for participants to make
health behavior changes, and 3) improve long-term adherence to a behavior.

How: In order for an incentive to be effective, the participant needs to find it desirable and worth the
effort. Finding out what incentives motivate your participants can be accomplished in many ways
including preference surveys, focus groups, structured interviews, pilot testing different incentives with
small groups, or just randomly asking key people what they think.

Experts recommend that incentives be kept as small as possible while achieving program goals. Small
but effective incentives are always more cost-effective. Smaller external incentives are more likely to
help individuals internalize their new behaviors and maintain them over the long term without ongoing
external rewards. The bottom line is that participation rates will increase if an incentive is offered.

Types of incentives can be categorized as follows:
      Achievement awards. Verbal praise and a pat on the back are motivational to some, but a
      token of recognition of achievement may offer more. A colorful certificate to congratulate an
      employee for achieving a health-related goal is one example.
      Public recognition. Most people love to see their names in print. Publish the names of
      wellness program participants in your employee newsletter. This will honor the employees who
      have attempted to make positive lifestyle changes and can motivate others to do the same.
      Merchandise. Award a t-shirt, canvas bag, cap, or an AM/FM radio to participants who sign up
      and/or complete a program. Your company logo may be imprinted on these items as well.
      Monetary rewards. Offer an employee $10 for completing a wellness program. Discount
      health insurance premiums for participants. Reimburse employees for attending a health-
      related educational training seminar.
      Food. Offer beverages and healthy snacks to employees who participate in on-site wellness
      programs. Use gift certificates to a local restaurant as door prizes.
      Entertainment. Hold a drawing for movie tickets, sporting events tickets, or fitness store gift
      certificates for participants of wellness programs.
      Time off. Allow employees to take an extended lunch break or a half-day of leave for
      completing a long-term, company-sponsored wellness program.

Resources:
      Health insurance providers
      Summex Corporation: www.summex.com
        Using Wellness Incentives-Positive Tools for Healthy Lifestyles



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                     Section 4


Section 4: Website resource descriptions
American Cancer Society (ACS): www.cancer.org
This site provides information about different types of cancer, prevention, and treatment options. The American
Cancer Society dietary guidelines and common questions about cancer and diet are covered.

American Cancer Society Workplace Outreach: www.acsworkplace.com
This site provides information on sample worksite wellness policies, tools to starting a wellness program, and
information for company employees on being active, quitting tobacco, staying sun smart, and being aware. There
are also recipes, resources, and Meeting Well guidelines under the “eat smart” link.

Centers for Disease Control and Prevention (CDC):
http://www.cdc.gov/hwi
www.fruitsandveggiesmatter.gov
These sites provide access to the CDC’s Healthier Worksite Initiative which includes a worksite health promotion
resource toolkit and nutrition toolkits, as well as access in how to promote the increased consumption of fruits and
vegetables.

Pennsylvania Department of Labor and Industry:
This site includes information on Colorado’s job market, job hunting, job availability, and Social Security. Key
components to labor market resources and laws are also included.

Penn State Cooperative Extension, Luzerne County: http://luzerne.extension.psu.edu/
This site provides information on nutrition resources and programs.

Fight BAC!: www.fightbac.org
Sponsored by the Partnership for Food safety Education, this site has a wealth of information on the basics of
food safety.

Fitness Wholesale: www.fwonline.com
This site sells a variety of fitness equipment including books, music, videos, posters, hand weights, tubing,
exercise bands, fitness balls, stretching mats, and more.

Healthy Eating and Active Living in Northern British Columbia: http://www.healbc.ca/
This is a group of individuals, organizations, and communities working to prevent Type 2 diabetes. This project is
funded by Health Canada and sponsored by the Northern Health Authority. They educate about healthy eating
and active living through projects, e-lists, newsletters, news releases, presentations, networking, workshops, and
the HEAL website.

MEDLINEplus: www.nlm.nih.gov/medlineplus/ency/article/000982.htm
MEDLINE plus is a source of health information from the world’s largest medical library, the National Library of
Medicine. MEDLINEplus has extensive information from the National Institutes of Health and other trusted
sources of over 600 diseases and conditions.

National Cancer Institute (NCI): www.cancer.gov
This site contains information on current research, food preparation tips, and dietary guidelines for people looking
for ways to reduce risk of cancer.

Prevention Institute: www.preventioninstitute.org/CHI_Workplace.html
The institute addresses complex health and social issues and advocates for solutions to improve community
health. The organization builds on the successes of a variety of fields such as injury and violence prevention,
traffic safety, health disparities, nutrition, physical activity, and youth development, and applies them to new
challenges in areas.



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                    Section 4

Produce for Better Health: www.pbhfoundation.org
Information and resources on the Fruits & Veggies-More MattersTM campaign can be found here. Additional
information can be found at; www.fruitsandveggiesmorematters.org.

Project Lean: www.californiaprojectlean.org/popups/pdfs/lowfatposter.pdf
California Project LEAN (Leaders Encouraging Activity and Nutrition) is a public awareness campaign to promote
low-fat eating by working with state and local physical activity and nutrition leaders to conduct programs in
communities throughout California.

Summex Corporation: https://www.summex.com/
This site offers a variety of Health Risk Appraisals and other population health risk management tools for
worksites.

University of Minnesota School of Public Health:
www.ahc.umn.edu/ahc content/colleges/SPH/index.cfm
This site has the Guidelines for Offering Healthy Foods at Meetings, Seminars, and Catered Events.

United States Department of Agriculture/Center for Nutrition Policy and Promotion:
www.usda.gov/cnpp/ and www.mypyramid.gov
Find the Food Guide Pyramid and Dietary Guidelines for Americans at this site.

Working Well Works: www.tompkins-co.org/wellness/worksite/
This site provides information about starting worksite wellness programs. One of the sections, Fruit and Snack
Bowl, provides guidelines on healthful snacks in the workplace.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                        Section 5




             Section 5: Worksite Environment
             Alter worksite environment and/or policy to encourage health and
             wellness.

             Action Steps:

                    1. Support cycling to work by providing bicycle racks in save,
                       convenient, and accessible locations.
                          Cost= $; Time=

                    2. Provide clean, safe, and aesthetically appealing stairwells, and
                       promote their use.
                          Cost= $; Time=

                    3. Establish on-site fitness rooms or exercise facilities.
                          Cost= $$$; Time=

                    4. Designate specific areas to support employees with sensitive health
                       issues, such as diabetics and nursing mothers.
                          Cost= $; Time=

                    5. Establish workplace programs that promote breastfeeding.
                          Cost= $; Time=

                    6. Add weight management/maintenance, nutrition, and physical activity
                       counseling as a member benefit in health insurance contracts.
                          Cost= $$; Time=

                    7. Create a company culture that discourages sedentary behavior, such
                       as TV viewing on breaks and sitting for long periods of time.
                          Cost= $; Time=

                    8. Create a company culture that minimizes consumption of low-nutrient
                       foods and beverages such as cakes at parties, candy bowls, and
                       sweets as rewards.
                          Cost= $; Time=


             Key:
                        Cost =                     Time =
                        $    = Minimum                  = Minimum
                        $$ = Moderate                   = Moderate
                        $$$ = Maximum                   = Maximum


                    Refer to Appendix A for adopting a smoke-free worksite



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 5




1
     Support cycling to work by providing bicycle racks in safe,
     convenient, and accessible locations

Why:
       Bicycling to work is an employee benefit that helps keep staff healthy, saves them money, and
       improves the environment all at the same time.
       Bicycling can be a safe, healthy behavior.
       Placing bicycle racks in prominent locations may encourage people to ride to your location.
       Bicycle parking is inexpensive to provide compared to automobile parking.
       Studies have proven that people who exercise in the morning are more alert when they get to
       work.

    How:
      Contact your facilities manager and/or city government to find out if a specific type of bicycle
      rack is required or if there are specific locations that bicycle racks must be installed on your
      property.
      If there is not standard rack, look for the inverted-U rack. This type of rack offers the best of
      short-term cycle parking and is widely regarded as the recommended standard.
      Determine a location that is convenient to access on a bicycle. Ideal locations are visible, well
      lit, and close to the building entrance. Make sure that curb ramps are in place so the bicyclist
      can ride directly to the rack. Keep in mind that bicyclists will park as close as they can to their
      destination. If your building has multiple entrances, make sure you install bike racks in multiple
      locations.
      To encourage bicycling, as you’re local police department about bicycle registration. Many cities
      offer to engrave a number on bicycles so that if they are ever stolen, they can be traced back to
      the owner. You can host a bicycling event at your worksite and have the police come to register
      bicycles.
      To encourage bicycle commuting, your worksite should have showers, locker room, and storage
      for bicycles.
      Advertise the location of all bike racks to employees.
      Offer bicycle safety training on-site. Talk to departments of transportation, local bicycle vendors
      or police officers about making a presentation about rules of the road and bicycle safety tips.
      Give free or low-cost helmets and/or retro reflective gear to bicycle commuters.
      Celebrate Bike to Work Week in May. www.bikeleague.org
      Log bicycle miles, and days travelled and provide prizes, such as gift certificates.
      Host a workshop on bike repair during lunch.
      Split any savings from reduced use of parking lots or garages with bicycle commuters.
      Support environment changes in your community that make it easier and safer to use bicycles,
      such as construction of bike lanes, shoulders, and designated trails.

Resources:
      Pennsylvania Department of Transportation Bicycle:
      http://www.dot.state.pa.us/BIKE/WEB/index.htm
      Biking to Work: http://www.biketraffic.org/trickstrips/
      League of American Bicyclists: www.bikeleague.org
      Luzerne County Pennsylvania:
      http://www.luzernecounty/departments_agencies/recreation/trails/greater-kingston-area-trail-
      greenway



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                       Section 5

      Bike Commuting and Transportation:
      http://www.kenkifer.com/bikepages/commute/index.htm
      Municipal government
      Police department
      Vendors that sell bicycle racks, safety gear, etc.
      Zoning or planning department




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                       Section 5




2
     Provide clean, safe, and aesthetically appealing stairwells, and
     promote their use.


Why: An important motivator in encouraging people to take the stairs is making stairwells more
inviting.

How: Consider the following ideas:
     Motivational signs at elevators and escalators (refer to Section 1 for more information)
     Adding carpet and rubber treading
     Creative lighting
     Artwork or mirrors on the walls
     Theme stairwells (tropical rainforest, cartoons, etc.)
     Include an electronic message board
     Add footsteps that lead from the elevators to the stairs
     Post arrows showing the way to the stairs
     Create a fitness zone inside the stairwell with a sign: “You are now entering the Fitness Zone”
     Put numbers on the doors to let users know which floor they are on. Start at the bottom floor
     and give each stair a number so that users can easily track their progress.
     Allow users to add their signatures to each floor creating a graffiti wall

Resources:
      Centers for Disease Control and Prevention:
      www.cdc.gov/nccdphp/dnpa/stairwell.index.htm
       StairWELL to Better Health Project




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                             Section 5




3
     Establish on-site fitness rooms or exercise facilities.


Why: On-site fitness facilities can range from a TV and VCR or DVD in your conference room available
for employees to participate in lunchtime fitness classes, to a fully equipped and staffed, state-of-the-art
gymnasium-type facility. It is important to match your company’s goals (i.e. employee satisfaction vs.
reduction in healthcare costs) with financial resources available for employee benefits.

Liability Issues:
It is extremely important to assess your company’s liability when considering an on-site exercise facility.
Talk to your company’s legal department and see Appendix C for more detailed information on liability
issues.

NOTE: It is strongly recommended that you review the following two books before implementing any
on-site fitness room or exercise facility:
        ACSM’s Health/Fitness Facility Standards & Guidelines, Second Ed., American College of
        Sports Medicine, 1992.
        Health Fitness Management, A Comprehensive Resource for Managing and Operation
        Programs and Facilities, by William C. Granthan/Robert W. Patton/Tracy D. York/Mitchel L.
        Winick, Human Kinetics, 1989.

Benefits of an on-site facility
       Potential reduction in overall healthcare costs
       Potential reduction in employee absences
       Improved employee health and fitness
       Increased employee satisfaction
       Increased employee engagement
       Informal building of community networks
       Can aid in the recruitment of top talent
       Can help facilitate a positive company culture

Possible limitations of an on-site facility
       Cost prohibitive
       Space prohibitive
       Falls outside the realm of core business
       Considered a fringe benefit
       Difficult to prove return in investment

How: Steps to take:
     Purchase the two books listed above.
     Read the books to learn about standards, guidelines, liability, and other issues.
     Create a survey to assess employee interest in an on-site facility.
     Talk with your legal department regarding liability issues.
     Consider hiring a qualified consultant or fitness management company to assist in the design,
     start-up, and possible management of your exercise facility.
     Work closely with your company’s facilities department to assess cost and space issues.
     Write a business plan for your proposed on-site fitness center.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                          Section 5

Cost ranges of an on-site facility
   Minimum
       Minimal or no staff (not recommended due to liability issues)
       No locker rooms
       Conference room with TV, VCR, or DVD, mats and exercise balls
       COST: up to $500*

   Intermediate
       Minimal staff
       Locker rooms or shower facilities on site
       Dedicated exercise space
       Universal weight-training machine
       2 – 5 pieces of cardiovascular equipment
       COST: $5,000 - $20,000*

   Advanced
      Staffed with qualified personnel
      Locker rooms
      Fully-equipped gym with strength training and cardiovascular equipment
      Fitness and health promotion programs
      Annual cost: $50,000 - $500,000*

   *Cost averages do not include facility construction costs.

Resources:
      American College of Sports Medicine: www.acsm.org
      Collage video: www.collagevideo.org
      Fitness on the Job: www.fitnessonthejob.com
      Fitness Wholesale: www.fwonline.com
      HEALTHBREAK, Inc.: www.healthbreakinc.com
      Human Kinetics: www.humankinetics.com
      Johnson & Johnson Health Care Systems: www.jjhcshealth-fitness.com
      Wellness Councils of America: www.welcoa.org




Steps To A Healthier Workforce in Luzerne County
   Worksite Wellness Kit                                                                                 Section 5


        Designate specific areas to support employees with sensitive health
   4    issues, such as diabetics and nursing mothers.

   Why: Title I of the Americans with Disabilities Act of 1990, which took effect July 26, 1992, prohibits
   private employers, state and local governments, employment agencies, and labor unions from
   discrimination against qualified individuals with disabilities in job application procedures, hiring, firing,
   advancement, compensation, job training, and other terms, conditions, and privileges of employment.
   An individual with a disability is a person who: 1) has a physical or mental impairment that substantially
   limits one or more major life activities, 2) has a record of such an impairment, or 3) is regarded as
   having such an impairment. Diabetes is a disability when it substantially limits one or more of a
   person’s life activities or causes side effects or complications that substantially limit a major life activity.
   Most sensitive health issues are covered by the Americans With Disabilities Act. Nursing mothers are
   not covered, however. See Step 5 of this section for the benefits associated with supporting
   breastfeeding women.

   How: A qualified employee or applicant with a disability is an individual who, with or without
   reasonable accommodation, can perform the essential functions of the job in question. Reasonable
   accommodation may include, but is not limited to:
         Making existing facilities used by employees readily accessible to and usable by persons with
         disabilities;
         Job restructuring, modifying work schedules, reassignment to vacant positions; and
         Acquiring or modifying equipment or devices, adjusting modifying examinations, training
         materials, or policies, and providing qualified readers or interpreters.
         Regular work schedules, meal breaks, a place to test blood sugar levels, or a rest area for
         employees with diabetes.

   An employer is required to make an accommodation to the known disability of a qualified applicant or
   employee if it would not impose an “undue hardship” on the operation of the employer’s business.
   Undue hardship is defined as an action requiring significant difficulty or expense when considered in
   light of factors such as an employer’s size, financial resources, and the nature and structure of its
   operation.

   An employer is not required to lower quality or production standards to make an accommodation, nor is
   an employer obligated to provide personal use items such as glasses or hearing aids.

   Other workplace goals:
          Develop a supportive work environment so that employees with sensitive health issues, such as
          diabetes, feel comfortable adopting and performing the behaviors that promote good control.
          Provide encouragement and opportunities for all employees to adopt healthier lifestyles that
          reduce risk for chronic diseases.
          Demand the highest quality medical care for people with sensitive health issues.
          Establish workplace programs that promote breastfeeding.

Resources:
         Americans with Disabilities Act: www.ada.gov
         Centers for Control/Disability and Health: www.cdc.gov/fact/diabetes.html
         CDC Guide to Breastfeeding Interventions:
         http://www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf
         Equal Employment Opportunity Commission: www.eeoc.gov/facts/diabetes.html
         Diabetes Advocate: www.diabetes.org/main/community/advocacy/default.jsp



   Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                        Section 5




5
    Establish workplace programs that promote breastfeeding.


Why:
       Reduces turnover; mothers are more likely to return to work after having a baby.
       Reduces sick time; breastfed babies are less likely to be ill.
       Improves productivity, loyalty, employee satisfaction, and moral.
       Creates a reputation of a company concerned for the health and wellness of its employees and
       their families.
       Offers a recruitment incentive for women.
       Can lower health care costs by an average savings of $400 per baby over the first year.
       Can decrease the cost of health insurance.

How:
       Develop a support system by creating a breastfeeding task force.
       Provide a clean, private comfortable space to pump or breastfeed (not a bathroom); with a sink
       nearby for hand washing and washing of pump parts.
       Communicate breastfeeding support policies to all employees.
       Consider flexible scheduling options, part-time work, or job-sharing for breastfeeding women.
       Allow sufficient break time for mothers to breastfeed or express milk.
       Be aware of and support breastfeeding promotion policies in legislation.


Resources:
      Centers for Disease Control and Prevention’s Healthier Worksite Initiative Lactation
      Support Program Toolkit: http://www.cdc.gov/nccdphp/dnpa/hwi/toolkits/lactation/index.htm
      Pennsylvania Breastfeeding Coalition: http://www.pabreastfeeding.org/
      LaLeche League International: www.lalecheleague.org
      International Lactation Consultant Association: www.ilca.org
      National Women’s Health Information Center: www.4woman.gov/Breastfeeding
      United States Breastfeeding Committee: www.usbreastfeeding.org
      Washington Business Group on Health: www.wbgh.org


Other resources for nursing mothers:
   ♦ Maternal and Family Health Services Inc. Women, Infants and Children Program (WIC)
       800-367-6347 or www.mfhs.org
   ♦ Pennsylvania Department of Health’s Healthy Baby Line 800-986-BABY




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 5




6
     Add weight management/maintenance, nutrition, and physical
     activity counseling as a member benefit in health insurance
     contracts.

Why: In the new environment of health care, many plans and programs are changing to include non-
traditional benefits. Weight management/maintenance, nutrition, or physical activity benefits are on the
horizon as employers recognize the benefits of promoting a healthier lifestyle to create better health.

How: This Action step may be difficult to achieve. To accomplish this action step, you may have to
advocate for your company with your healthcare provider. Awareness of policy issues and policy
content will help to achieve your goal.

First, contact your company healthcare provider to see what is already included in your policy. Many
programs include a “behavior and health” section. Some programs include continuing education for
employees, if requested by the company. Use this benefit to address nutrition and physical activity
topics.

Second, be sure to compare and contrast provider benefits for nutrition and physical activity when the
company is negotiation with health insurance providers. Depending on the cost/benefit, you may want
to upgrade your package to include nutrition and physical activity benefits.


Resources:
      Company healthcare providers/insurers




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                            Section 5




7
    Provide a safe walking environment on facility grounds.


Why:
       Walking is a safe, healthy behavior.
       Walking is a form of physical activity that does not require equipment, has a low risk of injury,
       and has been proven to improve wellness.
       Walking trails and sidewalks can be aesthetically appealing. With a little investment, you can
       make your walkways look much nicer.
       If facilities for walking are in place, employees are more likely to use them.

How:
       Talk to your city/municipality engineers and planners to find out about any restrictions/options
       for building trails or sidewalks on your facility grounds.
       Work with an architect to develop plans to make your facility more walk able. The design
       should focus on connectivity and interesting design.
       Consider amenities like benches, water fountains, and signage.
       If you have large parking lots, designate areas for pedestrian access in the lots. This enhances
       safety and allows sites to connect disjointed areas.
       Keep pedestrian safety and comfort in mind. Tree lawns, lighting, and signage make walking
       more enjoyable and safer.

Resources:
      Pennsylvania Recreation and Park Society: http://www.prps.org/
      Luzerne County Parks and Recreation: http://www.luzernecounty.org/
      National Center for Bicycling and Walking: www.bikewalk.org
      Pedestrian and Bicycle Information Center: www.walkinginfo.org
      Wyoming Valley Wellness Trails: http://www.wvwellnesstrails.org/index.html




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                          Section 5




8
     Create a company culture that discourages sedentary behavior,
     such as TV viewing on breaks and sitting for long periods of time.




9    Create a company culture that minimizes consumption of low-
     nutrient foods and beverages such as cakes at parties, candy
     bowls, and sweets as rewards.
Why: A sense of culture exists among groups of individuals who come together for work. One
definition by Merriam-Webster.com defines culture as “the set of shared attitudes, values, goals, and
practices that characterizes a corporation.”

Employee health directly impacts productivity. Poor diets and inactivity decrease alertness and
creativity. Healthy employees equal a healthy and productive organization. Creating a company
culture that discourages inactivity and promotes healthy eating makes it easier for employees to adopt
those lifestyle changes. This means not only creating an environment conducive to an active and
healthy lifestyle but also one that encourages it.

How:
       Ask management to help create a culture that promotes healthy eating and regular physical
       activity.
       Develop programs from the grassroots level for added success.
       Create or identify change agents who can be leaders to push for a healthier more active
       worksite.
       Boost enthusiasm by using group programs to create team efforts and foster healthy
       competition within the company.
       Creating cultural change is an ongoing process that involves periodic re-evaluation. According
       to the Human Resources Institute, Inc. (2001), the “Normative Systems Culture Change
       Process” involves four phases:
                Phase 1 Analysis, Objective Setting and Leadership Commitment
                Phase 2 Systems Introduction
                Phase 3 Systems Integration
                Phase 4 Evaluation, Renewal, Extension

Resources:
      Healthy Culture: www.healthyculture.com/Articles/Ccplannier.html
      The Organizational Culture website: www.organizational-culture.com/
      Workforce Management: www.workforce.com
      Book review: www.tricare.osd.mil/hcr/newsletter/review3.html
       Managing at the Speed of Change
       Case study: www.sedl.org/change/issues/issues54.html
       Confronting and Managing Culture in a Changing Environment
       TV-Turnoff Network: www.tvturnoff.org Annual TV-Turnoff Week last week of April.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                           Section 5


Section 5: Website resource descriptions
American College of Sports Medicine: www.acsm.org
The American college of Sports Medicine advances and integrates scientific research to provide educational and
practical applications of exercise science and sports medicine. This site contains health and fitness information
on aerobic activity, strength training, and stretching.

Americans with Disabilities Act: www.ada.gov
This site provides information on people with disabilities, accessibility guidelines, research questions and
answers, as well as many other subjects pertaining to promoting the health of people with disabilities.

Ball Dynamics: www.balldynamics.com
This site provides information on using exercise balls and an on-line catalog for ordering FitBall Products,
exercise bands, workout videos and more.

Centers for Disease Control and Prevention:
http://www.cdc.gov/nccdphp/dnpa/hwi/toolkits/stairwell/index.htm
This site has information on the StairWELL to Better Health Project.

Centers for Disease Control and Prevention/Disability and Health:
http://www.cdc.gov/ncbddd/dh/default.htm and
http://www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf
This website provides information on people with disabilities, accessibility guidelines, research questions and
answers, as well as many other subjects pertaining to promoting the health of people with disabilities and
supporting nursing mothers.

Collage Video: www.collagevideo.com
This site sells videos for all types of physical activity including aerobic fitness, strength training, stretching, yoga,
Pilates, intervals, etc.

Pennsylvania Department of Health http://www.health.state.pa.us/worksitewellness
A resourceful website that offers valuable data on implementing worksite wellness within the state of
Pennsylvania.

Pennsylvania Department of Transportation Bicycle:
http://www.dot.state.pa.us/BIKE/WEB/index.htm

Pennsylvania Parks and Recreation Association: www.cpra-web.org
Colorado Parks and Recreation Association is a private, non-profit, membership organization advocating parks
and recreation. Currently 1,000 individual members representing over 140 agencies throughout Colorado belong

Diabetes Advocate: http://www.diabetes.org/advocacy-and-legalresources/state-
legislation/overview.jsp
This site is a source of legislative news for people with diabetes.

Fitness on the Job: http://www.fitnessonthejob.com
Fitness solutions for business; organization located locally in NEPA. Provides fitness programming matched to
an organization’s goals, budget and space.

Fitness Wholesale: www.fwonline.com
This site sells a variety of fitness equipment including books, music, videos, posters, hand weights, tubing,
exercise bands, fitness balls, stretching mates, and more.



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                      Section 5

HEALTHBREAK Inc.: www.healthbreakinc.com
HEALTHBREAK, Inc. is a health promotion company that provides consulting, wellness program management,
and fitness center management services.

Healthy Culture: www.healthyculture.com
This site features resources on culture change including videos, books, and training.

Human Kinetics: www.humankinetics.com
Human Kinetics produces textbooks, consumer books, software, videos, journals, and distance education for
teachers, coaches, researchers, sport participants, and fitness enthusiasts.

Johnson and Johnson Health Care Systems:
http://www.employerhealth.com/EHR_sample_pages/sp3144.htm
Johnson and Johnson Health Care Systems offer a variety of services from health risk appraisals to full scale
fitness center management. Many resources can be found on this site.

LaLeche League International: http://www.llli.org/
This group was founded to give information, encouragement, and personal help to all mothers who want to
breastfeed. This website includes breastfeeding information, a calendar of special events, and access to local
groups. LaLeche League provides a collection of materials in English and many other languages.

International Lactation Consultant Association (ILCA): www.ilca.org
This association of International Certified Lactation Consultants has a website that offers recent news releases
regarding breastfeeding, information on finding a local Lactation Consultant, breastfeeding research and more.

National Center for Bicycling and Walking: www.bikewalk.org
This site provides information on how to create active environments in neighborhoods and communities where
people can walk and bike.

National Women’s Health Information Center: www.4woman.gov/Breastfeeding
This project of the U.S. Department of Health and Human Services Office of Women’s Health provides basic
breastfeeding information, frequently asked questions, recent news releases, and more. Information on this
website can be accessed in English, Spanish, or Chinese.

Pedestrian and Bicycle Information Center: www.walkinginfo.org
This walking organization is a clearinghouse for information on health, safety, engineering, advocacy, education,
enforcement, access, and mobility.

The Organizational Culture website: www.organizational-culture.com/
This site provides tools and information about organizational culture. Organizational culture is the set of beliefs,
values, norms, and rules (both written and unwritten) with which an organization functions.

TV-Turnoff Network: http://www.turnoffyourtv.com/turnoffweek/TV.turnoff.week.html
Annual TV-Turnoff Week last week of April. Organizer kit and publications are available.

United States Breastfeeding Committee: www.usbreastfeeding.org
This website provides position papers on Breastfeeding in the Workplace, The Economic Benefits of
Breastfeeding, The Benefits of Breastfeeding, State Breastfeeding Legislation, and Breastfeeding and Childcare.

Washington Business Group on Health: www.wbgh.org
This site has publications and materials on establishing a lactation room at a worksite, support for breastfeeding
women at the worksite, and working and breastfeeding.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                    Section 5

Wellness Councils of America (WELCOA): www.welcoa.org
This non-profit membership organization promotes healthier lifestyles through health initiatives at the worksite and
serves as a national clearinghouse and information center on worksite wellness.

Workforce Management: www.workforce.com
This site is dedicated to helping professionals get the information they need to drive business results for their
organizations. Workforce has 80 years of experience in identifying trends in human resources and providing tools
to be successful.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                                  Appendix A




Appendix A: Website resource descriptions
American Cancer Society (ACS): www.cancer.org
ACS provides information on smoking in the workplace and the benefits of a smoke-free worksite. Also
the site provides a sample of a model policy.

American Lung Association: www.lungusa.org
The American Lung Association’s site provides many resources about the benefits of quitting smoking
and an online cessation program entitled Freedom from Smoking.

Asthma Initiative of Michigan: http://getasthmahelp.com/tobacco.asp
This site provides information about secondhand smoke, asthma, and a smoke-free worksite.

Center for Disease Control (CDC):
http://www.cdc.gov/tobacco/research_data/environmental/etsguide.htm
The CDC provides a guide in PDF format that gives helpful instructions on how to make a workplace
smoke-free. It provides a model smoking policy and additional options to help companies and other
organizations design policies to fit their needs.

Pennsylvania Alliance to Control Tobacco (PACT): http://www.pactonline.org/
This site contains information and resources on PACT’s initiatives as well as resources on other
tobacco control issues.

Pennsylvania Department of Health (PADOH): http://www.dsf.health.state.pa.us/health/
This site includes information about smoking cessation, asthmas, and a link to helpful national, state,
and local resources. Free PAQuitline: 1-800-QUIT-NOW

Pennsylvania Medical Society: https://pamedsoc.healthstatus.com/cgi-
bin/hscalc/calc.cgi?calc=smc
This link provides a cost of smoking calculator that one could utilize to see how much money they are
spending on a pack of cigarettes over a certain period of time.

Quitnet: http://www.quitnet.com/
Quitting smoking all together with Quitnet, provides smoking cessation resources and tips for quitting
smoking.

Rural Health Corporation: http://www.rhc1084.com/
Provides Freedom from Smoking cessation program on and off-site. Contact 570-825-8741 for
additional information.

Wyoming Valley Drug and Alcohol Services: http://www.stophiv.com/details.asp?id=1152
Provides intervention/education and outreach to schools, the elderly, industries, hospitals, and individuals with
handicaps. For further information contact: Carmen F. Ambrosino, CEO (570) 820-8888




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                       Appendix B


                                 Stress Management

      What is stress?
        • Stress is a naturally occurring reaction of your body to psychological or physical
             demands of the environment.
        • Stress reaction increases blood pressure, heart rate, and respiration as well as
             other changes to major body systems. These reactions prepare the body for
             “fight or flight” from physically dangerous or psychological threatening situations.
        • Stress reaction can be positive or negative.
                 —    Positive stress reaction leads to increased performance, feelings of
                      success and confidence and allows the body to return to the normal, non-
                      stress state.
                 —    Negative stress or mismanaged stress, keeps the physical reaction of
                      the body turned on and does not let the body completely recover to the
                      non-stress state.

      What causes stress reaction in the workplace?
        • Task demands- having to repeatedly learn new processes, meeting unrealistic
            deadlines.
        • Time demands- frequent deadlines, schedule conflicts, “too much to do,”
            interruptions and unpredictable schedules (particularly for employees who have
            daily rhythms in shift work).
        • Physical demands – environment (weather, noise, vibration) and activity
            (standing, walking, bending, and lifting).
        • Role demands—added responsibility in supervision and leadership.
        • Interpersonal demands—interacting with public, customers, co-workers.

      What are the consequences of negative stress?
      Negative stress or mismanaged stress reactions to workplace demand can be grouped
      as:
          • Behavioral-may include alcohol or drug abuse, accidents, violence, and eating
             disorders.
          • Psychological-may include family problems, sleep disturbance, depression, and
             burnout syndrome.
          • Medical-may include heart disease, stroke, headache, cancer.

      Long-term effects of negative stress can lead to exhaustion, reduced ability of the
      immune system to fight off illness and disease and put the employee at risk for health
      problems and work performance issues.

      Worksite wellness committees can initiate programs and activities to help
      employees manage the demands of the work environment.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                           Appendix B



             Some companies are taking a proactive approach to managing employee stress.

             •   37.5 percent of workplaces offer stress management programs.1
             •   34 percent of workplaces that offer full-intervention stress management
                 programs saw a reduction in health care use by employees, lowering company
                 health care costs.2

             And these programs are truly helping employees reduce their stress levels.

             •   77 percent of employees who sought treatment for issues such as stress or
                 depression through an employee assistance program (EAP) reported increased
                 work performance after three months of treatment.3
             •   94 percent of employees in an EAP reported missing fewer days of work after
                 three months of treatment.3

             Simple Ways to Manage Stress

                 •   Set prioritize and achievable goals
                 •   Be realistic about what is possible, and let people know what you can or
                     can’t do under reasonable circumstances
                 •   Don’t procrastinate
                 •   Turn to people who can provide support
                 •   Be open to change- at work and home
                 •   Take a few slow, deep breaths
                 •   Stretch-roll your shoulders forward and back
                 •   Get regular physical activity-even a walk around a few blocks will help calm
                     you and put demands into perspective
                 •   Meditate for 15 minutes
                 •   Talks with family and friends
                 •   Listen to music
                 •   Take breaks


          Source:

     1.        "Are Stress Management Programs Indicators of Good Places to Work? Results of a
        National Survey," International Journal of Stress Management, Nigam, J.A.S., Murphy, L.R.,
        & Swanson, N.G., 10(4), November 2003.
     2.        "A Novel Stress and Coping Workplace Program Reduces Illness and Healthcare
        Utilization," Psychosomatic Medicine, Rahe, R.H., et al., 64, 2002.
     3.        "Once Again, Treatment Improves Productivity," American Psychiatric Association and
        the American Psychiatric Foundation, MentalHealthWorks, Third Quarter 2003.




          For additional stress management information visit North Carolina Health Smart
          Worksite Wellness Toolkit.
          http://www.eatsmartmovemorenc.com/Resources/wwtoolkit/managestress.html



Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                        Appendix C


                                       Liability Issues

Liability is a major concern when dealing with on-site physical activity and wellness programs and must
be addressed prior to any program implementation. The issue of liability is broad. Use the following as
a guide and not an all-inclusive resource.

The law varies from state to state; therefore every company should check with legal counsel before
implementing a health or fitness program. Many participant forms are needed to release your company
form liability before participants start a program. Areas to consider:
        Always start by checking with your company’s legal department.
        Have participants fill out a Physical activity Readiness Questionnaire (PAR-Q), Health History
        Questionnaire, physician statement and clearance form, agreement and release of liability, and
        an informed consent agreement (all of these forms can be found in ACSM’s Health and Fitness
        Facility Standards and Guidelines).
        Any personal health information collected from fitness center participants is considered
        confidential and should be treated as such. Be sure to understand all current guidelines for
        storing and archiving all personal health information.
        Be certain that all outside fitness vendors have the appropriate certifications and liability
        coverage on their insurance policies (for example, aerobics instructors, massage therapists,
        etc.)

The American College of Sports Medicine is considered the gold standard for all fitness and/or wellness
programs and operations. It is highly recommended, though not mandatory, to follow the guidelines set
forth by the American College of Sports Medicine. By following these guidelines, your company will
limit its liability exposure.

The following standards are cited directly form ACSM’s Health and Fitness Facility Standards and
Guidelines, Second Edition:

It is the position of the American College of Sports Medicine that any business or entity that provides an
opportunity for individuals to engage in activities that may reasonably be expected to involve placing
stress on one or more of the various physiological systems (cardiovascular, muscular,
thermoregulatory, etc.) Of a user’s body must adhere to the six standards.
        1. A facility must be able to respond in a timely manner to any reasonable foreseeable
            emergency event that threatens the health and safety of facility users.
        2. A facility must offer each adult member a pre-activity screening that is appropriate to the
            physical activities to be performed by the member.
        3. Each person who has supervisory responsibility for a physical activity program or area at a
            facility must have demonstrable professional competence in that physical activity or program
        4. A facility must post appropriate signage alerting users to the risks involved in their use of
            those areas of a facility that present potential increased risk(s).
        5. A facility that offers youth services or programs must provide appropriate supervision.
        6. A facility must conform to all relevant laws, regulations, and published standards.




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                        Appendix C

It is also important to be mindful of the legislation pertaining to wellness programs, incentives and
HIPAA nondiscrimination rules. The following are some key points to consider in offering incentive-
based programs;

       1. If an incentive is not based on satisfying a set standard for a health factor i.e. blood
          pressure or weight goal then that incentive program is not subject to the HIPAA
          requirements.
       2. The amount of the reward/incentive may not exceed 20% of the cost of employee-only
          coverage or 20% of the cost of employee plus dependent coverage if dependents are
          eligible to participate in the wellness program.
       3. The program must be reasonably designed to promote health or prevent disease.
       4. The program must give eligible individuals the opportunity to qualify for the incentive/reward
          at least once per year.
       5. The reward/incentive must be available to all similar situate individuals and provide a
          reasonable alternative for obtaining the reward/incentive that is clearly described and
          disclosed in all wellness program materials.


Please access these documents for additional information regarding the rules and regulations for
wellness programming;


   U.S. issues final HIPAA rules affecting wellness programs (Kathy Gurchiek, December 20,
   2006). http://www.shrm.org/hrnews_published/archives/CMS_019638.asp

   Part III Federal Register, December 13, 2006. Nondiscrimination and Wellness Programs in Health
   Coverage in the Group Market; Final Rules.
   http://www.dol.gov/ebsa/regs/fedreg/final/2006009557.pdf

   Dechert on Point, January 2007, Issue 51. Final HIPAA Nondiscrimination Requirements and
   Wellness Program Rules Issued. http://www.dechert.com/library/EB_01-07.pdf




Steps To A Healthier Workforce in Luzerne County
Worksite Wellness Kit                                                                         Appendix D

                               National Health Observances
      January                         May                            September
      Cervical Health Awareness       Asthma and Allergy             Cold and Flu Campaign
      Month                           Awareness Month                (212) 315-8700
      (818) 909-3849                  (800) 7-ASTHMA                 www.lungusa.org
      www.nccc-online.org             www.aafa.org
                                                                     National Cholesterol
      National Birth Effects          Better Sleep Month             Education Month
      Prevention Month                (703) 683-8371                 (301) 592-8573
      (888) M-O-Dimes                 www.bettersleep.org            www.nhlbi.nih.gov
      www.modimes.org
                                      National High Blood Pressure   National 5 A Day Week
      National Glaucoma               Education Month                (800) 4-CANCER
      Awareness Month                 (301) 592-8573                 www.5aday.gov
      (800) 331-2020                  www.nhlbi.nih.gov
      www.preventblindness.org                                       Family Health and Fitness
                                      Mental Health Month            Day USA
      Healthy Weight Week             (800) 969-6642                 (800) 828-8225
      (701) 567-2646                  www.nmha.org                   www.fitnessday.com/family
      www.healthyweight.net
                                      National Osteoporosis          October
      February                        Prevention Month               Domestic Violence
      American Heart Month            (202) 223-2226                 Awareness Month
      (800) AHA-USA1                  www.nof.org                    (303) 839-1852
      www.americanheart.org                                          www.ncadv.org
                                      National Employee Health
      Wise Health Consumer            and Fitness Day                Healthy Lung Month
      (800) 345-2476                  (317) 955-0957                 (800) LUNG-USA
      www.healthylife.com             www.physicalfitness.org        www.lungusa.org

      March                           June                           National Breast Cancer
      National Nutrition Month        National Headache              Awareness Month
      (800) 877-1600                  Awareness Week                 www.nbcam.org
      www.eatright.org/nnm            (800) NHF-5552
                                      www.headaches.org              November
      Workplace Eye Health and                                       American Diabetes Month
      Safety Month                    National Men’s Health Week     (800) 232-3472
      (800) 331-0202                  (800) 955-2002                 www.diabetes.org
      www.preventblindness.org        http://www.menshealthmonth.
                                      org/week/                      Great American Smokeout
      American Diabetes Alert                                        (800) ACS-2345
      (800) DIABETES                  July                           www.cancer.org
      www.diabetes.org                Fireworks Safety Month
                                      (800) 331-2020                 December
      April                           www.preventblindness.org       National Drunk and Drugged
      Alcohol Awareness Month                                        Driving Prevention Month
      (212) 269-7797                  August                         (202) 452-6004
      www.ncadd.org                   Cataract Awareness Month       www.3dmonth.org
                                      (415)561-8500
      Cancer Control Month            http://www.aao.org/            Worlds Aids Day
      (800) ACS-2345                                                 (202) 466-5883
      www.cancer.org                  National Immunization Month
                                      (800) 232-4636                 Safe Toys and Gifts Month
      National STD Awareness          http://www.cdc.gov/vaccines/   (800) 331-2020
      Month                           events/niam/default.htm        www.preventblindness.org
      (919) 361-8400
      www.ashastd.org                 World Breastfeeding Week
                                      (814) 519-7730
                                      www.lalecheleague.org
                                 15 Public Square, Suite 101
                                  Wilkes-Barre, PA 18702
                            570-408-1630 Phone 570-408-1633 Fax
                           info@stepspalc.org www.stepspalc.org




                         Steps To A HealthierPA Luzerne County
  Empowering the people of Luzerne County to live longer, better, healthier lives by enhancing
and expanding partnerships that reduce the burden of asthma, diabetes and obesity by promoting
                   good nutrition, physical activity and tobacco avoidance.




    Steps to a HealthierPA Luzerne County is part of a national health promotion and disease
 prevention initiative to help all Americans live healthier, longer and better lives by focusing on
  the prevention of diabetes, obesity and asthma and their related risk factors of poor nutrition,
                         physical inactivity and tobacco use and exposure.




                          The Steps Initiative Community Lead Agency
                               570-945-5623 www.nepaahec.org

This project is supported by the Pennsylvania Department of Health and the Centers for Disease
           Control and Prevention Steps To A HealthierUS Cooperative Agreement

								
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