Chapter Outline

Top 10 Wellness Secrets to Transform Your Workplace Program Handouts 1 Kathy K. Cash, RN, CHPD 6/2/2009 Wellness “Reality” Articles Concept: Real-life articles in a serial format used in internal newsletters or community newspapers to create a ―link‖ between wellness concepts and the lives of the target audience. Once involved in the ―reality‖ articles, the readers seek out supporting content and learn about existing wellness services. Process: Find two volunteers from the target audience who represent the demographics of major subgroups. Example: If the target audience includes both males and females, bluecollar and white-collar employees, with dominant age groups in the 20s and 30s, and ethnicities of white and African American, a good choice for two volunteers would be a white male blue-collar employee in his early 20s and an African-American female whitecollar employee in her late 30s. Take the volunteers through the full battery of wellness assessments available to the reading audience. This would likely include:    Health risk appraisal and needs assessment Fitness test Biometrics screening Meet with each volunteer individually to      Discuss findings Determine personal health goals Review available health promotion services and strategies to support goals Enroll in appropriate programs Establish information parameters volunteers are comfortable in sharing with the public Commit with volunteers to meet at set intervals to    Monitor progress toward health goals Counsel / Refer as needed to assist volunteers towards reaching these goals Review information for upcoming articles Plan a calendar of articles chronicling the volunteers‘ progress, wellness services accessed, setbacks, obstacles to success, and strategies to overcome any problems encountered as they progress through the programs. Ideally, the frequency of articles should be at least once a month to maintain readers‘ interest. The entire series would likely run between six months and a year. 2 Kathy K. Cash, RN, CHPD 6/2/2009 The initial article should       Provide sufficient personal and professional information on each volunteer to elicit a sense of connection with the reading audience. Include lifestyle behaviors / habits, especially if they are commonly found among the target audience. Explain the evaluations conducted on the volunteers and what the findings mean to their health risks. Emphasize that these same services are available to reading audiences. Outline the all goals set and general strategies to achieve them. Explain the frequency and type of articles to expect in the future relating back to the progress of the volunteers. Subsequent articles should include a brief summary of volunteers‘ overall progress, but should focus on only one or two health topics per article, i.e., smoking and fitness one month, cholesterol and blood pressure another month, etc. Attempt to achieve a ―reality show‖ tone to the articles.       Discuss life events in the context of how they positively (or negatively) affect the volunteers‘ progress. Wherever possible, use the volunteers‘ own words to describe how the lifestyle changes are effecting their lives. What is going to happen next? Will they overcome problems slowing their progress? How did they celebrate a milestone? Finish with a ―teaser‖ paragraph about the topic of the next article. Include related information articles in each edition of the newsletter that tie in to the theme of the volunteer article. Example: if a volunteer is trying to quit smoking and has a relapse, a general discussion about how smoking triggers played a part in his or her setback would be appropriate in the volunteer article. Include a second article on smoking triggers—how to identify them and develop strategies to overcome them. A line in the main volunteer article directs the reader to the accompanying article: ―for more information on how to identify triggers, see the article entitled ‗____‘ on the next page of this newsletter.‖ The final article of the series should compare the volunteers‘ lifestyle and health status at the beginning of the program to their current status. If possible, estimate health years gained as a result of the lifestyle changes; but don‘t ignore more intangible benefits, such as improved self-esteem and increased energy. Even if they have not achieved their goals, the article should emphasize what progress they‘ve made, what they learned, and how they are committed to move forward. It is important to be positive, even in the face of ―apparent‖ failure. People often are afraid to make major changes in their lives out of fear of failure. Remind them that Thomas 3 Kathy K. Cash, RN, CHPD 6/2/2009 Edison, who failed in more than one thousand experiments to invent the light bulb, was asked how it felt to fail so many times. Edison snapped, ―I didn‘t fail one thousand times. I discovered one thousand ways that wouldn‘t work.‖ Note: There is a frequent side-benefit for the volunteers. As a result of their notoriety in the ―reality‖ articles, they will soon have a tremendous support system of people who are encouraging them toward their goals on a daily basis. 4 Kathy K. Cash, RN, CHPD 6/2/2009 Bogus Bucks Concept: Not surprisingly, money consistently ranks at the top as the most valued incentive. Play money is an excellent alternative to stretch a tight budget while putting a higher perceived value on traditional wellness program products and services. Process: Design the ―bogus bucks‖ so they can be economically produced but not easily forged. A few examples:     Number the dollars sequentially Use a special paper with a specific thickness, color, watermark Use a unique color of ink Require a signature or stamp for the ―bucks‖ to be cashed Provide an easily accessible list of all incentive program products and services available to customers. Some possibilities:    T-shirts, mugs, sports bottles, refrigerator magnets, etc. Services raffle of housecleaning, car wash, lawn care, taking over an office responsibility, etc. Discounts in company dining facility, at local restaurants, movie theater passes, grocery store coupons, etc. Place a ―bogus buck‖ value on each product, service, or privilege in the list. For example, if $10 in bogus bucks equals $1 worth of real (or perceived) value in products or services, then:    A $2 coffee mug would be worth $20 in bogus bucks A free house cleaning service done by volunteers as a contest prize with an estimated commercial value of $60 would be worth $600 in bogus bucks A special office parking place for a month, with an estimated commercial value of $100, would be worth $1,000 in bogus bucks Develop a list of ways employees can ―earn‖ bogus bucks through the company wellness program and place a value on each.      Attending a seminar Winning or placing in some type of wellness competition Achieving an established health goal Accomplishing voluntary biometric screenings or health risk assessments Practicing healthy behaviors observed by a designated oversight official (See ―I Caught You Cards‖) 5 Kathy K. Cash, RN, CHPD 6/2/2009  Note: Consider ―weighting‖ programs that target high-priority corporate goals with more points. Display all incentives with their bonus buck price tags. Once the ―Bogus Buck‖ incentive program is established, include the bonus buck value of all programs and activities as part of all marketing campaigns. 6 Kathy K. Cash, RN, CHPD 6/2/2009 “I Caught You” Cards Concept: Acknowledging small successes in behavior change is as important as celebrating the big ones. In most work environments where career-oriented employees respect management, combining management recognition and approval with an ongoing, structured incentive program is highly effective in encouraging behavior change. Process: Define desirable behaviors that can be observed or demonstrated within the workplace. Base desired behaviors on health promotion, management and human resource goals. Examples:         Personal attainment of an established health goal: weight loss, tobacco free. Personal growth: special training, college programs, completion of behavior modification course. Healthy eating: snacks, lunch breaks, office meeting. Exercise: using the stairs instead of elevators, working out at lunch, walking during breaks, placing in a company or community run. Workplace safety: practicing sound body mechanics, wearing safety equipment, asking for assistance when lifting or running large equipment. Conflict management. Communication skills. Teamwork. Define supervisor responsibilities in participating in the incentive program, such as the number of cards to be disseminated within a set time frame (monthly, quarterly, etc.). Set up tracking systems to monitor whether supervisors give out all their cards each period and that awarded cards are given for appropriate reasons. Health promotion staff should report on both elements in management meetings and encourage discussion when programs goals are not met. Brief all supervisors on program and purpose of changing the identified behaviors. Provide written suggestions to assist supervisors in determining whether an action meets the criteria for a desirable behavior. Establish a process to ensure each supervisor receives his or her allotted cards at beginning of each period. Award of individual cards can be done informally, but supervisors should make an effort to pick a time when other employees are available to witness the event. 7 Kathy K. Cash, RN, CHPD 6/2/2009 Design of cards should include all necessary information on the incentive program, as well as a place for supervisors to write down to whom the card is awarded, the date, the behavior observed, and supervisor signature. Each card should have a defined value. Consider awarding a special incentive to the employee with the most accumulated cards in a period and/or a year. Ideally, the awarding of incentives should be conducted by senior management in a special setting, such as a luncheon or a general meeting of all employees. 8 Kathy K. Cash, RN, CHPD 6/2/2009 Behavior Change Bingo Concept: Encouragement and approval from peers and coworkers is one of the strongest motivators within an organization. Behavior Change Bingo is based on the popular group game of Bingo. In order for someone to win, participating employees monitor and support each other (and themselves) as they work towards adopting a desirable behavior. To encourage this, a prize of some value for winning each game is necessary. Winners of the game should be given the prize immediately. All winners‘ names are placed into a lottery for an annual grand prize of even greater value. Process: Identify an area (or areas) where success or failure in achieving a desired behavior or goal can be readily identified. For instance:        On-the-job accidents Compliance with safety policies and use of safety equipment Substance-abuse related accidents / offenses (on- or off-the-job) Seatbelt use Conformance with no-smoking policy Fighting, racial slurs, harassment, etc. Achieving company production and deadline goals Post the rules of the game and the behaviors that are considered an infraction to demonstrating the desired behavior change.         Any on-the-job accident Off-the-job automobile accidents/infractions reported through the police department or insurance company Failure to use appropriate safety equipment / body mechanics Failure to use seatbelts reported through police accident reports or by parking lot guards / monitors Fighting / formal complaints Customer service complaints Failure during random drug testing Smoking on-the-job or in designated no-smoking areas Provide all employees who wish to participate with a bingo card (Most toys / gaming stores will have the necessary cards and equipment). Consider setting up some method to ensure each employee gets only one bingo card per game (such as a coding system). On the first day of the game and every day thereafter, a designated employee draws out a bingo number, which is then posted in some spot easily accessible to all employees, 9 Kathy K. Cash, RN, CHPD 6/2/2009 i.e., marquee, email, bulletin boards, etc. Maintain a central game board, where employees can learn which numbers have been drawn in the current game. A new drawing occurs every day that no infraction of the rules has occurred. If an infraction of the rules does occur, all cards are pulled and the game starts over after a predetermined penalty period. Depending on the circumstances, describe the details of the infraction. Use of the ―guilty‖ employee‘s name is usually not necessary. If an infraction-free period goes on long enough for there to be a winner, the winning employee gets the prize / incentive. When the employee presents a winning card, verify the numbers and post the winning numbers (employees usually like to see for themselves). Pull all cards and issue new ones. Some companies use the same cards over and over, but if an employee wants to try a new card, he or she must return the old one. Start a new game the following day. 10 Kathy K. Cash, RN, CHPD 6/2/2009 Adopt-a-Spud Program Concept: Previously sedentary individuals starting out on a fitness program frequently become frustrated and lose their motivation. Personalized one-on-one counseling and coaching is a strong motivator and increases success. However personal coaching is often difficult for a small health and wellness staff. Peer support from fitness-oriented individuals can be a valuable adjunct to a structured fitness program. Process: Schedule a beginners‘ fitness program offering the usual spectrum of services, information, and assessments expected for a novice athlete. The entire program should ideally span a number of client interactions include the following:       Fitness assessment. Body fat and / or BMI calculations. Programs / Information on the physical and emotional benefits of fitness. Medical evaluation and clearance as necessary. Protocols for beginning and advancing in an exercise program. Counseling and reevaluation. Schedule a running and / or race-walking competition six to eight weeks from the beginning of the fitness program. Offer competition prizes for both the experienced athletes and the novices. Marketing of the competition:   To the novice runner or walker – Promote the competition as a culmination to the beginners‘ fitness program. To the experienced athlete – Initiate an aggressive promotion campaign defining the expectations for ―adopting‖ someone from the beginners‘ fitness program. Consider holding a raffle or some other type of special recognition as an incentive for volunteer adopters completing the program. Offer a special coaching class for the ―adopters‖ covering such areas as:       Expectations of the adopters. Training protocols for beginners. Nutrition and other related lifestyle issues. Motivation tips. Inappropriate training concerns. Dealing with problems such as frustration, injuries, etc. Rules of the race: 11 Kathy K. Cash, RN, CHPD 6/2/2009     Length of the race should be no more than three to five miles. If race-walking is part of the event, it is best to hold the competition on a track where the entire course can be viewed to ensure competitors walk the entire race. The race involves teams of two: a novice and his / her adopter (coach). Prizes for best times can be given, but emphasis should be on team placement in of the following ways: o Best cumulative times for the novice and the experienced athlete or o A combination of the experienced runner‘s time and number of seconds/minutes the novice has improved since a baseline measured at the beginning of the program. 12 Kathy K. Cash, RN, CHPD 6/2/2009 Healthy Smoker Program Concept: Every health promotion manager faces the challenge of how to help the smoker who has not committed to quitting. At some level, the majority of smokers realize they are putting their health at risk. A Healthy Smoker program does NOT ask the smoker to quit (yet). The focus is on behaviors that will help the smoker to be healthier until he / she does quit. The secondary goal of the program is to make it easier for the smoker to quit… when ready. The program gets this hard-to-reach audience in the door and helps them drop their natural resistance to smoking messages. Process: A Healthy Smoker Program focuses on three areas: 1. Objective, nonjudgmental data-driven information about what smoking does to a person physically and mentally. No scare tactics. Include the positives, as well as the negatives, i.e., relaxation, mental alertness, increased memory, higher metabolism, etc. 2. Strategies a smoker can use to improve his / her health while they still smoke. For instance, exercise provides some protection against heart disease risk factors associated with smoking. The cancer reducing diet and vitamin / antioxidant supplementation helps a smoker improve immunity. 3. A menu of strategies for quitting, when they are ready. Another aspect of a ―Healthy Smoker‖ program would include teaching strategies for modifying their smoking practices to reduce nicotine consumption. This is more than cutting down the number of cigarettes. Smokers who merely attempt to reduce the number of cigarettes they smoke, tend to inhale more deeply thus negating the benefits of cigarette reduction. So modifying the smoking technique is important, as well. For more ideas on a ―Healthy Smoker‖ program, buy the book, ―The No Nag, No Guilt, Do It Your Own Way Guide to Quitting Smoking‖ by Tom Ferguson, MD. It‘s been around a long time, but it is still full of wonderful information. You might need to augment the book with more up to date information, but it is an excellent framework from which to start. Variation: A similar strategy can be applied to weight management. ―Healthy at Any Size‖ programs do not focus on losing weight. They focus on behavior that will enhance the health of the person regardless of their weight, i.e., healthy eating (versus dieting), proper attitude towards food, positive self-esteem, being more active (versus exercising), etc. It won‘t be unusual for attendees to lose ―some‖ weight in these programs, but again… that is not the goal. 13 Kathy K. Cash, RN, CHPD 6/2/2009 Sneaky Fitness Concept: ―I don‘t have time!‖ is probably the single biggest reason people give for not exercising. ―Sneaky Fitness‖ programs attempt to accommodate the time constraints and real-life obstacles facing today‘s employees. To work, ―Sneaky Fitness‖ programs require the health promotion team to determine their audience‘s obstacles to exercise. Process: Consider new mothers. Few fitness centers offer childcare, and even then, many mothers are understandably reluctant to put a baby in someone else‘s care. Task an exercise instructor with developing a ―Baby Aerobics‖ class for this audience. Such programs actually incorporate the baby into the exercise. Much of the exercise focuses on the legs. It is important to keep the center of gravity stable since the exercising mothers hold their babies throughout the program. Some activity can include moving the baby with the arms (rocking, holding the baby out from the body, up in the air, etc.)…such movements need to be adapted to the baby‘s ability to hold up its head. Floor activities can be done with the mother holding the infant on her stomach or laying the infant in front of her. Housecleaning provides another opportunity for sneaky fitness. Using typical housecleaning supplies/equipment, develop a class that teaches your audience how to ―sneak‖ in a little extra exercise into their household chores. For instance, before cleaning a countertop, do some standing push-ups from the counter. Do ―curls‖ and squats with the mop water bucket. Put more effort into window washing and furniture polishing with larger circles going in alternating directions. Try doing slow deep lunges when vacuuming to get more stretch. Go up and down a ladder a few more times than necessary. When putting a large object (like a bottle of water or large can) on a shelf, take a few seconds to hold it above your head and slowly bring it down to chest height. Use the same principle to develop a class that ―sneaks‖ exercise into the workplace. When energy flags, encourage workers to keep a simple step stool in their office or cubicle so they can do step exercises or standing pushups off the desk or wall. Discourage phone usage within the same building. Get employees to walk the halls and deliver the message personally. Of course encourage use of the stairs over elevators. 14 Kathy K. Cash, RN, CHPD 6/2/2009 Creative Problem Solving Concept: Stress is the end result of one (or more) stressors. You eliminate or modify the reaction to the stressor and the stress goes down. For a variety of reasons, Americans have had their creativity stifled. They can‘t (or won‘t) think outside-the-box. The consequences of stifled creativity has a huge impact on ordinary day-to-day living. Creative problem solving comes from the ability to take past life experiences and rearranging those experiences in order to address an unusual event or problem. A person, who cannot think creatively, will face frequent obstacles in successfully working through many life- and workplace challenges. The solutions the non-creative person takes are often self-destructive and lead to STRESS in their lives. Recommendation: One successful problem-solving program that I offered involved teaching the class to use a deck of 64 cards developed by the famed creativity author, Roger Von Oech. This deck is reasonably priced (about $15) and can be found through Amazon and in bookstores. It is called, ―The Creative Whack Pack.‖ Each illustrated card in the deck has a different activity that allows individuals (or groups) to look at a problem from a fresh perspective. It also helps take the participant(s) through the entire problem-solving process… including identifying the true problem, defining it, identifying resources, exploring all options to solving the problem, putting the chosen strategy into action, and monitoring the problem to ensure that it has been properly addressed. The deck has many useful applications: problem solving for businesses, problem solving for families, problem solving for individual problems, etc. In a classroom setting… stressors, behavior change obstacles, etc., I would take a common problem facing the group, ―deal‖ out cards to the participants, and together we would work through the deck to solve develop new strategies to approach the problem. The programs were always a hit. I‘ve known parents that find this deck very useful in helping children work their way through their life problems. The parent helps the child work with the deck. The child works through the activities presented by the deck and comes up with his or her own solutions. This can be VERY empowering for anyone, but especially a child. 15 Kathy K. Cash, RN, CHPD 6/2/2009 Stressor program - What would a kid do? Concept: Participants work together to solve their own problems by stepping back from the emotions surrounding an issue and looking at the problem from the perspective of a child. Example: A major group stressor has been identified as "How to deal with difficult co-workers." Using either a flipchart or transparency projector, make two columns. The first column is "Today" and the second column is "What would a kid do?" Ask leading questions that will generate comments on the kinds of problems "difficult" co-workers create for the group. Write the answers in the first column. If the question is focused enough, there will likely be an obvious trend in answers (if not, you need to focus your question more). Answers would possibly look like these:       Distraction from accomplishing work Makes the work place unpleasant Leads to fights and rumors Leads to feelings of stress Makes the whole work group look bad in eyes of employer Employees ask for transfers to other groups Next ask the group to suggest a childhood experience or feeling that is comparable to the situation described by the above answers. Again, you will likely see a trend emerge. It may be necessary for you to distill the trend into two or three possible statements, like...    A disruptive student in a classroom A bully on the playground or neighborhood Being the littlest sibling in a family Have the group vote on which childhood situation comes closest to generating the same feelings as the adult situation. Let's say they choose "Bully on the playground." Group interaction is always dynamic at this point. Have the group brainstorm solutions to the childhood situation. How would they have solved the situation when they were kids. Place the answers in the second column. Possible answers could be along the lines of:      Tell the teacher Get a bigger, older brother to beat up the bully A group of smaller, weaker kids join together to back the bully down Avoid situations that put you alone with the bully Join in a sport to make yourself stronger and feel more confident 16 Kathy K. Cash, RN, CHPD 6/2/2009  Try to make friends with the bully, maybe he's lonely... Post the childhood answers where everyone can see them, then brainstorm how to translate these childhood solutions into solving the adult problem. Again, be sure to capture the answers on a transparency or flip chart. Get as specific as possible in the suggestion, but generically, the following illustrates the concept.       Tell the teacher = Document the misdeeds and present to a supervisor Get a bigger, older brother to beat up the bully = Get a respected co-worker to privately talk to the disruptive person(s) A group of smaller, weaker kids join together to back the bully down = Get the rest of the work group to agree to ignore the disruptive person when he/she tries to agitate the group Avoid situations that put you alone with the bully = Get your desk moved to another area, sit as far away from the person in meetings, etc. Join in a sport to make yourself stronger and feel more confident = Stress management techniques and exercise will help minimize the negative feelings generated by the person Try to make friends with the bully, maybe he's lonely... = Actually, is a good strategy for adults, too! Before, long the group will have a very practical list of potential solutions to apply to their problems. Put the list together and present to each participant. 17 Kathy K. Cash, RN, CHPD 6/2/2009 Recommended Resources The depth and breadth of available wellness program resources grows on a daily basis. Consider this as merely a starting point for building your own list. 1. Vendors/Products a. American Institute for Preventive Medicine – www.healthylife.com b. Channing-Bete – www.channing-bete.com c. ―Creative Whack Pack‖ – Deck of ―playing cards‖ to encourage creative thinking and problem-solving. Available through book stores. d. Health EdCo - www.healthedco.com e. ―Healthwise‖ – www.healthwise.org f. HeartMath – www.heartmath.com g. ―Kits for Life‖ – Incentive programs. www.kitsforlife.com h. Krames – www.krames.com i. Mayo Clinic online health information services – www.mayoclinic.com j. Nasco – www.enasco.com k. NutriSum - www.nutrisum.com l. Parlay International – www.parlay.com 2. Corporate wellness consultants a. b. c. d. e. American Specialty Health, Inc. – www.ashcompanies.com ComPsych – www.compsych.com Gesell, Izzy (Workplace humor/leadership) – www.izzyg.com Health Enhancement Systems – www.hesonline.com WebMD – www.webmd.com 3. Free/low cost written products a. ―5 a Day in Worksites‖ implementation guide – Product of the American Cancer Society. www.cancer.org b. Centers for Disease Control and Prevention – www.cdc.gov c. ―Freedom from Smoking‖ Program – Product of the American Lung Association. www.lungusa.org d. ―Healthfinder‖ – Consumer gateway produced by the National Health Information Center www.health.gov/nhic e. ―Making Health Communication Programs Work,” developed by the Office of Communications of the National Cancer Institute – www.cancer.gov/pinkbook f. ―The Worksite Wellness Resource Kit‖ dhfs.wisconsin.gov/health/physicalactivity g. WebMD – www.webmd.com 1. Books and wellness publishers 18 Kathy K. Cash, RN, CHPD 6/2/2009 a. Ferguson, Tom, "The No Nag, No Guilt, Do It Your Own Way Guide to Quitting Smoking," G.P. Putnam‘s Sons, 1988. b. Health Resources Publishing – www.healthrespubs.com c. Whole Person Associates – www.wholeperson.com. Including (but not limited to) the following books: i. Cash, Kathy, ―How to Add Sparkle and Pizzazz to Your Health Promotion Program,‖ 1998. ii. Gesell, Izzy,― Playing Along, 37 Group Learning Activities Borrowed from Improvisational Theaters,‖ 1997. iii. Tubesing, Nancy Loving and Donald A., ―Structured Exercises in Wellness Promotion, Volumes 1 – 5.‖ 2. Professional Groups/Associations/Conferences a. American College of Sports Medicine – www.acsm.org b. Families and Work Institute - A nonprofit center for research providing data on the changing workforce, changing family and changing community, including the 2004 survey ―Overwork in America: When the Way We Work Becomes Too Much,‖ mentioned in the body of the chapter. c. International Health, Racquet and Sportsclub Association – cms.ihrsa.org d. National Wellness Association – www.nationalwellnessassociation.com e. Physicians Committee for Responsible Medicine – www.pcrm.org f. Wellness Councils of America – www.welcoa.org 3. Other Useful Websites a. b. c. d. e. f. g. h. i. j. k. l. American Diabetes Association – www.diabetes.org American Heart Association – www.americanheart.org Canadian Health Network – www.canadian-health-network.ca Diabetesatwork.org – www.diabetesatwork.org International Council on Active Aging – www.icaa.cc March of Dimes – www.marchofdimes.com National Health and Wellness Bureau – www.nhwb.org Office of Disease Prevention and Health Promotion – odphp.osophs.dhhs.gov Tobacco Control Resource Center for Wisconsin – www.tobwis.org Bureau of Labor Statistics – www.bls.gov Partnership for Prevention - www.prevent.org Jon Robison website on ―Healthy at Any Size‖ - www.jonrobison.net 19 Kathy K. Cash, RN, CHPD 6/2/2009