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					A Dietitian’s Role in a Government
    Employee Health Program



    LCDR Sandra Magera, MS, RD, CDE
        U. S. Public Health Service
   2011 Scientific & Training Symposium
              Objectives

• Describe why dietitians are needed for
  the delivery of employee health
  programs
• List the different roles a dietitian can
  perform within an employee health
  program
• Describe the importance of creating
  partnerships and networks to enhance
  program effectiveness
  In support of President Obama's Federal
 Employee Worksite Wellness Initiative, and
in an effort to improve the health of Federal
 employees, the Department of Health and
 Human Services (HHS) Secretary Kathleen
Sebelius introduced FedStrive, an integrated
 Health, Wellness, and Work/Life Program.
                       An Innovative Worksite Health and
                            Wellness Program
•     In alignment with the President’s wellness initiative, our mission is to:
    Promote a culture of wellness that transforms the overall health and well being of the Federal
    workforce, resulting in reduced absenteeism, increased productivity, improved morale, and an
                                 overall reduction in healthcare costs

•     We accomplish this through:
       – Comprehensive suite of wellness and health education programs                          First Lady Michelle
                                                                                                 Obama and HHS
       – Programs based on each individual’s readiness to change                                Secretary Kathleen
                                                                                               Sebelius both spoke
       – Maximum engagement through total integration and linkages                             to the importance of
                                                                                                   the FedStrive
       – Creation of a supportive social and physical environment                               Employee Wellness
                                                                                               Program on October
       – Continuous evaluation and improvement                                                        13, 2009.

• Federal Occupational Health’s Fedstrive provides comprehensive health and
  wellness services to 3,000 employees at the Department of Health and
  Human Services (HHS) headquarters in Washington, DC
Employee Engagement and Cultural Change
  The team draws on experience in the marketing of health and wellness programs.
          An integrated multimedia marketing campaign helps employees:

• Embrace overall culture of wellness
  through Branding and Affinity
• Understand information as it pertains
  to individual wellness objectives using
  Marketing Communications
• Engage and activate, driving overall
  program utilization via Response
  Marketing
• Participate in an encouraging, activity-
  based Incentives Program
                            Fedstrive Services
•   Health Risk Appraisal (HRA): The HRA is an online health
    assessment tool that provides employees with pertinent
    information to improve their health

•   Fitness Activities: Employees can participate in on-site
    activities such as Walk@Lunch Day, Fun Runs, Pedometer
    Challenges, and “Get Fit as You Sit” sessions

•   Nutrition and Weight Management: On-site Dietitian
    consultations available in addition to healthy menu options
    at the Humphrey Café and through the Healthier Vending
    Program. Team Lean Challenge, a three-month group weight
    loss opportunity, is offered to employees annually

•   Participation Incentives: A free one-year Fitness Center
    Membership available with the completion of the online
    HRA and a cholesterol screening
                             Fedstrive Services
•   Go Green HHS: A website outlining the
    department’s plan for sustainability incorporating a
    monthly subsidy for bicycling to work

•   Health Education Classes: Informational seminars
    offered on-site and on-line. Example lecture topics
    include: Preventing Diabetes, Heart Health, and
    Stress Reduction

•   Tobacco Cessation Programs: Customized quit plan,
    free Nicotine Replacement Therapy products,
    group classes, and access to counseling

•   FRESHFARM Market at HHS: Weekly farmers’
    market offering employees the opportunity to
    improve their nutrition by purchasing locally grown
    produce
 Our online HRA tool collects the
         following data:
• Risk Stratification / Overall       • Weight Management
  Self-Rating                         • Use of Medical services and
• Existing Medical Conditions           screenings
• Risks for Cardiovascular Heart      • Personal Safety habits
  Disease                             • Eating habits/patterns
• Blood Chemistry                     • Substance Use / Abuse
• Activity Levels and Other           • Psychological, Social, Cultural,
  Readiness for Exercise Criteria       and Spiritual beliefs/practices
                                      • Readiness for Change

    The HRA collects detailed, population-specific data for analysis.
          Why dietitians are needed for
          employee wellness programs?
• Leading Health Indicators categorizing Healthy People
  2020 objectives are:
   –   Overweight/obesity
   –   Physical activity
   –   Tobacco use/substance abuse use
   –   Mental health
   –   Access to health care
• Nutrition experts shape health outcomes for these
  indicators at an individual level (counseling/group
  education) and a population level basis (promoting
  nutrition where people work, shop, and eat).
          Dietitians serve various roles
               in health programs
• Health Service Administrators
• Program Directors
• Contract Officer Technical
  Representatives/Contract Officers
• Project Managers
• Communications Directors
• Website Designers/Social Media
  Site Coordinators
• Educators/Health Coaches          Think outside the lunch box!
• Policy Makers
            Networking enhances
             program offerings
• Dietetics/Health community
  – Government
     • NIH
     • Office of Health
       Promotion/Disease Prevention
     • USDA
  – Corporate health care
  – Non-profit organizations
  – Grocery industry
              Partnering infuses energy
• Lectures by:
   – MD Affiliate of Susan G.
     Komen volunteers
   – NIH/CDC/HHS National
     Diabetes Education Program
     leaders
• Events co-presented by:
   – HHS Office on Women’s
     Health
   – Corporate health providers
      • Blue Cross/Blue Shield
      • Kaiser Permanente
                                                                       Office on Women’s Health
                                                                           May 8 – 14, 2011
Monday – 9th                          Tuesday – 10th                  Wednesday – 11th                     Thursday – 12th            Friday – 13th




        What does a                     How to read a label?               Physical Activity               Risk factors of disease?   Importance of updated
        Balance Meal                                                                                                                    health information
         consist of?                  Always check the daily value     Adults need at least 30                     Controllable
                                      (%DV) on a label.                minutes of moderate to                                         •Insurance Info
                                      •5%DV or less- LOW                                                   •Smoking
•Grains – 6oz                                                          vigorous activity a day!                                       •Emergency Contact
                                      •20%DV or more – HIGH                                                •Obesity/Overweight
(1 oz equivalent is 1 slice of                                                                                                        •Medications
bread, 1 cup of dry cereal, ½                                         Moderate activity:
cup cooked rice, pasta, or            Check the serving size and                                           •Noncompliant of
cereal)                               calories                        •Walking Fast                                                    Your Family History may
•Vegetables – 2 ½ cup                 •40 calories is low             •Water Aerobics                      Medications                 affect your future health!
(broccoli, peas, dark greens,         •100 calories is moderate       •Lawn Mowing                         •Unhealthy Diet
some starches, dry beans)             •400 calories is high                                                                            Do certain diseases and/or
•Fruits – 2 cups                                                      Vigorous activity:                   •Sedentary Lifestyle         health conditions run in
(1 cup of grapes, medium size         Limit your intake                                                                                      your family?
apple or banana)                      •Sodium                         •Jogging or running                  •Stress
•Milk – 3 cups                        •Cholesterol                    •Swimming laps                                                   Are you due for an annual
•Meat & beans – 5 ½ oz                •Fat (trans, saturated &        •Playing basketball                         Uncontrollable
                                                                                                                                              checkup?
(lean meats, 1 oz of poultry or
fish, 1 egg, 1 tsp of peanut
                                      total)                                                               •Age
                                                                      Compute your heart rate
butter)                                                                                                    •Sex
                                      Make your calories count!       for best workout!                                               Build Your Questions List!
                                      http://www.accessdata.fda.gov   http://www.cancer.org/healthy/to                                http://www.ahrq.gov/questionsare
*Based on a 2,000 calorie diet.
                                      /videos/CFSAN/HWM/hwms          olsandcalculators/calculators/app/   •Race/ Ethnicity           theanswer/questionBuilder.aspx
http://www.cdc.gov/healthyweight/he
                                      k02.cfm                         target-heart-rate-calculator
althy_eating/fruits_vegetables.html
                                                                                                                                      My Family Health Portrait!
                                      For reliable health             Calories burned?                     Health Data?               https://familyhistory.hhs.gov/fhh-
                                      information!                    http://www.cancer.org/healthy/to                                web/home.action
                                      www.womenshealth.gov            olsandcalculators/calculators/app/   http://www.womenshealt
                                                                      exercise-counts-calculator           h.gov/statistics/          http://www.cdc.gov/family/check
                                                                                                                                      uplist/index.htm
Invite Leaders to participate
                 Our Accomplishments
• In just over 9 months, Fedstrive
  moved from a .01% to 37.4% Health
  Risk Appraisal utilization rate.

• More than 3,463 Federal employees
  participated in six Fedstrive Health
  and Wellness events held since
  launch in Oct. ‘09. All six events
  were supported by HHS leadership.

• A highlight event was National
  Walk@Lunch Day where more than
  1,900 HHS employees laced up their
  walking shoes to walk for health
  with HHS Secretary Sebelius.
                                            # attending




                         300
                                     600
                                            900
                                                    1200
                                                           1500
                                                                  1800
                                                                             2100




                     0
           FedStrive




                           250
            Launch




10/14/09
            Health
           Awarene

                                                  750




1/27/10
            ss Day



             Team
             Lean
                               106




1/29/10
           Challenge



           National
           Walk@Lu




4/28/10
                                                                         1,900




           nch Day


            National
            Women's
                           275




             Health
5/12/10
             Event

             HHS
                                                                                    10/2009 through 10/2010




           Domestic
                                                                                                              Fedstrive Event Attendance




           Violence
                         175




10/6/10




           Awarene
           ss Event
             USDA
           Discovery
             Food
                                      374




10/6/10




            Safety
           Zone Tour
Services Provided Oct 1, 2009 through Sept 30, 2010
                Services              Number Accomplished

HRA/Wellness Profile Completions      1,124 (37.4%)
Lipid Panels with Glucose check            890
Health Education Classes                    18
Education Class Attendance                  410
Monthly Gym Memberships                     481
Dietary Consultations                       135
Team Lean Challenge Participants            106
Weight Loss by TLC Participants             364
Tobacco Cessation Participants              11
      Risk Stratification


        17%
                            52%
31%




                                  Low (0-2 Risks)
                                  Moderate (3-4 Risks)
                                  High (5+ Risks)
                          Common Medical Conditions (percent)

              Diabetes          4
     Metabolic Disease          4
  Migraines/Headaches                7
               Asthma                7
              Arthritis                  8
    Anxiety/Depression                       9
Neck/Back/Musculo Pain                            12
   High Blood Pressure                                      18
      High Cholesterol                                            20
              Allergies                                                     29

                          0      5           10        15        20    25   30   35
      BMI Categories


              1%

27%                       35%

           37%




                   Underweight (BMI < 18.5)
                   Normal (BMI 18.5 - 25)
                   Overweight (BMI 25 - 30)
                   Obese (BMI > 30)
           Leading the way for
Federal Government Health and Wellness!
                              References
1.   MacMunn, A. and Spittler, L. Portraits of Prevention: Approaches to Launching
     Successful Programs. ADA Times. 2011; 8, 3: 10-14.
2.   Balch, G. Employers’ perceptions of the roles of dietetics practitioners:
     Challenges to survive and opportunities to thrive. Jrnl of the American Dietetic
     Asso. 1996; 96,12:1301-1305.
3.   Position of the American Dietetic Asso: The Roles of Registered Dietitians and
     the Dietetics Technicians, Registered in Health Promotion and Disease
     Prevention. Jrnl of the American Dietetic Asso. 2006; 106, 11: 1875-1884.
4.   www.foh.hhs.gov
5.   www.motorola.com
6.   www.pfizer.com
7.   http://www.fsis.usda.gov/fsdiscoveryzone
8.   http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm257499.htm
9.   Photo of HHS Secretary Sebelius contributed by PHS Officer LCDR Loren Rodgers

				
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