6 tips for keeping employees engaged in wellness programs
If corporate wellness programs are to live up to the promise of controlling company health insurance costs, they require some care and feeding. The wellness concept is not simply a matter of designing a program, launching it, and hoping it works — it requires a consistent effort to keep employees, and their spouses, engaged in their own health outcomes.
With some doubts being raised about the effectiveness of corporate wellness programs, IB spoke to area employers and wellness executives about ways to keep employees engaged for the long haul. Much depends on how culturally ingrained an organization’s wellness program happens to be, but a great deal depends on the creative dedication of wellness coordinators.
So once you have established the basic elements — active C-suite participation and leadership, employee health-risk assessments, and the right mix of incentives to address cost drivers like obesity and smoking — you can use this six-pack abs’ worth of tips to deliver consistent follow-through.
Tip #1: Get on the family plan
Marcus Gagnon, wellness coordinator for Trek Bicycle Corp., says employee engagement is an ongoing issue for his company. That might sound counterintuitive for a company whose products promote active lifestyles, but believe it or not, Trek actually has some employees who do not own bicycles.
In 2014, with the Affordable Care Act allowing employers to incentivize healthy behaviors and punish bad health habits, the company will shift from what Gagnon called a participation-based program to more of a health-contingent program, “which is basically health premiums based on results,” he says.
As the company encourages employees to take a more active role in their health, it will also ask spouses to participate in the program. The rationale? Spouses who are covered through a family insurance plan add to costs, too, and whether or not they are employed at Trek, it’s worthwhile to open wellness up to them. Starting next year, spouses of employees will have access to company health coaches, nutritional outreach, exercise plans, and the company’s onsite clinic for services like blood pressure checks, full blood work and panels, and cholesterol testing.
In addition, spouses will be encouraged to use Trek’s 4,000-sq.-ft. fitness center, which includes exercise equipment and separate studio space for fitness classes. “Roughly half of our health costs are from non-employees,” Gagnon says. “I think that’s probably a standard thing, but it’s certainly true for us. The reality is that we can do all the things we want internally, but if you’re not reaching out to the families, it’s not going to have the impact that we want on our health care costs.”
Tip #2: Ratchet up the competition
This summer, 113 Trek employees took part in the National Bike Challenge, a wellness initiative that encourages people to bike for both transportation and recreation. Collectively, about 16 Trek employee teams logged more than 750,000 miles during the competition, which was held from May 1 to Sept. 30. Internal leader boards were set up throughout the building so that team members, who were competing for cash prizes, knew where they stood. An Internet page accomplished the same purpose, so that everybody could see what position their team was in.
Through its commuter program, Trek has always encouraged employees to bike to work, but as he strolled through the company’s Waterloo facility, Gagnon noticed the bike challenge was generating more interest and chatter among employees. “You could hear conversations around the building [about team status],” he says. “That was a really cool thing. We have some employees who don’t ride bikes, which sounds counterintuitive but true, but people were buying bikes and getting out and riding them for the first time in 10 years, which is really exciting.”
Historically, cash incentives have worked well for Trek. When health risk assessments were introduced in 2005 as a voluntary measure, the resulting participation rate of 21% was not what the company was hoping for. When it introduced a $100 cash incentive, the participation rate jumped to 61%. And after linking wellness participation to higher employer contributions for medical insurance, Trek experienced near universal wellness participation.
Tip #3: Create a garden of eatin’
At Trek, nutrition took on a greater emphasis in 2013 when the company added an onsite community garden in partnership with McKay Nursery. Employees could buy a garden plot and McKay would do all the watering and weeding for them. So instead of settling for, say, taste-challenged tomatoes that had been shipped halfway across the country, Trek workers could grow their own richer-tasting garden variety, which definitely counts as an incentive for healthier eating.
According to Gagnon, 65 employees took advantage of the garden this year, and Trek also partnered with McKay to serve more local food in its company cafeteria, which is there to ensure that employees eat properly during working hours and to encourage the development of better eating habits when they are not in the facility. The cafeteria’s healthiest food items — lower in calories and fat — are identified with color codes.
“Employees getting fresh, organic food in the cafeteria was an interesting, cool thing for employees to take advantage of,” Gagnon noted. “We want to make sure we’re pushing the envelope, as well as holding people accountable at the same time to take an active role in their own health.
“We try to keep things fresh around here so that it’s not a stagnant program.”
Tip #4: Look outside
Gundersen Health System serves portions of south central and southwestern Wisconsin, southeastern Minnesota, and northeastern Iowa. The anchor of its wellness program is the MyHealth screening process, known as MyHealth Reward. Employees complete a personal health risk assessment, and they go through biometric screening. With employees’ permission, the screening includes a review of their preventive care information. If an employee is up to date on his or her preventive care and meets other criteria related to body mass index and smoking status, he or she is eligible for a financial reward that is paid out the following year.
If employees don’t meet the BMI and smoking criteria, they can qualify for the reward through participation in a variety of available programs, either through Gundersen or other community resources. For example, if they are smokers, they can participate in a nicotine-cessation program, whether it be at Gundersen or through another resource. If their BMIs are out of the healthy range and they choose to document their physical activity through a company-provided online tracker, they can take part in a weight-management program, whether it be at Gundersen or elsewhere in the community.
Program activities are also promoted inside and out. “Our employees are hearing this messaging, not only through our direct vehicles to them, but they are hearing from their managers, from their peers, from their providers about much of what we do within our walls as far as promoting health care for our employees,” noted Sarah Havens, director of community and preventive care services for Gundersen Health System. “But we’re also involved in the community in a variety of collaborative efforts and committees to get the same kind of messaging to our regional communities, so they are hearing it outside of the walls, too.”
Tip #5: Choose incentives carefully
As Trek employees demonstrated this summer, competing for cash can be a great motivator. Gundersen Health System offers a financial incentive as part of its engagement strategy, and it’s made more than $2 million available for payouts under the MyHealth Reward process. “It’s a cash payout of $360 [per rewarded employee], and it’s paid out over the year,” Haven explained.
However, Gundersen has found that some incentives are more effective than just plain cash because competition with a cash reward is an irresistible lure. “For engagement as far as incentives, it’s not a cookie-cutter approach,” Havens stated. “If you are participating in a challenge where you are going to be drinking more water [as first lady Michelle Obama is promoting] and we have a drawing involving the 200 employees that might have participated in that to win a $50 gift card, I think that a bit of a challenge and the opportunity to win something is really important.”
Toward that end, Gundersen has created a community challenge called Minutes in Motion, where the La Crosse-based health system invites the community to participate along with employees. Participants pledge to be physically active for at least 30 minutes a day, for six consecutive weeks. Employees who accomplish that goal have their name entered into a drawing for $500. “That’s the ‘little’ extra motivator that’s hanging out there,” Havens notes.
Beware, however, because as local wellness coach Nancy Turngren has observed, competitions bring only short-term results. Some catch the fitness bug and never let it go, but left with no other motivators, others revert to old, unhealthy habits. Best to keep those competitive fires burning. “Incentives create those short-term results once they have gained the incentive,” she laments. “They can be helpful in some situations, but if you are looking for lasting change, [remember that] incentives can be a little more short term.”
Turngren says that to establish that lasting lifestyle change, there has to be a long-term change of mindset rather than a short-term change of behavior, and that might involve digging a little deeper below the surface. Wellness, she notes, is multidimensional, and she often ends up talking to clients about the dimensions of wellness that go beyond diet and exercise and finds things that might be standing in the way. “That can be their jobs, their career, financial status, their environment, and their personal growth and development,” she says. “Often as you start to work on those things, they start eating healthier, they have more energy to exercise, and they have more focus and attention to give to smoking cessation.”
Tip #6: Take measurements
How do you know if your employees, or your workforce as a whole, are falling short unless you measure results? Gundersen measures every piece of its wellness initiative, and everything is based on evidence that has been proven in medical research. Whether it be weight, stress-management programs, or nicotine cessation, there will be some impact of participation in the program, and Gundersen measures that impact. “The programs that we provide are evidence-based,” Havens states, “and if it’s a pilot program that we’re not able to find a lot of information about, we are evaluating that by comparing pre- and post-test results to make sure it’s having an effect and is meeting the outcomes we had hoped for. If not, we go back to the drawing board and figure out another program.”
Theresa Islo, director of operations for the Wellness Council of Wisconsin, says corporate wellness programs should be crafted by a diverse design team with representation from all departments, and they require good role models in upper management who literally walk the walk. The better wellness programs are based on a keen understanding of company culture, usually gleaned from internal surveys that seek revealing information about the employer’s attitudes about the well-being of employees.
And like Havens, she believes in measuring results, taking that data, using it to evaluate the program, and being prepared to adapt — if necessary, with individual interventions. If a smoker is not making enough progress in his or her nicotine-cessation program, it might be time to “meet them where they are at and provide opportunities to make changes when they are ready to make them,” Islo counsels.
“They do have to be ready for it,” she states. “There are things you can do through wellness and the right kind of culture to help them become ready, and then having tools in place at the time they are ready. It’s not an easy thing to do, but if you have a lot of different things available to people at different points in time, it’s really the best way to make that happen.”
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