MPH Project: Final Presentation Determining Barriers and Possible Solutions to an Online Employee Wellness Program Elaine Goldstein University of Maryland Spring 2007 Origin of the Project • Intern and part-time employee at LiveHealthier – LiveHealthier is a health and wellness company that engages individuals in actively managing their health by providing access to • Comprehensive health management tools • Personal health records • Trusted health information • Private consultations with health professionals. – With an emphasis on prevention, risk reduction, early detection and quality care, LiveHealthier leverages its proprietary platform to deliver highly- customized private health portals to employers seeking to • Improve employee health and well-being • Decrease healthcare costs • Reduce absenteeism • Improve productivity. • Client with online employee wellness program • Low site-usage • Desire to expand globally if site-usage increases Interest in the Issue • Interested in what motivates and prevents people to actively engage in caring about their health. • Curious as to why employees are not taking advantage of a FREE employee wellness program with the goal of improving their health. • I believe that this online employee wellness program can impact employee’s health in a positive manner by encouraging them to: – Quit smoking – Provide a customized meal and activity plan that fits their needs and goals – Provide them with a network of support as they pursue their individual health goals – Provide them with screening recommendations which could help in the early detection of cancer. • Course in Health Informatics and Communication – Connection between background in communication and working knowledge of public health. Literature Review • Growth and influence of the Internet – 2002: over 100 million people in the US searched online for information Forkner-Dunn, 2003 • The Internet is the most prominent force shaping health and health care Eysenbach & Jadad, 2001 – The Internet is the primary source of health information and education eHealth Institute, 2006 Literature Review • Pew Internet & American Life Project: – 41% of people surveyed in the year 2000 claimed that the Internet affected their health decisions in one way or another • Patient-physician relationship can be enhanced by health information on the Internet – In one study, breast cancer patients who used online education and support groups had increased confidence in their doctor and reported increased competence to deal with health information – More comfortable seeking information during doctor’s appointments and overall, felt more comfortable participating in their own care. – More likely to ask specific and informed questions during doctor’s visits. Forkner-Dunn, 2003 Literature Review • Employee wellness programs have grown in popularity – Since the 1980s, the number of wellness activities within public and private companies has increased rapidly Haynes et al., 1999 – Health-insurance premiums are rising 10% / yr Panepento, 2004 • Benefits – Reduce health risks and costs – Reduce employee absenteeism – Cut down on recruiting and hiring costs – Improve employee morale Franklin et al., 2006 Literature Review • Employee Wellness Programs Barriers – Perceived as labor-intensive and costly to implement – Scattered locales make disseminating wellness information a challenge • Organizations are not housed in a single building. Literature Review • Online Employee Wellness Programs – Web-based employee wellness programs offer a unique solution by providing a cost-effective approach to employee wellness programming. Franklin et al., 2006 – Internet can span geographic and time differences, available 24/7. – 74 % of US adults in 2005, reported having Internet access. – 66% of US adults in 2005 reported having home access. Franklin et al., 2006 Literature Review • Barriers to site-usage and possible solutions to increase site-usage should be considered in order to improve existing programs and increase the amount of employers who chose to implement these programs. – Participation rates are not always at optimal levels – Many employers avoid employee wellness programs because employees do not take full advantage of these programs. Literature Review • Innovative strategies are needed – Package information in a consumable manner - less overwhelming • Tailor content according to individual characteristics • Use electronic communication – Broad reach – Eliminates the need for users to seek out health information, which will entice less-motivated adults to get involved in the online employee wellness program – Personal online-accessible health record • Enhance communication with a medical professional • Consumer empowerment • Drive the self-care movement by allowing patients to manage their own health conveniently and proficiently Franklin et al., 2006 Description of Project • Developed a Focus Group Moderators Guide • Conducted a Focus Group. – Goal: To identify and assess barriers, which may reduce employee participation in a company’s online employee wellness program and explore possible solutions to increase online participation. • Wrote a Final Recommendations Report – Purpose: To logically group the barriers and solutions and give practical recommendations that could be implemented or investigated further. Summary of Findings: Barriers to Site-Usage 1. Difficulty navigating the site. • Recommendation: A site map with a hyperlinked table of contents. 2. Remembering the site URL. • Recommendation: Include link to the site on company intranet. 3. Difficulty logging on and remembering username and password • Recommendations: • Provide a single sign on (SSO) process as a corporate initiative • Provide usability test 4. New-employees are not aware of the site. Recommendations: Include a hyperlink with log on information on intranet. Newsletter campaign Find offline ways to encourage employees to log on Promote site around the office Free giveaways 5. Information on the site needs to be more proactive. • Recommendation: Tailored information based on location and stage of change. Summary of Findings: New Feature Ideas • Health management tool. – Possible Barrier: Confidentiality concerns and diagnosis concerns. • Access to other health experts in addition to RD and CPT. – Possible Barrier: In-person interactions were considered valuable. • Segmented health information by age and gender. – Possible Barriers: • Appropriate age ranges are up for debate. • Some health topics are applicable at all ages • If you were to segment health topics by age and a user identifies with a health topic that is not in their age range, they may feel isolated. • Incentives / rewards program. – Possible Barriers: • Costly • No way to verify or monitor self-reported behaviors • Discrimination • Health news alerts (RSS feed) – Possible Barriers: • Credibility issues • Distract users away from the main site • Over-communication Project Outcome • Multiple barriers to site-usage and multiple solutions. • Developing a health management tool with dynamic content was agreeable but would not bring them to the site any more often. • Overall recommendation: Survey a larger employee population to determine if these recommendations have a broader corporate appeal. Conclusions and Suggestions for Modifications • Importance of focus groups – Ideas that come from the intended audience can serve to be more powerful than the developer’s ideas • Benefits of Evaluation – High level of stakeholder ownership – User involvement at the early stages of design can help to identify problems and suggest valuable additions or modifications – Further refinements will reflect the requests of the target audience more closely Pagliari et al., 2003 Presentation References eHealth Institute. (2006). Sixth Annual eHealth Developers’ Summit Summary Report: eHealth: the Momentum is Building. Retrieved May 1, 2007, from http://www.ehealthinstitute.org/assets/Summit/2005/eHealthSummitReport05.pdf Forkner-Dunn, J. (2003). Internet-based patient self-care: the next generation of health care delivery. Journal of Medical Internet Research, 5 (2), e8. Franklin, P., Rosenbaum, P., Carey, M., & Roizen, M. (2006). Using sequential email messages to promote health behaviors: evidence of feasibility and reach in a worksite sample. Journal of Medical Internet Research, 8 (1), e3. Haynes, G., Dunnagan, T. & Smith, V. (1999). Do employees participating in voluntary health promotion programs incur lower health care costs? Health Promotion International, 14 (1), 43- 50. Pagliari, C., Clark, D., Hunter, K., Boyle, D., Cunningham, S., Morris, A., & Sullivan, F. (2003). DARTS 2000 online diabetes management system: formative evaluation in clinical practice. Journal of Evaluation in Clinical Practice, 9 (4), 391-400. Panepento, P. (2004). Employee-wellness programs pay off in productivity and morale. Chronicle of Philanthropy, 16 (18), 38-39. Thank You Questions? Comments?
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